The Tight Five: Origin Stories from The Second Row

NOTE: The initial post of this episode was edited for brevity, in the spirit of offering more to those that are interested, this post includes the video and full transcript of my conversation with Matt, ENJOY!

The Tight Five: Origin Stories from The Second Row is a series of conversations with smart, thought-provoking folks who are doing great things in ‘The Front Row’ of work, mental health, marketing, service and technology and how they came to their personal and professional path in life. The series is named after the moniker of the combined Front Row (two props and the hooker in the middle) and the Second Row in the rugby scrum which I explained in this previous post.

Today I’m proud to present the second episode of The Tight Five: Origin Stories from The Second Row featuring Matthew Doyle, a therapist and entrepreneur who lives and works in Salem, Massachusetts and a friend of mine for almost 30 years, dating back to our time together at Boston College. The founder and owner of Castle Hill Counseling & Consulting beginning in 2015, Doyle is a thought leader and expert on how to support troubled teenage boys and their families. Involved in mental health and education for over 20 years, Doyle’s work with families and adolescents facing mental health challenges has enabled his client to excel in school, at home and in life.

This conversation delves into the dynamics of the modern family, how a therapist simultaneously manages a clinical team, while also growing a business and why gaming is often the highway to understanding the ever elusive personality of a teenager. Enjoy!

Matt Landry:

There are five questions, three of them are for you, and two of them are consistent ones that I ask everybody. I'll just dive into the first one. How important to you is the family dynamic when working with kids and teens, especially.

Matthew Doyle:

Family dynamics are essential in working with kids and teenagers. So, thinking about kids, they have their nest and it's all about the nest. They're out of the nest for many hours a day at school, going on activities, different things like that. But the nest is where they are always returning to.

So, all the early learning and development and patterns that kids and teenagers are both exposed to starts in the home environment and you have to think about how important it is to engage all parts of that system. If you are meeting with a kid one time per week and then individual therapy capacity. And if that work exists purely in a silo, there's no reinforcement loop. But the reinforcement loop is where the work really takes hold, and it starts to expand in terms of the people that are available to support that child or adolescent well-being.

Matt Landry:

Earlier in your career, you were doing a lot of work with the wrap around concept, how has the concept evolved into the way the Castle Hill is doing its work today?

Matthew Doyle:

We try to think around three tiers of contact and three tiers of support.

Tier one is really all about getting to know a child or teenager and bringing a consistent, weekly, individual therapy approach to children and adolescents. We do a lot of walking and talking. We've been recently experimenting with doing some parallel gaming with teenagers, and that's been interesting, because even 5 years ago most parents would have sets something like you're going to be gaming with my teenager like during therapy time?!

But the amount of information we can get sitting and parallel gaming with a teenager. Specifically in areas like frustration, tolerance, communication strategies, skill building around how they build up a new part of a world that they're working on in their gaming. There's a lot of executive functioning pieces in there as well. As a result, we can identify the sorts of “Hotspots” that kids are experiencing within their gaming world that very much mirror what's happening outside of the gaming world.

Tier Two is really the parent partnership piece that we were talking about earlier. Building in those feedback loops, identifying patterns and strategies in the family and home.

Tier Three is how we expand that strategic brainstorming time with as many people as possible that are involved in that child's life.

It's essential that we communicate with their medication prescriber. We see things that might not be seen in an office or on a virtual zoom session during prescriber’s medication check-ins. That information is really valuable to share with the provider, and it also enables us to get into really good, rich, strategic, brainstorming conversations.

So that's a very important area that we're tying in the medical component with mental health and with the family to try and make sure that everyone that’s involved in that child's life is aligned. Very similarly we are actively involved with key teachers, as well as parents are really wanting us to have communication with guidance counselors within school systems and people who are overseeing special education in a variety of school districts.

Having a good consistent strategy available to people across all these different environments is only going to support the well-being of the child first and foremost and by extent the parent and the caretaking system, and then we get into brainstorming conversations.

Matt Landry:

Meanwhile, you're also running a business. How do you tackle the operational and business requirements of running Castle Hill, while still balancing that with overseeing a team of therapists? What's the key there?

Matthew Doyle:

It is a combination of trial and error, and deliberately laying out on a daily and weekly basis, ‘How do I make sure I'm at my peak?’ I wrap my energy around a balance of really paying close attention to the most important aspects of the business that make it function well and progressively moving the business forward.

It starts with an amazing team. We now have 13 people within Castle Hill, and they each know that I am paying attention to their individual needs and the direction of each of the therapists on the team. I meet with all of my therapists formally at least one time per week, which is something we call clinical supervision and that is something that I value very highly.

Matt Landry:

What are the other 2?

