Are Therapist Conferences Elitist? An interview with Linda Thai, LMSW Curt and Katie interview Linda Thai on her experiences as a conference attendee, keynote speaker, and educator. We discussed the need for more accessible, community-centric, and culturally humble education as well as how to more effectively share knowledge. The limitations of traditional educational models (which Linda calls the Continuing Education Industrial Complex) are discussed as well as how conferences can be exclusive or elitist. We explore how to best access continuing education and take advantage of all types of educational opportunities. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode, we look at how privilege and elitism show up in therapist conferences. Katie recently took one of Linda Thai’s courses and was fascinated by the way that she was able to make an engaging virtual course. We reached out and requested she share her wisdom with us and we found ourselves talking about the nature of continuing education.   Why should therapists attend (or not attend) mental health conferences? ·      If you understand what type of conference you are attending and take advantage of that opportunity (to learn, build community, or something else) attending mental health conferences can be beneficial to therapists ·      There can be an inherent elitism in conferences, both in who is able to comfortably attend as well as who can participate as speakers or in supporting conferences ·      Continuing education can also have bias and privilege white (typically female) therapists, especially those who have been in private practice for many years. ·      Conferences are often events designed to inspire and create community, the learning experiences may not be as deep as therapists need to truly get what they need as clinicians What are the primary concerns in continuing education for mental health professionals? ·      What qualifies as continuing education seems limited (i.e., lived experience is discounted as valid education) ·      There is a bureaucracy within continuing education approval that makes it difficult for speakers and conference hosts to be able to allow for interactivity and emergence within the workshops ·      Too often the same speakers are elevated and there is a need to center lived experience and marginalized voices to co-create collective learning and liberation Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement: Our Linktree: https://linktr.ee/therapyreimagined Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/

How Much is Too Much? Thoughts on therapists being too branded, niched, and political Curt and Katie chat about the delicate balance between authenticity and influence in therapy, with a focus on avoiding bias and discrimination while still being real people. We also navigate the challenges of political discussions in therapy, emphasizing the need to balance political awareness with client needs and goals. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we explore the risks of bringing too much of your own beliefs into your work as a therapist We have been rethinking the conversations we’ve had about blank slate and the Brand Called You. We look at the risks of being too branded or niched, or too political. We also talk about what might be more beneficial for clients, without losing the work toward authenticity and real connections as therapists. Do therapists bring too much of themselves into their work? Curt and Katie did a CE presentation and then an episode called the Brand Called You, which talks about how to create personal branding as a therapist to refine who seeks you out for therapy When you bring yourself into the therapy room, you want to assess for bias and discrimination If you’ve advertised a specific type of treatment or, especially, a specific type of outcome, you may be unduly influencing clients who may not know if that outcome is right for them How can therapists be “political” without just talking politics or inappropriately influencing their clients? Therapists can successfully navigate political discussions in therapy to benefit clients. It is important to distinguish between political in therapy (systemic pressures, opportunities, access) vs pushing viewpoints (talking about politics, biased) Discussions about the limitations of resources or systemic pressures are political Conversations about voting for a particular party would be talking politics Helping clients to look at things from a different viewpoint may be helpful, but only if you assess your own bias and the client’s readiness It can be challenging to be a political therapist, clients may feel uncomfortable or resistant to discussing political issues in therapy What can therapists do to balance branding and authenticity with effective client care? Tailor your client sessions to their needs and perspectives and values Consider providing additional referral resources for clients whose goals do not directly align with a therapist's specialized approach. Evaluate whether strongly branding oneself risks prioritizing showing one's values over directly addressing what clients are asking for in therapy. Assess the efficacy of your treatment for the client in front of you. Make sure even clients who resonate strongly with a therapist's approach are empowered to think critically and come to their own conclusions. Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement: Our Linktree: https://linktr.ee/therapyreimagined Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/

More Than Cogs in the Machine: Bringing trauma-informed principles into the workplace Curt and Katie chat about trauma-informed workplaces. We explore what a trauma informed workplace is, why it is important to implement, and how best to do so. We also explore some practical challenges to creating a trauma-informed workplace and ideas for how to handle these challenges. This is a continuing education podcourse. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about how to create a trauma-informed workplace People affected by trauma are expected to perform in the workplace, but often have difficulty with environments that treat them as replaceable. This can lead to employee underperformance, burnout, and turnover in the workforce. Healthy interactions with the workplace can help both the individual and corporate performance. This workshop addresses principles and practices that allow for employers to create a trauma informed workplace. What is a trauma-informed workplace? ·       Remembering that all workers are human ·       Collaboration and encouraging autonomy for employees ·       Acknowledging that trauma exists for everyone ·       Trauma is addressed in the workplace (e.g., mitigating secondary or vicarious trauma) ·       4 R’s of Trauma can give guidance to how to identify and respond to trauma ·       Supportive policies go beyond self-care ·       There is a systemic mechanism to support staff and improve ·       Based in trust and trustworthiness What are the risks of not having a trauma-informed workplace? ·       Lower employee productivity, lower quality work ·       Higher levels of burnout, absenteeism, presenteeism ·       Recreating past traumas when we’re not aware of the dynamics in play How can therapists create and benefit from a trauma-informed workplace? ·       Create supportive policies and procedures ·       Evaluate how well trauma informed principles are being implemented ·       We discuss an evaluation tool for this purpose ·       CTIPP Toolkit (Campaign for Trauma Informed Practice and Policies) ·       Acknowledge shared humanity ·       Creating connection and collaboration between team members ·       This may be something that needs to be repaired or built within a workplace that has problems ·       Understanding how to build, sustain trust, and effectively take feedback and implement it ·       Transparency and accountability What are some challenges in implementing a Trauma-Informed Workplace? ·       Very challenging conversations needing repeated repair ·       Avoiding conversations about trauma ·       Digging deeply into emotional life of employees (i.e., with the potential of HR violations) ·       Practical limitations to what employers can provide to their employees ·       Us versus them mentalities and not seeing opportunities to collaborate Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide CAMFT CEPA: Therapy Reimagined is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LPCCs, LCSWs, and LEPs (CAMFT CEPA provider #132270). Therapy Reimagined maintains responsibility for this program and its content. Courses meet the qualifications for the listed hours of continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences. We are working on additional provider approvals, but solely are able to provide CAMFT CEs at this time. Please check with your licensing body to ensure that they will accept this as an equivalent learning credit. Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement: Patreon Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/  

