Maya Hollister 
Priya was 47 when her therapist of seven years said the sentence that changed her life: “I think your depression is hormonal, not psychological, and we should get you to a menopause specialist before we change another antidepressant.” Priya had been on three different SSRIs in two years. None of them had quite worked. She … Read more
Therapy Across Years, Not Months The cultural script around therapy treats it as an episode. The patient enters with a problem, works on the problem, and exits when the problem is resolved. The reality for many people who use mental health care over a lifetime is different. Therapy is a relationship that can span decades, with periods … Read more
Sergeant First Class Devon Reyes had been back from his third deployment for eleven months when the nightmares stopped letting his wife sleep, and the family’s first call about tricare mental health benefits ran into a wall. The base behavioral health clinic at Fort Liberty had a six-week waiting list. His wife Karina, herself a … Read more
Why Substance Use Has Its Own Levels of Care The continuum of mental health care has a parallel continuum specifically for substance use disorders, with its own terminology, its own clinical structures, and its own evidence base. The American Society of Addiction Medicine, often called ASAM, has codified this continuum into a set of levels that providers, … Read more
Hannah grew up in Provo. Her family was eighth-generation Mormon. She served a mission in São Paulo at twenty-one, married in the Salt Lake temple at twenty-three, and by thirty-one was a stay-at-home mother of three who could no longer make herself believe. She did not announce it. She kept showing up to sacrament meeting … Read more
Why Couples Therapy Is Different From Individual Therapy Couples enter therapy with a different set of constraints and goals than individuals. Two people are in the room. The therapeutic alliance is not with one patient but with the relationship itself. The skills the therapist needs are not the same as those used in individual mental health … Read more
Frank, a 67-year-old former hospital systems engineer in Tucson, retired on a Friday afternoon in March with a sheet cake, an engraved clock, and a folder of HR paperwork his wife Marta still has somewhere in a kitchen drawer. By the following October, Frank had stopped shaving on weekdays, was sleeping until 9:30, and had … Read more
Marcus, a 34-year-old combat veteran living in Austin, Texas, came home from his second deployment with PTSD that nightmares could not loosen. He tried weekly therapy. He tried sertraline. He tried a meditation app his wife downloaded for him. The first time the panic crested in line at H-E-B, he abandoned a half-full cart and … Read more
Reece Tomlinson had survived two combat deployments to Helmand Province with the Marines and the homicide of his older brother in 2019. By the time the 38-year-old San Antonio veteran walked into a Sheppard Pratt admissions office in December 2024, he had completed two 30-day stays that had not held. The first program in Arizona … Read more
Adolescent Mental Health Care Is Its Own System The continuum of mental health care for adolescents looks superficially similar to the adult continuum, with outpatient therapy, intensive outpatient, partial hospitalisation, residential, and inpatient levels. The actual experience inside each level is dramatically different. Adolescent programs incorporate school components, family work, developmental considerations, and identity-formation issues that adult … Read more