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Parenting Now

August 31, 2015

Silhouette Happy Family on Walk in Action, Vector Illustration for Design

Becoming a parent – through birth, adoption, marriage – regardless of how, is the most joyful, terrifying, confusing, life-changing, earth-shattering, conflicting, miraculous, adventure you may jump or tiptoe into, with eyes wide open or shut tight, mind full of wonder, books full of advice, well-meaning loved ones with advice that conflicts with our books…

The reality is, each child is unique, and every parent has differences.  And as our child grows and develops, what was helpful when she was 6, you may as well as throw out with the bathwater now!

At Vista Hill SmartCare, we are frequently referred children with behavioral concerns, and moms and dads (or grandparents raising their grandchildren) who are asking for assistance with their parenting.   And we pride ourselves with utilizing evidence-based curricula with these families and in our Wellness groups to support them in improving their relationship and interventions.   The techniques and the guidelines provide wonderful foundations for improved parenting and child/parent relationships.

But my colleagues, my fellow parents/friends and myself have noticed a significant shift over the past few decades that should be factored in, when addressing parenting.

Life is different, and we cannot ignore that.  Of course, this is nothing new, and with each generation, parents face new challenges that their parents didn’t face, complicated and exacerbated  by advances in technology and other factors;  somehow, seemingly even more profound with this generation.

Our kids are growing up in a fast-paced, vibrant, interactive time, an era of instant gratification and instant familiarity that can lead to a disconnect from nature, a heightened need for approval, 100’s of “friends”, a sense of entitlement,  quick fixes, “boredom”.

I suggest that despite these changing times, developmental stages and changes are still very much the same, and children continue to need (and desire), perhaps more than ever, consistency, routine, predictability, stability, clear communication and boundaries, as well as of course, unconditional love, support and encouragement.  We have the awesome responsibility to our children to guide, teach and role-model the values and choices we hope to instill in them.  First and foremost, are their parents, not their friends.

Our kids, just like ourselves, learn from disappointments, from struggles, even from failures. They will learn to solve problems, they will learn to handle disappointments, they will build resiliency.   If we give them a bit of room to do so safely, hopefully they will take these lessons learned with them, as they move forward successfully into adulthood.

Mostly, we have the best intentions as parents.  We make mistakes, we have our own challenges, at times our kids even “hate” us. We’re judged by our own parents, by our kids’ teachers, even by strangers.  We occasionally even have our breakthroughs and “aha” moments.

And tomorrow, we get up and do it all over again.

Pamela Sachs, LCSW


Do We “Walk the Walk”?

July 23, 2015


As a supervisor and program manager of an integrated behavioral health care program, each year I assist my behavioral health educators and consultants with Vista Hill SmartCare to develop personal and/or professional goals, as part of their evaluation process, for the coming year.  As our program has progressed over time,  our team members are more likely to incorporate wellness goals for themselves, often stating that they have either been influenced by the wellness messages we promote through our program, or inspired by their patients’ motivation and commitment toward healthier lifestyle choices.  Goals might incorporate healthier eating, increased physical activity, adding daily meditation, affirmations, a yoga practice, aromatherapy, or other activities that support self-care.

We often find ourselves promoting the airlines’ safety proclamation of putting on your own air-mask first, before tending to your loved ones and other fellow passengers.  In other words, you can’t give to others if you don’t give to yourself first.  Those of us in the health fields may know this from our training, but in truth, we may be the least likely to put ourselves first. When caregivers are our patients, we try to help them to create a self-care plan.  But truly, all of us, whether officially caregivers or not, could, and should benefit from self-care.

Self-care of course includes caring for our physical selves – through proper nutrition, physical activity and proper sleep, but also those extra steps that only you know will be nourishing to you, such as a soak in a tub, a pedicure, a massage, walking barefoot on the sand…  as important as these things are, self-care is much more than tending to your physical needs.

Self-care must also include nurturing your emotional needs – whether it’s having alone time or time with friends, saying “no”, setting boundaries, taking time to read or to write, time to meditate, time to pursue artistic ventures… it is about refueling and nourishing yourself each and every day, mind and soul, as well as body.  The more you do so, the more you have to give to others.

