At Handel Behavioral Health, every therapist takes a unique approach to putting clients first. During our chat with Carolyn Pacheco, a Licensed Mental Health Counselor in Massachusetts, we learned how she tailors even the smallest details of treatment to the individual, helping them feel comfortable from the very first session.
Carolyn specializes in anxiety, grief processing, and neurodivergent diagnoses, including ADHD, autism and OCD. “All of these hit home for me in various ways,” she says. “But it’s really the process of creatively collaborating with the person that I find most magnetizing to this line of work.”
A career rooted in curiosity
Carolyn has always been naturally curious and eager to help. When she took a psychology class in high school, she fell down a “rabbit hole of questions,” which led to furthering her education and seeking a career path in the field.
“I landed at Handel Behavioral Health after experiencing extreme burnout in a large organization,” she said, explaining that HBH offers the balance she was looking for.
Now, she’s able to show up fully in both her work and her life, and she brings that same ethos into her meetings with clients. By taking the time to understand each person’s interests, needs, and preferences, she can use that knowledge to shape their treatment plan.
Meeting clients where they are
Mindfulness practices, such as using grounding techniques or noticing physical sensations, show up regularly in Carolyn’s treatment plans, as do solution-focused approaches that can have a positive emotional, mental or physical impact.
A good example of this is her traffic light exercise for people who deal with anxiety. Here’s how it might work:
You’re heading home at the end of your workday, and you’re already worrying about what kind of mood your partner is going to be in. Instead of running through every possible scenario in your head, you get in touch with your partner and ask if it’s a green light (everything’s great!), yellow light (proceed with caution), or red light (bad day all around, pick up a pizza on your way home) kind of day.
An exercise like this could make it easier for someone with anxiety to shift to the next stage of their day. That little bit of preparation can make the changeover from the workday to home life less stressful for everyone.
Overall, Carolyn’s approach to treatment is person-centered, and she lets the client lead the way when it comes to goal-setting. From there, progress is measured based on the client’s individualized report, appropriate assessments, and reflections during therapy sessions. Throughout the process, open communication is a priority, even when the subject is difficult to talk about.
Honest conversations in a safe space
Carolyn stresses that she creates a safe space for her clients to speak about whatever they need to: “I’ve had a lot of clients who are very cautious about how honest they are about intrusive thoughts or self-harm. What I always say to those folks is, ‘I will never make a decision without you.’”
Carolyn goes on to explain why she won’t, for example, place a crisis call without first having a conversation with the client. “My job is to check on safety and to educate people and make sure they have the right coping skills. I don’t want to traumatize anyone. I don’t want to send them to a place that’s going to be too intense for what’s really called for.”
In an escalated situation, Carolyn often does safety scaling with the client to gauge exactly what’s going on. For example, when working with the neurodivergent population, Carolyn says a lot of expressions can be intensified. What’s verbalized might have a different context than what it seems at first, though, and more clarity is needed to understand where thoughts are coming from.
Getting to know each client is an important part of discovering how to best support them. That process starts with the very first appointment.
What’s a first session with Carolyn like?
During an initial therapy session with a new client, Carolyn goes over the following:
- Current challenges
- History of symptoms
- Individual life experiences
- Cultural considerations
- Personal interests
- Past experiences with therapy
Additionally, Carolyn discusses expectations for treatment, such as session frequency and whether they’ll meet in-person or virtually.
When it comes to frequency, there isn’t one straight answer, and the timing might change as the client’s situation evolves. For example, someone working through a crisis will likely want to meet more than someone in a routine part of their life.
For clients who have had therapy in the past, Carolyn likes to discuss the pros and cons of those experiences. By knowing why a client is returning to therapy or what didn’t work for them in their past, she can best plan a way forward.
And while those conversations help Carolyn customize treatment to each client, she’s also mindful of the smaller things that can make therapy more approachable. Case in point: Carolyn gives clients permission to eat during sessions. “Please don’t come hangry to therapy!” she jokes.
This bit of leeway serves an important purpose regarding self-care: Therapy is already uncomfortable for some clients, and giving them the liberty to snack or sip during the session can help them feel more at ease. And for clients who are squeezing in a session during a busy day, it may be the only chance they have to eat.
Take the next step
Carolyn’s interest in helping people better understand themselves extends beyond her therapy sessions. Lately, Carolyn’s been recommending two books. The first is It Didn’t Start with You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle by Mark Wolynn, and the second is The Last Lecture by Randy Pausch.
If you’re ready for one-on-one treatment, you can learn more about Carolyn here. You can also get in touch with Carolyn by calling 413-779-8217, or you can see her availability calendar here.
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