I am Kezia, stroke survivor and a member of BIND.
And hi, I'm Carrie, a stroke survivor, and also a member of BIND. And today we'd like to welcome Denise Chalk, our guest who is a rehabilitation counselor at Center for Neuro Skills with over 30 years experience. So welcome Denise.
Hi. Thanks for having me.
Absolutely. So excited to finally meet you. Yes.
So just tell us a little bit about you and your experience working with brain injury survivors.
Sure. So I'm originally from New Jersey, so I started there after I graduated from NYU. I went to, um, the Center for Head Injuries in Edison, New Jersey. I was there for almost a year before I moved to Texas. And started at Center for Neuro Skills in, gosh, 1989. So a really long time. Then I did go back in 03 from 03 to 09 back to New Jersey and, um, worked there doing community mental health and at a brain injury rehab facility. And that was time to go back to Texas.
So I went straight back to CNS and um, so I've been there going on 27 years. Oh. Long time.
Yeah know. And that's a really big change. New Jersey to Texas
Yes. Yeah. And it was a huge change back then. It's so different now. You know? It's grown so much. So there was a bit of a culture shock.
Yeah.
Yeah. So a little bit of adjustment me, man.
For sure. Yeah. Yeah. So why did you end up pursuing your career into like a counseling?
Well, that's a really good question because actually my undergraduate degree was in psychology and elementary education. I was training to be a teacher. Oh, wow. And my senior year in college, I actually did a semester at sea. So I was on a ship and, um, for four months, um, taking. And, um, during that time, my brother, who was 16, he was still at home, he had, um, an AVM rupture. Oh. And so he basically had a stroke, you know. Okay. At the age of 16.
So when I came home, I did my student teaching, but immediately after that it just, I think it, it was just such a huge thing for our family, you know, to deal with that. It really impacted me and I saw that there weren't. back then, this was 1982, so I know I'm really dating myself, but But in, in 1982, they didn't have, um, as many rehabilitation facilities. They really didn't have anything.
I mean, they sent my brother home after two, back to back six hour surgeries and said, you know, good luck. Have a good life. you know? Right. Yeah. So he had to, you know, I just saw how he had to struggle through to graduate from high school and, um, the good news is he ended up going to college and getting a law degree and, you know, so he's doing really well. Um, but I think that just impacted me so much that it just changed my course Yeah. Of my career.
So, I then, um, went back to school and got a graduate degree. And at that time what really appealed to me was the whole idea of like vocational rehabilitation. Um, helping people to, you know, get their life back and figure out what am I gonna do, you know, even though I have a disability mm-hmm. um, you know, and it was, it was regarding all different disabilities, you know, helping people. But, um, ultimately I chose neuro probably cuz of my. Yeah. I, I think that that's what impacted me.
Yeah. Oh my gosh. Of course. That's like listening to your story for sure, like that could definitely change your whole course in life. Right? And like you as a sister, right? Yes. Yeah. Wow. Oh yeah. Just seeing him go through that. And he's my only brother. I have two sisters. I'm the middle of three girls and we're all a year apart. And then my brother is, um, came four years after my younger sister. So, You know, just whew, Yeah. It really, um, changes
things. Yeah, it does. And I think that's what we hear over and over again, that when one person in the family is affected with the brain injury, it really does affect the whole family and changes everyone's life and where they thought things were gonna go and what was gonna happen. Definitely. Because it's not just the person. Survives a brain injury that's affected. It is, that's right. Definitely a family
affair. That's right. Yeah, absolutely. So, um, yeah, yeah. So right now that you were saying
like how, um, as a, so you were running for your, I'm not running, but you were going for your degree on psychology and K kids, and so now you change it to be more about adults and like, what's the difference between like a counselor and a normal counselor, like not normal, but a counselor. Neuro skills. Yeah,
so, so I started my. I got, I'm certified as a rehab counselor. Yes. And then, um, but here in Texas, you're, and so when I worked in New Jersey, I was licensed as a rehabilitation counselor moving back to Texas. Um, I, they, they don't recognize that it's licensed professional counselor, so it just meant that I had to. An exam and instead of just doing like 35, 3400 hours of supervision, I think I've done like 7,500 Wow. Hours between the two licenses. Yeah. So it was a lot Yeah.
