Spotlight Interview With PlushCare’s Melissa Dowd, LMFT
Meet Melissa Dowd, Licensed Marriage and Family Therapist (LMFT) at PlushCare. Melissa received her Master’s in Counseling Psychology from Dominican University of CA. She has extensive experience working with clients of diverse nationalities and backgrounds, including LGBTQ clients, and she uses that knowledge to inform her work. Melissa believes that one size does not fit all; thus, she utilizes multiple therapeutic modalities to support her clients’ individual needs.
At PlushCare we know the importance of having a connection with your therapist. Getting comfortable and establishing trust can take time, but it helps to get a sense of who your therapist is before you book an appointment.
To help you get to know Melissa (and how virtual therapy works), we sat down with her for an in-depth interview. Here are some of the questions we asked Melissa:
- Do you specialize in any area of therapy?
- What do you do in your free time?
- What happens in your first virtual therapy session?
- How has COVID-19 changed therapy?
- How can I tell if therapy is working?
- Can therapists prescribe medication?
- What makes PlushCare’s mental health program unique?
- What would you say to anyone considering therapy for the first time?
- …and many more!
Let’s dive in and find out her answers below!
Don’t have time to watch? No problem! Read it below.
Hey Melissa, thanks for being here! Before we jump into the Q&A, could you introduce yourself?
Yeah, thanks! Hi, everyone. My name is Melissa Dowd, and I am a licensed Marriage and Family Therapist in California. And I’m super excited to be joining the PlushCare team.
Thanks for joining! I guess one of the first questions is, do you specialize in any area of therapy?
I actually provide therapy under the model that one size does not fit all. So I utilize many different therapeutic modalities based on whatever it is that my client is coming to me with.
Typically, I will utilize a lot of CBT, which is cognitive-behavioral therapy. So that focuses a lot on what we’re thinking and what our behaviors are. I also utilize a lot of psychodynamic techniques, which helps bring the unconscious conscious. A good example of this is, identifying some unhelpful patterns, that we may not be aware of, and how we can work to readjust.
I also utilize a lot of mindfulness-based therapy techniques. So to really help kind of manage our feelings of depression, and anxiety, and get us into the here and now.
Solution focus therapy is also a really great one. Sometimes people come to me and they have a very specific struggle that they wanna work through. And solution focus really narrows in on the struggle at hand. We’ll come up with some solutions and strategies and see what works and what doesn’t work. But again, it really depends on what my client comes to me with and what is gonna be the best fit for them overall.
That’s awesome, thank you for sharing! Could you let us know what attracted you to PlushCare?
Yeah, definitely. So, I really do think I was living under a rock before I came across PlushCare. I was under the impression that you had to be part of a larger healthcare provider in order to get the services that PlushCare offers. But when I came across PlushCare and saw that there are these on-demand virtual healthcare appointments, including therapy, that really appealed to me.
I think it really makes therapy and doctor’s appointments so much more accessible to the greater population. And the other thing that I really appreciate about PlushCare is from a clinical perspective, it’s really wonderful knowing that when I refer my clients out, potentially getting a medical evaluation, let’s say we think maybe some medication might help with their symptoms, that I can feel really confident knowing they’re gonna get really wonderful care and they’re going to get care in a quick amount of time.
Oftentimes, if I need to refer out, sometimes it can take weeks for someone to get that medical evaluation. And so being a part of PlushCare means that we work in a team environment. And I think that really benefits me, from a clinical standpoint, and then also our members.
I wanna jump back to you before we dive a little bit deeper into the Q&A. What do you like to do in your free time?
Good question! Well, my answer pre-COVID is different than my answer during COVID! Pre-COVID my passion project is actually volunteering with endangered wild animals around the globe. I had it on the books to go this year, but unfortunately, that didn’t pan out. So we’ll see what 2021 brings.
But during COVID, any opportunity to get outside and be in nature is what I really love. I live in San Francisco and I’m so fortunate to be right here near the bay. So, beaches, spending time with friends and family. And sometimes I just like downtime too, you know, TV, Netflix.
