Reimagining Mental Health Care: How Psychiatric NPs Are Driving Innovation And Change With Dr. Lindsay Hill

 

Psychiatric nurse practitioners are revolutionizing mental health care from the inside out—and Dr. Lindsay Hill is at the forefront of this movement. With a dual lens as both clinician and entrepreneur, she shares how nurse practitioners can lead the next chapter of behavioral health innovation. As President of the APNA Arizona Chapter, founder of PMHNP Bootcamp™, and a consultant in AI and digital health, Dr. Hill unpacks the clinical, financial, and personal pressures providers face—and how to overcome them with strategy, support, and systems. From her own experience with TMS therapy to the healing power of DBT and the urgent need to end the martyrdom culture in mental health, this conversation is a roadmap for anyone building a sustainable, purpose-driven life in psychiatric care.

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Reimagining Mental Health Care: How Psychiatric NPs Are Driving Innovation And Change With Dr. Lindsay Hill

Welcome to the show. I am here with Dr. Lindsay Hill. I’m so excited to have this conversation with you. Our guest is a powerhouse in the world of psychiatric and mental health, a PMHNP, also AKA a nurse practitioner, educator, and an entrepreneur. She holds a Doctor of Nursing Practice with a specialization in DBT, and is passionate about empowering clinicians while transforming how psychiatric care is delivered. She’s the Founder of the Psych NP Bootcamp, which has helped hundreds of nurse practitioners gain clinical clarity and confidence, and the co-founder of The Psych NP Network, a thriving community for psychiatric NPS across the country.

As president of the APNA Arizona Chapter, she’s a leading voice in advancing innovation, advocacy, and collaboration in mental health. She’s also bridging clinical practice with cutting-edge technology through her work as an AI healthcare consultant, helping organizations and using tools like artificial intelligence to improve workflows and outcomes. Dr. Hill, welcome to the show. I’m so glad to have you here.

Thanks for having me, Tim. I’m excited to be here.

We’re going to talk about a lot. Specifically, I’m excited to talk about your work as an AI healthcare consultant. As we mentioned earlier, artificial intelligence is not going to take your job. People who are using AI are going to take your job, and I’m sure that’s your experience as well.

You have to figure out how to leverage it at this point.

The Journey To Psychiatric Mental Health

We’re going to get into that, amongst other things, in this conversation. First, let’s start with your journey. What inspired you to become a psych NP and eventually launch your own ventures?

First of all, I have dealt personally with my own mental health struggles. I’ve had family members and friends who have dealt with their mental health struggles. I’ve always seen myself in a helping profession, but I never thought that I would work in psychiatric nursing per se. I did my clinical rotation in Dayton, Ohio, in an inpatient unit.

Are you from Ohio?

Yes. Are you?

I’m not. I’m from Southern California. You’re from Ohio. Did you grow up in Ohio?

Washington State and Ohio.

Tell me about your mental health struggles.

They started in high school. That’s when I was first diagnosed with ADHD. I struggled before that, but with the academic load, I got more overwhelmed. I had a harder time with things that other people seemed like they weren’t struggling with as much. I felt like, “Why is this so much harder for me?” It was tough, but I was also dealing with people close to me who are struggling on heavier levels with their mental health, and that was also very hard. I never even knew about what a psychiatric nurse practitioner was in Ohio. I never even heard of that role until I relocated to Arizona. I was working at Arizona State University.

What brought you to Arizona?

My parents were moving back out here to be close to their parents, who were getting older. Where I was from was a very small town with two stoplights. I was ready to expand my horizons because I had gone to high school there. I went to my undergrad and nursing school there in that small town, so I was ready to spread my wings. When I got here, I didn’t have connections. I was a new grad, and I had a very hard time even finding that first nursing job. That was stressful, but lo and behold, I met somebody on Craigslist buying a couch that connected me with this job opportunity at Arizona State University as a community health nurse.

That was crazy but very cool. It was there that I saw a new side of mental health. I saw ASU students who were not functioning. Some of them were almost dropping out of school and were very distressed. They go from that to being able to live purposeful lives. I instantly knew that’s what I wanted to do. I would try to learn as much as I could from those two-second pieces. I loved everything about the role. I knew it was for me. Thankfully, I was able to go back to school after a year and a half of working as a community health nurse. It was sooner than I would have anticipated, but the opportunity presented itself. It worked out, so I’m glad that I did it. It’s been a whirlwind.