Wow. When I, when I was in New Jersey, I studied under a, um, a psychiatrist. I, uh, he was my supervisor, so yeah, just gave me a little bit different, um, you. background,
I guess. Yeah. And I'm sure working, I mean, doing your education with kids helps a lot because even though as KE has said, now you're working with adults, as we all know, brain injured survivors kind of turn back into children after theirs. Right. Brain injury. That's right. Yeah. So you have to kind of have, have a different kind of mindset to deal with. Mm-hmm. big adult children,
Yeah, exactly. Yeah. And just understanding development, you know, the developmental process. Yeah. It was helpful. Yeah.
And like I think, uh, also right now that just like we go back to being kids at some point, how do you, uh, what happens like during, while we're in rehabilitation, like you work at a, um, a CNS center for neuro skills. You work there, and right now we're supposed to be there like through our, like our. insurance space for at that moment. So we're there. We kind of have to be there. Um, how do you deal with that?
Like what are the huge benefits of being, having a rehab, um, a counselor at that time?
Well, Basically, we help people adjust to the changes. And it's like we, we've been talking about, it's not just the patient, but we work with the families too. And um, so we're just trying to help them kind of navigate the whole system, you know, because we do more than just, I mean, certainly counseling and supporting them through their journey. Um, Being alongside of them and encouraging.
Um, we also get to be creative because if there's something that's like blocking them from making progress, um, whether it be their mood mm-hmm. you know, it has impacted it or what, you know, whatever it may be. Um, our job is to kind of help them figure. What's gonna keep them moving forward and helping them make progress
and, you know, that makes sense. And that, that kind of is like one of my big questions I had because I was that patient. I remember, I mean, I was in day room, I didn't go to cns, but I was at a day nor program, which I liked and I liked my counselor and I liked going in and talk to 'em, but. I didn't think I needed counseling. I was like, I don't, you know, I don't really know why I'm here and what I'm supposed to be doing, so. Right.
How do you encourage people like me, those patients that think they don't need counseling? Mm-hmm. to encourage them to get the help they really need, that we just don't realize we need it.
Right. Yeah. It's kind of like there's, you know, one of the techniques is called motivational interviewing is one aspect of like helping them to kind of, you know, you're not forcing them, but you're kind of peeling back the layers so that they can kind of see maybe why it's necessary. But the other thing is, it makes me laugh when you say that because I have a. I have a patient who said, who at one point was like, why am I in the principal's office? why am I, yeah.
I was like, me the principal. You know? So, um, you know, it's just sometimes people's perception, you know? Yeah. So I don't even really frame it well, that's one of the word first things I usually talk about with my patient is have you ever had counseling? You know, what's your perception of what counseling is? Yeah. Um, Because, um, you know, everybody has a different view of it, and I'm really, I really try to emphasize to them. I'm here for you just to be your advocate.
Um, you know, you can kind of use me in any way that that would be helpful to you. And so I just kind of go alongside them without like, pushing it on them so to speak. Yeah. You know? Yeah. That makes
sense. Yeah. Yeah. And I think, um, at the time when I was in rehabilitation, like I didn't feel like I needed it, but mostly it wasn't because I. like I was sitting in denial mode mostly cuz I was like, I, I can move. Mm-hmm. like, I'm not sad right now. I'm also like at the point where I'm like, I kind of know I need to do stuff, right? Mm-hmm. So that was my, but I also wasn't. I was at the time, there was a lot of people that were really like mad that they were there, like this anger.
Mm-hmm. and dealing with that. Mm-hmm. which maybe I did deal with anger when I was still in Chicago, but like once I moved here I was in a different phase. Um, so how do you treat the people that are just like really frustrated, angry, like, just frustrated in the position that they have at
that moment. Mm-hmm. Yeah, I mean, I think a lot of it goes back to, um, just developing the rapport with them and trying to find out what is it that, that they enjoy or have enjoyed doing. Finding a way to kind of, um, you know, help them know and give them hope and encouragement that there's still a lot of things that you can do. One of my favorite stories that I've used, um, over the years, even with groups is there's a guy named W Mitchell who was severely um, injured.
He was burned and was disabled, and then he ended up having a crash in an airplane and he became a. Uh, paraplegic on top of what he already had, burns and a brain injury and all that. And so what he, one of the things that he always said was, um, even though there's, um, you know, a thousand things I can't do, there's still, you know, 9,000 things that I can do. Right. So really kind of focusing on, um, you know, their strengths and.
