Episode 19 Play in an American Private Practice; an interview with Mandy Jones

Podcast Episode Description:

In this insightful episode, we sit down with Mandy Jones, a skilled therapist, based in Chicago, who shares her expertise on the transformative power of play in therapy. Mandy discusses her unique approach, combining sand tray work and Theraplay, to help children and adults process and understand their trauma. She explains how these therapeutic techniques foster emotional healing and support the parent-child relationship.

Mandy also opens up about her personal journey, detailing the interesting path that led her to open her practice. With a deep passion for supporting children and families, Mandy has become a dedicated advocate for those impacted by the challenges of COVID-19, helping them navigate the emotional toll of the pandemic. Listen to the episode for a pondering conversation on the essential role of play in healing, connection, and emotional growth.

Website: Meet Our Team - Nurtured Roots Counseling & Consulting

Mandy Jones-Fischer (She/Her/Hers) is a licensed clinical social worker and registered play therapist from Chicago, Illinois. She is also a Certified Theraplay® Practitioner, Trainer, and Supervisor and is the former Executive Director of The Theraplay Institute.

Mandy has extensive training in sandtray therapy. She has worked almost exclusively with adoptive and foster families since she began her career. She takes a particular interest in helping families with young children form strong attachments and work through sensory concerns. Mandy is also experienced in helping adopted individuals with identity, loss, and anxiety concerns throughout their lifespan. More recently, Mandy has been focusing her clinical work on helping children born during the height of the COVID-19 pandemic who are struggling with overwhelming anxiety.
While Mandy doesn’t regularly practice law, through her legal work she has advocated for children in both the Illinois and Michigan child welfare systems. She continues to use her legal knowledge and advocacy skills to help families gain Individualized Education Programs (IEPs) and other essential resources for children. Mandy earned her BA in Political Science and her BS in Psychology from Loyola University Chicago. 

She currently runs a private therapy practice serving children under 8 and their families in Chicago. 

Pondering Play and Therapy | Instagram, Facebook, | Linktree

Transcript

Play in private practice with Mandy Jones-Fischer

Philippa: [00:00:00] Welcome to this episode of Pondering Play and Therapy with me, Philippa. And this week, my guest is Mandy Jones Fisher. She's a licensed clinical social worker and registered play therapist in Chicago, US of A. She is also a certified therapy practitioner, trainer and supervisor and the former executive director of the Theraplay Institute.

 Mandy was my supervisor and the person that supported me in my Theraplay training and becoming certified. But Mandy has extensive training in sand tray therapy. She's worked almost exclusively with adopted and fostered families since she began her career. She takes a particular interest in helping families with young children form strong attachments and work through sensory concerns.

[00:01:00] Mandy is also experienced in helping adoptive individuals with identity loss and anxiety concerns throughout their lifespan. More recently, Mandy has been focusing her clinical work on helping children born during the height of COVID 19 who are struggling with overwhelming anxiety. While Mandy doesn't regularly practice law Through her legal work, she has advocated for children in both Illinois and Michigan children welfare system.

She continues to use her legal knowledge and advocacy skills to help families gain individualized education programs, and other essential resources for children. Mandy earned her BA in Political Science and her BS in Psychology from Loyola?

Is that the right way to say that Mandy? Loyola. [00:02:00] Loyola University, Chicago. And now you are currently running a private therapy practice which serve children under the age of eight and their families in Chicago. Goodies, Mandy. Are you 70 with all that experience that you've got there? Wow! 

Mandy: And I think, the important part has led me here is that I have my master's in social work and my law degree.

So, in the United States, those additional credentials are important ones for becoming licensed, and doing what we do, but, Yeah, no, I, not 70. Worked a lot. My husband would probably say that I don't do well with idle time. And I'm always going to fill it with something. And I don't know if that's something for my therapist to work through, if that's a good thing or not, but yet here we are.

Philippa: So, social work in America is slightly different than the social worker in the UK. Is that right? [00:03:00] Yes. 

Mandy: Yes, it is. In the United States, the vast majority, I shouldn't say vast majority, but the mental health services are provided either by psychologists, which is doctoral level, or master's level social workers, master's level professional counselors, or master's level marriage and family therapists.

So, the combination of those latter three positions, we do very similar work, but based upon our training, just see family systems and the way, we approach theoretically working with families and children is a little bit different, but in terms of our credentials and the ability to do that work, it is very similar.

And the, those 3 professions of clinical social worker, professional counselor and marriage and family therapist do a lot of work. do the primary work in the United States of mental health services, mental health therapy for children and families, as well as adults, of course, and then psychologists, doing that work as well.

