Hi, I’m Dr. Nicole Beurkens.
Those of you who want to know who I am and what makes me tick as a person and professional will probably be more interested in this version that tells you the story of how I came to be doing the work I am doing today, and why I’d love for you to join me on my mission.
How It All Began
I started my college journey on a path toward medical school, but quickly decided that things like calculus and chemistry didn’t make my heart sing. A particularly torturous semester of chemistry landed me under the wing of a very patient and supportive senior chemistry and education student who was my lab supervisor. She not only got me through that course but helped me identify my true passions, and pointed me in the direction of some exceptional faculty members in the education department.
I took a course in educational psychology, and was hooked. Understanding how people learn, and how to teach in brain-engaging ways did make my heart sing. I spent the rest of my undergraduate years learning from and working alongside some of the most talented education professors in the country, and graduated with a degree in special education (and a minor in political science just for fun).
During my various student teaching experiences, I had the opportunity to hone my skills and observe what worked and didn’t when engaging students at the elementary and secondary levels. I was blessed with incredible mentors who fueled my desire to unlock the potential in struggling learners. There is nothing like being a fresh-out-of-college student teacher attempting to engage a class of 15 middle school students with significant learning and behavior disorders to keep you humble and remind you of how much more you have to learn!
I’m not exactly sure what my students got out of that semester (although the ones I’ve seen around the community in recent years remember me, so at least I was memorable) but I apparently made an impression on the special education director for being adventurous and not shying away from challenges. At the end of the semester, she approached me about teaching in a new classroom opening that fall for young students with autism.
I vividly recall telling her two things during that initial conversation: I had virtually no experience with young children, and I didn’t know anything about autism.
Despite my reservations, she felt that I would be a good fit and set up some classroom observations and an interview. I remember going home to study up on autism, although at that time there were very few resources available. The internet was not really a thing at that time, and Wikipedia didn’t even exist. Apparently my enthusiasm and interest in a challenge overshadowed my lack of knowledge or experience, because the interview committee decided to give me the job.
Fast forward to my first official day of teaching when I faced 5 children with autism between the ages of 3 and 5. I instantly became acutely aware that I had a lot to learn. Suffice it to say that the three books on autism available at that time, which I had read cover to cover, had left me vastly unprepared for engaging these five small people for six hours a day.
What I can say is that there was an immediate connection between those students and me. We found our way through one day, and the next, and the next; me learning as much or more than them as each week went by.
I may not have known about all of the specific techniques to teach communication or modify behavior, but I got to know them as individuals; and kept pushing for them to do more. There are so many things that I would change about that first year, knowing what I know now; but I would not change my firm expectation that each of them would engage and learn to do more than they could when we started. I still carry that same expectation and tenacity with me in my work today, and I believe it’s the most important component I bring to all my working relationships.
At the time when I accepted that first teaching position, some of my family, friends, and mentors questioned whether it was the right decision given that I had expected to teach secondary-age students with learning and emotional disorders. I just felt I needed to follow my gut, and it was telling me to take this position. As you’ll see, “following my gut” is a theme throughout my life.
I accepted this job not knowing for sure if it would work out, or what direction my career would end up taking. But I’ve found that when I take a leap of faith, there are always signs that let me know whether the leap was the right one or not. The confirmation that this particular leap was the right decision came in the form of a construction project.
It Must Be Love
My first summer of teaching actually took place in a different building than where my classroom would be permanently located. That building was under construction at the time and therefore unusable that summer. The week prior to the start of the school year, we were given permission to enter the building and set up our classrooms.
I’ll never forget heading into the building for that first time with all the exuberance of a brand new teacher who was going to set up her very own classroom. I headed down the hallway with my sister who was kind enough to assist with unpacking boxes, and I saw him out of the corner of my eye. He was standing with a group of construction workers in some kind of meeting, but he glanced over at me and smiled.
I got busy with the work of setting up my classroom, and saw this man (whom I later found out was the electrical foreman) in passing over the course of the week. To condense the series of events that happened next, we were married at the end of that school year. There is no question that I was meant to take that job! It changed the direction of my career and my life. It was definitely love personally and professionally.
