Ken Huey 0:00

Welcome to the Voice of Hope, where bold leaders and healers share how they're building hope, not just talking about it. I'm Dr. Ken Huey. Let's meet the change makers transforming lives from the therapy room to the boardroom. Hello, welcome today's episode. I don't usually do this. Hello, and welcome to today's episode of The Voice of Hope. Our guest today is Zach Schaefer, Executive Director at Mountain Valley Treatment Center, and a dedicated occupational therapist specializing in mental health. He helps individuals overcome challenges to engage in the daily activities that give life meaning and has led innovative programs that promote resilience, independence, and recovery across the lifespan. Zach, welcome. We're so glad to have you. Thanks, Ken. Appreciate you giving me opportunity to be on the show.

Zachary Schafer 0:44

You better. We'd like to start with what brought you to this point? What is your why? Yeah, that's a great question and a big question. When I share this story, I often go kind of way back to elementary school. I was a young boy with some ADHD, a little active in the classroom, liked to make people laugh, liked to make some stimulation in my environment because it filled my internal needs. Wasn't always the way teachers wanted me to be behaving and engaging. So in fourth grade, I actually, as a part of a corrective action plan for me, I was to go to a special needs classroom and help out during my recess time. And when I first went down there, I wasn't sure what to expect. And when I got in there and started engaging with these kids who had disabilities, I absolutely fell in love with it. And even though my corrective action plan was kind of over with, I found myself continuously choosing to spend a recess time going there to spend time with the kids and engage them in different activities, reading, playing games, anything I could do to put a smile on their face. So I felt really started to light me up. And so that kind of started me on my path towards wanting to be a helper, uh, wanting to be an OT. I got really familiar with OT's role with people with developmental disabilities and autism, and spent some time in high school shadowing our occupational therapist at our high school doing some really cool work. And then in college, I started to go through some of my own mental health challenges. Myself, my brother went through about a pretty serious addiction that really had a big impact on my family. And it kind of culminated in my grad school years where my best friend from high school actually ended up taking his own life. And so after that happened, I kind of vowed to myself that I was going to dedicate the rest of my life and my career towards helping people with mental health challenges. And so that's sort of what still drives me today. And honestly, is once you get into the work, it just kind of becomes this own flywheel effect where like you're starting to impact people's lives and make a difference in their lives and save people who may otherwise not be here if they weren't met with the love and support and compassion that they need. And so I think that's what started it, but what keeps me uh are the families and the kids that I get to work with every day.

Ken Huey 2:51

How do you help individuals focus on what matters to them rather than just what's the matter with it?

Zachary Schafer 2:58

That's a great question. And I think given the fact that I work with adolescents and young adults, it's a challenging question because I think that this is the time in life where you're really trying to figure out what does matter and what doesn't matter. And like your prefrontal cortex is developing and you're starting to kind of see behind the veil of Oz. And it's very easy to develop that classic adolescent cynicism a bit about the world and how things are. And what I do, and it's not really what I do, what we do at Mount Valley is give them a sense of community. Because I think a sense of community all of a sudden really starts to highlight really quick what matters and what doesn't matter. Like I remember even more recently, I'm on a journey. I'm a dad now, and this has been a new journey for me. I've got two kids under two. And even just like becoming a dad, like how much more what actually matters to me has become so much more clear the amount of extra fat in my life that I've trim because it just why was I even doing that before? Why was I spending my time doing that? That doesn't matter, right? And so I think people really help us recognize what matters. And so I think what we do and what I do is try to connect people with communities that they want to belong to and be a part of. And that really helps connect them with what matters most to them.

Ken Huey 4:19

Can you explain how meaningful daily participation supports overall mental health and well-being?

Zachary Schafer 4:25

Yeah, so this is at the heart of occupational therapy. I think it's something that not everyone fully understands about our profession. I think people have heard about TGs working with folks with strokes or elderly folks who are aging, people with dementia, as I mentioned before, people with developmental disabilities, but it all comes down to this core concept that if we can't participate in life, if we can't do the things that matter to us or that we feel like matter to those around us, our own sense of internal confidence, confidence, well-being, all of that starts to get atrophied, right? And so sometimes what's most important for people isn't just talking and processing through what's going on with them. That's an important part of the therapeutic process. But then being able to actually make a difference in the world around that, that's what everyone wants for themselves. That's what most people want for themselves, is to do something. We are inherently doers as human beings. And so really there's a lot of therapy in just helping people participate in everyday activities for particularly for people who've had a hard time doing that. I think a lot of us in the as my professional call it, the ableist community take for granted things, just like brushing your teeth and being able to get dressed, right? And like you realize how fragile these things are until you start working with a veteran who's had amputations and can't tie his shoes anymore, or uh a person mid-age who's at the height of their career who has a stroke and cannot or type on a keyboard, right? Like we we get really dissonant from the intricacies that it takes to be a human being and to do all the things that we do. And I get a lot of passion in just helping people get back to doing some of those simple things again.

