photo by: Journal-World File Photo

The reasons why seven therapists resigned en masse from the Bert Nash Community Mental Health center remain unclear, but indications are that many of the therapists plan to open a new therapy center in Lawrence.

Multiple patients of the therapists have told the Journal-World they’ve been informed that six of the seven departing therapists are going to open their own practice that specializes in the intensive type of therapy — dialectical behavior therapy — that they were providing at Bert Nash.

The news is consistent with information that Bert Nash is now releasing about the string of resignations. Patrick Schmitz, the center’s CEO, initially told the Journal-World that the reason for the resignations was a personnel matter, and he could not comment. Now, Schmitz said he’s since heard from the group via email:

“Their reason for leaving is to seek something new,” he said Wednesday.

As the Journal-World has reported, the last day for seven therapists who are part of the specialized program at Bert Nash will be this coming Wednesday, Aug. 15. The mass resignations sparked speculation or concern among some community members that something was amiss at Bert Nash, the nonprofit community health center that serves thousands and receives significant public funding from Douglas County.

Schmitz this week said he’s still not sure why the therapists resigned en masse.

“It is unclear to me as to the motivation behind the seven therapists submitting their resignations in this manner as a group, and we hope to continue to learn more as time goes on,” Schmitz wrote Wednesday in an email response to follow-up questions.

Schmitz said the center recently has confirmed there are 224 active clients of its dialectical behavior therapy (DBT) program who will be impacted by the changing personnel. Schmitz also confirmed that Bert Nash hasn’t yet hired any new therapists to work specifically on the DBT program, but he said three other therapists have been hired and will begin work next week.

DBT therapists require special training, and the departure of the seven therapists will leave just four therapists in Bert Nash’s DBT program. The program is intended for higher-risk clients and may benefit patients dealing with such problems as severe mood disorders, PTSD or addictions, or those who have suicidal or self-harming behaviors, according to Bert Nash’s website.

The Journal-World’s attempts to reach the departing therapists have been unsuccessful. They have, however, shared their plans and addresses with Schmitz.

The Lawrence accounting firm Roark Group filed articles of organization with the Kansas Secretary of State’s office in June for the DBT Center of Lawrence and Kansas City LLC. The paperwork doesn’t list where the therapy center will be located.

‘A lifelong commitment’

The Journal-World recently requested an interview with the creator of DBT, psychologist Marsha Linehan. Her assistant said via email that Linehan “must decline at this time.”

However, the website for the University of Washington-based Behavioral Research & Therapy Clinics, where Linehan is director, offers a great deal of explanation about the program and its early roots.

DBT was developed to “treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD),” but research has shown it to be effective in a wide range of other disorders, according to the website. It teaches clients pragmatic strategies and procedures to help them regulate their emotions and behaviors.

Bert Nash patient Laura Higbee, 37, of Lawrence, explained that she and other DBT clients don’t go “for kicks and giggles.” Rather, they go “because we woke up one day and realized that we couldn’t manage our lives without help.”

“DBT isn’t like regular therapy where you go in going, ‘Oh, I think I need to work on my anxiety a little bit; I’ll just go into DBT,'” she said. “No, it’s a lifelong commitment that you work on these skills on a daily basis.”

Standard protocol in DBT includes four components, the first three of which directly involve patients: skills training group, individual therapy and phone coaching.

Bert Nash offers an intensive outpatient program, IOP, which meets in group sessions for 15 total hours per week, according to the center’s website. There is also a second level that offers ongoing therapy that, in general, entails a weekly group therapy session. Both include one-on-one therapy sessions for each client.

Higbee is part of the ongoing DBT program now, but she said the work on these skills doesn’t end with the therapy sessions.

“You practice this stuff at home,” she said. In regards to the phone coaching component, she continued, “You’ve got to have that comfort level to be able to call if you’re going into crisis, either your therapist or your group therapist.”

‘A big sense of loss’

That necessary comfort level Higbee cites is one of the biggest complicating factors in her therapist, and six others, leaving Bert Nash.

“The therapy relationship is something that you have to work at,” she said. “It’s not like you just drop in and then you’re best buds.”

Kevin Elliott has been a patient at the center since October of 2016. In that time, he’s seen four different individual therapists and several other personnel changes in positions such as those who handle his medications.

He’s been with his fourth individual therapist for a little more than a year, and he has gotten comfortable with her — but she’s leaving next week. Elliott said he intends to leave, too, when he has a workable transition plan.

“I don’t need to pay them to provide this type of instability,” he said.

The seven therapists “were initially instructed they could not refer their clients to their future practice,” Schmitz wrote via email last week.

Since then, however, the center has changed its tune. “We subsequently clarified with the seven that the intent of those instructions was to protect a conflict of interest violation of their professional ethical standards while balancing informed consent and client choice,” Schmitz continued in the email.

Even now that many of the clients have an idea of where the therapists are going and whether following them might be an option, it is still unclear to those who have spoken to the Journal-World when the new practice will open, and — likely the bigger concern — when the group can get credentialed through the state to accept insurance.

“Sometimes, that process takes months,” Elliott said. “Insurance companies are not easy to work with, but I can’t really be in limbo for months and months right now.”

After his weekly group meeting on Thursday, Aug. 2, Elliott told the Journal-World that the transition was “kind of all we talked about tonight.”

“There’s a big sense of loss because a lot of us would like to stick with our therapists but a lot of us aren’t necessarily prepared to go two or three months without somebody,” he said. “… We’ll have to re-establish a new relationship with a therapist only to leave and go back to somebody else later — and that’s not ideal, either.”

One question Elliott and Higbee both said they’ve been unable to get answered was whether they could be allowed to follow their individual therapists to the new practice, but to remain at Bert Nash for the group component.

“I don’t see why we wouldn’t, because we currently allow for that,” Schmitz told the Journal-World. “… As I’ve understood it, we do have individuals who see a provider individually in the community that participate in a group with us.”

Whatever routes clients do decide to take will require much communication between the center’s staff and administration, the therapists who are leaving and the clients affected.

In the interest of full disclosure, Elliott said he worked for Bert Nash for a while in the 1980s as a medical records clerk, and he was fired.

“I was a kid. I wasn’t a great employee,” he said. “I don’t harbor any resentment about that at all.”

Updates on patients, personnel

Schmitz told the Journal-World on July 25 that Bert Nash had mailed letters to 258 clients who could potentially be affected by the seven therapists’ resignation; as of Wednesday, the center has discharged 34 inactive clients, leaving 224 in transition.

“Everybody has been assessed for the appropriate care, and that process is ongoing,” Schmitz wrote in a follow-up email Wednesday. “We are tracking everybody to make sure no one falls through the cracks.”

Schmitz can’t discuss specific clients or personnel with the Journal-World for confidentiality and privacy reasons, but he said he can’t address problems if they’re not being brought to him.

“If (clients) feel like what they’re getting is a different message than I’m getting, have them call either me or the COO and have us take a look at that,” he said. “… Again, we want the absolute best that we can provide for our clients, and so if there seems to be a disconnect, I want to know about it so I can bridge that gap.”

Schmitz said that after Wednesday, the duties of the DBT team leader will be overseen by the center’s adult services director, Joshua Reese, and child and family services director, Stephen O’Neill.

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