A New Direction
I loved my years of teaching, and created an innovative program that met the needs of more and more students with autism and related disorders. During that time I attended many graduate classes and seminars on the topics of autism and related disorders, and received various specialty certifications.
When my husband and I had our first child, I decided to shift my focus from classroom teaching to consulting. This was not my original plan when I returned to teaching after my maternity leave. However, a sequence of events involving a human resources administrator who vastly underestimated my level of personal and professional chutzpah led me to walk away from my safe paycheck with benefits in the public schools and to embark on an adventure of freelance consulting.
This leap of faith got immediate confirmation when on the very day I resigned my teaching position I received a call from a colleague wondering if I had any time to do any consulting for a district about an hour north of my home. It just so happened that I was available, and thus began my consulting career.
Consulting was an amazing opportunity to work with students across the age span with a wide variety of challenges.
I learned so much about how school systems work, and the challenges of providing for unique learners in traditional and non-traditional educational settings. It was during this time that I completed my master’s degree in special education, with a research focus on the professional development needs of teacher and therapists engaging students with neurodevelopmental disorders.
I had the opportunity to create unique professional development opportunities for school staff members across the state, and found that I could impact many more students by helping teachers and therapists understand how to better meet their needs in the classroom. This period also brought projects involving grant writing and administration of large professional development grants for school districts around the topics of evaluation and school-based intervention for students on the autism spectrum. I found that I enjoyed teaching adults as much as I enjoyed teaching children.
While I was passionate about my work in the schools, I became very aware of the needs of these students and their families outside of the school system.
Parents and families living with these children were struggling with a lack of information and support. They desperately wanted to help their children learn and grow, but didn’t have opportunities and resources to learn and implement strategies for their children at home. One specific need I discovered was in the area of summer services. Many of these children did not receive school services in the summer, and families were left searching for how to best support their children during these months.
A Leap of Faith
In the spring of 2003 I had a 3-year-old son, a 1-year-old son, and was pregnant with our third child. I came home one day and announced to my husband that we were going to renovate the basement of our home and start a summer program for children with autism and related disorders. That might have stunned or distressed some husbands; but mine had long since become accustomed to me getting ideas and acting on them. Being the amazingly supportive and resourceful man that he is, he got busy on that renovation.
By the time June rolled around, we were ready to welcome the 13 children and their families who had signed up for whatever it was we were going to do that summer.
We must have done something right, for in the summers that followed more families found out about what we were doing and wanted to be a part of it. In two years that small summer program in our basement grew to the point where we needed a separate facility.
My husband and I took a leap of faith and purchased a piece of property with a home on it that could be rezoned and renovated to meet our needs. Horizons was officially born. We received ongoing confirmation that our decision was the right one as more people found us and joined our clinic family.
I continued to study everything I could that was relevant to the population we were serving, and collected numerous certifications in various treatment approaches and therapies. By the time 2007 rolled around, I had a staff of 4 clinicians, a few assistants, and an office administrator. We found ourselves out of space again, and put a major addition on the property — and the clinic continued to grow, and the population we were serving broadened to include many adolescents and adults with a wide range of developmental and mental health challenges.
The Perpetual Student
By this point in the story you have probably come to realize that I do not shy away from challenges, or hesitate to meet needs when I become aware of them.
The more work I did with families at my clinic the more I realized that there was a limited number of professionals who specialized in evaluating children with developmental and mental health concerns. While there were clinicians in our area who performed diagnostic evaluations for this population, parents found that wait lists were long and outcomes of these evaluations were less than helpful.
I decided that I wanted to be a professional who could support children and families from the initial diagnostic evaluation through the treatment process. This required additional training; so I went back to graduate school to pursue a doctorate in clinical psychology. Because my master’s degree was in education I had to start all over again in the graduate process, and was facing a four and a half year journey to degree completion.
Three weeks into my first semester, while working full-time at the clinic, my husband and I got a call that our daughter had been born.