Philippa: Okay. And so I guess we're going to come onto your [00:04:00] experience of play, but I suppose for us in the UK, when we think about the healthcare system in the States, It's different, isn't it, than the UK? We get free access however broken that is and however long our waiting lists are.

There is free access for these services. Is that the same way where you guys are? 

Mandy: Oh, definitely not. No. So everyone has I shouldn't say everyone has, but in order to gain access to most healthcare in the United States, you need to have some sort of insurance, whether there's private insurance that is provided by your employer, or the government does provide, insurance for either seniors, the older population, that is our Medicare program or Medicaid, which is insurance for those who.

Make very little are [00:05:00] impoverished, or have some other level of subsidy. So for example, if a child is adopted out of the foster care system, they will be given a medical card until they turn 18 or 21, depending on the state. And then they will be entitled to state services. However, this is what gets tricky is that individual providers like myself, we have to go through what's called an paneling process and we say, okay, I'm willing to take that insurance, or I'm not willing to take that insurance.

And those pay rates are different. They are different based upon where you are geographically. Educational level, and truly whatever the insurance companies decide. And each insurance company pays clinicians different rates. And so some, there are some insurances that for mental health providers are just not Financially viable for us to take.

So, for example, my partners and I, we only take 1 insurance, because it's just not financially viable for us to run our business to be able to take the other insurance policies that [00:06:00] pay us less because we are given a contracted rate that even if I charge my hourly rate, to people who don't have that insurance policy.

That type of insurance, by being contracted with this insurance company, I have to take a lower rate, and I cannot, what's called balance bill, I cannot bill the difference to the client, I have to do that as a write off. So it's also a horribly broken system. 

Philippa: Wow. In the UK, all our children whatever age they are would be able to access, if they have a need, a service.

The services might have a long waiting list, they might, people have lots of views on it, but in theory you can, if you're a child, do it. Under the age of 18, access a level of child service or a level of, the IEPs that you're talking about in there, the education programs, all those sorts of things.

Is that the same in the States? [00:07:00] Can all, do all children get insurance regardless? 

Mandy: Theoretically, yes. And execution, no. Okay, so theoretically yes. If a family doesn't have or can't afford to include children under 18. On their employer provided, health insurance, or parents themselves are on Medicaid or Medicare, then children, yes, are eligible for, are given that state insurance. So, yes, however, they still need to be.

Registered parents need to be able to go through the process to get that and to get it documented and be able to get the insurance, in the United States, not to turn this podcast political, but we have a very large issue right now and always have, but it's, more at our forefront with immigration.

And so children who are here, and perhaps their parents, don't have the [00:08:00] proper documentation may not be able to get. Services or may not be able to get that insurance, or they may, depending on their parents, depending on a lot of different factors. And so theoretically, yes, every kid is eligible.

Does that actually happen? Not necessarily. And additionally, a lot of providers do not take state insurance because the payment rates to, folks like myself are low. The documentation required would put me out of business and the amount of time it takes to get reimbursed depending on the state and the work you're doing can take up to six months.

And so I, my small business, I can't afford to see a client and wait six months to get paid for it. And the amount of paperwork I'd have to do that. You don't get paid for doing the paperwork. Makes it so that I'm not able, to see kids with medical cards. And so, those tend to be the places that do see children with medical cards.

As you [00:09:00] said, tend to have very long wait lists. A lot of those professionals are overworked underpay. They're primarily in our community mental health programs, which are often not always, but are very often clinicians right out of school. So, they are not yet seasons practitioners. Many of them are working towards the clinical licensure.

And so they just. They haven't had the time to develop a ton of expertise and the turnover rate is usually pretty high. And so the kids who are really most vulnerable are not always getting the best care, not because the clinicians. Don't care. That's not it at all. It's just, they're young, they're green, or they're overworked with a very large caseload and don't, always have access to the expensive trainings that many of us have access to thinking about a product of their play, as you said, which if I were paying for that out of pocket is not affordable.

Same thing with EMDR and a lot of other [00:10:00] training modalities or therapeutic modalities, I should say. So, I think every country has its own problems, I suspect, with mental health services, and the U. S. is certainly no different than that, in that we are a pretty broken system. 

Philippa: So what led you into this, Mandy? Did you always enjoy playing and engaging with people, or is it something that happened as you started your career? 

Mandy: So my I wrote is a winding one. So as a kid, I always wanted to help people. I was an only child or still am an only child. And my parents and I, we lived in the middle of nowhere and farmland, rural Wisconsin.

And my parents were definitely playful. Definitely engaging. I also, until I started first grade, my grandmother, my great grandmother, and my grandpa watched me and my great grandmother, especially lots of playing lots of singing. But it didn't [00:11:00] really register to me that that was. Of vital importance to me until I got older. But as a kid, I remember asking my parents if I could start doing volunteer work, which we are not a religious family. That is not where that came from. My parents were like, sure. What do you want to do, kiddo? And so I tried a couple of different things. I was like, I just really want to commit my life to helping people.

