Get to Know: Holly Tufan, LAPC

Holly Tufan, LAPC, is a group therapist and care coordinator with the Skyland Trail adolescent treatment program for teens ages 14 to 17. In that role, Holly leads therapeutic groups, including dialectical behavior therapy (DBT) skills and ecological systems theory. They also help adolescents prepare for discharge from treatment, ensuring that teens and their families have plans and providers in place to help them continue their progress after graduating from Skyland Trail as they return to their families, schools, and communities. Holly joined the adolescent treatment team in 2019.

What inspired you to enter the mental health field?

Growing up, I always had the awareness that I wanted to help people. By happenstance really, I selected psychology on my college application. I enjoyed the class in high school and thought I would check it out. I loved the program! I realized, through my classwork and through my own therapy, that, when I was younger, I often felt like people didn’t hear me, especially when I was struggling. I thought, “Wouldn’t it be great to work with people, hear them, and listen to them in a way that I wasn’t listened to when I was younger.” Understanding that I could really be there for people was a big motivating factor. I felt I could validate them, understand what they are experiencing, and really hold that space for people in a way that could be healing and make a difference.

“I think one of the biggest changes I see is clients developing the knowledge that, just because they have a thought or a feeling, they do not have to act on it. That is a big focus of dialectical behavioral therapy (DBT). They become able to cope more proactively rather than reacting to their emotions or thoughts.”

What is your favorite part of working at Skyland Trail?

I really enjoy the diversity. I feel like I can fully be myself. I am non-binary, and I feel like I can go by my pronouns, be me, and be accepted. I also like the support I feel here. I’m on a team and feel like I can go to them for guidance. I also enjoy working here because of the resources we have. We have so many opportunities to help clients and to be enriched professionally. I feel very blessed by that. And I definitely enjoy working with the kids. I have such a great opportunity to work with the adolescents in a way that is meaningful!

What are some of the biggest challenges you see teen clients struggling with?

I feel like clients, especially the clients who identify as queer, struggle with pretty big things. For some kids, the world doesn’t see them like they want to be seen. Obviously, we can’t change that, and it’s hard for them to reckon with that reality as they determine their own identity, especially the kids who are “finding themselves” actively while in treatment with us.

And I feel like some kids are dealing with a lot of hopelessness about the world. They talk about that broadly in some of our groups that examine how we interact with our communities and how we think about our role in big issues.

On a smaller scale, feeling invalidated at home by their families is something many kids struggle with. Our family therapists do a great job helping parents shift that environment so that when clients return home and start using the skills they learned in therapy, their parents can respond in a supportive way. After treatment, the kids can feel more seen and heard, and, as a result, also be more open to hearing their parents’ concerns as well.

Of course, all of our clients are struggling with symptoms of depression and anxiety, which makes all of the underlying concerns about validation and an uncertain world much worse than for other kids their age.

How do you think the pandemic has affected teen mental health?

Our clients are ages 14 to 17, and that is such an important developmental period. We have clients now who were in the seventh and eighth grades during the worst of the pandemic. They didn’t really get that time to acclimate to high school or to develop the maturity you would expect for an older teen. I think a lot of their feelings of anxiety and self-judgment come from that lack of transition. They often don’t feel prepared to handle all these high school expectations and dynamics. And I think the pandemic has contributed to that overall sense of worry for teens. The pandemic was scary. And for teens who were already struggling with family dynamics, they were stuck at home during the pandemic without other social inputs or interactions. Isolating at home together was a challenging situation for many families.

What are some of the ways you see adolescent clients change from when they admit to when they complete treatment?

I think one of the biggest changes I see is clients developing the knowledge that, just because they have a thought or a feeling, they do not have to act on it. That is a big focus of dialectical behavioral therapy (DBT). They become able to cope more proactively rather than reacting to their emotions or thoughts.

