Mind Matters: Practitioners and patients navigate new frontiers of mental health care

Last edited 8:50 a.m., Feb, 28, 2024 [Editor's note: A title has been corrected.]

As mental health care evolves, pioneering treatments are making strides toward transforming the way practitioners and patients address mental wellness. From the therapeutic realms of eye movement desensitization and reprocessing and Cereset to the new use of federally approved psychedelics like esketamine, these modalities offer groundbreaking approaches to healing.

After witnessing a murder while on vacation and grappling with the ensuing trauma, Whitney Gillenwaters found solace and stability through EMDR therapy after returning home to Springfield.

“My therapist recognized immediately that EMDR would be helpful for me, and I was able to get an appointment within a few days,” she said.

EMDR, which underwent its first clinical trial in 1989, has been found to help people work through traumatic memories, according to trauma expert Wanda Holloway of Burrell Behavioral Health. Patients are led to think about their trauma for a short time while also doing something else that distracts them, like following a therapist’s finger movements with their eyes. This dual attention can make the traumatic memory feel less intense and less upsetting for patients, she said.

“EMDR logically allows them to release the fears attached to their traumatic experience and let them look at it from the experience from a distance, versus feeling stuck or frozen,” said Holloway, a licensed professional counselor.

Gillenwaters describes the experience as nothing short of magical.

She said, “I recognize there is a solid scientific basis to the process, but it really felt magical the way all the very strong emotional reactions I was still having surrounding memories of the violence I had witnessed slipped away and seemed to get physically smaller in my mind.”

Holloway said EMDR has shown effectiveness across a spectrum of conditions, including post-traumatic stress disorder, anxiety and depression. She was first trained in EMDR following the 2011 Joplin tornado when a humanitarian assistance program was sent in to train community professionals. After seeing the rapid effectiveness, Holloway said she became certified through the EMDR International Association and now is an approved consultant and international trainer.

“We have a waitlist of about 80 people to get that treatment,” said Holloway, who serves as Burrell’s outpatient clinical provider supervisor. “It continues to grow, and a lot of people are interested and have heard a lot of positive results.”

With hundreds of EMDR counselors listed in the Springfield region with the EMDR International Association, Holloway recommends patients perform due diligence on the practitioner’s training and certifications.

“We’re dealing with the brain, which is such a powerful tool,” she said, noting EMDRIA.org has a searchable database of certified therapists.

Holloway said next steps for EMDR involves group settings and virtual care platforms.

Harmonizing the mind
Cereset, a blend of the words cerebrum and reset, is a new treatment company using patented BrainEcho technology and represents another noninvasive modality gaining popularity in the area. Launched locally in mid-2023 by Diana Eul, a licensed professional counselor, Cereset Springfield focuses on aiding individuals to reach mental equilibrium and wellness by optimizing their brain wave patterns.

Eul said the technology utilizes electroencephalography to capture brain wave activity, which is then transformed into sound through Cereset’s BrainEcho algorithm. The unique sound, crafted with vocals and instruments by a Nashville-based group, is played back to the individual through earbuds while they relax in a chair. This process allows the brain to recognize its own patterns in the sound, facilitating a return to equilibrium.

“The brain wants to be in balance,” Eul says. “What we’re doing with the brain echoing is allowing the brain to hear its own brain wave, recognize where it’s out of balance, and reset.”

Eul first learned of the technology during an International Institute for Trauma and Addiction Professionals conference in 2021 and immediately wanted to learn more. After going through a protocol designed to help treat insomnia, Eul said she was convinced.

“After my third session, I went to bed at 8:30 p.m. and awoke the next morning, uninterrupted, at 8:30 a.m.,” she said. “This was the first time in 25 years I had slept like that.”

The technology, which formally came on the market in 2018, was first developed to research PTSD for service people at Walter Reed Army Medical Center and is still undergoing studies at Wake Forest University School of Medicine and Womack Army Medical Center in North Carolina.

Eul said because the technology is still so new and it’s not part of the established medical protocol, there are some hurdles for people wanting to try it, particularly cost. Currently, the treatment is not covered by insurance and starts at $1,580 for a five-session package.