And for the longest, for a hot minute, I was like, doctors, and I was like, just kidding, hate blood, not doing that. My parents were very much into law and order, the television series, and so I was like, I'm going to be a lawyer. That's what I'm going to do. And so I actually went to college with the plan that I was going to be an attorney, but I didn't want to be the attorney that made a lot of money.

I wanted to be the attorney that helped people, the people who, you know, some sort of legal aid. And I thought I wanted to work in immigration and international law and really working in the American immigration system. And in my dual degree program, I was working towards my degree in political science, again, working towards, being [00:12:00] an attorney, and I was really interested in psychology.

And I had an opportunity to join a research team that was looking at, children's memory and the way language helps to encode memories. And so there were, two play situations one with a very elaborate, like, Where would you use this? Where would you see this? Where else have you seen this before?

Versus do you like this? What color is it? The way that we're making connections in the brain. And so that this research study had moms and toddlers, pretty much. Yeah, like three and four year olds play and mom's given one script or another and then they would interview the kiddos over time to see how much they remembered of that play experience.

And then they started a smaller related but separate study that had a researcher, me, go in and have very similar play experience with kids in Montessori schools that were again three and four years old and it was a pretend camping experience. So we had [00:13:00] magnetic fishing poles and we had a little grilling stand.

I would go and play for 15, 20 minutes using this script of play and then afterwards we would go and interview the kids a week after, three months later, six months later, and a year later, and then encoded all of it was all recorded and coded it. And it was really through this experience that I was like, Man, three and four year olds are the best humans.

They are so authentically themselves. They have no filter. They are funny. They are funny, funny little beings. And I was like, I really love really little kids, which I didn't know that I knew that about myself. And so then as I entered law school, I was like, actually, I want to work in the foster care system because I was like, okay, who are truly some of the most vulnerable humans on earth.

And it is kids in foster care. And so my plan was to get my, told you this was a long winding story, Philippa, sorry, I'm trying to make it short, and here we are, so I decided in [00:14:00] getting my law degree that I was going to find a program where I could also get my master's in social work, because I thought understanding family systems and child development, it would make me a better lawyer.

In the foster care system, and so I was doing my law degree and my master's of social work at the same time for Michigan State University and realized partway through this four year program. That I actually liked my social work therapy experiences much more than I liked the lawyering stuff. And so I completed both degrees all of my internships were in child welfare, both on the legal side and on the social work side. So I knew no matter what I was doing, I was working with kids. And I was really fortunate that my program was very heavily play based therapy. And I had a focus in child welfare. And so, I had several professors who were registered play therapists.

My final internship on the therapy [00:15:00] side, my internship placement, My supervisor was a sand tray professional, and she was also very much into child center play therapy, and so my, deep play therapy clinical training came from her in that very first experience before I even graduated. So I graduated both programs.

I sat for the bar. I am licensed in the state of Illinois as an attorney, though I don't practice. And as soon as I graduated, I never intended to practice, but I was like, I made it this far. Might as well take that big, awful test, because if I don't take it now, I never will. And yeah, I immediately started working in therapy.

So, that's kind of my long, winding road. 

Philippa: Well, that's a great way in because you've got both sides, haven't you, of what goes on. You mentioned sand tray in there, and when I read your bio out, we mentioned sand tray. What's that, Mandy? What is sand tray?

Mandy: So, sand tray, You start with a tray of sand.

Usually it's blue, though it that's in its truest [00:16:00] form. And it's, I realize you can't see me as I'm holding my arms out. It's maybe about, I don't know, two feet by three feet or so. It can come in different shapes and sizes. But the idea being that you take miniature figurines and provide them to the client.

It's, meant to be non directive, but an external representation of what they're experiencing internally, and they can use the miniatures to play out or to represent how they're processing the world, how they're processing their feelings, how they're processing emotions, you as the therapist are holding space and that containment that happens within the tray is very powerful.

The other thing that I love about SandTree is that it's so tactile and that there's a high sensory component to being able to touch the sand, to be able to feel the sand run through your hands, to feel and experience and weight of different miniatures and the visual representation of different miniatures, and then being able to verbally process it in ways that you're like, I [00:17:00] didn't necessarily say that notice or experience that was in me As a client, and so I think it's a very powerful, I wouldn't call it expressive arts, but definitely a more right brained approach to therapy.

And that there is a playful component to it. I think that's like the quick and dirty explanation of it. Of course, it's way more detailed and you can bring in other professionals who can speak even better to it than I can. But I, it's definitely a modality that I really enjoy. 