Medical Assistance in Death (MAiD) in Canada: Mental Illness and Assisted Suicide Curt and Katie chat about assisted suicide related to an upcoming expansion of the MAiD laws in Canada to include mental illness. We discuss what these laws seems to say as well as how they might impact patients, medical providers, and therapists. We explore the moral and ethical questions as well as what other countries have done to put in further safeguards to protect patients and doctors.   Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about the expansion of Medical Assistance in Death laws in Canada We have been watching the MAiD laws in Canada that are soon going to include assistance in death for folks with mental illness. We talk about the law and the concerns we have related to the safeguards (or lack of safeguards). What are the updates coming to the Medical Assistance in Death laws in Canada? With the approval of 2 medical professionals and a 24-month waiting period (for psychological illness), individuals can get medication or an injection from a medical provider to end their lives Requirements for application include chronic, “grievous and irremediable” conditions Information on requirements are here: Final Report of the Expert Panel on MAiD and Mental Illness The differences in laws in other countries that seem to have more safeguards in place What are the moral and ethical questions facing medical and mental health providers? “Do we have the right – the moral right – as therapists, mental health professionals of any sort of background or license, to tell clients that they must live or that it is okay for them to end their life?” – Curt Widhalm, LMFT What responsibilities do mental health providers have to their clients related to end of life? Who will be negatively impacted versus who will be positively impacted? Who would qualify and who would seek out assistance in dying? “I'm not worried that someone that's a little depressed is going to decide they want to die by suicide… I think it's more that there are going to be folks [diagnosed with serious mental illness who are receiving insufficient mental health care] … who really don't feel like they have options (and maybe they don't) and they choose to die by suicide versus advocating for stronger treatment.” – Katie Vernoy, LMFT What is mental illness? Is it only what is in the ICD or DSM? What are the impacts of these laws on physicians? Concerns raised by First Nations groups in Canada Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Final Report of the Expert Panel on MAiD and Mental Illness NY Times: Is Choosing Death Too Easy in Canada? Medical Assistance in Dying in Canada: Too Much, Too Fast?  Canadian and Dutch doctors’ roles in assistance in dying Relevant Episodes of MTSG Podcast: Part 1: Risk Factors for Suicide: What therapists should know when treating teens and adults Part 2: What Therapists Should Actually Do for Suicidal Clients: Assessment, safety planning, and least intrusive intervention What's new in the DSM 5-T-R? An interview with Dr. Michael B. First When Clients Die: An interview with Debi Frankle, LMFT Therapists Struggling with Darkness Suicidal Therapists: An interview with Norine Vander Hooven, LCSW Therapist Suicide Consultation services with Curt Widhalm or Katie Vernoy: The Fifty-Minute Hour Connect with the Modern Therapist Community: Our Facebook Group – The Modern Therapists Group Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/

What Therapists Should Actually Do for Suicidal Clients: Assessment, safety planning, and least intrusive intervention Curt and Katie chat about suicide assessment, safety planning, and how to keep clients out of the hospital. We reviewed the Integrated Motivational Volitional Model for Suicide, we talked about what therapists should be assessing for in every session, what strong assessment looks like (and suggested suicide assessment protocols), and why the least restrictive environment is so important when you are designing interventions and safety planning. This is a continuing education podcourse. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about suicide assessment, safety planning, and intervention We continue our conversation on suicide, progressing from risk factors (from last week’s episode) to how to assess and safety plan with the least intrusive interventions at the earliest stages.  Review of the Suicide Model: Integrated Motivational Volitional Model by O’Connor and Kirtley   Continued to review the IMV model (graphic in the show notes at mtsgpodcast.com) What should therapists assess for in every session, related to suicide? “When clinicians are burnt out, when we have caseloads that are too big, when we aren't taking care of ourselves, we tend to [think], “Okay, this client is at a six, they can live at a six for a while,” which is absolutely true. And if they can [live with this level of suicidality], and they have the good factors that allow them to live there – great. It's just how close are they to that 7, 8, 9?” – Curt Widhalm, LMFT Moderating motivational factors, which move clients from passive to more active suicidality (or the reverse) Looking at what is keeping someone from being at risk for suicide (protective factors) The importance of knowing our clients well before they move into the volitional phase Understanding the clinician factors and putting structure around assessment Assessment for Suicide “Assessment is intervention.” – Curt Widhalm, LMFT SAMHSA’s GATE protocol Gather information using a structured assessment tool (Columbia Scale, LRAMP) Looking at intention, means, plan as well as risk and protective factors Moving into a safety plan The importance of recognizing the human during the assessment (versus focusing only on the protocol or your liability) Seeking supervision or consultation – don’t do this alone The importance of using the least restrictive intervention for suicide “There is a rupture in the therapeutic relationship when you are sending your client or facilitating a hospitalization against their will. It can save their lives …but that may not always be the case.” – Katie Vernoy, LMFT The idea of “responsible” action The range of options for keeping a client safe Having a conversation with the client on how to avoid attempting suicide The potential impacts of hospitalization, including trauma The danger of hospitalizing someone who does not need this level of intervention Additional intervention between sessions The practicalities to set up your schedule and your practice to support your clients and your self Additional risk factors (transition phases between providers)  

