Navigating Mental Health Support During a Crisis: What You Need to Know By Kerrie Toole, LICSW, Executive Director
As September marks National Suicide Prevention Month, it’s a meaningful time to reflect on the resources available when we or someone we care about faces a mental health crisis. While many people are familiar with emergency numbers like 911, 988, or the Samaritans hotline, there are also other, often more accessible, options for getting help right in your community. Today, I want to walk through what you can expect when seeking emergency mental health services, so that if the time comes, you feel informed and supported. Resources You Can Turn to in a Crisis For those in Massachusetts, the Massachusetts Behavioral Health Help Line offers real-time support 24/7. Whether you prefer to call or text, help is just a moment away at 833-773-2445. Additionally, Community Behavioral Health Centers (CBHCs) provide 24/7 walk-in services, as well as mobile services, meaning they can come to your home or another location if that’s where you feel safest. You can find more details about these services here. If you're local to the Metrowest area of Massachusetts, there are several Emergency Service Provider (ESP) agencies that can conduct emergency assessments and provide care without needing to go to the emergency room. In some cases, these agencies are also the ones conducting evaluations if you do go to the ER. Here's a quick guide to some of these providers:
What Happens During an Emergency Mental Health Evaluation Whether you’re evaluated in an emergency room, at a CBHC, or through an ESP agency, the process is quite similar and designed with care and thoroughness in mind. A trained clinician will meet with you—and any supportive person you have with you—to assess the situation. They’ll look at both risk and safety factors and, with your permission, may gather additional information from any mental health providers you’re currently seeing. Once the clinician has all the necessary information, they’ll consult with a team of professionals to determine the most appropriate level of care for you. This could be anything from a referral for outpatient services to inpatient hospitalization. If you're in an emergency room, there will be an added step of a medical evaluation to ensure there are no underlying physical issues that need attention. Understanding Your Care Options After an evaluation, the agency will help you access the right level of care. Here’s a breakdown of what that could look like:
You May Not Need to Go to the Emergency Room In many cases, you can access these services without stepping foot in an emergency room. By reaching out directly to your local ESP or CBHC, you can get the help you need in a more familiar, less overwhelming environment. Navigating a mental health crisis can be a deeply personal and often overwhelming experience, but knowing what to expect and who to call can make all the difference. Whether it's through a quick text, a phone call, or a walk-in appointment, support is available—and it’s closer than you might think. If you or someone you know is struggling, don’t hesitate to reach out. There’s help, hope, and people ready to stand by your side. The Art of Art TherapyBy Niamh Smithers, M.A.
This spring I had the pleasure of attending a webinar called “Nurturing the “Art” in the Art of Therapy” hosted by Victor Yalom, PhD and Judy Rubin, PhD, ATR-BC. Dr. Yalom facilitated a discussion with Dr. Rubin about her experience as a Registered Art Therapist with over 50 years of experience; reviewing some of her favorite moments as an art therapist, showing recorded demonstrations of art therapy sessions, and exploring how she views the use of art in the therapeutic process. As someone who has always aspired to incorporate art into counseling sessions, this webinar gave me so much insight, inspiration, and motivation to offer more art-therapy based interventions to my clients. One of my favorite parts of the webinar was seeing Dr. Judy Rubin on an episode of Mr. Roger’s Neighborhood, a classic show that aired beginning in the late 1960’s. In the episode, Dr. Rubin showcased how children engaged in art, creativity, and exploration of ideas. She appeared authentically inspired by each child’s artwork and how their perspectives informed how and what they created with materials she provided. Dr. Rubin emphasized the importance of “play” and “choice” when using art as a tool for exploring oneself and one’s experiences, while also highlighting there is no age limit for this type of intervention. Dr. Rubin discussed how many of her clients who had been resistant to incorporating art into their therapy sessions were often artists themselves who were focused on the “final product” or were individuals who struggled to engage in “play.” As an artist myself, this idea resonated with me due to often having my art evaluated or critiqued in classes or by people close to me. The idea that someone would be interpreting or making judgements about the art that I was creating made it much harder to focus on the process and having fun. This webinar reminded me of