What do they say? Success happens when a person is prepared when opportunity knocks. It’s like you did all these other things. The door opened to become a psych NP to go down that path. It presented itself, and you were ready. You took that step.

Exactly. I had a mentor at the time who was very much like, “Where do you want to be in five years from now?” He’s helping me think ahead, even though I was having impostor syndrome and trying to get through that first job. I appreciated that, in retrospect, I had somebody who was thinking ahead for me, too, as far as my goals.

DBT’s Transformative Power In Clinical Care

You specialize in DBT. How has that shaped your approach to clinical care and clinical education?

I had this unique opportunity in Psych NP School at the Phoenix Indian Medical Center, which is pretty close. They came to me. They said, “You could help co-lead these DBT skill groups.” I thought, “That’s interesting because I want to incorporate psychotherapy into what I’m doing when I graduate.” I thought that I would be leading these skills groups off the bat. They were like, “No, you’re going to be going through it as a participant.” This was with adolescents who were chronically self-harming and dealing with pretty big mental health struggles.

I was like, “I’m pretty functional. What am I going to get out of this?” I was skeptical, and then I realized that there was a lot of work that I needed to do in terms of uncomfortable emotions. It was a transformative experience for me. It got me thinking about, “Why didn’t I know about these coping skills sooner? Why aren’t we teaching this stuff in schools?” It made me think differently about mental health and a passion about wanting kids and adolescents to have more of these coping skills earlier, so that we’re not waiting until people are sick, then they go get mental health treatment. It’s more of that preventative approach.

 

It has helped me on a personal level a lot in terms of when we are more stressed out and dealing with mental health issues, we tend to get more black and white, and more rigid. That cannot be a great thing. Being able to find that middle ground, that wise mind, that two things can be true has been super helpful for both my clients and myself.

My TMS Experience For Brain Injury Recovery

I want to talk about CMS first. You’re doing TMS at Camelback Recovery and Camelback Integrated Health and Wellness. What happened in your life that made you think, “I want to try out TMS?”

I had a traumatic brain injury in 2021 or 2022. It was a ski accident, and my memory and my cognition have never been the same. I experienced a lot of even personality changes and more irritability. It was a difficult time. Shortly after that, I got burned out in my role as a psych NP. I was tapped out on helping people. I felt like I needed to take care of myself. Since then, I’ve done different things for my mental health. I do take psychiatric medications. I’ve done therapy. I am invested in taking a holistic approach to my mental health.

That being said, though, ideally, I would like my memory and my recall. I’d love to be back to my baseline at some point. I don’t know if it’s in the cards for me or not, but I’ve never been back to that point. It has made me significantly more empathetic to people who deal with traumatic brain injuries. I think I took that for granted, being able to remember things and be sharp. I’ll think on the spot, and now I’ll have moments where I’ll totally lose my train of thought in the middle of talking about something.

I can relate. I had a traumatic brain injury as well.

I didn’t know that.

It was a long time ago. It was in 1996. I wasn’t the same person on the other end. It was a major car accident. I don’t remember anything for two weeks of my life. It probably took me two years to recover. After that accident, to your point, my memory wasn’t as good as it was prior to the accident. It took me a long time to recover. As I said, it’s a couple of years. I wasn’t the same person. I’m empathetic to it, and it’s a big deal.

I would say wanting to continually improve my mood, and then maybe be able to taper back on some of my medications. I have been hearing that other people are able to do that once they start in TMS. I felt like this was a cool intervention. I’ve been wanting to learn more about it and do it for several years. I took a job because I thought that I was going to be able to have that opportunity, and then there were billing issues and coverage issues. They didn’t end up offering that service, and I was super bummed. I was very grateful for the opportunity to do it here at Camelback Integrated.

TMS is FDA-cleared for OCD, smoking cessation, and depression. My experience is that it helps with cognition and so many other things. What made you decide, “I think it’s going to work for me?”

Looking at the research and the potential, even though it’s not FDA-cleared for exactly my psychiatric conditions. We use a lot of things off-label in psychiatry. Looking at the modality and how it works, I felt like there was room for improvement. It’s been specific, the things that I’ve noticed an improvement with. I was telling you about the rumination.