Work environments have been recognizing the importance of self-care for their employees, adding workforce health programs that may include gyms or gym memberships, tobacco cessation programs, education on nutrition, sleep hygiene and others.

One of the most beautiful and encouraging examples I recently came across was at MedStar Georgetown University Hospital in Washington D.C.  They commissioned artist Stacey Sachs* to paint the stairwells of this five story building with inspirational wellness quotes as well as birds of flight, to encourage the employees to take the stairs. I can certainly imagine that taking the few extra moments to climb these stairs, with the beauty of these images and inspiring quotes, only refreshes and rejuvenates the health care workers as they  continue on with their day.




 It is also important to remember that your own self-care needs, just like the needs of those you care for, are fluid and dynamic.  I suggest that you take the time each day to check in, take inventory, and assess what you need today, right now.

Breathe, listen and accept.

Pamela Sachs, LCSW


*all paintings courtesy of Stacey Sachs

A Gift

June 4, 2015


In “The Small, Happy Life”, David Brooks shares a story of a man who’s most prized possession is a banged up pot, that he lovingly kept wrapped in a cloth.  When questioned as to why this pot was so special to the man, he explained that it reminded him that we do not all have to shine.

Brooks continues in his article to express his thoughts about gratitude .  When Vista Hill SmartCare recently was recognized as San Diego County Director’s Program of the Year, I do admit that we all enjoyed the opportunity to “shine” for our few moments of recognition.  But as I sat down to write our acceptance speech, what was most important for us, was to give thanks: thanks for being given the opportunity to create and implement a program that would bring preventative mental health and wellness services to rural communities in such creative ways, thanks to the rural clinics that readily accepted our integration, thanks to our collaborative partners in each of these communities, thanks to our teams of providers that are so welcoming and flexible, and most of all, thanks to the patients and community members who briefly allow us into their lives and are motivated to make changes toward wellness.

Our services are designed to be brief.  And so our hope is that we provide the patients with some useful tools and healthful choices that they will incorporate into their lives as they move forward.   Occasionally we hear back after a time, that they are doing better, or that they did indeed maintain some changes that have been helpful.  But more often than not, patients move on, and we move on to assist others, not knowing for sure what the outcomes might be.

After delivering our brief thank you speech at the Behavioral Health Recognition Dinner the other night, we sat back down at our table to listen to the other wonderful awards and speeches.  I felt someone take the vacant seat beside me.  I glanced over, and a young woman gave me a big, friendly smile.  She asked me if I had worked at the County children’s inpatient hospital 20+ years prior.  Indeed I had, it had been my first position when I moved to San Diego almost 30 years ago.  She told me her name, and I immediately recognized the young girl she had been, in her current smiling face.  She told me she had recognized my voice when I had been giving my brief speech earlier, and wanted to come over to thank me for helping her, so many years ago.

I expressed my gratitude for her taking the time to seek me out, and to let me know she is doing just fine.  This was my moment to shine.

Pamela Sachs, LCSW

Art & Wellness

May 7, 2015


As an integrated behavioral health program tasked with providing wellness events for members of rural communities, Vista Hill SmartCare has recently begun to include art along with yoga, mindfulness, nature and other activities.  Our hope has been that with the addition of art, we could offer additional avenues for folks to experience emotional and physical health.

Whether offering these activities with children or adults, the first hurdle is moving past the worry that one must have some sort of artistic “talent” in order to benefit from participating in art activities.  But in our experience, once we do so, the benefits are great.

At the crux of SmartCare is a holistic approach to wellness, incorporating mind, body and spirit.  We support the mindset that emotional health supports physical health, and vice versa.  The idea of art as medicine has been embraced throughout the ages, and more recently, a growing body of empirical studies and anecdotal evidence suggesting that the arts of all kinds, including music, dance and the visual arts, are healing, and are being integrated into all sorts of healthcare settings.

I have written here previously about the importance of health/wellness and stress management.  One of the biggest benefits of incorporating art into one’s life is for the management of stress: the act of creating is mindful, and it can help you to find balance in your daily routine.