one of my favorite phrases when it comes to art and therapy alike: “Process over product.” Dr. Rubin also introduced the idea of approaching art as another language and stated, “By only using words we are limiting the information.” Story-telling and use of imagery are important components of many cultures across the world, and this quote really validated what I have felt for many years, even before becoming a therapist: Art is a universal experience and can be a powerful change agent when used in the therapeutic process. Dr. Rubin shared, “You don’t have to be an artist to do art therapy. It’s not about being an artist, it’s about expressing yourself in a different language.” Similar to how words can be lost in translation between languages, Dr. Rubin noted the imperativeness of maintaining the client as the expert and asking questions about a client’s art or artistic process, rather than making interpretations, translations, observations, or judgements. She explored how art therapists may sometimes offer premature responses to a client’s art and reiterated the importance of getting to know oneself as a provider in an effort to prevent our own experiences from blending into the client’s: “Get to know yourself to prevent your own interpretations clouding message of the client.” My hope is that, by giving clients more choice in how they use their time in sessions and having various art supplies available, utilizing art in therapy may lead to deeper connection, understanding, and exploration, or, at the very least, lead to a client trying something they’ve never tried before! Clinician Spotlight: An Interview with Nicole Curtis, LICSWLauren Chapin, LICSW
Welcome back to Clinician Spotlight, a series where I sit down with some of our wonderful therapists for a cozy conversation about work, mental health, and many life tidbits in between. Recently, I had the pleasure of getting to know our newest clinician, Nicole. She discussed the joy she feels working with children and their families, her approach to clinical work, and where she loves to snowboard. Lauren: Welcome, Nicole! You're new to Castlebrook, where are you coming from and what’s your background? Nicole: I work full-time as a medical social worker at UMass Memorial Medical Center, where I specialize in neurology and neurosurgery. Although I've been in this role for only three years, my entire social work career prior to this was focused on pediatrics. Working with children and their families has always been my passion within the clinical field. Lauren: Wow! How did you get into medical social work? Nicole: I had been wanting to delve deeper into this field for a few years, and then, when COVID hit, the opportunity came up unexpectedly. Lauren: That's great! What made you want to start doing individual therapy again? Nicole: I miss the clinical work and the life-changing impact it can have. I love seeing the successes of my clients, which I don’t experience as often in the medical world. In hospitals, people are often at their most vulnerable, so it can be challenging to witness their progress. I needed to return to a role where I can make a difference by talking with someone and helping them achieve their goals, rather than dealing with the often broken systems that many people face. Lauren: Yeah, that makes total sense. Do you work only with kids or a variety? Nicole: In my medical social work job, I work exclusively with individuals who are 18 and older. However, at Castlebrook, I'll be working with children and their families, as well as couples, which is where my true passion lies. It’s a small percentage of the population I haven’t yet reached, but I do have a special interest in foster families and adoption. These areas hold a special place in my heart, and I’m deeply committed to helping children and parents involved in these situations. Whether it's assisting kids currently in foster care and supporting their parents in reunification or helping families navigate the next chapter when relationships have strained, working with these families is a significant reason why I entered social work. I’m excited to return to serving this particular community. Lauren: That's amazing. How did you get started working with kids in general? Nicole: My first step into social work was with the Department of Children and Families (DCF). I started there during my undergraduate work. I’ve had personal experience with DCF through distant family members, which has given me a unique perspective on these situations from both a professional and personal standpoint. This experience has deepened my understanding and reinforced my commitment to working with children and supporting them across various systems. Lauren: What style of therapy do you gravitate towards? Especially for kids, families, and couples. Nicole: I think working with kiddos is different. If a child needs one-on-one play therapy or floor therapy to address their needs, I can provide that. I really enjoy structured family work, which is a big part of my clinical skills, along with Cognitive Behavioral Therapy (CBT) for parents and their kids. Those are the main