Ken Huey 6:10

So you're working with anxiety, OCD, and there can be a real sense of hopelessness when you're confronted with that. How do you foster hope and resilience in your clients?

Zachary Schafer 6:22

Yeah, I think one of the best ways that we do that, and the one of the best ways to do that in general is to connect people to other story arcs that remind them of their own. So I think inspiring hope for a lot of people is being able to see like that could be me. And so one thing that we do really well here at Mountain Valley is sort of this phased model that we have, and where once you're getting closer towards the end of graduation, you have to give back to the younger kids who are just kind of committed to the community. I call them younger. They're not always younger. Sometimes it's a 13-year-old mentoring a 20-year-old with the way our ages work, but they're further along their process of transformation than the other person is, right? And so being able to mentor them and to kind of show them like this is where you could be at the end of this, if we're able to kind of put in the work and like this process does actually make a difference. Um graduation day. So today was a graduation day on campus. When someone graduates, it's just one graduation for that one individual, and the rest of the community gets to sit around and watch and listen to today's parents talk about the journey that their family's been on, and they get to walk away, kind of saying, like, that could be me. And then the final big piece uh is you can came on and delivered an awesome episode for me on my podcast, but our Fear Less Podcast does a lot of that too, because a lot of the podcast episodes that I host are actually with our alumni who are sharing their story and sharing what they've been through and where they are now in their lives. And there's a lot of kids who come into the program and like I listened to that podcast with so, and that inspired me to sign up to come here because they got that hope of like there's a brighter future, but they have to be able to tie it back to their own personal experience. And so I think that's where because we're so specific with working with anxiety and OCD, they're just surrounded by other people who they can really relate to, and it all comes back to that relationship piece of things, and that's one of the biggest catalysts for hope, I think.

Ken Huey 8:13

Can you share a story of a patient or a client whose progress? Yeah, I'll do it again. Share a story with us about some client whose progress or recovery really impacted you.

Zachary Schafer 8:26

Yeah, that's a great question. I mean, so many of our kids had impacted me from many different ways. There was a young man here uh a few years ago who reminded me a lot of my best friends that I lost. And so I think it impacted me a lot just because it helped me see what my buddy might have been going through in a way that I didn't see it at the time. Unfortunately, with the way he chose to go about ending his life, we didn't get any sense of closure. There was no note, there was nothing left behind, and it kind of explained what was going on for him. And so me and my larger group of friends have been left guessing a little bit around what might have been happening, and it almost felt like in that moment, like that resident was brought to Mount Valley in a way that kind of maybe highlights and reflects back some of the things because there were just so much similarities between the story and the family background that they came from. And I often talked about my buddy passing away from suicide, and a lot of the times when we think suicide, we think depression, but I think there was a lot of fear in there. I think there was a lot of anxiety in there. And so this client really, for me, brought home this idea that like we don't just end up at a place of depressed and suicidal. There's a lot of things that lead us to that. And a lot of times it's fear, it's trauma, it's a lack of self-confidence through because of wife experiences that we've had. And so that was a client that I think had a really big impact on me because not only were we able to address his suicidality, but we did it by addressing his anxiety and his fear. And I think that there's a lot of anxiety and fear out there in the world. And I think he just really reminded me why we're on the mission that we're on.

Ken Huey 10:07

Tell us about the strategies that you use to help clients overcome setbacks.