Philippa: Do, wonder if parents listening to this and think, Sandra, well, my kids would just go and play in the sand. They wouldn't do anything. Does that happen? Do they just come and play in the sand or does something happen when they come into that therapy space that, that play just turns into something more?

I don't know. 

Mandy: It turns into something more, and I think what's also different from maybe how parents experience it is that the child isn't sitting in the box. They are standing next to it, and that it's really [00:18:00] much more about the miniatures and the metaphorical representation of what the metaphors stand for in terms of the child's experience, the child's existence, or the adult.

I have done plenty of SANTREs with adults, couples, whole families, so I think that's the other thing that's really lovely about SANTRE is while we may think of it as starting with children, it doesn't. have to just be with kids. And I sometimes at the end of a really rough day as a way to process how I'm holding the day myself is I might just go and make my own sand tray as a way to get out whatever's in me as a way of doing my own trauma processing from holding other people's traumas.

I'll go and take some of my miniatures and make a tray and be like, Oh wow, that is okay. That's what needed to come out today. And so it is very different from kids just playing in the sand because of the role of the miniatures. 

Philippa: Yeah. Okay. So you did that at university. [00:19:00] You learned about that and then you left and decided to take the bar, become a lawyer. But not practice. You went into social work. And what's that like? What did you do there? And how, did you use play there? Or, here, when we think about social work, we think about somebody who's filling in forms, trying to manage risk situations, supporting families to receive stuff.

It's not really a therapeutic role unless, I mean, I am a social worker, but I had to specialize. Generally, you stay within a system that you are almost like a case manager rather than So, 

Mandy: I came out and immediately became a therapist. But let me tell you, it was, my first job was not doing what I expected I would be doing as I think many of us are when we first graduate [00:20:00] and plus, we're in our early to mid twenties, in the United States, that tends to be the age that you might graduate from university or your master's program.

I was a ripe age of 26 and you take the first job you can get because you've now got to. Payback student loans and pay rent and feed yourself and all of those things. My very first job that a friend had recommended me for was doing substance abuse counseling and starting an adolescent program.

I didn't know. I don't know if I can say it. I didn't know a damn thing about alcohol drugs, other than my own experience and having experimented in my younger days, my first day on the job, I learned I was working in a methadone clinic and my silly little 26 year old self was like, isn't methadone a street drug?

And my supervisor, I kid you not, was like, Your first assignment, go Google drugs. And I was like, okay, I went off to, learn about drugs. And I didn't know what to do, [00:21:00] because my experience was all in play, and my caseload was all adults, and then because I, quote unquote, worked with kids, this agency was like, you can figure out how to start an adolescent program, primarily focusing on teens use of marijuana who are mostly court mandated.

And I'm like, oh, this is also so out of my wheelhouse. Yeah, sure. Why not? And, because I didn't know what to do with these adults, I just started pulling out all my board games. And I remember playing like barrel of monkeys and Using how the monkeys connected to each other to talk about life experiences of if one monkey falls off, what does that mean?

How can we make a metaphor out of their life for that? And I remember taking the game of sorry and using that as, ways of processing different choices they could have made in life to get us to different places. And at first, the adults I was working with were like. Oh, [00:22:00] no, I am not doing that.

Especially those who are court mandated to see me. But then after a while, they're like, yeah, that wasn't so bad, but that wasn't so terrible. But I was only there for 4 months. And then, as is often the case, when you're working, and this is a community mental health agency, we lost state funding.

My position was then eliminated, after only being there for 4 months. And then, I ended up getting a job, and this is what led me to where I am now. I got a job with another very large, I believe it is the largest community mental health agency in Chicago, working in a program called Adoption Support and Preservation.

And the goal of that program was to provide free mental health therapy for children and families who had adopted. Through any means, it could have been private adoption, could have been foster care, could have been kinship adoption. It didn't matter. So long as the family was touched by adoption, it was up to 2 years of free therapy in home or in school and with the goal of [00:23:00] avoiding. Disruption in the adoption process, or post adoption, I should say, because this really came from a lawsuit filed by children of the state where there was a very large number at one point in the 80s and 90s of failed adoptions and children being rehomed. And so this program was put in place to help stabilize families who might be at risk.

And so that was all home based work and it was through that program. We were every therapist in that program. We were required to undergo fair play training. And so that was where I got my initial theraplay training. And from there the rest is kind of history. So I did that job for about three and a half years before I burned out.

Um, 

Philippa: yeah. So do you want to, talk about theraplay? I am trained in theraplay and Julie is trained in Theraplay, but I have to say we haven't actually talked about Theraplay on any of our podcasts. We, obviously, we talk about play a lot, but I don't think we've actually explained what [00:24:00] Theraplay is. So you were the, You worked your way through and ended up as the executive director of the TheraPlay Institute in Chicago.

