Clinician Spotlight: Addison Kay

Clinician Spotlight: Addison Kay

Nicole: What drew you to working with teens and young adults, especially those navigating intense emotions?

Addison: I was a camp counselor for six summers. I worked with a lot of different kids, and I found myself connecting with campers who were having a hard time at home and experiencing anger, anxiety, and grief. I loved being a camp counselor. I also knew that I wanted a role where I could dedicate time and energy to people dealing with intense emotions and experiences.

Nicole: What can a new client expect during their first few sessions with you?

​Addison: Starting therapy can be a nerve-wracking process. In our first few sessions, I will do my best to get to know you – who you are, what brought you to therapy, and what your goals are. Therapy is a collaborative process and can look very different for different people. Together we will figure out what works best for the two of us. I always invite feedback on what is working and what isn’t. 

Nicole: What’s important for clients to know about your approach when working with trans youth?

Addison: Gender-affirming care is life-saving care and something I strongly believe in. I’d love to help you with any part of the process from navigating conversations with loved ones about your identity to writing gender letters for supportive surgery. 

Nicole: How do you help clients feel comfortable opening up, especially if they’re new to therapy?

Addison: People often come to therapy to talk about issues in their life that they have never talked about before. It can be hard to trust someone you don’t know with some of the most important things in your life. We can start slow. Sometimes it is helpful to talk about what it is like to talk about the things that brought you to therapy. 

Nicole: How do you explain DBT to someone who’s never heard of it before?

Addison: Dialectical behavior therapy is a flexible “by the book” treatment with the goal of helping people process intense emotions. DBT has two major mechanisms to help people process their emotions: acceptance and change. The treatment uses skills – specific things you can do to help you accept the emotion you are feeling or change your response to the emotion. DBT has several other bells and whistles, such as clients can opt in for in-the-moment phone coaching with their therapist and clients complete a daily emotion and behavior tracker to help organize each therapy session.  I am a BIG believer in this treatment for two reasons. One is that treatment is collaborative. DBT assumes that therapy is a real relationship between equals – you know your own experience, and I help you with your goals – we must do treatment together. The other reason I love DBT so much is that the treatment is so expansive and descriptive. There are a lot of resources for troubleshooting skills training. When I am teaching a skills group, if I get asked a question I don’t know the answer to, I know where and how to find it. 
 
Nicole: What’s your philosophy on balancing validation and change in therapy?

Addison: Balancing validation and change is key to doing quality therapy. I see these two ideas as intertwined. Sometimes the most validating thing you can do is to take seriously someone’s desire to change and help them. Sometimes the most change-oriented thing you can do is validate the pain someone has experienced. During a session I tend to move back and forth between change oriented and validation approaches depending on what the client needs.

Nicole: How do you help clients stay motivated when progress feels slow?

Addison: When trying to change your life you have to learn to do things differently, (such as practicing more self-compassion or changing the way you interact with other people). Inevitably, you will run into roadblocks. As you try new strategies, you will likely struggle to do them “well,” especially the first time. This can be so frustrating! Clients are trying hard to get better and it can feel so devastating when progress feels slow. I try to help clients see slow progress or treatment setbacks as part of the therapeutic process. 

Nicole: What’s something you wish more people understood about borderline personality disorder?

Addison: There are a lot of inaccurate portrayals of borderline personality disorder in popular culture and on social media. One thing I wish people knew is that borderline personality disorder (BPD) is a broad condition – to qualify for BPD you need to meet 5 of 9 criteria – making 256 individual permutations of BPD. Sometimes people assume that they need to have a self-harm or suicidality history to meet criteria and although many people with BPD struggle with self-harm and suicidality they are not requirements for diagnosis.

Another thing I wish people knew is that folks with borderline personality disorder are incredibly sensitive emotionally. Often people with BPD wind up in therapy because their emotional pain is causing them problems in their life. Because people with BPD often come to therapy wanting help with feelings of intense anger or anxiety or using impulsive or dangerous coping strategies they later regret – it can be easy to consider emotional sensitivity as a deficit. However, at its core being sensitive to emotions is a strength. People with BPD have an increased ability to feel joy and love and to be attuned to other people in their lives. 

Nicole: What are some of your interests outside of the therapy office?

Addison: I love rock climbing. I’ve been climbing (bouldering) for almost 10 years. On the weekends, if the weather is nice I usually spend at least one day climbing outside. The sport and the community mean a lot to me. I am also a huge board games nerd. I love to learn and play a new game – some favorites are Patchwork, Stella, One Night Werewolf, Blood on the Clocktower, and Magic the Gathering. Additionally, I have two pet rats. They are grey dumbo rats named Catchling and Poirot and they are the best. 

Nicole: What’s something you wish every client knew before starting therapy?
​
Addison: The best time to plant a tree was twenty years ago. The second-best time is today. Sometimes people feel like it is “too late” to start treatment – or that they should have come to treatment earlier and believe they don’t deserve help now. It is not too late to start. Change is possible. Therapy can be difficult and anxiety provoking – and overtime it can change your life for the better.