areas where my clinical skills are focused, but structured family work is my niche. That’s definitely the type of work I love the most. Lauren: What do you mean by structured family work? Nicole: Working from the bottom up, generational patterns often lead to specific traumas for clients. It’s important to delve deep into these issues rather than just addressing surface-level concerns. This involves understanding how you were raised, how you're raising your children, and how they perceive your parenting. Exploring the family structure—often referred to as the family tree—can reveal long-standing relationship issues. For instance, you might identify patterns from your upbringing that you don’t want to repeat with your kids. Remember, it’s never too late to address and change these patterns. This approach is also helpful for young adults and teenagers trying to understand their parents. Lauren: That sounds like it goes with your style of meeting people where they're at when you first start. Nicole: Yeah, I think a key thing for me when I start with a client is that, while there are obviously reasons why you want to go to therapy, we should get to know each other first. My approach is that, although I am an expert in social work, I am not an expert in your life. You are the expert on yourself, so I need you to teach me who you are. I need to understand you to best support you. Your feedback on my suggestions is crucial for making progress toward your goals. If I make a suggestion and it doesn’t work for you, then we need to go back to the drawing board. I’m here to guide you, not to wave a magic wand and fix all your problems. My role is to help you figure out what will work better for you than what was tried before. Lauren: What might you tell a parent who's nervous about bringing their child to therapy? Nicole: You know, there are all different reasons, like the culture of therapy, the stigma of mental illness, and your cultural and religious beliefs. The first thing I would say is that it's not going to be easy; it's a scary and uncomfortable step. But the best thing is to recognize that this uncomfortable situation is happening and let's deal with it together. Let’s figure out where you’re at and be with you at that point. If you just want to talk about simple things, then let’s do that and focus on surface-level issues. I’ll be transparent that surface-level discussions might not get you to your eventual goals, but we’ll take it day by day. It’s about being able to sit with the discomfort and acknowledging that it’s okay to feel uncomfortable. Lauren: That’s great. Shifting gears, what do you like to do in your spare time? Nicole: I love being outdoors and snowboarding—I'm definitely a winter person through and through. We’re a snowboarding family, which is a lot of fun. On the flip side, I also enjoy the ocean, so you can find me at the beach in the summer or in the mountains during the winter. Recently, I’ve taken up reading, which I never thought I’d say. I’ve also started embroidering. Lauren: What have you been reading? Nicole: I'm a psychological thriller kind of gal, so anything Frida McFadden. But, I’ve also just started reading this sobby love story, it's like all based on a romantic comedy family dynamic, so yeah that's what I've been reading! Lauren: Great! I like metaphors, and I like how metaphors can be used in therapy. Can you think of any particular intervention or metaphor you use that often lands with your clients? Nicole: It’s just a saying, but one thing I often tell my clients is that being uncomfortable is okay. It doesn’t make things any easier, but it’s still okay. The key is to process that discomfort. I’ve found that this has been a common theme in my sessions this past week. It’s interesting to see how people react to this idea. They often realize that it’s true—uncomfortable situations are something we naturally try to avoid, whether it’s a social interaction or confronting someone about our feelings. Acknowledging that discomfort is the first step toward dealing with it. Lauren: What is your favorite vacation spot? Nicole:I love San Diego, California, but I must say that the state of Maine holds a very special place in my heart, no matter how cold the water is. I even have a tattoo of their motto, “The Way Life Should Be.” My parents had a place there for 20 years. Lauren: What's one thing that you would really want a potential client to know about you? Nicole: Nothing you say will scare me away from supporting you. No matter what you’re going through or what you might feel isn’t okay to say out loud, it’s okay to share with me. I approach each situation with an open, caring, and empathetic heart. So, no matter what you say or do, I’ll always support you on your therapeutic journey. That’s what’s truly important. |
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Mission Statement
Castlebrook Counseling Services, Inc. is a group of private practice clinicians with a shared goal of strengthening our community by providing therapy and clinical support designed for children, adults, and families to successfully meet life’s challenges.