And that really is the home of TheraPlay and everybody else in the world who does TheraPlay all is funneled somehow through the TheraPlay Institute in Chicago. Is that right? And therapy is a very specific form of play, isn't it? So do you want to explain what that is and then maybe how it touches the world?

Mandy: Sure. So therapy is a structured type of play therapy that utilizes the strength of the parent child relationship to effectuate change. That's it at its core. And so Fair Play is premised on four dimensions of the parent child connection being structure, [00:25:00] engagement, nurture, and challenge.

Those are the four dimensions. And so we, as a therapist, Really hold the relationship as our client versus just the child or just the parent because attachment is a dance and if one part of the dance partners gets out of sync or gets out of step, it's up to both of them to figure out how to get back into step.

And so if we can strengthen that relationship, it provides the resilience for lifelong positive mental health. And so that's really, in a very, very basic nutshell, what theraplay is premised on. And it's rooted in attachment theory and attachment, therapy. 

Philippa: And so, do you have loads of toys then, Mandy?

Loads of toys that people come, a whole kit that you need. Yeah. 

Mandy: No, therapy is also premised on, it turns out the things that parents, the securely attached parents, let's put it that way. What parents do in. The rocking, the swinging, the cooling, the cuddling, the [00:26:00] mirroring, the, my baby sticks his or her tongue out and I stick my tongue out back because, and then we both giggle.

All of those things, it turns out that the brain science people are like, Oh, this is what builds healthy people. And so, we don't need, just like we don't need a lot of toys with infants. We don't need a lot of. Toys to recreate that's for kids who, for whatever reason, those experiences went off course.

And so we, as parents to infants, we are the most exciting plaything. Sure, we might have rattles or stuffies or the mats that we put kiddos down with little mirrors and swingy things, but we are always going to be more interesting than those things to itty bitty babies. And so that's our goal in fair play is to adapt those concepts to be more age appropriate, but that. The interactions just still be between me as a therapist facilitating that connection between the parent and child. So I don't need a ton of stuff to do that. Might I need a few [00:27:00] things? Sure. But if things like cotton balls, feathers, bubbles, balloons, a blanket, we do a lot of feeding in therapy.

So snacks, trying to think, I mean, those are, Paper streamers. I'll use those sometimes toilet paper for shopping because I can make those a good karate shopping space out of toilet paper. But I think that's the other benefit of fair play, especially for, new practitioners is that it's not expensive to get started in this modality.

The training itself is great. Definitely the most costly of it, but it doesn't take a lot to get this going in your work. And the lovely part is it doesn't take much for parents to be able to do this work at home either. 

Philippa: And so it doesn't really work with teenagers then, if you're doing that baby in stuff.

Mandy: It does, actually. It does work really well with teenagers as well. Is it going to look a little bit different? Yes. Am I probably going to have to add, when we're talking about those four [00:28:00] dimensions, I'm probably going to need to use more challenge because that's how teenagers are going to engage with me.

Am I going to be able to rock a teenager in my arms to soothe and care for them and nurture them? No. But can I give a really great manicure as a way to take care of them? Yeah, I sure can. And so it is going to look a little bit different. I am going to need to adapt some activities, if we don't have a secure attachment as infants and toddlers and six year olds and 10 year olds, we're not going to have a secure attachment at 12, 18, 22, 35, and so on.

And so we need to go back and heal that. And so that attachment is so necessary at any age. And the beautiful thing is we can always heal it. And so if we take a teenager back to That experience of having felt safety and creating emotional containment within someone who is bigger, stronger, kinder, wiser, and caring [00:29:00] for them, it works really beautifully.

But does it look different than me doing Fair Play with my precious four year olds? Yeah, of course it does. Their bodies are bigger, and probably, yeah, I'm going to talk a little bit different, I'm probably going to use more sarcasm, I'm probably going to be cursing, because that's me. Teenagers natural language and so, but am I gonna curse with a four year old?

Definitely not. 

Philippa: So the teenagers and the young people engaging. What about the parents? Are the parents involved in this? Or is it just you as a therapist and the child? Because if you're building attachments, the parents are the most important thing in that. Is that right?

Absolutely. 

Mandy: Yes, you've actually got it. You've definitely got it right. Because I don't know about you, but my kids aren't coming home with me. I don't want to bring my clients home. I don't want to move into their homes. And so you're absolutely right. I need to incorporate the parents from the very beginning to.

build the [00:30:00] attachment between them. So I, my role is to facilitate that. So in the beginning, I'm going to be more of a leader directing things between parent and child. And then as the treatment progresses, turning over that leadership in time to the parents. So that way the parents then become front and center.