Whereas before Skyland Trail, teens may have been hiding self-harming behaviors or keeping secrets about what is really happening at school or with friends, during treatment they develop skills to communicate those things with their parents and ask for support. Parents do their work in family therapy too and learn skills to respond in a way that is going to validate their child and help them be proactive in getting through a difficult situation. 

A key milestone for many teens is accepting that they are not yet adults. While they learn to be more intentional about what they want out of school or relationships and how to communicate that, they also learn to accept that while they are still adolescents, there will be boundaries that they will have to follow. They learn to work with their parents and with their schools instead of against them. They are more open to considerations about what does it mean to “give to get” in some situations through interpersonal effectiveness.

And I always love to see kids who develop that self-compassion. They let go of some of the self-judgment and fear of failure or fear of disappointing someone. They can recognize and celebrate progress in themselves and in their families.

How do you feel that Skyland Trail prepares adolescents to return to school?

Before Skyland Trail, most of our clients are really overwhelmed by school. They may not even be attending school. They may not feel like they can handle it, or they may be using defiant behaviors at school as a reaction to other things going on in their life.

During treatment at Skyland Trail, I see them start to work with their teachers and their school rather than against them. They learn what accommodations they can request from the school as well as how they can make those accommodations work for them. As they develop self-compassion, they can recognize, “Hey, I may not have been able to complete physics while I was in treatment, AND I’m going to reach out and be assertive with my teachers to figure out the best options for me moving forward.”

Rather than being terrified of school or school being a trigger for them, they are able to work within the system more. I think they often feel more capable to handle the expectations of school, instead of feeling paralyzed.

What are some of your priorities as you help clients and families prepare for discharge?

I think success often depends on finding community. So, in addition to making sure clients are connected to mental health professionals, I try to make sure they are connected with other resources and services to help support the whole of who they are. That can be especially important for kids who identify as queer or who may feel like a minority or outsider in their schools or communities. It’s helpful if they can find a space where they can talk about experiences or emotions that other people in that space share and can understand.

What would you tell your 16-year-old self?

I would go back and say, “It’s going to be ok. You are not going to need math as much as you think you do. That was such a stressor for me!” I would encourage myself to be unapologetically myself without that worry and anxiety. I would go back and give myself confidence and the freedom to feel more sure in my decision-making. “You’re going to make it.”

Who or what inspires you?

I am part of a professional group called “American Academy of Psychotherapists,” and the powerful women in that group really inspire me. They are older than I and have been in their careers longer, and they seem to me to be so “themselves.” I can see myself following that path as well and becoming someone who is really aligned with myself, wise, and making a difference in my career.

I’m also inspired by the queer community in Atlanta. I came into my identity as a non-binary person in 2020, and I am inspired by people living unapologetically as themselves. I am especially inspired by the people in the queer community who are advocating for gay rights, trans rights, and human rights.

What’s one way you practice self-care?

I have been in therapy pretty consistently since graduate school. My ongoing self-care outside of therapy is really having a lot of self-compassion and trying not to be so hard on myself. I also like journaling. And I’m a gamer. I love video games! I have to put boundaries around it of course, but getting lost in a good game, that’s self-care for me. (My favorite game is the Mass Effect series.)

I am also a fire performer. It’s very movement-oriented performance art. It’s such an expressive activity, and it’s a lot safer than it sounds! Fire performance with my friends on weekends definitely feels like self-care.

What’s your favorite cheerleading statement or mantra?

My dad was into Buddhism and Daoism when I was growing up. He came into my room one day when I was a teenager and said, “Holly, the more you know, the less you understand.” At the time, I thought “…ok??” But I’ve since come to really embrace it.

I’ve learned that, when we get so rigid in our thinking or approach to things, our focus narrows, and we filter out other ideas or experiences that might contribute to another way of looking at the issue. Knowing is not the same as understanding. “The more we know, the less we understand.” And I apply that to my work with clients. I really try to listen and understand before I assume that I know what they are experiencing.