Risk Factors for Suicide: What therapists should know when treating teens and adults Curt and Katie chat about suicide risk factors. Suicide rates have been increasing across the nation and there is an increasing need for the mental health workforce to be prepared to assess and intervene with clients of all ages. We take an in-depth look at the risk and protective factors associated with suicidal ideology and behaviors in both teens and adults. We also lay the beginning foundations of a suicide model to help clinicians better understand and intervene with clients exhibiting suicidal thoughts. This is a continuing education podcourse. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we explore what makes someone more likely to attempt suicide We’ve talked frequently about suicide, but thought it would be important, especially during Suicide Prevention Awareness Month, to go more deeply into the risk factors that make someone more likely to attempt and complete suicide.  What are the highest risk factors for suicide? “Anxiety Sensitivity… the fear of the feelings of being anxious… is even more so correlated with suicidal ideation and suicide attempts than depression is.” – Curt Widhalm, LMFT Defining acute, active suicidality (versus passive or chronic suicidality or non-suicidal self-Injury) Going beyond the list of risk factors to how big of a risk each factor is for attempting or completing suicide Exploring how impactful a previous attempt is on whether someone is likely to attempt of complete suicide The importance of getting a complete history of suicidality and suicide attempts at intake The impact of family members who have attempted or died by suicide Alcohol and other substance use and abuse as an additive risk factor Cooccurring mental disorders (eating disorders, psychosis and serious mental illness, depression, anxiety and anxiety sensitivity, personality disorders) Child abuse history, especially folks with a history of sexual abuse history Life transitions, especially unplanned and sudden life transitions Owning a firearm makes you 50 times more likely to die by suicide Racial differences in who is more likely to attempt or complete suicide Living at a high elevation What are additional risk factors for suicide specific to teens? Early onset of mental illness Environmental factors Exposure to other suicides (social media, contagion) Not being able to identify other options Seeking control over their lives and lacking impulse control leading to suicide attempts The importance of communication and the potential for a lack of communication Bullying and lack of social support, without a way to escape due to social media and cell phones What are protective factors when assessing for suicidality? “Just because protective factors are present doesn't mean that they balance out risk factors [for suicide].”– Curt Widhalm, LMFT Reasons for living, responsibility to others Spirituality or attending a place of worship that teaches against suicide Where you live based on cultural or societal factors Having a children or child-rearing responsibilities, intact marriage Strong social support, employment Relationship with a therapist   Suicide Model: Integrated Motivational Volitional Model by O’Connor and Kirtley

How Therapists Can Manage a Sedentary Job: An interview with Celina Caovan, DPT Curt and Katie interview Celina Caovan about physical self-care for therapists. We talk about how to mitigate the impacts of a sedentary job as well as the benefits of physical therapy and consistent physical activity. We also look into what physical therapy is, how clients can advocate for it, and how therapists might collaborate to support the physical and mental health of their patients. Transcripts for this episode will be available at mtsgpodcast.com! An Interview with Celina Caovan, DPT Celina Caovan received both her undergraduate degree and Doctorate of Physical Therapy degree from the University of Southern California. She has been practicing in an outpatient orthopedic setting in the South Bay in California for the last two years and is a Certified Strength and Conditioning Specialist. In this podcast episode, we talk about how therapists can take care of their bodies while working in a sedentary job Many therapist friends of ours have described low back pain and challenges in maintaining physical health when much of the work we do is while sitting. What should therapists know about physical activity and physical therapy? “Physical therapists are trained movement experts… we can diagnose, we can treat using hands on skills, patient education, and then we prescribe individual exercise for a bunch of different injuries, the ultimate goal being to improve the way someone moves and emphasize injury prevention. And the cool thing about physical therapy: it can be an alternative to pain medication, in a society where they prescribe a lot of a lot of pain medication, and then surgery as well.” – Celina Caovan, DPT There are a number of subspecialties in physical therapy to support all different elements of improving movement The importance of moving outside of a sedentary job US Department of Health guidelines on activity levels What can therapists do to take care of themselves during the work week? Getting out of the chair, some chair exercises Stretching and gentle movements during the breaks between sessions No drastic differences in activity from the work week to the weekend (i.e., avoid weekend warrior behavior, especially when extremely sedentary during the week_ Slowly increase activity and gradually increase cardio or resistance training Stretching (static and dynamic), warming up, and cooling down How can therapists think about physical therapy for their clients? “Someone's physical and mental health – that’s interconnected… that mind body connection. And I think this would be a really great opportunity for us to create this interdisciplinary relationship where we can approach it from a physical and mental standpoint.” – Celina Caovan, DPT Referrals and direct access to physical therapy Psychoeducation and support for advocacy to obtain physical therapy Chiropractors versus physical therapists How physical and mental health therapists can collaborate to support patients  Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Physical Activity Guidelines for Americans from the US Department of Health and Human Services Beach Cities Orthopedics and Sports Medicine Reach out to Celina Caovan, DPT: celinaDPT at gmail.com Consultation services with Curt Widhalm or Katie Vernoy: The Fifty-Minute Hour Connect with the Modern Therapist Community: Our Facebook Group – The Modern Therapists Group Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/