And I back myself further and further out of the treatment. So that the parents can do this without me. I think the best therapists out there are the ones who do their work so well that they can essentially put themselves out of business. Of course, that's never the case because there's another family who's going to need us, but, we want our families to do well without us. If we can empower parents, to do this work, then. They don't need to see us anymore, and that's a beautiful thing. 

Philippa: I think that's the thing, isn't it, about TheraPlay, is it's like a happy sad? Yeah. So I think is that you're, you get to a point where they don't need you anymore, but you might have spent 18 months, two years building relationships with the family, and really love [00:31:00] your family and your child, but they don't need you anymore.

So it's really I don't know about you, but I'm really happy that they've built that security in one another. They've built that joy. They've built that connection. And that's a great thing that you, like you say, you do yourself out of that role, but it's a little bit sad sometimes. For the families, for the little people and for us, that you're not going to see them once a fortnight or once a week and that, but it's a happy sad.

It is a happy sad. 

Mandy: Yeah. And those termination sessions are. Are hard ones for everyone because like you said, it's very much. It's bittersweet. The other thing I will say is that over the years of doing this, I have a number of families who regularly reach out who will send an email or a text with a picture and just say thought of you today.

Here's a picture [00:32:00] of how kiddo is doing that really warms my heart, and it's, thinking about the boundaries that I think are our profession puts in place to say, once they're no longer your client, you shouldn't have a relationship with them anymore, which I think is, of course, there are reasons for that, but it also is a hard.

A hard rule, ethical rule when we are humans. And like you said, we spend 18, sometimes two, three, five years with families, helping them heal to then one day, no longer be a part of each other's lives that I think is, opposite of the human experience of building relationships. And so I think that when I do get those responses from clients, I always respond and say, thank you so much for sharing with me and, or get the occasional holiday card or the occasional drawing of something or another and it just is okay, this is why we do this work.

Philippa: Absolutely. And just knowing that I know that I've had little ones that have left or big ones and then they come and say, oh gosh, they did this [00:33:00] school play this week or they've started this new activity or new club and they couldn't have done that. The joy that you feel as a, therapist in your heart, it really hurts your heart, but in a really nice way, isn't it?

That those little people or big people are now achieving something. And you have been a really small part of that, but that, yeah, that is just, amazing, isn't it? It's an honor, I think, a massive honor to have that. Exchange. 

Mandy: Yeah. It's an honor. It's humbling. I think it puts us in a unique place that a lot of other healthcare professionals don't see. I'm not inviting. My primary care physician to my kids, high school graduation, we do sometimes get invited to those things. And I think it's really hard because our profession, at least in the United States, says that we have to put that boundary up that we shouldn't be part of those.

But. I don't know about you, but certainly at my core, I don't go [00:34:00] to them, but I'm like, Oh my gosh, do I want to go see my client star in their school play that took them months to work up to doing? Yeah, I would love to be there. Or do I want to go join their soccer game or watch them? Of course, yes, I would love to do that.

But are we allowed to? No. And that really stakes, the boundaries within our profession are, they're there for a reason, but stinks sometimes. 

Philippa: Well, you can celebrate it in your heart, can't you? And celebrate it for them. But yes, those boundaries are there to protect us all, aren't they?

And also, Mandy, however many clients you have, there's a point where you just can't keep doing all those things. Physically, there's a good reason that the boundaries are there. But you, yeah, celebrating it in your heart is fine. So you've moved on from therapy. So you did a period of time, during therapy, during the COVID period, which was really a hard period for everybody and therapy went online.

And that's hard [00:35:00] doing any therapy online is that therapy is really important to be in person, I think. And just being in the same physicality of somebody. And that COVID I think, was very difficult and you saw You were there during that period. How was that for you? 

Mandy: It was awful. We shut down the office.

We went virtual. We laid off about two thirds of our staff. Those of us who remained, a few staff members for a couple of weeks, months. I don't know. I don't have a great concept of time. We were down to 80 percent of our pay, but we're still working probably double what we were working before to try to keep things moving.

Those people who work with me closely know that my best ideas always come to me in the shower. And so one of my shower ideas was, let's create the modules. And so we created the Fairplay modules as a way to, like you said, adapt Fairplay training online. I also, so Andrea Bus, she and I worked together to write them and then, 

pilot them that was a very, [00:36:00] very big undertaking. We were planning to have our in person play conference in 2020 that we then shifted to make that online and I turned it into the summer learning Institute. Because at that point, I was the program director. I know, I had tickets to 

Philippa: I had tickets, and my flight's booked, and we were gonna meet in person, weren't we?