This was five weeks after completing our home study and filing all the paperwork to adopt a baby girl. We picked her up two days later, and became a family of six: full-time working mother and doctoral student, full-time stay-at-home dad, and four kids ages 6 and under. I’m quite certain that had we known at the time what we were getting into, we might have questioned our sanity. But life has a way of throwing things at you, and you just learn to roll with it.
Those four and a half years of completing my courses, residencies, internships, and a dissertation (all while working at my clinic) are a blur. The outcome was a PhD in clinical psychology, a dissertation research study that was published in a prestigious scientific journal, licensure as a clinical psychologist, four well-adjusted happy kids, and an intact marriage. I’d say we weathered the entire journey pretty well!
Catching up to the Present
In 2013 our clinic was once again under construction as we built two major additions on the building to bring it to almost 10,000 square feet. And that pretty much brings us to today. Our clinic has a staff of 10 people, and each year we serve over 125 patients and families from throughout the state of Michigan, around the country, and abroad — people of all ages and challenges that range from autism and ADHD to anxiety and brain injury come to us for comprehensive, innovative, and individually tailored treatment. I could not be prouder of what we have created.
I continue to have the privilege of working with patients and families who, though they struggle with many challenges, share my vision of progress — tomorrow being better than today. My colleagues are second-to-none. I wouldn’t choose to spend my professional life with any other group of people. We push each other to learn, and daily hone our clinical skills.
These days I spend a lot of my time working directly with patients and families in our clinic, and continue to study, research, and develop innovative treatment protocols. I spend some time traveling around the country speaking at seminars and teaching parents and professionals how to understand and support children and young adults with developmental or mental health concerns.
When I get the chance, I participate in research projects, do some writing, and collaborate with other professionals throughout the United States and around the world. And in my personal life I get to enjoy time with my fabulous husband and children. I figure we’ve done something right that even in the teen years, we still enjoy spending time together!
My life has been a series of twists and turns that led to a career and personal life I would never have imagined 20 years ago. It’s been a story that has unfolded one step at a time, with lots of surprises along the way. My journey has been one of trusting that each leap of faith would bring me to where I needed to be.
As I reflect on what has brought me to this point, it has been a process of seeing needs and striving to meet them. It has become clear to me over the past year that I need to educate parents and professionals that meaningful improvement and lasting change in children and young adults with learning, mood, and behavior challenges is possible, but requires more than prescription medications.
Children and young adults come into my clinic everyday with a host of developmental and mental health challenges. They are experiencing failure in their lives at home, school, and the community. Their parents are worn out and frustrated, not knowing where else to turn to get help for the children they love so much. They have been to countless professionals, and have tried every medication available; but they are still struggling.
Here they are in my office ready to tell their story again, answer personal questions again, and ask for help again. I’m amazed that many of them show up at all, given the tortuous road it has taken to get here. And yet they do show up — hoping for the best, yet expecting to leave with little that will make their lives better.
Children come into the world with a myriad of gifts and challenges. Some experience more problems than others, and may live life as a square peg in a world full of round holes. These are the people I see in my practice — the children and young adults who:
- wander around the classroom and never complete anything; or sit perfectly still and complete everything they are told to do.
- resist everything; or resist no one.
- have no energy; or have endless energy.
- can’t find joy in anything; or are over-excited about everything.
- can’t speak; or speak non-stop.
- were born with serious neurological issues; or acquired them at some point in their lives.
- can’t sleep; or sleep too much.
- eat next to nothing; or eat everything in sight.
- can’t stop touching other people; or want to touch no one.
- are dependent on others for everything; or won’t depend on anyone for anything.
- have no fear; or fear everything.
These are people at the extremes of life, individuals for whom everything is “too much” or “not enough.” These are kids who struggle to find a middle ground in one or more areas of their lives. They live on the high or low side of everything, sometimes going back and forth between both extremes but without finding a happy medium.