One of our favorite activities to introduce to Wellness participants is the creation and/or coloring of Mandalas, which have been used throughout history for meditation and healing. “Mandala” comes from Sanskrit, meaning “circle”, and represent the Universe.  Mandalas were first used in therapy by Carl Jung, who found that the act of drawing mandalas had a calming effect on patients while at the same time facilitating psychic integration. Whether creating original Mandalas from found materials, drawing them from imagination, or coloring printed Mandalas, we receive highly positive feedback from participants in these activities.

Although we are not certified Art Therapists, we have found incorporating art into our Wellness Activities to certainly be therapeutic.  Participants report that engaging in the creation of art reduces stress and anger, and express appreciation for the empowering benefits, as it is used as a means of self-expression.

As we assist others to become re-connected to their natural creative impulses, our own joy meets and exceeds theirs!  As we look forward to continued partnerships with community art teachers and instructors, we anticipate further beauty, health and wellness in all of the communities in which we serve.

And here is some amazing inspiration for you:  Blind man paints

Pamela Sachs, LCSW

Encouraging Hope & Empowerment through Complementary & Alternative Medicine

March 10, 2015



Vista Hill SmartCare is an Integrated Behavioral Health Care Program.  “Integrated” because we are partnered with rural health care clinics, have teams of behavioral health care members working side by side the providers, and providing their wellness interventions within the health care setting.

Additionally though, I believe that we strive to be “Integrated” by supporting our patients’ rights to choose to include Complementary and Alternative Medicine (CAM) as a part of their health care.  And of course, the patient is the 3rd,  but primary,  key partner.

“Alternative medicine refers to those practices explicitly used for the purpose of medical intervention, health promotion or disease prevention which are not routinely taught at U.S. medical schools nor routinely underwritten by third-party payers within the U.S. health care system”,  according to Harvard.

The preventative focus of CAM is a perfect fit for SmartCare: strengthening and preserving health vs. curing illness.  CAM covers many practices: there are whole medical systems, which include ancient healing systems such as Ayurveda and traditional Chinese medicine,  homeopathy and naturopathy;  mind-body medicine, such as  meditation, prayer, relaxation and art therapies; biologically based practices, which include dietary supplements and herbal remedies; manipulation and body based practices, including chiropractic and osteopathic manipulation and massage; and energy medicine, such as qi gong, therapeutic touch, reiki and magnet therapy.

As we work in partnership with our partnering health clinics, we of course communicate with the  providers, so that they are aware of any complementary or alternative practices our patients may be utilizing.  Many patients have much to teach us with the practices they bring from their own cultures, for example, through their herbs and dietary practices as well as spiritual beliefs.

It’s been a delight to pair yoga and art in our recent wellness camps to over 100 Ramona youth.  Additionally, after we learned more about reiki and aromatherapy at our annual retreat, we are excited to bring this information out to the communities we serve through Wellness events.

And, of course, Mindfulness practices have become a routine intervention in many of our Wellness activities as well as our individual and family interventions.

Our SmartCare teams strive to be a part of our patients’ healing journey, by being mindful of our own healing environments and incorporating wellness in ways that are significant to each of us, through our ongoing training and our daily practices.

It seems to us that being an equal partner and having a sense of control in their health care and well-being, situations that often times seem to feel uncontrollable, is a vital factor in our patients’ motivation, participation and positive outcomes.  Just as health care providers can and do successfully work in partnership with behavioral health providers for the ultimate care and well-being of their patients, so too can conventional medicine and alternative medicine successfully work together for ultimate wellness.


Pamela Sachs, LCSW


Pain is Personal

January 12, 2015


Pain can be acute, pain can be chronic. Pain is physical, pain is emotional.  Pain can be debilitating, pain can lead to despair.  Those in severe, lasting pain want to be heard, to be believed, to be understood, to be validated.   But more than anything, they will go to all extremes to find relief from their pain.

Pain is caused by injury, by illness, by lifestyle choices, by life circumstances, and by as many triggers as there are experiences to pain.  There is no single, simple, “one size fits all” answer or relief from pain.

And so, of course, a large percentage of patients that visit their primary care provider are seeking relief from pain.

When prescribed medications haven’t provided relief, some patients may resort to taking medications prescribed to others, or to self-medicating with illegal drugs.  Or, if they have become “tolerant” to the medications they have taken over a period of time, they may seek another provider, and another, to obtain the prescriptions they have come to depend on.  An extremely frightening fact:  approximately 45 people die every day from prescription drug overdose in this country, and these deaths are attributed to people who are using the drugs as prescribed, with doctor supervision.