I was coming, I was bringing my mom, we'd got all that booked, and Yeah, that COVID thing was like you're not going. 

Mandy: Yeah, it was devastating. It was awful. It was so hard. We then gave up the office. We moved into a new office in the height of the pandemic. We were trying to shift very quickly because we had a clinic at the time.

We get our clinicians to continue seeing the clients that we were seeing in the clinic to be able to do it safely. So clinicians, with the Therapy Institute were working. Doing fair play sessions in parks and in garages with garage doors open and like trying to get as creative as possible to not lose [00:37:00] total contact because fair play, it can be done online.

I don't, and there are a lot of clinicians who adapted it very well, but I was not one of those people. I am an in person therapist. I'm terrible at virtual work. So yeah, it was a hard time. I don't think this is a zero out of five stars experience would not do again. No. 

Philippa: And then there's an impact isn't there of COVID.

And I've talked to other professionals, and we often think about with parents, my teen really was impacted when they didn't go to school, when they couldn't see their friends, when they, and there's, been a big impact. And you've moved from the Theraplay Institute now and you've set up your own practice, Nurturing Roots.

Is that right? Yeah. Nurtured Roots. 

Mandy: Nurtured Roots, Counseling and Consulting. Yep. I sure did. 

Philippa: And you're Seeing the impact now in your clinic of, that time of [00:38:00] COVID. 

Mandy: Yeah, 

yeah. So, 

Because I specialize in kids under eight, what I'm seeing is a lot of these four soon to be five year olds who were born in the midst of COVID who were delivered in 2020 or early 2021 and the impact that all of us experienced anxiety.

I don't know. I'm sure there's someone out there, but I haven't met them who was like, yeah, COVID was a great time. I really enjoyed that experience. All of us were impacted by it. None of us knew what was coming next. None of us knew how long it was going to be like this, right? In the beginning, we were like, Oh, we'll work from home for two weeks.

Let's stock up on all the snacks and the toilet paper, and then it's going to be fine. And it wasn't, it wasn't fine for a long time. And so the baby's born into that. Thinking about several of my clients We're born so early on that either some of them, their dads weren't allowed to be in the hospital when they were born, there were clients who the kiddos were immediately [00:39:00] removed from mom because they didn't know if babies could touch it.

And so then that immediate separation for the first day or two days, or mom's being really. Diligently tested and isolated. So the delivery being really difficult and then, or the babies who are born in like July, August, September of 2020, those final months of their, of mom's pregnancy, just full of adrenaline and cortisol from all of that unknown anxiety, which baby is just.

And then they come out and parents were isolated. They didn't have the support systems that were The community comes around new parents and provides them with support and meals. And grandparents are there or siblings or whatever, and now parents are alone and the parents who then Got coven in the midst of this and who are trying to work from home and was just all of us were just [00:40:00] functioning in anxiety and doing the best we could to survive, not to mention a new baby.

And so the little ones I'm seeing are really just. Functioning in states of anxiety because that's what their little brain and biochemistry was developed in 

Philippa: I guess in isolation that isolation for parents and not knowing as a new parent with a new baby, you learn from people around you how to do things, don't you?

And if you haven't got that, so you've got the stress of COVID and being on your own, and then the stress of, am I doing this right? And Yes. And even though most parents can and do, you need that reassurance, don't you, from your own parents or from your friends or from your siblings or from the toddler groups, the baby groups, the GPs.

And not to have that must have been so [00:41:00] horrendous. And that anxiety remains even after the pregnancy. 

Mandy: Yeah, the other thing I've seen in some families, there are two additional complicating factors. For some just naturally a very, a significant enough portion of women develop postpartum depression and postpartum anxiety.

Moms who had that's just part of the hormone shift after delivery, were struggling with that and not being seen and not being monitored the same way because They just don't have as many people who are checking in on them. And so that contributing to the postpartum experience for moms really being difficult.

And then I've also worked with several families where either mom or dad, one of them, got COVID and then had to isolate. So then you're a brand new parent. But also totally isolated parent, even from your partner, because they've had to isolate in another part of your home. So, and then the fear and concern about your partner [00:42:00] having COVID, it's just the complicating factors.

It's like, no wonder when these little, these sweet, adorable little nuggets are coming in, just being little walking balls of anxiety and presenting in a couple of, primarily the same few ways, but coming into my office, I'm like, yeah, I don't know. It makes sense. And something that in the height of COVID, none of us could have anticipated that this is how some kids were going to function.

Of course, there are plenty of four and five year olds who are doing just fine I don't want to pathologize that all kids are doing poorly. Some parents handled it really well, were better resourced, had different outlets, maybe they had a bubble, so that way they could have those safe interactions.