Zachary Schafer 10:13

Yeah, so I mean, in our model at Mount Valley, we use exposure and response prevention. That's our primary model. And so when you're using that model, that's what's called an expectancy violation. So a lot of people are afraid of failure because they have an expectation of what that failure is going to mean. And exposure to therapy is all about putting them in front of that feared response and creating a different outcome than what they expected to come, right? That's why I thought if I failed, then my parents would be incredibly disappointed in me. And then our process is taking them through failing and having their parents show up more loving and more supportive than they ever believed that they could, right? And so when we're talking about building resiliency for people, we're talking about putting them in situations where their fears actually do come true, but the outcome that comes from their fear coming true does not happen, right? Like they don't knock it into college, they don't, everybody doesn't hate them, right? And so we're challenging these cognitive distortions, not through talking about it, not that you're trying to convince them differently through words, but through lived experience of actually facing these things in real life and using that real experience to kind of change the way the brain associates that failure, right? So a lot of times kids leave thinking like I don't know what's gonna happen when I fail, or I don't know what the outcome of this set pack is going to be. But in the long run, I have agency in actually shifting how this event impacts me, right? Like the story doesn't end at the end of the event, the story just begins, and how this event gets laid into the narrative of my entire life, but this chapter, I can do it to write the next chapter, which gives this chapter context, right? And so like giving that agency back of like it's not what happened to you, it's what you do with it, right? Uh all of those kinds of concepts, but do you get through the lived experience of actually living those things out is how we go about building it.

Ken Huey 12:13

Let's pivot to occupational therapy just for a second. So tell me about occupational therapy interventions and how they address both emotional and functional challenges simultaneously.

Zachary Schafer 12:24

Yeah, so OTs are a very interesting profession. I'll just say we started in mental health. That's where the roots of our profession are, and a lot of people don't recognize that. But the first OTs, the first American association of occupational therapists were psychiatrists who were working in institutions in the late 1800s and early 1900s, and the whole moral hygiene movement was going on at the time, which was this movement towards treating people in institutions more humanely, which meant engaging them in activities. And once they started to engage them in activities, they realized that this long-term schizophrenic individual, like all of a sudden, started some of their symptoms that they were seeing on the outside were shifting because they gave them meaningful occupations to do, meaningful activities to do, right? And so there's this deep correlation between our mental health, our spiritual health, our sense of being human with doing. And so that's where OT is really strategic in like we're not just gonna do the basketball because someone says basketball is really good for your mental health, right? It's like we're gonna do an activity that actually gets at the core of what you felt like you were here to do, right? What your purpose is, and like those are the kinds of activities that are gonna give a lot of your life meaning. I think the other piece too is UT's really practical. Like we're not symptom focused very much, we're not a bottom-up approach, we're a top-down approach. And so we'll look at you and say, you know, you're an anxious and depressed 13-year-old. We look at you and say, you're a brother, you're a son, you're a student, you're an athlete, and like these are the roles and the different identities that you have in the world, and how can we help you fulfill those functions better rather than trying to treat the symptoms? Um, we'll always say that OT goes best with something that is more treatment-oriented, right? So even when you look at us in like physical disability settings, you have somebody who just had a surgery. Yes, we need the surgeon, but that we need someone that's showing you how to use your leg again, right? And so, like, and then more than mental health, I often like to think about like my psychotherapists as my surgeons. Like, we need someone that's going in there and digging in, like, where did that come from? And how did you learn that and doing all that cognitive processing? But then, like, once you're kind of thinking differently and all of that, how do you actually rehabilitate your ability to engage in the world? Because that's been stripped from you from the mental health piece. So really rehabilitational professionals, and I think that's how we complement uh really good comprehensive mental health treatment.

Ken Huey 14:52

The hopelessness you can feel when you're staring at anxiety. Is this just my life for the rest of my life? I'm never gonna feel okay again. What would you say to somebody who came to you and said, I don't even know how to have hope?

Zachary Schafer 15:07

Oh man, that's a big question. And we get it a lot. Um, I try not to overpromise. Uh, but you know, one of the things that we do know from the literature and from the research is that anxiety is highly treatable. Uh, and there's really good, robust research out there that like this is not something you have to live with forever. Like, you can find freedom from this fear, and there's tons of people that have done it, and there's a lot of good clinical evidence and protocols behind it, and they've been doing it for years and years. The other piece is it's a both and, right? And if you did live this way forever, how can we use anxiety as a strength? Like, I eat people in my organization that have a higher sensitivity for anxiety, that have a higher sensitivity for the worst possible outcome or the risks, right? Like those people make great risk managers, they make really good litigation people and legal people because they're looking at the nitty gritty of the words that are being used and all of that kind of stuff, right? So it's both you don't have to live with this forever. And if you do, and this is a part of like a core part of who you are, you just have an anxious, more temperament, you have a role to play in society. And how do we help you actually make this a superpower for you in a way that you maybe didn't think about before?