Therapists on the Hostage Negotiation Team and Supporting Police Work: An interview with Dr. Andy Young Curt and Katie interview Andy Young about hostage (crisis) negotiation and his work with SWAT and crisis negotiation in Lubbock, TX. Content warning: discussion of violence, suicide, and homicide. We talk about what therapists can do within police departments, the interplay between mental health and law enforcement, what that work looks like – especially when involved in crisis negotiation, and skills therapists need when working in these settings. We also look at trauma response and how it is handled when things go south. Transcripts for this episode will be available at mtsgpodcast.com! An Interview with Dr. Andy Young Dr. Andy Young has been a Professor of Psychology and Counseling at Lubbock Christian University since 1996 and a negotiator and psychological consultant with the Lubbock Police Department’s SWAT team since 2000. He also heads LPD’s Victim Services Unit and is the director of the department’s Critical Incident Stress Management Team. He has been on the negotiating team at the Lubbock County Sheriff’s Office since 2008 and is on the team at the Texas Department of Public Safety (Texas Rangers, Special Operations, Region 5). He is the author of, “Fight or Flight: Negotiating Crisis on the Frontline” and “When Every Word Counts: An Insider’s View of Crisis Negotiations.” He was recently added as a third author for the 6th Edition of “Crisis Negotiations: Managing Critical Incidents and Hostage Situations in Law Enforcement and Corrections”. In this podcast episode, we talk about the role therapists can play in crisis negotiation There have been many calls to defund the police and create roles for mental health professionals in law enforcement. Dr. Andy Young has already been doing this for 20 years. We talked with him about what that experience looks like. What can therapists do for law enforcement? Crisis counseling Hostage or Crisis Negotiation support (advising on the negotiation) Psychiatric consultation Predicting violence or suicide, assessing subjects’ mental health What is the interplay between mental health and law enforcement? Police officers get 40 hours of active listening and mental health Officers started out a bit stand-offish, reported increased mental load due to needing to protect mental health professionals at the scene Finding value in taking mental health out of scope of law enforcement There is a huge importance in developing relationship with the officers Specialized training needed that can support integrating mental health providers into law enforcement teams What does work look like for therapists in law enforcement and crisis negotiation? Coaching on communication Assessing the situation and the subject Strategizing interventions to de-escalate the situation Provide context and reassurance to law enforcement professionals Hostage Negotiation calls are typically once to twice a month (and not every month). There are successful outcomes 97% of the time How do these law enforcement and mental health providers handle things when they go south? Crisis support Critical Incident Stress Management Mental health providers who are accepted within the law enforcement culture The political, investigative and personal elements of a lethal force incident Processing and debriefing within the team What skills should therapists have to work with law enforcement and hostage negotiation? Pragmatic and understanding the situation you’re in Practical, knowing your own limits Ability to manage emotional situations calmly Navigating the extreme stakes out in the streets Understanding law enforcement The benefit of having a mental health provider on a hostage negotiation team Training the team on mental health concerns Improving “batting average” on successful outcomes The importance of a well-trained team Resources for Modern Therapists mentioned in this Podcast Episode:

Why Therapists Shouldn’t Be Taught Business in Grad School Curt and Katie debate whether graduate school programs for therapists should include business education. We look at the pros and cons for including business education for students, specifically identifying a mismatched developmental level, bloated curriculums, and underutilized career resources. We also look at the responsibility graduate schools have to their students to be employable or to be able to create a sustainable business.  Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about whether clinical grad programs should include business education We have seen marketing that highlights that business isn’t taught in grad school (and have done a lot of it ourselves). We discuss whether it actually should be included. What is already included in grad school for therapists? A large number of clinical courses required for graduation Career centers and other business resources may be available, but not used What career or business resources should therapists get through graduate school? Career centers with up-to-date relevant employment resources Potentially an optional class or workshop for how to run a business Why shouldn’t business education be added to clinical programs? “The timing of it just isn't right. Like, yeah, these are ideas that can be introduced, but the practicalities of it, in my experience, just aren't developmentally where a lot of grad students are… I don't think that [teaching someone to run a business] at a developmental time when people aren't capable for it or aren't ready for it – or legally not allowed to put those things in place – it just ends up being so far off that it's not a practical sort of training thing.” – Curt Widhalm Accreditation bodies don’t access for employability, so programs won’t focus their attention The increasing number of credits required to become a therapist Developmentally inappropriate timing for what therapists are able to do when they graduate What would business education look like if it were included in graduate programs? “I'm not ready to let the grad schools off the hook for their responsibility to students. I feel like they are responsible to students to adequately prepare them for the job.” – Katie Vernoy Potentially lackluster participation due to overwhelm The importance of introducing what clinicians will actually face Seminar versus a full course Orientation to job options and business basics Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Saving Psychotherapy by Dr. Ben Caldwell