There are definitely, those families that were very resilient in this. So I don't want to minimize that, but The ones who are doing okay aren't the ones coming into my office. 

Philippa: No. So how do you use play within that, Mandy? So you use TheraPlay, you use SandTray, do you use other types of play?

Mandy: Those little kids, I am primarily using TheraPlay because we need to help parent and child work together in [00:43:00] reducing that. anxiety, creating structure so that child has felt safety and connection and parents feel better resource. So for the kiddos that we were just talking about those sweet little covid babies.

Primarily using their play, but because I do see kids for other needs. I have a very fairly sizable sand tray miniatures collection. So I'll do some sand tray. I also have a full non directive room. So I have a couple of kids who very much are into the 

Philippa: kitchen. What's non directive for people listening that aren't therapists?

Mandy: Sure. So my playroom is I have a bunch of toys, that are well organized. So it's not overwhelming coming in that there's a section with Lego and building blocks and construction toys. And then I have baby dolls with all the stuff that comes with baby dolls, you know, the diapers, the bottles, the strollers, what have you.

I've got a whole section of stuffies. I have some board games. I have a [00:44:00] kitchen that has all the plates. Food, cash register. I've got some sensory toys. I have a very large bot bag. I have swords and pool noodles for doing battle. And the idea behind non directive or child centered play is that the child comes in and selects the toys and the materials that they need to play out whatever is Going on inside of their body inside of their mind and my role as the therapist is to track that at times to reflect it back to the child to be the one that is holding the space for them.

If they draw me into their play, then I will be part of it. So for kitchen, for example, if they want to make me a meal and serve me a meal, then I am going to be there to receive it or with the swords and the pool noodles. Often I am the one that they are doing battle against. And so then my role as the therapist is based upon my training experiences to then interpret what they're working through.

Children's natural languages [00:45:00] play as opposed to talking and cognitive processing. And so they're playing out the themes that are in their mind and in their body. They're playing that out. And so it's been my role to interpret that and use the space and use the supplies to help them to progress and consolidate, and work through whatever it is that they're experiencing.

Philippa: That sounds really interesting. So you've got quite a lot going on in the clinic. Do you still do training? Do you still do guest speaking? Do you do other things outside of that as well, Mindy? 

Mandy: Of 

Philippa: course we do, Philip, 

Mandy: but because I don't like idle time, here we've come full circle. So yes, I still do TheraPlay training, so even though I'm not, an employee of the TheraPlay Institute any longer, I am still doing TheraPlay training.

I am doing TheraPlay supervision. I am, just a few hours away from completing my Registered Play Therapist Supervisor [00:46:00] Certification. And so I'm hoping by summer I will be, an RPTS, so then I can provide supervision for other people working towards their Registered Play Therapist Certification.

I have been in this last year on the conference circuit, so I am presenting at a number of conferences. I do other trainings on child development, on adoption trauma, on foster care.

Yeah, I think those are The main things I'll do a little bit of consulting here or there on child welfare issues. Something that I'm interested in and we'll see where it goes is serving as, an expert witness in child welfare cases if need be, since that is, a priority. Testifying doesn't scare me like I know it does a lot of other professionals.

Let's use that legal experience in a little bit of a different way. And so, yeah, we'll see where this goes. I just started the practice, in July of this past year. So it's only been about, seven months or so. But [00:47:00] I'm really excited for where this next chapter of my professional career takes 

Philippa: Oh, that's fantastic. So we'll put a link in the description of the episode. I'll put a link to your website. So if people are interested in finding out more about you or contacting you, then they'll be able to do that through the website. Is that right? Is there a contacts page or, yeah.

Yep. Yep, there is. You got it. And you do offer these things, outside of the States, don't you? Because I am in the UK and you, for a period of time, were my supervisor going through the therapy training. You were actually my 

Mandy: very first supervisee. Oh, okay. Well, I didn't know that one. Yeah, you set the

Philippa: bar very high.

That's very kind of you, Mandy. But maybe you just didn't know any difference at that time.

We both had some things to learn. Yeah, definitely. I am still learning. But yeah, [00:48:00] so thank you very much, Mandy, for being part of this podcast. Like I say, I will put the website in the links if people want to get in touch with you. And I hopefully will have you back on the podcast in a period of time and see where else you've, gone with all the other bits that you've got going on.

So thanks very much. You are amazing. Thank you 

Mandy: so much for having me. I love everything about this podcast and I love that it's just turned into. Yeah, us having a little chat, which feels very authentic for us. So thank you very much for inviting me. It has been my honor and privilege and, keep doing the good stuff that you're doing, Philip.

I love every bit of it. 

Philippa: Perfect, thank you.