While it is alluring to think that regulation (a happy medium) can be found with a prescription, the solution generally cannot be found via a pill bottle. These children and young adults require thorough evaluation to get to the root issues causing their challenges. They need patience and understanding to untangle symptoms and behaviors even they can’t understand.
When we fail to investigate what is going on beneath the surface, we may rush to treatment that is ineffective at best and inappropriate at worst. Nowhere is this more evident than in the massive increase in prescriptions for psychiatric medication given to children. The lack of significant evidence that these medications are helpful in the short or long term has not stopped us from running headlong down a path that is now littered with prescription bottles and kids who can’t function even when on medication; as well as those who have lost the ability to function without.
As a professional, I am not against the use of psychiatric medications. I believe that these medications can be an important part of a comprehensive treatment plan for some patients. That being said, I believe that medications are used too widely and as a poor substitute for appropriate evaluation and intervention. I am against what I consider to be inappropriate, irresponsible, and unfounded use of these medications.
- I am against the use of medication before understanding the person’s complete history.
- I am against medicating on the basis of a 10-minute office visit.
- I am against medicating without fully informing patients and parents of the potential risks involved, as well as all available non-medication options.
- I am against the use of medication without looking at other options that can provide benefit.
- I am against medication when it is used to make people conform to a mold, without looking at what may need to change in the environment around them.
- I am against medicating children to give them an edge over their peers.
- I am against medicating children without using other interventions to resolve the underlying problems.
- I am against medicating children with the assumption that they cannot function without it, and will require medication for the rest of their lives.
- I am against medicating children because the teacher feels they are too inattentive or unruly in the classroom.
- I am against medicating children because parents are stressed out and can’t manage them at home.
- I am against medicating children because everyone else in their family is on medication.
- I am against medicating children because professionals don’t know what else to do.
- I am against medicating children because systems find them difficult to deal with.
- I am against medicating children without thorough evaluation of their nutrition status.
- I am against medicating children without thorough evaluation of their sleep status.
- I am against medicating children without thorough evaluation of physical health problems.
- I am against prescribing psychiatric medications in order to counteract the side effects of other psychiatric medications, resulting in a cocktail of pharmaceuticals that is untested and potentially unsafe.
- Most of all, I am against continuing to medicate people when their symptoms aren’t getting better.
The reality is that more than medication is needed to solve the complex problems affecting many children today.
When we commit to understanding an individual’s unique strengths and challenges, we can develop a treatment plan to address the real problems. While medications may be temporarily useful to address surface symptoms, they generally do not solve the underlying issues. When medication is used, it should support the child’s ability to engage with interventions that will ultimately solve the problem.
Truly treating the issues in these children requires a big-picture approach that encompasses multiple aspects of their functioning. Meaningful and lasting change comes via treatments addressing areas such as nutrition, movement, sleep, connections with others, problem solving, as well as cognitive and emotional flexibility.
Leaving out these critical aspects of treatment, and treating solely with medication, is akin to putting a band aid on a deep wound: You temporarily mask the surface injury, but the underlying problem remains. Patients with developmental or mental health concerns experience enough pain in their lives. We should not compound the problems with treatment approaches that are either insufficient or completely inappropriate.
My professional mission going forward is to make sure every child, parent, and family understands what is going on beneath the challenges they experience, and knows all of their options for treatment.
It should be a goal for every child and young adult with challenges to have access to a thorough evaluation by professionals who understand them, and the opportunity to participate in treatment that allows them to reach their highest potential. Every person, no matter how impaired, has the potential to be better tomorrow than they are today. Every parent, family member, and professional has the ability to understand more and provide better support tomorrow than they did today.
People have a right to receive treatment that helps them attain a state of physical and neurological health necessary to become the person they were created to be.
As a professional working with children and families for almost 20 years, I engage in this change process daily. I learn something from every patient who walks through my doors. I am committed to sharing what I’ve learned, and continue to lean, with patients, parents, family members, and professionals who wish to join me in understanding more and doing better for the current generation of children and those that are to come. I’d be honored to have you connect with this mission and come along for the journey.
Together, we’ve got lives to change!