That’s great, fingers crossed for 2021! So moving into virtual therapy, can you tell us what virtual therapy is like?
Yeah, that’s a great question. You know, to be honest, it’s actually very similar to in-person therapy. You’ll meet with your therapist through a video session from the comfort of your home, which is really great. I find that many of my clients are more comfortable because they have privacy and they’re in their safe space.
So what would you say is the biggest difference between in-person and virtual therapy?
As a therapist, my job is really to create a very safe and contained environment in my therapy office for the sessions to take place. And of course, that’s different in a virtual setting. Not to say that we can’t have a really safe environment, it’s just that now we’re through a screen, and you’re over there, and I’m over here. But the communication between me and my clients, and my ability to listen and work towards solutions with my clients, remains constant whether we’re in person, or virtual.
That’s great. Thanks for sharing. How long does each therapy session normally last?
Typically, therapy sessions last between 45 to 50 minutes. That’s a pretty standard therapy session.
Okay. Great. And if I were, for example, looking to find a therapist online, what would you say I should be considering when I’m looking for one?
Yeah, it can sometimes be a daunting task. I know that I often get asked, “How do I find a therapist?” So when searching for an online therapist, I think one of the good things to do is to determine what sort of care and what level of care you’re hoping for. Are you wanting talk therapy? Are you wanting to text with your therapist? How much money do you wanna spend and how much time do you wanna invest? Once you have those questions answered, then you can sort of narrow it down between the options that are out there.
Another good thing to do is ask friends and family. You know, oftentimes a lot of people are in therapy and we don’t even know it. So if we kind of reach out to our network and ask around, we might be surprised at the resources and referrals that we can get through them.
I also think asking your primary care physician is a great place to start. They often have therapists that they like to refer their patients to.
That’s good. So like a group effort kind of thing?
Yeah, definitely. Like I said, it can be a really daunting task, and if it’s something that we feel like we have to do alone, and we don’t have support with even finding a therapist, that can feel really overwhelming. So, absolutely, I definitely encourage people to reach out and ask around.
That’s good to know, thanks! I think a lot of people wonder if therapy is like how we see it on TV or in movies, can you speak to that?
I love this question. No! The answer is no, it is not. Some TV shows and movies do a really good job at representing what a therapeutic relationship looks like but I have to say, more often than not, they don’t. There’s a lot of inappropriate dynamics and relationships that I see occurring between a therapist and client on TV, and I can assure you that should not happen in real life.
Okay. Good to know. How often would you say someone should meet with their therapist?
I think it really depends on the person. But for everyone, I always initially recommend, when you’re first starting with a new therapist, to commit to meeting with them weekly for a period of three to four weeks. So one time a week, over three to four weeks. That really helps to build rapport and trust with your therapist, the therapist gets to learn so much more about you, and you, them.
From there, the two of you can collaboratively determine what kind of care is best for you going forward. Maybe from that point, you wanna go every two weeks. I would say anything beyond every two weeks can get a little bit tricky because oftentimes what ends up happening is the therapy session ends up being a catch-up session. You’re trying to let your therapist know everything that you’ve done over those three to four weeks, the things that you’ve been struggling with, and then once you’ve done that, you’re already, like, let’s say 30 minutes into the session, and now you only have about 15 to 20 minutes to really delve in and kind of work through the struggles.
So, my recommendation is always once a week for the first three to four weeks. And then after that point, if you feel like you’re doing really well, and you wanna go less, then I think every two weeks sounds like a good fit. And again, that would be a really good question to ask your therapist when you two are working together, and you both can decide what’s the best level of care for you.
That makes sense. So consistency is sort of key here then?
It is. Yeah, absolutely. If we think of starting anything out, we wanna do it often so that we get better at it. Consistency is a great word. We wanna do it consistently because that’s how we build any momentum. Let’s say we’re trying to start or learn a new instrument, well, we don’t wanna pick it up once a month. We’re probably not gonna get very far in a short amount of time. So, yeah, it’s a good way to look at it.