You know, even, even kind of, I think what can be helpful is, um, finding someone else, maybe another patient who's a little bit further down the road in their recovery that they can connect with. Mm-hmm. and that can help them. Because, you know, sometimes from our perspective, even as a therapist, as hard as we try, we may not really be able to, we can empathize, but to be able to fully understand. Mm. What it's like. And even for, for each survivor, it's different. Right, right.
You know, so, um, just getting creative and thinking, is there someone like down the road, further down the road that can help them, that can, they can kind of see that it's gonna get better. I've seen that work really well. Yeah. For people.
You know, I, I agree. We're gonna take a quick little minute to remind everyone to go ahead and click that like button share and go ahead and subscribe if you haven't already. Thanks for listening. And now I was gonna ask, what you just said is like, something that I always say when I go speak for support groups is like, only a brain injured understands another brain injured. Mm-hmm.
I mean, our, the speech therapists, the occupational, all the therapists are great at doing what they do, but they really don't understand, and I can see what you're saying. The same for a counselor. Mm-hmm. that's one of the benefits of bind. therapy by doing. We're all here to help each other. We're therapists in our own right just being here and helping, encouraging everyone. Right.
But one of the things that we wondered kind of as, um, as you go through rehab, when insurance decides you're, it's time for you to move on, is there a continuum of care in rehab counseling that you encourage survivors to continue with when they leave?
Yeah, so I think. I think one of the things, because I've been doing this so long, I've kind of seen the change over the years. Not just in terms of like insurance and what they're willing to pay for, but also just in our knowledge of how the brain can rewire itself. Right. You know, and um, so I always encourage my patients to just remember. just because you're leaving us for whatever reason it is. You know, even if insurance paid and you're, you know, you have to, there's an end point, right?
Mm-hmm. that. continue to challenge yourself, you know, and hopefully during the course of my work with them, we've, we've already discussed and figured out things that they're gonna be doing, you know, um, um, kind of, you know, I was taught that like discharge planning starts on the first day, you know, kind of, because you wanna always have that objective and like, what, what's the end, end goal gonna look like?
Sure. And so, Really just helping them to, um, to figure out ways that they're gonna be productive and feel, you know, like even if it's not gainful employment, um, a place like bind where you're gonna be interacting with other people, you're gonna be, um, challenging yourself, keeping your brain stimulated, you know, just so anything that's gonna help in that regard. Right. Um, I think is really important. for people. Yeah. And I think right now, like,
um, I think you said it a little earlier, how like, as a counselor, you're there for brain injury survivors, but also for the families for mm-hmm. you know, just, it's not just for one person that was in an accident or whatever it was. Um, so for those people, like as our listeners or whoever's here listening to us, like as some resource in case like they're leaving, uh, rehabilitation centers and now. maybe they don't have a bind somewhere near them. Mm-hmm. Right.
What would be a good resource for someone to just continue the, um, to continue the effort of being, be
getting better? Yeah. I always try to consider that when someone's leaving, you know, what's gonna support that patient, what's gonna support their family. Um, I know that with, um, I always look for support groups in their area. Mm-hmm. and even we, we see a lot of patients too that have had strokes and there's, um, the stroke association you can put in the zip code and there's a stroke finder support group that people can, you know, can join. Um, now with things being virtual, Sure.
There's, there's a lot of opportunities in that regard too, which is helpful. Um, and just things that, like helping them find respite, you know? Yeah. And consider that how are they going to take care of themselves and what's that gonna look like for them, you know, in the future. Yeah. So, um, and it may be just giving them just the ideas of, you know, are you, maybe you're gonna need like a weekend with your family or friends, you know, just something to recharge your battery and Yeah.
You know, give you some, um, some respite. Yeah. For families.
Yeah. No, that, that definitely makes sense. I know that, um, when everything happened to me, I was like, only. I was 27 years old, or 28, honestly, I don't remember you guys Um, but I was, you know, this wouldn't happen to someone within that age. And for my mom, it was like this, like, it, it was too much for her to understand at the time. Right. But one of the things that she was told is to like, watch this movie. Um, it was on Netflix.
I can't remember the title so I shouldn't have mentioned it. but yeah. But, um, it was good for her to see it on someone. You know, like seeing on someone else and that kind of helped her understand these things. So I, you know, like, like I said at the time, maybe a counselor, I, I didn't see it the right way, but for, for my mom as a caregiver mm-hmm. as a mother to.