What Goes in Your Notes? Interstate therapy practice and documentation for clients considering abortion or gender affirming care Curt and Katie chat about documentation and practice questions related to abortion or gender affirming care when providing therapy to folks in states where these types of medical care are banned or will be banned soon. We look at medical documentation privacy concerns (related to HIPAA and the 21st Century Cures Act), how therapists avoid “aiding and abetting” a client to get an abortion, what to include in your notes, and special considerations related to duty to warn and child abuse reporting. This is a law and ethics continuing education podcourse. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we explore post-Roe documentation for therapists We’ve heard a lot of questions about what therapists should do now that Roe has been overturned. We decided to dig into practice and documentation guidelines to help modern therapists navigate the changing times. Medical documentation privacy concerns with interstate practice and the new abortion bans HIPAA and the 21st Century Cures Act The impact on clients who move from safe haven states to states with abortion bans The impact of the Counseling Compact (and similar mental health compacts) and how many participating states have trigger laws to ban or limit abortion Paying attention to jurisdictional differences and where the client lives Who qualifies as a HIPAA covered entity? Psychotherapy (Process) Notes versus Progress Notes Psychotherapy notes are not defined the same and/or protected in every state The impact of civil law suits on confidentiality of process notes The huge challenge of information blocking and who may pass along your treatment information Talk to an attorney or your professional organization when subpoenaed How do you avoid “aiding and abetting” a client to get an abortion during mental health treatment? Processing feelings and helping client to make their own decisions Aiding and abetting can include telling them where to go, encouraging them to get an abortion, or providing practical support (like money or a ride) How to provide resources without aiding and abetting Self-empowerment and clients making their own decisions Liability and risk in practice (check with your malpractice insurance) Whether/how you let your clients know where you stand on the overturn of Roe v Wade What do you include in your notes when talking about abortion and gender affirming care? What is relevant to your treatment goals? Documenting progress toward treatment goals Creating a policy related to medical decision-making Phrases that you can use to briefly describe what is happening in session How much to document and the recommendation to be less specific in progress notes when discussing medical decisions The special considerations related to duty to warn and child abuse reporting when talking about abortion and gender affirming care No case law to guide us here The difference between permissive versus required reporting Vast differences across the states with all of the different pieces HIPAA says that we should not report, but we will be impacted by state laws Recommendations to pay attention to what is happening in the states where you practice and to identify advocacy opportunities to protect information, safe haven laws

An Interview with Metta World Peace Metta World Peace played professional basketball for 19 years. He won the NBA World Championship with the LA Lakers in June 2010 and received the J. Walter Kennedy Citizenship Award – the NBA’s highest citizenship and community service honor – in April 2011. He was selected to the 2005-06 NBA’s All-Defensive Team, was voted by the media as 2003-04 NBA’s Defensive Player of the Year and was the only man with 271 steals in his first two seasons in the NBA, breaking Michael Jordan’s record. His autobiography, “No Malice: My Life in Basketball” was released in May 2018 with Triumph Publishing and a documentary on his life in basketball, “Ron Artest: The Quiet Storm” was released on Showtime in May 2019. World Peace is currently pursuing entrepreneurial projects including the XvsX Sports project he cofounded in 2017 and an NFT project, Meta Panda Club, to bring decentralized basketball community to the masses. World Peace is also known as a prominent mental health advocate, pop culture personality, philanthropist, and media favorite. He raffled off his 2010 NBA World Championship Ring with the proceeds going to his nonprofit, Xcel University (now known as Artest University). The online ring raffle raised more than $650,000. Funds were donated to nonprofits in 5 cities that provide mental health therapists and mental health services to their communities, and to provide scholarships to underprivileged youth in the New York City area. World Peace was part of the 13th season of ABC’s Dancing With The Stars, a contestant on CBS’s first edition of Celebrity Big Brother, as well as the CBS competition show, Beyond The Edge. He is active in entrepreneurial endeavors, serves as an advisor to several tech start ups, and seeks to help other basketball players who have aspirations for a pro career with his app and league, XvsX Sports. For more information, please visit https://www.xvsxsports.com/, https://metapandaclub.com/, and https://artestuniversity.org/. Why did Metta World Peace start speaking about his mental health? Metta shared his story growing up The Crack Epidemic and the impact on his neighborhood The challenges of incarceration, lack of education, and access to resources Building a shell to protect yourself on the streets What you learn and practice in the neighborhood he grew up in The role of history and the impact of slavery on mental health of generations of Black people The number of friends who are incarcerated The role of “chemical imbalance” in the mental health landscape and the family members who have dealt with more serious mental illness Metta’s desire to give back to the mental health community How Metta World Peace is working to solve the problems that lead to poor mental health The meaning of his name and why he changed it Coming together with all types of people Pushing back on separation and division or divisive statements No guns or drugs allowed in my neighborhood Challenging what has been defined as “life” in his neighborhood The lack of connecting resources (like parks) in all neighborhoods The importance of play and letting kids be kids The challenges that Metta World Peace faces in putting forward his message Describing self as emotional and colorful Needing to boost his confidence Mental health stigma before his first disclosure (thanking his therapist in 2010) How people perceive Metta versus how he sees himself interacting in the world Metta World Peace’s vision for the future Everyone has access to mental healthcare Everyone has a chance to have a good life We try to understand each other and what motivates them, what they are going through People coming together to improve society Parenting and partnership training in schools Putting parks in every neighborhood so kids can play, connect, and be kids