Rumination is something that has improved significantly for me. I’m now 61 sessions in, and that’s been great. Also, my concentration has improved, and I know this because I’m reading a lot more, and I’m able to sit there for extended periods of time and read. That has not always been the case since my brain injury. I’ve been cautiously optimistic, but I’m happy that I did it. It’s pretty cool.

Have there been any side effects?

No. There was one day that my neck felt a little bit muscle-achy, but I don’t even know if it was that. There haven’t been side effects.

In your experience, who would benefit from TMS?

A lot of people could benefit from TMS. I love how some people describe it, as far as going to the gym for your brain or physical therapy for your brain. The more that we learn about mental health, the more interrelated aspects that I think a large population of people could benefit from the intervention. I’m hopeful for how it advances in the future in terms of being able to offer it to more people, because coverage can be an issue, and getting it paid for.

 

I see this huge potential, even in the adolescent population, potentially. To have more non-medication options to help them is pretty huge because it’s hard these days. A lot of people start self-medicating or turn to unhealthy coping skills pretty young, sometimes. Having more options out there that aren’t psychiatric medication, I’m very excited to see the future of TMS.

Any reason someone should not try out TMS from your perception?

From my understanding, if they’ve had a history of a seizure, then they might not be the best fit for TMS. I’m still learning more about using it with individuals who have been diagnosed with bipolar disorder. It seems like it’s not completely a contraindication if there are certain aspects on board. I’m still in the research and in the weeds. I ordered the APA 2025 TMS book. I’m nerding out. For treatment-resistant OCD, too, I have some patients that I’m very hopeful for. It gets you down when you feel like you can’t make any more progress with a patient. You want to help them, and they’re still distressed, and you’ve maxed out on other options.

You are 61 sessions in. When did you start to notice a difference?

It was right around the 33rd session. I remember my husband said, “That stinks that insurance most of the time covers 36 sessions because I feel like you’re just now starting to see this therapeutic benefit.” I’m like, “I know. You’re right.” I would say it was around that I started noticing more of a significant difference.

Since then, how much more of a difference have you noticed?

Quite a bit. I would say PMDD or premenstrual dysphoric disorder is something else that I dealt with. That was a lot more stable during that time. Sometimes, we use SSRIs during that time. We’ll use them sometimes during the luteal phase for that, or we’ll use a higher dose. I wasn’t needing to use that extra dose of sertraline that I sometimes use. That was a great indication. I’ve been pleased with the outcomes. I’m hopeful to be able to get more people connected with that treatment to get better, because our meds only do so much.

I love that there are no side effects. You can drive to the clinic and drive home. It’s not invasive. There’s no reason not to give it a shot.

It’s pretty incredible.

Empowering Clinicians: The Psych NP Bootcamp

Let’s talk about your nurse practitioner bootcamp. You’ve supported so many nurse practitioners. Tell me about your program. What is involved? How does it work? Before you start talking about that, why are you so passionate about this bootcamp?

I have always loved precepting, so I’ve always had a student usually with me as I’m delivering care. I learned from them and they learn from me. It’s a fulfilling collaborative experience. When I broke off and did my own business, I wasn’t precepting as much, and I missed that aspect. I decided to go on social media and talk about being a psych NP. It seemed like the people who were drawn to my content were other psych NP students or new grads, and other providers. I kept hearing the same problems from them, as far as not feeling prepared after school, or having a hard time finding quality preceptorships, or difficulty with the quality of their psych NP education. That type of thing.

I ended up putting together an offering based on hearing these repeated complaints. Since then, it has evolved, and it feels like it evolves all the time because I’m constantly seeking feedback from the people who go through it. It fills a very important need. Not that it’s the solution because it’s a bigger systemic issue, but it helps to provide more resources because it’s also a very lonely and isolating feeling to be new and to have that impostor syndrome and not feel like you have support. It’s not a good way to feel.

Also, a lot of people end up not continuing their careers as psych NPs because they’re like, “That was too heavy. I think I’m good. I am fine. What I was doing was great.” We need more people to provide mental health services. Nurses tend to be more holistic and integrative, which has cool potential, but we still need to have good mentorship. We don’t get a residency like psychiatrists get.

We need more people providing mental health services. Nurses are holistic and integrative, which holds cool potential. Share on X

That seems like it could be an issue.

It is.

