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Ever wondered how psychiatric nurse practitioners seamlessly blend talk therapy with medication management? In this illuminating conversation, we're joined by Dr. Kate Wheeler (lovingly dubbed "East Coast Kate") who shares her journey of maintaining a vibrant psychotherapy practice even after retiring from academia.

Dr. Wheeler offers a candid look at her approach to therapy, particularly her specialization in EMDR for trauma patients. With refreshing honesty, she explains why she prioritizes psychotherapy over medication management: "My goal is always to get people off of stuff rather than starting a medication." Her practical insights on patient screening, managing therapeutic relationships during extended absences, and documentation practices provide valuable guidance for practitioners at any stage.

Meanwhile, Dr. Kate Melino ("West Coast Kate") provides a fascinating contrast with her work in a home-based primary care setting. Her approach to therapy with homebound adults, many facing end-of-life issues, demonstrates how narrative therapy and existential approaches can be adapted to serve unique patient populations.

The conversation takes an enlightening turn when the hosts discuss documentation requirements, with Dr. Wheeler candidly sharing her preference for process notes over insurance-driven progress notes in her cash-based practice. This sparks a valuable discussion about balancing clinical needs with regulatory requirements.

Whether you're a psychiatric nurse practitioner looking to incorporate more therapy into your practice, a student wondering about the practical aspects of psychotherapy integration, or simply curious about the intersection of talk therapy and medication management, this episode delivers practical wisdom from clinicians who've successfully navigated these waters.

Want to learn more about bringing psychotherapy back to psychiatric practice? Subscribe to Peplau's Ghosts for more insightful conversations on advancing psychiatric mental health nurse practitioner practice.

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Dr Dan Wesemann

Email: daniel-wesemann@uiowa.edu

Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner

LinkedIn: www.linkedin.com/in/daniel-wesemann

Dr Kate Melino

Email: Katerina.Melino@ucsf.edu

Dr Sean Convoy

Email: sc585@duke.edu

Dr Kendra Delany

Email: Kendra@empowered-heart.com

Dr Melissa Chapman

Email: mchapman@pdastats.com

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Have we lost the art of truly seeing our patients? In this profound conversation with Cheryl Puntil, a psychodynamic psychotherapist who recently retired as Chief Nursing Officer at Austin Riggs Center, we explore the unique power nurses bring to therapeutic relationships after her remarkable 43-year career in psychiatric mental health nursing.

Cheryl shares why she chose nursing over other professions, calling it "the best profession ever" for its unique integration of psychology, medicine, and social work perspectives. With passionate conviction, she explains how nurses observe patients in contexts no other providers witness, creating unparalleled opportunities for meaningful connection and healing.

The conversation ventures into fascinating territory as Cheryl describes how psychodynamic principles operate not just in individual therapy but throughout entire organizations. She reveals the concept of "parallel process" – how themes emerging in staff meetings mysteriously appear in patient community meetings, creating unconscious connections throughout therapeutic communities.

Perhaps most compelling is Cheryl's concern about the future of psychodynamic nursing. Despite overwhelming evidence that combined therapy and medication approaches work better than either alone, healthcare systems increasingly devalue nurse psychotherapists who don't prescribe. Meanwhile, educational foundations weaken as non-psychiatric specialists teach mental health content in nursing programs, and many students never experience psychiatric clinical rotations.

The episode concludes with an inspiring tour of Austin Riggs Center's unique approach – an open-setting residential treatment facility where patients lead community meetings, engage in creative programming, and receive intensive psychodynamic psychotherapy four times weekly. This 100-year-old model stands as living proof that relationship-based care produces transformative results.

For anyone concerned about the direction of mental healthcare or seeking to deepen their therapeutic approach, this conversation offers both validation and a roadmap forward. What might our healthcare system look like if we truly valued knowing our patients?

CLARIFICATION FROM THE EPISODE

Mrs Cheryl Puntil does have a certificate in psychodynamic approach but is NOT a psychodynamic therapist as she does not provide direct care to patients in her role as CNO.

Also the the Austin Riggs Center opened in 2019 not 2017.

Please reach out with any other questions or comments to Mrs. Cheryl Puntil at cherylpuntil@gmail.com

Let’s Connect

Dr Dan Wesemann

Email: daniel-wesemann@uiowa.edu

Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner

LinkedIn: www.linkedin.com/in/daniel-wesemann

Dr Kate Melino

Email: Katerina.Melino@ucsf.edu

Dr Sean Convoy

Email: sc585@duke.edu

Dr Kendra Delany

Email: Kendra@empowered-heart.com

Dr Melissa Chapman

Email: mchapman@pdastats.com

Send us a text

What if you could teach your patients to be their own therapists? Chelsea Landolin, psychiatric-mental health nurse practitioner from UCSF (University of California-San Fransisco: Chelsea.Landolin@ucsf.edu), reveals how cognitive behavioral therapy creates lasting change beyond medication alone.

Chelsea shares her fascinating journey from psychopharmacology researcher to CBT advocate, describing that pivotal moment watching Carl Rogers' therapeutic approach with 'Gloria' and recognizing how empowering the right therapy can be. Her candid explanation of how our brains process negative thoughts literally—"When you say 'I'm a failure,' your brain believes it completely"—offers a compelling case for cognitive restructuring as an essential skill for mental health providers.

The conversation explores a powerful success story of an elderly patient who transformed decades of self-criticism through CBT, developing a gentler relationship with herself as she learned to challenge core beliefs about her worth. Chelsea's innovative approach adapts traditional CBT to fit into brief clinical encounters, making therapy accessible even in busy settings. "If you only have five minutes to do cognitive restructuring, you can make meaningful progress," she explains, describing how separating treatment over multiple sessions often deepens the therapeutic impact.

Most provocatively, Chelsea highlights how nurse practitioners are uniquely positioned to address America's mental health access crisis. While psychiatrists increasingly focus on medication management alone, NPs can bridge the treatment gap, especially for Medicare patients typically excluded from many therapy options. Her vision? A future where every psychiatric nurse practitioner receives comprehensive CBT training, dramatically expanding access to this life-changing therapy nationwide.

Ready to expand your therapeutic toolkit and help patients develop skills that last a lifetime? Like, subscribe, and comment to join the conversation about the evolving role of nurse practitioners in transformative mental healthcare.

Let’s Connect

Dr Dan Wesemann

Email: daniel-wesemann@uiowa.edu

Website: https://nursing.uiowa.edu/academics/dnp-programs/psych-mental-health-nurse-practitioner

LinkedIn: www.linkedin.com/in/daniel-wesemann

Dr Kate Melino

Email: Katerina.Melino@ucsf.edu

Dr Sean Convoy

Email: sc585@duke.edu

Dr Kendra Delany

Email: Kendra@empowered-heart.com

Dr Melissa Chapman

Email: mchapman@pdastats.com