Infant and Early Childhood Mental Health: An Interview with Dr. Barbara Stroud An Interview with Dr. Barbara Stroud Barbara Stroud, PhD, is a licensed psychologist with over three decades worth of culturally informed clinical practice in early childhood development and mental health. She is a founding organizer and the inaugural president (2017-2019) of the California Association for Infant Mental Health, a ZERO TO THREE Fellow, and holds prestigious endorsements as an Infant and Family Mental Health Specialist/Reflective Practice Facilitator Mentor. In 2018 Dr. Stroud was honored with the Bruce D. Perry Spirit of the Child Award. Embedded in all of her trainings and consultations are the activities of reflective practice, demonstrating cultural attunement, and holding a social justice lens in the work. Dr. Stroud’s book “How to Measure a Relationship” [published 2012] is improving infant mental health practices around the globe and is now available in Spanish. Her second book, an Amazon best seller, “Intentional Living: finding the inner peace to create successful relationships” walks the reader through a deeper understanding of how their brain influences relationships. Both volumes are currently available on Amazon. Additionally, Dr. Stroud is a contributing author to the text “Infant and early childhood mental health: Core concepts and clinical practice” edited by Kristie Brandt, Bruce Perry, Steve Seligman, & Ed Tronick. Dr. Stroud received her Ph.D. in Applied Developmental Psychology from Nova Southeastern University, and she has worked largely with children in urban communities with severe emotional disturbance.  Dr. Stroud’s professional career path has allowed her to work across service delivery silos supporting professionals in mental health, early intervention (part c), child welfare, early care and education, family court staff, primary care, and other arenas. She is highly regarded and has been a key player in the inception and implementation of cutting-edge service delivery to children Prenatal to five and their families; her innovative approaches have won national awards. More specifically, Dr. Stroud is a former preschool director, a non-public school administrator, director of infant mental health services and agency training coordinator. She has held an adjunct faculty position at California State Long Beach and maintained a faculty position in the Infant-Parent Mental Health Fellowship for 12 years. Currently, Dr. Stroud’s primary focus is professional training and private consultation from an anti-racist lens, with a focus on social justice, in the field of infant mental health. Dr. Stroud remains steadfast in her mission to ‘changing the world – one relationship at a time’. What is infant and early childhood mental health? Looking at big feelings and social and emotional development The current brain science that is impacting infant and early childhood mental health How adults impact infant developing brains What are the basics that therapists should know when working with children under 5 years old? The importance of dyadic therapy Parent training Social emotional developmental stages The damage of punishment on the development of an authentic self What infants need to love themselves, have healthy development Infants want to be safe, seen, heard, and helped Co-regulation and holding the big feeling with the child The impacts of this work on adults Transgenerational work – we treat the parent in the way that we would like the parent to treat the child How to support parents in healing their own wounds Therapy Interventions for infants and children under five years old Play therapy is complex and advanced and requires training and supervision Before children can think symbolically or have words, play is not effective Attunement and attachment work

What Maslow Missed in his Hierarchy of Needs - The Native Self Actualization Model: An Interview with Dr. Sidney Stone Brown An Interview with Dr. Sidney Stone Brown, LPC Sidney Stone Brown was born in Kalispell Montana, and is an enrolled member of the Blackfeet Indian Nation of Browning Montana. She was raised on / near her reservation until 1955, living in her great grandmother’s log house with her parents, great uncle, brother and older sisters. They had no running water or indoor toilets; the house was heated with oil and light by kerosene lanterns until 1950. Dr. Brown’s family relocated to Coos Bay Oregon when their reservation faced termination in 1955. Thereafter Dr. Brown attended west coast schools. She attended 30 different schools between first grade and graduation at Oregon State University in 1974. Dr. Brown worked her way through college and was employed by her tribe as an employment counselor, where she met a resident psychologist working at the tribal Hospital and became interested in Psychology. Near completion of her master’s program she contracted with 1) the University of Minnesota developing community action teams for the Red Cliff Reservation, 2) a Lakota CAP agency in Rapid City South Dakota acting alcohol program director and 3) the University of Utah (Montana Wyoming) Alcohol Counselor Trainer and 4) became permanent employment as director of NARA 1974. The program was originally funded at $81,000 and in ten years was 1.2 million. NARA (1981) won a national recognition award for program excellence and it was noted at the presentation in New Orleans that the model (Native Self Actualization) she developed was the most innovative cross-cultural model ever submitted to the National Council on Alcoholism since the awards began in 1946. She has served on many other non-profit boards, appointed a member of the (ADAMHA) Alcohol and Drug Abuse Mental Health Administration Minority Advisory Committee (1974-1976). She lobbied for Indian and minority services at the Oregon State Legislature subcommittees, and before the US Senate. she helped form the board and helped develop the certification criteria for NW Indian Alcohol Drug Counselor Certification Board. In this podcast episode, we talk about The Native Self-Actualization Model How has native teaching impacted psychology? Erickson and Jung studied with different tribes Maslow studied with the Blackfoot people before creating his Hierarchy of Needs Maslow did not publish or acknowledge the work of the Blackfoot tribe Maslow’s work was for corporations What did Maslow find when studying Native people? Most people were secure (versus the high percentage of folks in poverty on the East Coast) He moved from behaviorist to humanist Learned the way of life with the Blackfoot Tribe What is the Native Self-Actualization Model? Inverted Lodge or Teepee (turning Maslow’s hierarchy of needs upside down) The inherent purpose or promise babies come into the world with The philosophy of Indigenous People The importance of culture and altruism What has impacted Native mental health? Clement Bear Chief’s concept of the holes torn through Native communities The sexualization and objectification of Native women The need for protection people, earth, animals The story of the Blackfoot relationship with the buffalo The commonality of the indigenous experience Everything that was taken from Native people creating holes How to incorporate indigenous practices and teachings to support mental health treatment Important Takeaways The importance of intergenerational knowledge It is essential that indigenous wisdom and way of life survive The power of altruism and reciprocity We all are human beings and need to take care of each other