When did you start the bootcamp?

A few years ago. It’s quite a while ago.

How long is the program?

The program is technically twelve weeks, but the thing is that people get indefinite access to my community. I’ve had people who have been in it from the beginning who still come to the live coaching and take advantage of the mentorship support. It is proof for continuing ed, which can be a great benefit, especially if an employer will cover that cost. A lot of the people who go through it will talk to their employers and say, “I want to do this transition to a practice program and get additional support. Is this something you would consider reimbursing?” which is pretty awesome. I’ve connected with so many amazing psych NPs across the country through it. It has given me this greater sense of belonging, community, and purpose. It’s been great.

What are the benefits of going through your program?

The benefits are having personalized mentorship, being able to attend the live coaching and bring up cases, and receiving case consultation and feedback on our clinical reasoning. Getting that feedback is very important as a new psych NP because we’re worried about whether we are being safe. Are we doing harm to somebody?

Being able to think through a case is super helpful, and getting feedback from experienced clinicians and learn from other experts, which I bring in other experts in and they lecture on their areas of expertise. That’s huge. They connect with other psych NPs. Networking is a huge aspect, too, and it has led to job opportunities for people. I’m like, “You would be great for. You need to meet this person.” I try to be that connector person.

 

A little bit of a connection network as well.

I would say so. There are people who are more experienced who have been through it, who say that they’re happy they went through it as well, because there is an element of professional development. Also, if somebody is considering doing their own private practice, some support around that. There have been a lot of people who have broken off from their corporate jobs and are able to practice more in a way that aligns with their values. It is nice to have that support and people cheering you on when you decide to do something like that.

Who’s a good candidate for your program?

A psych NP student, a new grad, or an experienced psych NP. Also, family nurse practitioners have gone through the program who work a lot with patients who have mental health conditions. That would be another. Physicians’ assistants who work in psychiatry or family practice, in general, have also benefited from the bootcamp.

Social Media’s Role In Mental Health Innovation

Let’s talk about social media. You’ve got your Instagram channel and your TikTok channel. How do you use those platforms to drive innovation or systems change in mental health care?

I try to provide helpful education. I use it as a way to provide additional clinical education because the reality is people are using TikTok and Instagram like their search engines. I think providing valuable content that I’m getting good feedback on, like, “I’ve never heard it explained this way,” in that practical fashion is something that I try to do, as well as trying to connect people.

We’re very siloed as nurse practitioners, and that’s not good for your mental health. The more that I can post other people on my stories, eyeballs are on that and then their practice. “Maybe I’ll refer to so and so.” It’s a ripple effect, the networking that can occur when you make yourself visible online, which terrified me for the longest time. I thought it was not for me.

You thought it was not for you. Why did you change your mind? How did you dip your toe in the water?

I would go live, and my mom would be the only one watching. It would be awkward, but what prompted it? I think because I was starting a private practice. Originally, that’s how I started the page. It was like under the “It’s going to be my private practice,” and then it didn’t feel like me, then I changed my page from being my private practice page to I’m just me. That was liberating in a way.

It’s helped me with my nurse practitioner identity because that’s been evolving over time for sure. It was one of those things where I was like, “I want to try it.” I got very bored because I was somebody who worked at Subway. I would stay at a job for long periods of time because I’m loyal, and I liked that. I think it was an anxiety thing, too, like knowing what to expect. I got to that point where I’m like, “Take some rest. What’s the worst that’s going to happen? If you hate it, then you can go offline. You don’t have to be on social media.” It’s led to the benefits far outweighing the downsides.

You can correct me if I’m wrong, or let me know if you agree with this. Being on social media creates a level of accountability. It’s almost like you have to be an example. You’ve got to follow through. You’ve got to do the next right thing because you’ve got a whole crowd of people who are watching you. What do you say about that?

You’re exactly right. When you are more accountable, knowing that there are people who are looking at your platform and are struggling with their mental health, and looking for ideas that they can do to help improve their mental health. I always clarify that this isn’t medical advice, and you should have your own provider and things like that. I still think there are a lot of things that can be done earlier, like earlier intervention and even risk factor identification. Education that can be out there that might change somebody’s life, potentially, that they might not have known. That is motivating as well.

AI In Psychiatry: Boosting Effectiveness & Reducing Burnout

You’re also working at the intersection of AI in psychiatry. What excites you most about how technology can support clinicians and patients?