These days, we see a lot of mental health content on social media. I’m wondering what your thoughts are on the intersection between social media and mental health. Do you think it helps?
I actually really appreciate that more mental health awareness is out there on social media. I think Instagram is a great source to get some tips and tricks. There are a lot of therapists who have their own Instagram business accounts, I actually have my own as well. And so if I come across something that I think would be helpful, I always share it, and then give, like, some general information about it. And you can find that all across Instagram.
There are people who have pages that cater towards mental health-related issues, and quotes, and all of that, and they might not be a licensed professional but that actually doesn’t mean that it’s not helpful.
So I actually think that social media is a great way to bring awareness to mental health. I think it’s helping to de-stigmatize seeking professional support. And oftentimes, my clients will say, hey, I found this really great post or quote on Instagram, can I share it with you? And when they do, I’m pleasantly surprised by it. And I definitely feel that it’s helpful. So I think it’s good. Like everything that’s online, we wanna take it with a grain of salt. We don’t wanna use that as fact. But I think if it helps someone, then absolutely it’s a good thing.
Another question newcomers to virtual therapy may have is, what happens after going to your first online therapy session?
So, typically in the first session, whether it’s in-person or online, you’re going to give a little bit of background and history to your therapist, about what it is that you’re struggling with, why you feel that therapy is a good fit for you and the things that you really wanna work on moving forward. So your therapist gets a general overview of what’s happening.
Then typically at the end of a therapy session, whether it’s the first one or the 10th one, I always provide strategies and tools that I would like my client to work on over the next week. So, oftentimes, when you’re done with your first therapy session, you’ll have maybe two to three specific things you can work on over the following week. And then when you meet for your second session, you can talk about how they went, what worked, what didn’t work, where you’re at, and then move forward from there.
When you’re thinking about pre-COVID versus the current state of things now, how is therapy different?
I think one of the main differences is it’s essentially all virtual at this point. And, you know, way back in March, I mean, me included, we all transitioned from in-person to virtual therapy. So I think that’s been a huge difference. And I actually think it’s really positive. It’s a positive difference because it is allowing people to have access to the level of support that they need from the comforts of their own home. And right now, with all of the uncertainty going on, and with different people’s comfort levels around leaving their house and being out in public, I think it’s really great. It offers consistency of care.
The other difference I would say is, I’m actually noticing that more people are open to the idea of seeking therapeutic support. It wasn’t maybe necessarily something they would have been open to pre-COVID. But we are all experiencing a lot of loss. And that looks different for everyone. But we are all experiencing loss. And this is something that none of us have had to endure before. And so we might not necessarily have all of the tools and strategies we need in order to manage what it is that we’re feeling and how we’re coping with it. And I think because of COVID and because of the state of the world right now, people are more open to the idea of seeking support. And I think that’s a wonderful change that has come of it.
I did want to ask some questions about the effectiveness of therapy, one of them being, what does the research say about the overall effectiveness of therapy? Does it differ between in-person and virtual?
Really great question. So actually, research shows that in-person therapy vs. virtual therapy is essentially just as effective. Virtual therapy is very effective in treating many mental health concerns and struggles, including depression and anxiety, which a lot of us are experiencing right now. So, yeah, the research shows that virtual therapy is just as effective. And it’s no surprise. I see it in my own practice too. Some of my greates and most fruitful sessions have been through virtual therapy.
That’s good to hear. How can I tell if therapy is working for me and how do I know if it’s not?
Another really great question. So, what I would recommend is just take a step back and reflect on your progress. Are you noticing any changes? Are you noticing that you’re feeling better or that you’re feeling more motivated or confident? Are you noticing that your relationships are improving? Are you better able to set healthier boundaries? Are the symptoms that you are experiencing minimizing?
Another great way to tell is, has anybody else noticed it? Oftentimes, when we’re finding changes within ourselves, sometimes they happen so gradually that it’s hard for us to really recognize them. But the people who are closest to us will often say, “You seem different, or you seem happier, or you look different, or, you know, your energy is different.” And I think that’s a really great way to have some kind of validation that you are making progress.