Pursuing Happiness as a Therapist: An interview with Stevon Lewis, LMFT Curt and Katie interview Stevon Lewis, LMFT, about how he makes his career more sustainable. We look at his current philosophies around low effort, alignment, and fun. We also explore how he was able to initially able temper his expectations, work through misaligned paths, and pivot when needed. Finally, we talk about what it looks like behind the scenes to pursue a number of different revenue and marketing streams. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode, we talk about how to make a sustainable therapy career We invited Stevon Lewis back to talk about creating a sustainable career, even if it means pivoting and rebuilding your career or your brand. How can you build a positive and sustainable career as a therapist? ·      It’s important to assess your performance, your level of happiness, etc. ·      Don’t be afraid to pivot ·      Assess if you are working too hard or are misaligned with the work ·      Determine whether your unease is due to lack of skill or misalignment ·      Frame assessment based on practical evaluation versus moving to “I’m a failure” When can you actually make choices that serve you better as a therapist? ·      Initial career choices may not be as ideal as one would like ·      It is important to temper your expectations to your current situation ·      Many therapists start in community mental health and may not be able to choose who we see and what we do ·      Be flexible and open to working with less than ideal clients, identify the learning opportunities ·      There is a ramp up and a building up of a caseload and career that takes time ·      Understand that pivoting is part of the journey because we don’t know what we’re good at or what we’re going to like How do therapist influencers work effectively? ·      There can be a lot of effort behind the scenes ·      Delegating and contracting out elements of the work can be helpful ·      Efficiency is important to be able to do a bunch of different things to be successful ·      Stevon talks about how he does his “low effort” version of social media posting and interaction ·      Looking at the minimum effort for maximum result ·      Accept doing what you need to do to get the results you would like (not comparing to all others) Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement: Our Linktree: https://linktr.ee/therapyreimagined Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/

What Therapists Need to Know about Abortion and Termination for Medical Reasons: An Interview with Jane Armstrong Curt and Katie interview Jane Armstrong, LCSW, a clinical social worker in Texas, about terminating a wanted pregnancy for medical reasons. We look at the impacts of the overturn of Roe v Wade on reproductive care. We also dig into what termination for medical reasons (TFMR) is, how society stigmatizes these parents, and what therapists can do to effectively support clients facing this decision and the outcome of TFMR. Transcripts for this episode will be available at mtsgpodcast.com! An Interview with Jane Armstrong, LCSW-S, PMH-C Jane is a termination for medical reasons (TFMR) mom, native Texan, & clinical social worker certified in perinatal mental health. Following the birth & death of her first child, Frankie, through TFMR, Jane opened Both/And Therapy, PLLC to provide individual therapy & support groups to other TFMR parents. These services aim to support clients through the unique barriers & grief of ending a wanted pregnancy, particularly in the state of Texas where such care is no longer accessible. She’s passionate about building community, eliminating shame, & honoring grief for TFMR families.  In this podcast episode, we talk about Termination for Medical Reasons (TFMR) In the wake of Roe v. Wade being overturned, we reached out to Jane Armstrong, LCSW-S, PMH-C who specializes in TFMR and is based out of Texas, a state with some of the biggest barriers to this type of medical, reproductive care. What are the clinical impacts on individuals who are considering or who have had an abortion? Trauma related to pregnancy as well as abortion The differences between ending wanted and unwanted pregnancies The shame – societal and internalized What therapists can get wrong when interacting with the topic of abortion Unexamined bias related to abortion TFMR – is baby loss and TFMR parents are entitled to grief Disenfranchised grief and traumatic loss The impact of anti-abortion legislation on patients considering abortion and TFMR Lack of access to all types of medical care Logistics related to getting access to medical care The emotional impact of continuing to carry a pregnancy when it is known that the baby will die How late parents can find out about medical concerns that mean that TFMR is indicated The lack of time to make a decision What is Termination For Medical Reasons (TFMR)? Terminating a pregnancy due to health issues with the pregnant person or with the baby For the pregnant person: fatal Hyperemesis Gravidarum, requirement for treatment, mental health conditions For the baby: 12 week genetic screenings or subsequent testing, scans, etc. can point out chromosomal abnormalities, neural tube deficits How can therapists work with TFMR clients? The conflict between the laws and a clinician’s own ethics Make sure your clients know you will be a support resource to them The importance of the client being able to tell their story Recognizing that TFMR is typically not talked about and opening space for these clients Trauma, grief, loss – sitting with the client with their hard stuff Helping clients to make this impossible decision Affirming parenthood and the challenge of the decision Decision versus “choice” and the ways in which bias can enter the conversation about decision-making