We are often inundated with the administrative burden of insurance requirements, paperwork, and documentation. It’s why I’ve left different jobs at points, because there have been points where I want to care for the patient. I feel like I’m more concerned about all this administrative stuff that I have to do because I don’t want to lose my job. When it starts taking away from your ability to care for the patient in front of you, it doesn’t feel good ethically. It’s not why we went into the field, to be more concerned about our documentation and our paperwork than the actual patients.

Efficiency in terms of documentation is a big one. For clinicians, I also think potentially more precision psychiatry, more individualized ability to look at somebody’s different data points and provide them with better mental health care. It would be ideal. We haven’t had the systems in place to do that, and it’s hard when you have a case load of 300 patients to get that overarching picture of how they’ve progressed when you’re also putting out fires of whatever acute is going on in their life. Having different tools that we can leverage to look at the overall progression is promising. I’m hoping it can lead to better outcomes for patients and less burnout for clinicians and their ability to provide better patient care.

How much more effective are you as a psych NP because of AI?

Much more effective.

Percentage-wise. I would imagine that you’re more effective because you’re able to spend more time with the patients, and then you can more easily look at their data.

I would say 80% more effective.

That’s a lot.

I feel like I am.

I believe it.

I’m not a numbers person, Tim, but I don’t know. That feels good.

You’re 80% more effective, which means you’re able to help more people.

The fact that I can see a patient and not be worried about the documentation piece at that moment is huge because you need that mental space to plan a treatment and to put the pieces together. The more support that you have on that front, the better your treatment plan is going to be, the more comprehensive and personalized.

The documentation is mostly insurance requirements.

Largely.

Demystifying The Psychiatric Nurse Practitioner Role

What are some of the biggest misconceptions about being a psych NP that you wish more people understood?

Who we are and what we do is confusing for people, and I don’t blame them, even in terms of our ability to provide psychotherapy. There are several psych NPs who get additional training in EMDR or different modalities and practice more of that. It’s misunderstood that it can be a part of our role and can lead to better outcomes. That’s another thing I’m passionate about. It’s showing more psych NPS that there are different ways of practicing that might help more patients, and that you might find more fulfilling. It’s not just medication management.

How do you maintain balance between clinical work, entrepreneurship, leadership, and innovation?

I try to spend intentional time looking at where my time is going and what engagements I’m agreeing to, and are these aligning with what’s important to me? If at the end of the day, I’m not spending quality time with my kids, then it’s not worth it. I have to prioritize my family. It’s not perfect, and I am passionate about what I do. Sometimes, when you’re passionate about what you do, you can go down.

When I have ADHD, too, I can go down all these rabbit trails. You’re learning and studying. It’s fun, but also, sometimes I have to rein it in a little bit and be like, “What are my goals for the week?” I have more flexibility in my schedule to be able to do that, and that was the goal. I love that, and I still have things to get done to reach my broader goals.

Cultivating Thought Leadership: Advice For Aspiring Psych NPs

What advice would you give to psych NPs who want to step into thought leadership or start their own program or their own business?

I would say be seen. Don’t be afraid to be visible. A lot of us want to be in the background and not stick out and not put ourselves out there. If I had been willing to put myself out there sooner in my career, because I’ve been a psych NP for a decade, I can’t imagine the opportunities that I would have had if I wasn’t so scared and almost paralyzed to even think about doing that. I was totally in a different mindset about going to conferences. Networking was not top of mind, and I didn’t necessarily understand the value of it. Being visible, networking, being curious when you are meeting these networking connections, and valuing relationships can’t be overstated.

Don't be afraid to be visible. Share on X

My best thinking got me where I am now. If I want to go somewhere else, I probably need to talk to somebody. It’s like I’m the average of the five people that I spend the most time with. If I want to grow or if I want to expand or develop, I’ve got to reach out to some other people who are smarter, more successful, and have what I want.

That can be tricky sometimes when there’s not an exact blueprint of the thing that you’re like, “That’s exactly what I want to be doing,” when you feel like you’re carving your own path. I still think it’s important to do what you’re saying, even though it might look a little bit different. It’s still seeking that feedback and being open to that and being willing to pivot. That has been something that was new for me. Again, being willing to take these micro risks and not like I have to stay in my anxiety bubble of what I know.

