The brain of a person living with mental health challenges is often like a locked room. Imagine a key ring holding a few different keys–only one of which can open the locked room and allow a new chance at healing to enter. Attempting to find the perfect key can be frustrating, but persistence prevails. Sometimes, we have to try over one key and sometimes it is a combination of keys that unlocks the door and reveals the possibilities of an integrated approach to therapy.
Multimodal approaches to therapy that address mental health challenges allow us to face these challenges head-on and acknowledge that different modes of therapy will work for different people based on their unique needs. After all, we are all wired differently, we all learn differently, and we all experience the world differently. It makes sense that a one-size-fits-all approach to therapy is ineffective at best, and damaging at worst.
A multimodal approach incorporates tried-and-true treatments with modern techniques, such as biofeedback and integration with digital tools. Let’s discuss three real-life situations where a multimodal approach has been put into practice in a professional setting, a community setting, and a more personal setting.
Police Officer Training
Police officers frequently interact with individuals living with mental health challenges in their day-to-day on the job. Typically, in police officer training, the focus is on physical safety, and while there may be some education on mental health issues, the real world application of interacting with the mentally ill population is lacking.
I worked closely with the deputy chief of Edmonton Police Services, who recognized that his officers needed a novel approach to training when it came to mental health challenges. The officers, by their own admission, felt inadequately prepared to help a citizen with a mental health challenge.
Using a multimodal approach, we developed a training that combined role-playing with behavioural feedback. Officers were paired with actors to enact a scenario that the officer was likely to encounter in the course of a work shift. Officers were challenged to consider the emotional impact of their body language and non-verbal cues on the individual with a mental health challenge, and how this behaviour could escalate a situation. Though the intent of their behaviour wasn’t aggression, it was perceived as such by the actors–a missing key in their officer training.
Reducing Student Suicide
In 2013, I heard a story on the radio about a small city in Alberta dealing with a spate of student suicides. The community was reeling from these losses, having perceived no warning signs from these high school students. I felt compelled to reach out to the school superintendent in this district and offer my help to develop a program that would tackle this issue.
Working with the superintendent, his team, local educators and clinical research group, we implemented a multimodal program that brought together local health care and mental health providers with active community involvement. The Empowering a Multimodal Pathway Towards Healthy Youth (EMPATHY) program was developed with a sense of urgency and utilized multiple interventions not usually used together.
One intervention in particular turned out to be the best-fitting key: a rapid response approach to student issues. Students were asked to help identify at-risk students, a process that was anonymous. The intervention team reached out to the families of the students determined to be at risk to begin a dialogue. This allowed the team to determine a course of therapy and action for the at-risk student that was appropriate for them, rather than suggesting the same treatment for every student. The program had a ripple effect, reducing stress and anxiety of those impacted by the mental health challenges of their loved ones. In five years, the suicide rate of the students who took part in EMPATHY dropped to 0%, proving that a multimodal approach that allows practitioners to develop an individualized treatment plan works.
Survivors of Child Sexual Abuse
In 2014, Little Warriors, a charity that focuses on awareness, prevention and treatment of child sexual abuse, opened the Be Brave Ranch. As a member of the Little Warriors board, I worked with my fellow board members and donors to develop the Be Brave Ranch, which is a trauma-informed, evidence-based treatment centre that serves children who have been sexually abused.
The Be Brave Ranch program, which takes a multimodal approach to provide therapy, provides healing to the children who come to the ranch. Children come for an intensive four-week session, after which there is regular follow up. The design of the program has evolved over the years, incorporating lessons learned from our research.
The program offers therapy in group and individual settings, which work together using a daily schedule that includes mindfulness, art therapy, animal-assisted therapy, exercise and music. The key to success in this program was the use of cohorts. Individuals moved through the program with a group that remained stable during their time at the ranch. Members of the cohort supported each other as they went through their treatment, which had a positive impact on the depression, anxiety, and PTSD experienced by the children in the program.
The multimodal approach works.
I know from first-hand experience that these integrated and intensive programs can be effective. Moving away from a one-size-fits-all approach towards a more individualized approach is not a radical concept; it makes total sense. Having access to different tools and modalities makes it more likely that a person living with mental health challenges will hit on the therapy or treatment that works for them. Remember, not all keys will unlock the door; sometimes it takes multiple tries and various combinations. Boldly cribbing from a Canadian musical duo, I call this type of therapy a “ubiquitous synergy seeker.” Therapies need to be accessible, available and, most of all, effective.