As many pain medications can be highly addictive, health care providers are appropriately cautious in managing the pain needs of their patients.  They may require periodic drug screens, “pain contracts”, and/or other referrals to closely manage and monitor their patients’ care.  Patients, in turn, may interpret this treatment as a distrust in the doctor/patient relationship, thus, leading to a breakdown in open and honest communication, of course a key component in the pathway toward wellness.

Our Vista Hill SmartCare teams, who partner with health clinics in rural communities, are tasked with assisting patients with “pain management”.    Many patients that are referred to us live in pain daily.  They may not be able to work.  It may have compromised their relationships, their daily activities, their sleep.  They may even have suicidal thoughts.   We know that there are no magical cures, no secrets to pain management.  We do our best to listen and encourage, to help our patients incorporate lifestyle changes that may enhance the treatments they are undergoing.

It is strongly recommended that those in pain be receptive (and have access to) an integrated approach to care, considering incorporating such practices as acupuncture, reiki, yoga and other movement, aromatherapy, meditation, massage,  and other healing methods in addition to or instead of prescribed pain medication treatment, that can have the side effects of nausea and constipation, disrupt one’s immune system and sexual function, and cloud  thinking and functioning, in addition to the risk of addiction.

A key component to managing pain is taking an active, participatory role in treatment and regaining a sense of control, especially when feeling at such a loss of control over the pain and access to medication that the patient may feel they need.

Our SmartCare teams are looking forward to incorporating “Pain Schools” at our partnering health clinic sites, thanks to the development of an integrative system by Kim Swanson, Ph.D., Behavioral Health Consultant at St. Charles Family Care in Richmond, Oregon.  Her 4 week curriculum encourages participants to better identify and define their pain, chronicle their pain symptoms in a pain diary, to learn and incorporate coping skills such as breathing techniques, pacing, progressive muscle relaxation, reframing fear,  guided imagery and meditation, and  learning to set realistic goals, improve relationships and communication skills, addressing sleep hygiene, and exercise.

In partnership with our patients and health providers we hope to improve the quality of lives of those who experience pain, regardless of origin.

Pamela Sachs, LCSW


6 Degrees of Kindness

November 13, 2014



I was personally, very recently, reminded of how small our world has become, how we seem to be all connected in one way or another; most of us have our own “small world” stories, especially now in this age of Facebook, LinkedIn and other social networks, but I was surprised to find that the theory of 6 degrees of separation is actually over 80 years old.  This theory is that everyone is actually six or fewer steps away from every other person in the world, so that any two people can find a connection in a maximum of six steps.

My recent experience occurred on Facebook, and connected me by way of only two other people, to a very dear friend that I lost way too soon to cancer last year.  It was a surprise encounter that touched my heart, and had me wonder that somehow it was meant to happen so that I would have another opportunity to cherish her memory.

I write about this today, in the month of November, for several reasons:  Veterans Day has just passed, World Kindness Day is 11.13.14 and it is the month of Thanksgiving.

Tragically, there has rarely been a time in our world’s history that we have called on our young men and women to fight for peace.  But, rather timely, I also came across this message on Facebook the other day:  “If you wish the next person peace, then one day we will all have peace”.    If we believe that we are all connected, then this thought is wonderfully true… and perhaps it is the more effective way toward peace.

And this brings me to World Kindness Day, which we at SmartCare look forward to promoting often!  Each year (and often throughout each year, when we promote Random Acts of Kindness) we are again and again amazed at the receptivity of patients, community members and collaborative partners’ excitement to pass on random acts of kindness.

Just last month, as we completed our year-long Youth Yoga, Art & Wellness Camps with our last two sessions, our theme was kindness toward self and others.  We distributed “Kindness Cards” to each youngster, and encouraged them to tell us how they will share them forward.  I was so pleased to see that each child took several extra cards with them.

There is goodness all around us, because we are connected; and because we are all connected, we need to be kind to one another.  Through this 6 degrees of separation, we can hope and assume that kindness will continue to spread, not just on 11.13.14, but each day throughout the year.

And this is something to be truly grateful for!

Pamela Sachs, LCSW


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