I love that you’ve been willing and open to go outside of your comfort zone. That’s how you got to where you are now.

It’s pretty cool because I have social anxiety. I hate it. I still don’t love public speaking. I can’t even tell you the level of anxiety that I would have in grad school. I was thinking about this, being on social media, how much that’s helped because I’ve done a little bit of public speaking. It feels different because I’m mentally used to it and even live. You’re talking to people, and it’s almost like that exposure therapy. I never would have imagined that you would have told me ten years ago, “You’ll be doing this.” I’d be like, “That’s funny.”

I can relate because I am not a natural public speaker. I’m not naturally good in front of big crowds and big groups. Even going to AA meetings and sharing at meetings and sharing at the podium at meetings. That has helped me. I’ve completely transformed, and I’m able to speak in front of large groups and large audiences. It’s not a big deal. I was thinking as you were talking, you said, “I’m not good in front of large groups.”

I went to Joe Dispenza’s retreat. He invited somebody to go to one of his events, and they said, “I’m not a good learner. I have ADHD.” He said, “Is that your affirmation?” Anytime I say anything like, “I’m not good at climbing up hills.” Is that my affirmation? “I’m not good at public speaking.” It has caused me to think about things before I say them. Instead of saying I’m not good at public speaking. I’m getting better at public speaking because whatever you believe is true.

Also, you might have that automatic thought. Do you challenge it? Do you let that stop you there, or can you work through it and still put yourself out there and take that risk? There’s a big difference there. Some people get stuck at the thought.

If they believe they’re not good at public speaking or climbing up hills or whatever, you’ve got no chance. Being able to face it head-on has been helpful in my experience. Are there any questions that I did ask you that I should have asked you?

I don’t think so.

Let’s talk about your morning routine. Tell me about your morning routine.

My morning routine, honestly, I have a five-year-old. Doing a low-dopamine morning where we’re not on screens. We’re engaging and playing. It’s organic. Sometimes that means going in the pool.

This time of year, 5:00 AM is probably pretty nice to go into the pool before the sun comes up.

Being able to treasure those special moments that I know won’t be there forever is important to me. I tend to schedule my work in such a way and my patients where I can start a little bit later and enjoy that time and do some reading. I ground myself for the day so that it’s not straight on my phone. That’s hard, though. It’s a struggle. We’re a screen-heavy society, and that’s a struggle for me, too, where I have to reevaluate that screen time, especially in the morning, because it changes the trajectory of my day.

How much time do you try to give yourself before you hop on the screen?

Ninety minutes. I’m not perfect at it.

At least you know. I think most people hop on their phone first thing. Their phone is next to their bed. They pick up their phone, and they’re on Instagram or TikTok or whatever they look at. It’s right away.

I’ve certainly been in those habits before. Remembering why I’m doing it and being that example for my sons. That’s important.

Where can people find you? How can they learn more about your Psych NP Bootcamp? How can they connect with you?

In social media. My handle is @PsychNPCEO. They can find me on Instagram, TikTok, and LinkedIn. I’d love to connect with people and help in any way that I can on their journeys.

That pretty much brings us to the end of our show. Thank you so much for reading. Lindsay, thank you so much for being here. I appreciate you and your time. Anybody who’s reading, make sure you connect with Lindsay on Instagram or TikTok. We will see you in the next episode.

Thanks for having me, Tim.

 

Important Links

• Dr. Lindsay Hill
• Dr. Lindsay Hill on LinkedIn
• Dr. Lindsay Hill on Instagram
• Dr. Lindsay Hill on TikTok
• The Psych NP Network
• APNA Arizona Chapter
• Camelback Recovery
• Camelback Integrated Health and Wellness

 

About Dr. Lindsay Hill

Lindsay Hill, DNP, PMHNP-BC, is a psychiatric nurse practitioner, educator, and entrepreneur dedicated to transforming mental health care. With a DNP in DBT, she simplifies complex psychiatric concepts into actionable tools for clinicians.

She’s the founder of PMHNP Bootcamp™ and co-founder of the Psych NP Network, supporting thousands of providers nationwide.

As President of the APNA Arizona Chapter and an AI healthcare consultant, Lindsay is passionate about advancing innovation, improving workflows, and empowering mental health professionals to lead with clarity, confidence, and compassion.