Ken Huey 16:24

Using it as a superpower, that's just really cool. So, an aside, I enjoyed that a lot. So I've got a daughter who's got anxiety and OCD and just stumbled on ERP a little while ago, and I wanted to show her this one and see if I can't get her a little bit excited. Okay. So looking ahead, what innovations in OT or anxiety and OCD treatment, depression, but particularly in OT, what do you see in the future that's coming?

Zachary Schafer 16:50

Yeah, I appreciate that question. I think I see some stuff coming in the future that I'm a little worried about. So maybe I'll share that. And it's artificial intelligence. And I think that there is a lot that AI can do of learning that very quickly as an executive director for a program, the ways that it can improve efficiency, approve reporting, be able to create really digestible memories of things that are going on in a meeting room and things along those lines. But I worry about our adolescents and our young adults not engaging in their minds and their bodies in a way that's supporting their nervous system and brain development, right? So like human beings were like meant to lift things and push things, and it's not just for muscle development, like all of that input gets organized in the sensory cortex of the brain, which feeds the higher cortex and the emotional centers of the brain. And so, like, I actually think the uptick we're seeing in mental health challenges in our youth is directly correlated to us not engaging our bodies in the world in the ways that we're actually designed to be doing. And so, like, we're wired very primitively, like we haven't evolved that much from a neurobiology and like an anatomical makeup standpoint as a species, and we're not actually meeting a lot of those needs with the way that we're living the world. And so I think the most innovative thing OT can do is actually getting people back to the basics of like what's actually gonna fulfill the human body and the human mind and the human spirit, and maybe helping put up some guardrails around like what adolescents are actually spending their time doing. Like it's incredibly unnatural for the brain to be processing so much movement and auditory and visual input while being stationary and sitting still. And that's what watching TikTok is, that's what playing video games is. It's like the brain's used to getting that much stimulation because it's running through the woods in real life, not through a virtual reality headset. And so there's a mix match between the input that the muscles are getting and the nervous system is getting versus what the brain is getting. And that's always going to lead to some challenging developmental delays that I think we're seeing in a lot of our youth.

Ken Huey 19:02

You know what's interesting. I've got one son who uses Chat GPT as kind of a thought partner and considers therapeutic kinds of things, but it just bounces ideas and it seems to work really well. And then I've got a daughter who has anxiety and the echo chamber of ChatGPT when used in that way, and the lack of the real connection and stuff, I think speaks to part of what you're saying. That for my daughter, it's not particularly helpful, and I would not be excited if she was using AI to try and get through her struggles, as opposed to my son just using it as a thought partner. I think you're speaking to some of that for specifically anxiety and OCD.

Zachary Schafer 19:42

Yeah, definitely. I mean, one of the things that keeps anxiety and OCD maintained in in somebody is this idea of reassurance seeking. And so like you can ask and even set up your AI model to reassure you and like sort of be super affirmative. You can also set it up to be really challenging, right? And kind of to challenge some of your cognitive distortions, or with the way it sounds like your son is using it, too. And this has been my experience. It's like how you phrase the question also impacts how the intelligence answers you. And so like it can be very reassuring if you ask it a question in a very particular way, or it can be very open-ended and challenged you if you ask it in a particular way. And obviously, a lot of our people with a predisposition to anxiety, OCD, or something along those lines, what they're looking for is that immediate hit of reassurance that helps them feel safer in the moment, but in the long run, it perpetuates all of that symptomology.

Ken Huey 20:39

All right. Well, Zach, I gotta say, you're impacting the planet in a very thoughtful and complete way, especially for anxiety and depression and OCD. And I really just appreciate you spending some time thinking through some of the current issues in the landscape with us. Thank you very much.

Zachary Schafer 20:57

Yeah, thanks, Karen. It's been great to be on here, and it's been great to get to know you and your team more. I've had a few of them on our podcast, and every single person I've come across been as world class. So I really appreciate the opportunity to collaborate with you guys.

Ken Huey 21:09

Thanks for joining us on The Voice of Hope. If you were inspired, share the light. And remember, hope's not just a feeling, it's a force. We'll see you next time.