Threads of Care - Continuity and Change on the Clinical Team at Gould Farm

Nancy Masino Martin, LICSW, Clinical Director

After nearly 25 years at Gould Farm in various clinical roles, we are happy to announce that Nancy Masino Martin has accepted the position of clinical director, following a year serving as acting clinical director. Her tenure overlaps deeply with that of Jane Linsley, who led the clinical team for two decades and recently retired.

Who we serve & our model

Gould Farm serves adults living with serious mental illnesses – most commonly mood and thought disorders.  These issues have significantly disrupted their relationships, education, employment, and sense of self. Guests arrive at the farm in a myriad ways; some after hospitalization or other residential programs or attempts at outpatient treatment that have not led to sustained stability.

The Gould Farm model is described as a long-term, residential therapeutic community built on three interwoven elements: clinical care, meaningful work, and shared community life. These are not separate tracks running in parallel; they are interdependent.

What a guest is working on in therapy may help shape how they participate on the farm team that week. A difficult interaction in the garden crew may become material for reflection the next morning. A pattern that once led to isolation in the outside world will often surface again here – this time in a setting with structure, support, and time to address it more deeply.

Time is a critical part of our model. Gould Farm is a longer-term treatment model because rebuilding stability, trust, and capacity rarely happen quickly. This is the context within which our clinical team operates, a team Nancy knows well from the inside out.

Learning the model from the inside

Nancy began as a case manager in our Boston residential program, living and working at Farrington House. At the time, case managers wore many hats: meeting individually with residents, supporting the work program, cooking dinner alongside guests, answering late-night calls, driving to appointments, and doing overnights. “It was a small team,” she recalls. “And everyone helped with everything!”

Most of the guests in Boston had previously lived at the Farm. What struck her most was how they spoke about their time on the Farm. People who had left the Farm years earlier would connect over shared memories: the bell that rang for breakfast, collecting sap with Bob, loving “potato day”... They reminisced the way families do: complaining, laughing, remembering. For Nancy, still early in her career, this was formative. The Farm was not just time spent in treatment, but a source of ongoing connection. 

Later, when she began visiting the Farm in Monterey monthly from Boston to help support transitions, she was struck again, this time by the clinicians. “They weren’t talking about symptoms and limitations, they had dreams for people,” she says. Clinical conversations were grounded in intimate knowledge of vulnerability, yes; but they were also oriented toward possibility beyond the Farm. That orientation shaped Nancy’s decision to pursue social work school and eventually return to the Farm as a clinician.

She describes those early years as overwhelming. “One of the hardest things is tolerating that you don’t have a lot of answers,” she says. “When you’re new, it's challenging to tolerate all that you don't know while also trying to be effective and helpful. You have this important part to play in someone’s recovery.” Over time, not having answers became less a deficit and more a stance: the capacity to tolerate complexity, to stay steady in uncertainty, to accompany rather than direct.

That stance has roots in her personal life. As a teenager, Nancy watched her uncle experience a manic episode and psychiatric hospitalization. The adults around her didn’t know how to think about what was happening or how to help; they were uncertain, unsettled. That destabilizing moment drew her to better understand the situation for herself, to gain knowledge and skills, and be able to provide support to others in times of crisis.

The clinical team as a structural thread

If you ask Nancy to describe the clinical team’s role, she reaches for an image. “Think of a tapestry,” she says. “The vertical threads you don’t see much – the ones the colorful fibers weave through.” The clinical team is part of that structural threadwork along with the work program and community life.

Our clinical team, including the nursing office, provides individual therapy and coordinates psychiatric and medical care. They hold risk, manage symptoms, and partner with families who are often struggling with acceptance, frustrated with previous systems, hopeful for new beginnings, and deeply invested. They operate within licensure requirements, documentation standards, and regulatory accountability that are not always visible from the outside. At the same time, they sit at lunch, walk the trails, dress up as the Golden Girls at Halloween, and raise their children here.

This creates complexity. In most outpatient settings, therapy is private and separated away from everyday life. Here, confidentiality and team-based care blend and coexist. Clinicians hold confidential spaces for guests while providing psycho-educational context to work team leaders and residential advisors to forward care. 

For one of the new clinical team members, Janna Delgado, who previously worked in outpatient settings, that level of integration was striking. “In the outpatient setting, it can feel solitary,” she says. “Here, it’s collective. From the outside you think, ‘Wow, there are a lot of meetings here!’ But those meetings are the glue. The baton gets passed well between people.”

Community is not a shortcut

When asked what Gould Farm does particularly well, Nancy answers without hesitation: “We create and invite people into community.”  For adults whose mental health struggles have taken them out of work, out of school, out of reciprocal relationships, that invitation can be life-saving. Community here is not abstract; it is negotiated daily: where to sit at lunch, how to manage a conflict in the kitchen, whether to join a walk, and whether to speak up in a meeting.

Some people arrive hoping the change in environment will relieve their distress, and when symptoms and patterns persist, it can be discouraging. And yet many discover that the patterns they hoped to leave behind reappear here. That can be demoralizing. And it can also be where change becomes possible. With structure and time, guests can experiment with new ways of responding. They can be deeply vulnerable in therapy and later contribute meaningfully to a work crew. They can experience themselves not as “patients”, but as coworkers, neighbors, musicians, bakers…

Jane Linsley, outgoing clinical director, often described the Farm as a place that helps people come back into relationship with themselves and others. Nancy returns to that language now, aware that it names an ongoing process rather than a fixed endpoint.

Serious mental illness can fracture a person’s sense of trust in themselves and the world. The work here is not to produce a new, healed self. It is not about restoration, and there is no destination at which one “arrives” and is done. Instead, the work is about supporting an ongoing process of re-engagement and return – to one’s own capacities and to relationship with other people.

Leadership and what continues

As Nancy steps fully into the clinical director role, she does so with a clear awareness that the position continues to evolve. “We learn something different with every person that comes here and every challenge we face. We both evolve and stay true to our mission. Though I have a lot to learn, I am excited to formally take on this role and support the team in the important work that we do with each guest.”

That humility feels consistent with the model itself: no quick fixes, no final answers, but a sustained commitment to thoughtful, integrated care. The threads continue even as the pattern shifts. The work – clinical, communal, and deeply human – goes on.