To someone that had just had a stroke, like that was so helpful for her and was able to communicate with like the rest of the family. Like, Hey, we need to give ha, give ke a patience. Like mm-hmm. we need to do this. Like, it was really
helpful. That's right. Yeah. There's so many good, um, helpful books and videos. Yeah. And you know, But one that I loved, that I have used a lot with, with patients is, um, there's life support music. I don't know if you've heard that. No. Oh, Jason Krier. It's a wonderful, um, I remember back when I purchased the D V D and um, you know, now I don't know how they do. He does have a TED talk. That's wonderful. But, and I use those a lot with my patients.
That's a great way too, to inform people and, um, and kind of, there's so many, um, survivor. You know out there. Yeah. That give people hope. But that's a really good one too. We were talking about crash reel earlier. Mm-hmm. that's another one. You know? So if you have someone young who is athletic and had a brain injury, that's a good one too. So, yeah. Yeah, I agree with you. That's a good way.
Yeah, I know. I think to help us still probably one of my favorite books that I read and my mom read that did us really good with my stroke of Insight. Oh, yes. By Dr. Julie. Jill Bolt. Jill Bolton. I was close and it was You were good. But yeah, I mean, but that was amazing book. I mean, yes. For parents to kind of look at and take. Definitely. But we also kind of talked about that, but I guess. key is when you leave rehabilitation.
If you, if we're getting something outta counseling and it was working, it's a good idea to keep with counseling. Yes. Find someone what maybe has the
nerve aspect and even, and even while someone is, um, a patient with us. So what I generally do is I like to see if I can see the patient with their family. That's, you know, able to happen. We do that. But also sometimes I'll just say to the family too, it'd be helpful for you to get your own counselor outside of, you know, cns, someone to support you that you can talk to, um, you know, and. Can help you through this journey. Right.
And then, um, definitely with my patients, you know, um, that to recommend someone for them ongoing I think is really important as well. Yeah. So I always try to do that. Hook them up with someone. Yeah. And I
know, like right now what you're saying, like about your patients and like you've been with CNS for a while now. What would some be like really great success stories as to like who you've been doing. I mean, you've been having great examples and like great things. I
know. Gosh, there's so, you know, I have to say, I think that that's probably my favorite part of being a counselor and why I stay so long is because, you know, I have seen such just the people that I have met.
over the course of my career, there has been so incredible people that I would never have met because they, you know, um, worked in construction, you know, and I just wouldn't, they, we wouldn't have crossed each other's paths probably, or, um, but I can recall a lady probably, oh, going back, I don't know, 15, 20 years maybe. And. Literally, she couldn't even sit up in her wheelchair. She had, her head was kind of lying on her shoulder and she was, she just, you know, was young.
She was in her thirties, but she had teenage kids and she just had a lot of different financial struggles and, um, just so many things. And I'm happy to say that I've kept in touch with her and she now lives on her own. You know, she doesn't work, but she.
You know, we had applied years ago for social security and she, she lives on that and just, I think that the thing that's so inspiring is, um, she probably herself never imagined that she would be able to live independently, but it just shows you how, um, to stay hopeful. and to know that, um, recovery, um, is possible and is, there's always a chance to that things are gonna be better.
Yeah. You know, and that is kind of one of our recurring themes is we try to tell everyone that there is life after brain injury. Mm-hmm. So if you've had one, keep your hope and keep positive because there is life after brain injury. Um, but before we wrap up here, is there a way. Any of our listeners would like to contact you or get more information about cns. That they could contact you? Like email or just the main website
or, sure, sure. Um, yeah, I mean, I, our, we, our main number, I can give that Yes. We'll,
we'll include all this in our show notes so that Oh, good. So that when they watch Yes, they'll have that information in the details. Absolutely.
Though I'm really open to, if somebody wants to contact me, you know, I'll, I'll give you my email. You can give them that. Okay. I'd be happy to do that, to talk with anyone. Uh, awesome. Sure.
Thank you so much for joining us. My pleasure, Denise. Um, we thank all of you for listening, and again, like I said, all information will be on the episode's description of our resources. And
if you want more information on BIND, um, or you would like to contact us as the hosts, Carrie, Kezia, um, you can email us at bind waves at the bind.org.
And again, don't forget to hit the light button, the share button, and the subscribe button. and hit notify if you're on YouTube. I always forget that one.
Yeah, you can find us on all of your favorite platforms, whether it's Spotify, whatever, whatever. You got it.
Okay. So
until next time. Until next time.