Get to know Dr. Dawn’s practice
How did I start providing neuroaffirming assessments and care? And how did I start using Acceptance and Commitment Therapy (ACT) as my main therapy approach with most clients of all ages?
I always knew I wanted to work with children in some capacity. After a pre-graduate internship at the Devereaux Institute in Pennsylvania working with children with complicated mental health issues who were in a pediatric psychiatric hospital or long-term residential treatment. My early career involved working with a lot of child sexual abuse survivors, children in foster care with issues of abandonment, and children who acted out their big emotions behaviorally.
When I became a mother, I moved to focusing on evaluations, as the flexibility of not having regularly scheduled clients as well as being able to write reports at home was a good fit for me at that time. Since 2011, I have been working at Bellefaire JCB in Lorain County, contracted with the mental health board to provide diagnostic clarification for complicated cases in both the juvenile court system and children’s services system for ages 8 to 18. As part of that job, I read many records and reports from other providers. I found that many of the autism evaluations done by some of the major hospitals and centers were not neuroaffirming and left parents with a diagnosis but not many recommendations for moving forward or knowing what to do next. In my own evaluations, I strive to provide the information needed for a child to receive services, but also explain the strengths a child has and give recommendations to build upon these strengths while addressing challenges.
Beginning in 2020 during the shutdown, I began my “deep dive” into first learning how to assess for autism (ADOS-2 training) which led to many books read and online webinar trainings which opened my eyes to the fairly new concept of using a neuroaffirming lens to understand neurodivergence. I have made a conscious effort to take classes from and read books by psychologists and other mental health workers who are neurodivergent themselves. I truly believe in the Autistic Self Advocacy Network’s (ASAN) motto: “Nothing about us without us.” You can read more here at their website: https://autisticadvocacy.org/about-asan/what-we-believe/]
We spent too many years focused on how to “train” autistic children to “look normal (neurotypical)” and many have grown up to advocate against the misery that ABA (Applied Behavioral Analysis) caused them as children with little benefit (at least how it was in the past, some ABA practitioners have also evolved to be more neuroaffirming). I am not autistic myself, though I do have ADHD, so I am careful to correct people when they refer to me as an “autism expert,” but I do continually read and take trainings from autistic people and others who have demonstrated strong neuroaffirming approaches and am continually learning from my clients. [You can read more hear about what ASAN has to say about ABA: https://autisticadvocacy.org/?s=aba&jet_ajax_search_settings=%7B%22exclude_terms_ids%22%3A%5B653%5D%2C%22results_order%22%3A%22desc%22%7D&jet_ajax_search_categories=0]
Though my early training and early career was focused on children and adolescents, in 2022 I joined a private practice in Oberlin, Ohio (Palmentera and Associates) and began to have a lot of Oberlin College students as clients. I quickly also learned that I really love working with college studentsl, especially because they were coming to therapy on their own with a desire to make changes and/or better understand themselves. Many adolescents and young adults today struggle with a great deal of anxiety, seemingly more than generations past. I have struggled with anxiety myself over the years and was always confused/confounded by the fact that I had learned all the Cognitive Behavioral Therapy (CBT) skills in graduate school and I tried everything I learned on myself, but alas, they did not work for me. When I first read Russ Harris’ book The Happiness Trap (that is in essence a lay person’s book to explain Acceptance and Commitment Therapy), I had a eureka moment! Actually, I first listened to the audio book which makes it easier to follow along with the exercises. I tell people this book was truly life changing for me.
That led me to reading every book I could find for practitioners about ACT and taking a lot of online trainings with some of the masters of ACT, including Russ Harris and Steven Hayes (the founder). I began incorporating what I learned with the college students with anxiety and was pleased with 1) how much faster they experience change and improvement vs. with CBT or other talk therapy, and 2) how flexible it is – once you learn the ACT model, it is easy to apply it to many things – suicidal thoughts, relationship issues, depression, making career decisions, and on and on! It has even been used to significantly decrease the suicide rate among refugees. As my training has progressed over the past 6 years, I have also learned how to incorporate the same model with children and teens, in part thanks to trainings and books by Dr. Tamar Black.
Once you have shifted your perspective to accepting what you cannot change, learn the messages the emotions are telling you, and make decisions based on your own values and what is important to you (which can change over time), you can make so many positive changes in your life!
And interestingly, since I started working with college-aged clients, I have been assessing college students referred by the Oberlin College counseling center and also have a good number of late-diagnosed student and adult autistic clients reaching out for help with feelings of being overwhelmed as well as just to learn how to better understand their own brains better so they can better advocate for their needs and learn how to balance what is important to them without becoming overwhelmed or experiencing burnout.
Turns out, ACT is a great approach for autistic people since one of the differences they often experience is inflexibility or preference for sameness, and since the main goal of ACT is “psychological flexibility,” ACT provides a framework for deciding what is important and giving them the power to decide what they want to accept about themselves (and understand better so they can find accommodations that help and know how to limit certain activities or encounters to prevent burnout) and what they might want to change or practice (e.g. they want more social connections, but their social anxiety prevents them from doing some of the things they really want to do).
While Acceptance and Commitment Therapy (ACT) is the main framework or model I use with clients, because of its very flexible nature, it is easy to incorporate the many other tools from other approaches I have studied and used as it meets the needs of individuals, including CBT, DBT, attachment theory, play therapy, parent training, motivational interviewing, and mindfulness-based interventions among others.
I use a very collaborative approach with clients and incorporate their feedback and goals into our work together. I really enjoy helping people to make positive changes and learn more about themselves. It makes me so happy to be a witness to improved social, emotional, and behavioral health!