Matthew Doyle:

The second piece is really truly understanding the parts of business, that I haven't really been exposed to previously, in a more formal way. Third, there’s me constantly learning about ways to streamline our business activities. It's a time seesaw. Everything is time. If you put 2 hours here, it's going to affect 2 hours there.

Matt Landry:

The knock on effect.

Matthew Doyle:

Absolutely. It's about putting good time investment into the business and doing the administrative related activities upfront will really help the process down the road as we continue to expand and grow.

Matt Landry:

And just adding to your wisdom of being a businessperson.

Matthew Doyle:

That's a mantra I'm very comfortable with now. It took me a while to get comfortable with it, but I do not know everything, but I know how to find what I need. That's been the real key. I am really dialed into what I need, and paying attention to my energy and making decisions that I know are in my best interest health wise and energy wise that has a direct impact on my ability to be very present with the business.

Matt Landry:

After the world shut down because of Covid, what are some of the impacts on the clients and the communities you work with, what are you're seeing three and a half years later.

Matthew Doyle:

One of the things that has been really striking around this period of time is the loss of control. The more I've been thinking about this while talking with people, from a psychological framework standpoint, it is a major component of what we are still in recovery from, and that it shows up in a variety of ways.

It shows up in the significant social, emotional regression that we’ve seen in children and adolescents, there's a direct correlation to isolation during a very pivotal developmental point in time that was lost, that's a big deal, and we're not out of it yet in a lot of ways.

We're seeing academic losses happening with kids. Retention has been compromised. We're seeing attentional and concentration issues with social navigation in a much more consistent way than we did three years ago, and when I say consistent this is now impacting everyone.

Matt Landry:

What about amongst your team, how has Covid affected them?

Matthew Doyle:

There was the fear factor was very high for a while. We had to make a lot of decisions about safety that we had always taken into consideration, there's now a psychological and a physical safety element that is different. It's shifting, but it is still very much here. Out of my 13 team members, 8 of us just this year have tested Covid positive, that’s 50% of our team!

So… how do we navigate that? Right? It was very interesting. Now for every session we have a Plan A and a Plan B. That's something new that's come out of the past three years. We have our scheduled time, and we have a backup virtual time available for every session automatically via our Google calendar set-up.

There's been a lot of moving and shifting and as a team, even getting comfortable with virtual therapy, which is a whole different world, it's a whole different sort of engagement practice, sitting virtually with an 8 year old with attentional issues. You can't throw the ball back and forth in the same way to bring the attention back to you during the session. We’ve been using Zoom whiteboard, AID.com is phenomenal. There are Plugins where you can bring in little characters that zoom in to your virtual session, which is so different for us.

Matt Landry:

It must be somewhat invigorating and changing to be able to work with your therapist about a virtual session, and like, have you tried using characters? Have you done jumping, Jacks? Have you done this?

Matthew Doyle:

Absolutely, things really had to shift, it's been an very interesting process.

One thought around your initial COVID question here, was a white paper that came out of New York by an organization called Fair Health and it was an eye-opening white paper (found HERE) to read through, and it complied a large number of health insurance claims between January to November 2020. Minors, defined as kids under the age of 18, there were 32 billion insurance claims analyzed. Okay, 1 billion with a B! There was a 103% increase in mental health claims for kids between January 2020 and November 2020.

Okay, so that works to the following… 99% increase in self-harm claims, 193% increase in anxiety based claims and a 90% in claims connected to depression.

That’s what we're seeing, kids are just feeling unsettled, and they are just coming into this recovery period after feeling like they had lost control in their lives. It's really an amazing sort of recovery effort, especially when you expand and include all of these different people and these different sorts of disciplines and arenas, right?

Matt Landry:

Okay, so close it out. What book or author, I think, has been a touchstone for you professionally?

Matthew Doyle:

There are people like a gentleman named William Madsen,  a very talented psychologist based in Watertown, Massachusetts who sadly passed away recently. I've been heavily influenced by his work over the past 15 years. His work is really about the importance of human connection. First and foremost, and then building out the technical aspects from there, but the key philosophy of staying curious with people, holding back from jumping into solutions prematurely. Getting into ‘the solution’ is our natural tendency, but it's not always the best step in that moment. What’s important is getting into the understanding of what is driving a dynamic for someone or an energy for someone or a or a mental health shift for someone, his work is amazing.

I also really like Dr. Ross Green, who created the collaborative problem-solving model. It's a model that is very popular within our practice. Is it just a tremendous way to support again the technical design of a really good action plan, but also the empathy that you need. Much like Madsen’s work, it's about staying in that empathic and curious mindset is one that we must be consciously aware of all the time and that's a big part of our supervision that happens every week.

Matt Landry:

Thank you for sharing your wisdom.

Matthew Doyle:

This was awesome. Thank you so much, and let's do this again.

Matt Landry:

Sounds good, alright. Talk to you!