“Anytime you bring a new modality to town, and it’s not from here, it takes a minute to stick,” Eul said, citing a similar process for EMDR when regional therapists started using it. “It’s very much about finding that stepping stone or that place to start.”

Breaking through the fog
These steps in managing mental health range from noninvasive methods to the pioneering use of psychedelics. Esketamine, which comes from one half of the ketamine molecule – an anesthetic long utilized in depression treatment – gained Food and Drug Administration approval in 2019. This variation of ketamine   is specifically approved for use as a nasal spray targeting treatment-resistant depression, marking a significant advancement in therapeutic options. Currently the use of ketamine in its entire molecular form is not FDA approved. “When someone with depression has failed two antidepressants, we can serve them with these modalities,” said Dr. Garima Singh, chief medical officer at Burrell Behavioral Health. “It’s another important tool in our toolbox as a psychiatrist, to provide to the patients.”

Burrell Behavioral Health started working on implementing protocols last year for Spravato, the name brand of esketamine, and this month started offering the treatment within the Brightli-Burrell system.

“Right now, we are offering it in Columbia region and set to span to Kansas City and Springfield once they complete undergoing renovations,” Singh said.

“The goal is to taper the treatment, but in some cases, patients may require coming back for another round.”

Other clinics in the area also offer the treatment, including Eustasis Psychiatric and Addiction Health, where co-founder and CEO Breanna Jain said she has seen positive results with an unexpected opportunity in peer support.

“I love our Spravato groups because I see their depression scores and symptoms going down both objectively and subjectively, and a lot of that is due to Spravato. But some of it I think is hope in a modality and the peer support they receive,” Jain said.

At Eustasis, Spravato treatment is done in a designated room with recliners and dark shades, making the experience comfortable for the client. Often coming in groups of two to four patients, Jain said many have started their own support groups together.

“They are going through horrible treatment-resistant depression, and nobody can understand that but somebody else who has also been through it,” she said. “They meet someone else who has gotten their life back from this therapy, and that is a gratifying experience.”

Amanda DiMartini, a licensed professional counselor at Thrive and Be Well LLC, has seen similar effects. Her practice, which began offering this therapy in 2022, aims to integrate counseling with appropriate pharmaceuticals.

DiMartini said her practice also encourages patients to take on new habits to support their wellness, highlighting the transformative potential of the treatment.

“To see people have success has been just thrilling because you can see them personally evolve in one session, and then the next week things are that much better for them,” DiMartini said.

Both Jain and DiMartini acknowledged a stigma surrounding esketamine because of its classification as a psychedelic.

“I think looking at it as a psychedelic makes it sound experimental, but it’s not,” Jain said. “The patients who get treatment are pretty high functioning; they could be teachers, parents, grandparents, nurses, etc. – people like you and me – and they feel safe because it’s an FDA-approved treatment. I am watching closely along with the rest of the psychiatric community on new treatment modalities that will give our patients success.”

On the front end of integrating psychedelics into mainstream health care are attorneys Kimberly Chew and Natasha Sumner, who co-founded Husch Blackwell’s Psychedelics and Emerging Therapies Practice Group in California. This team is dedicated to guiding clients through the regulatory landscape associated with the development of new drugs. Recognizing the significant potential of psychedelics for mental health treatment, their initiative was motivated by an expanding base of research and a pressing need for innovative therapeutic options.

“As an industry, it’s facing a lot of stigma,” Chew said, adding that a lot of communication still needs to be done separating the work on psychedelics in the 1960s from the medical model it is becoming today.

Currently, the FDA is reviewing a new drug application for the use of MDMA – commonly known as ecstasy – alongside therapy for treatment for PTSD. If approved, which Sumner said could happen as early as late August, it would mark the first authorized therapy of its kind. Sumner said once approved, it could still take years to trickle down to an affordable solution for patients.

“We really do care about what this means for our communities,” Sumner said. “It’s just so needed, and it’s really amazing to be alive today.”