Sometimes your therapist will mention it too. I often tell my clients, “I noticed such a change in you. Have you noticed it?” And sometimes they think, “Well, yeah.” You know, I get different responses in different answers, but sometimes it does take just reflecting yourself and then also seeing if anyone else notices.
And let’s just say you’re struggling. You’re taking the time to reflect and you’re struggling to feel any differences or notice any differences. In that instance, I would really recommend that you talk to your therapist about it. Your relationship with your therapist is really one of the safest, and confidential, and non-judgmental places to voice those concerns. And they might also say, “Yeah, I haven’t really noticed a lot of progress.” Like, maybe there’s some resistance you have and you just haven’t noticed it. And so even having that other perspective and not being afraid to ask.
Moving on to the topic of medication therapy. Can a therapist prescribe a client medication?
No. So we are not licensed to prescribe medication. Our license really is all about talk therapy. And if someone is seeking a medical evaluation or feels they need some medication to help minimize their symptoms, then they would either visit a psychiatrist or go to their primary care doctor.
I guess on that note, could you tell us a little bit about the difference between a therapist versus a psychiatrist versus a psychologist?
Sure. Yes. That can be a confusing one, especially if you’re not in the field. So, basically, the difference between a therapist and a psychologist primarily is around education. So a psychologist would have further education than a therapist. A therapist typically has a master’s degree. And psychologists typically has either a Psy.D or a Ph.D. And that further education for a psychologist is really around research. So, when they are seeking their higher education, a lot of it is research-based, conducting studies and all of that, finding answers to some of the questions we may be Googling. That’s really what a psychologist’s further education allows for them. Both a psychologist and a therapist are very well-versed in talk therapy, and so is a psychiatrist.
A psychiatrist differs between the other two in that they are a medical doctor, and are able to prescribe medication. So, oftentimes, someone will see a psychiatrist for a medical evaluation and then medication management. As far as talk therapy goes, some of them do it but most often, they’ll refer out to either a therapist or a psychologist for that.
Could you dive a little deeper into PlushCare’s mental health program and maybe let us know what makes PlushCare unique?
Absolutely. So what I appreciate about PlushCare’s model is that we really do help to provide care for the whole person. So, not only physical health but also emotional health. We have therapists on staff as well as primary care doctors. And the reason PlushCare is so unique is that we really work in a team environment when it’s appropriate for the PlushCare member. So they have access to therapists as well as primary care doctors who can not only help treat, you know, medical conditions that they’re experiencing, but they can also prescribe medication for symptoms such as anxiety and depression.
It’s really a whole-person model that a lot of other platforms don’t offer. And from a clinical perspective as a provider, it makes me feel so confident that I know that my client is going to receive the level of care that they really need. And then from a member perspective, it’s so great because it’s all housed under one model. It can be a really daunting task to try and find a therapist, or find a primary care doctor and get an appointment but with PlushCare, all of that is really accessible.
That’s great, thanks! I do wanna wrap this up, one last question for you, is there anything else you want to share with those that are considering therapy for the first time?
Yes, I love this question. My recommendation to anyone who is considering therapy is, if starting therapy is on your mind, try it out. There’s no harm in just trying it out. And I think because so much of therapy is done through a virtual setting now, you get to do it from the comfort of your own home.
Sometimes it can be a little bit scary because it’s new and it’s different but in order for us to make any progress and grow, we need to challenge ourselves. And, you know, if it’s on your mind, if you’re thinking about it, take that next step and just see what it’s like. It doesn’t have to be a scary process. Therapists are humans too! And hopefully, we’ll make it a really painless and easy process. But yeah, I just think that if you’re thinking about it, just go for it. See if you can challenge yourself. I think 2020 is really putting us outside of our comfort zone and challenging us to do things differently and think differently, and what an awesome opportunity this can be.
Great, thanks for joining us today, Melissa!
Thank you so much. Thanks for having me!
You can book an online therapy appointment with Melissa by clicking here.
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This article has been edited from its original format for editorial purposes.