Therapy for Executives and Emerging Leaders Curt and Katie chat about how therapists can support leaders. We look at optimal leadership, leadership identity development, barriers for emerging leaders, challenges that executives face, and how therapists can support these leaders. We explore specific interventions and career assessment questions. This is a continuing education podcourse. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we explore how therapists can help leaders During times of turmoil - like a global pandemic, an unstable economy, and social unrest - we want to be able to rely on our leaders to help us weather the storm. We look to our employers, our legislators, and our community leaders to solve problems and remain calm. But who supports our leaders? It’s important for therapists to understand leadership and the unique challenges that leaders face, so they can help. Further, therapists must be available to provide support to emerging leaders who are coming from much more diverse backgrounds and perspectives who may need help navigating a system that doesn’t always accept them or align with their lived experiences. We talk about leader identity development and how leaders develop over time. We look at common barriers and challenges for leaders at all stages of development as well as suggested interventions to address these needs. What do therapists get wrong when working with leaders? Therapists don’t include career assessments and leadership assessment Understanding the interrelation between work and mental health Bias related to stereotypical leaders and not seeing leadership where it shows up outside of able-bodied, tall, white men The calm, peaceful, work-life balance versus optimal performance and ambition Cosigning on poor work behavior and overwork What is good leadership? Leadership can be taught and can be beneficial for every client Concepts of leadership as a process and a position Interdependent, collaborative Servant Leadership Transformational Leadership What does leadership identity development look like? The 6 stages of the model created by Komives, et al. Moving from identifying leaders, understanding positional leadership, then moving to more of a process and interdependent relationship How leadership identity development impacts adult clients What impacts emerging leaders? Identities, especially marginalized identities Relationships with authority figures Resources, privilege within typical leadership development opportunities during childhood and early adulthood Relational trauma, boundaries, communication Marginalized identities and stereotypes with no sure-fire way to perform acceptably Lack of safety and empowerment Career and Leadership Assessment Leadership identity development stage Current employment Work/life balance Role of work in client’s life and within family system Therapists Working with Leaders Life experience that therapists can draw upon Identifying what you don’t know Understand your own work trauma and leadership development The CHAT Model (or Katie’s model: clarify, imagine, simplify, act) Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide Hey modern therapists, we’re so excited to offer the opportunity for 1 unit of continuing education for this podcast episode – Therapy Reimagined is bringing you the Modern Therapist Learning Community!  Once you’ve listened to this episode, to get CE credit you just need to go to learn.moderntherapistcommunity.com/pages/podcourse, register for your free profile, purchase this course, pass the post-test, and complete the evaluation! Once that’s all completed - you’ll get a CE certificate in your profile or you can download it for your records. For our current list of CE approvals, check out moderntherapistcommunity.com. You can find this full course (including handouts and resources) here: learn.moderntherapistcommunity.com

I Just Graduated, Now What? – Career Advice for New Mental Health Clinicians Curt and Katie discuss how clinicians can decide what types of jobs to pursue when they first graduate from their clinical program. We look at whether you should go into a community mental health organization or a private practice. We also dig into what you might want to consider when making these choices and looking for these jobs. Curt and Katie share their own perspective and experiences to help you consider many different options at this stage in your career. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about a new therapist’s career path  We received a listener email asking advice for how to approach getting their first job after graduating. We decided to answer that listener and to address the question of how to start your career more broadly.  Should you go into a community mental health organization or private practice? “I'm of the philosophy that, especially if where you imagine yourself being is in private practice at some point, my recommendation is start doing that as soon as reasonably possible” – Curt Widhalm, LMFT Considerations related to longer term goals Practical and logistical factors related to compensation, benefits, and time Clinical training and opportunities What to consider when looking to join a group private practice “When you are looking for a group practice, don’t look for something that’s just a duplication of a community mental health organization… there is a discernment that needs to happen to identify: is this actually preparing you for the private practice that you want to have in five years? Or is it a mill, where you're churning through insurance clients that don't align or… you're working for a fee that you wouldn't be able to sustain?” – Katie Vernoy, LMFT Caseload and pay expectations Training and supervision opportunities What you are willing to do to obtain your own clients Whether you will stay at an agency while building a caseload What are the job options for therapists when they graduate? The importance of informational interviews to understand the options The benefits (and detriments) to different types of work settings Community mental health versus private practice Moving around and getting different experiences versus starting in a niche Identifying what is right for you

What Therapists Should Know about the Rollout of 988 Curt and Katie discuss the new suicide hotline, 988, that is set to roll out July 16, 2022. We talk about the legislation for 988 as well as what the primary concerns are for the launch. We explore the resources and infrastructure that is promised (but not ready) as well as ideas that might improve the success of this new initiative. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about what is already going wrong with the 988 roll out.  We have been paying attention to the 988 roll out and are concerned by the lack of preparation and funding for its implementation. We talk about why we’re freaked out about the upcoming roll out. What is 988? Legislation (from 2020) makes the national suicide hotline easier to access, using the phone number 988 – set to launch on July 16, 2022 Crisis, Suicide, or Lifeline phone number Replaces the previous numbers: 800-273-8255 (phone) or text to 741741 Connecting local resources to local callers An entry point into the local crisis response system Opportunities for call, text, or messaging support during times of crisis What are the primary concerns with the launch of 988? Lack of infrastructure (calls are being sent out of state or not being answered at all) Lack of local resources to handle crisis response Lack of funding to develop these resources (potentially NO funding for staff, text, chat) Huge gaps in the crisis response system that will be exposed by increased access to this system Challenges with training hotline workers, who are likely going to be volunteers Inadequate training for inclusive services and linguistically responsive services. Ideas to improve 988 and the United States Mental Healthcare program Funding streams through Medicaid, combining forces with 911 Using the implementation to identifying gaps RAND suggestions to coordinate with local organizations for strategic planning and identifying stable funding sources, needs assessments related to personnel Advocacy at the state level to make sure state legislatures are making this work Curt’s idea: have hotlines staffed with prelicensed or provisionally licensed folks (earning double hours toward licensure) Advocacy at the federal level to increase funding across the whole country Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! SAMHSA 988 webpage RAND Report: How to Transform the US Mental Health System RAND Working Paper – Preparedness for 988 Throughout the United States: The New Mental Health Emergency Hotline Find Your Legislators Relevant Episodes of MTSG Podcast: Fixing Mental Healthcare in America A Living Wage for Prelicensees Episodes on Suicide

The Clinical Supervision Crisis for Early Career Therapists: An Interview with Dr. Amy Parks Curt and Katie interview Dr. Amy Parks about the lack of resources for pre- and provisionally licensed mental health professionals to find a clinical supervisor. We discuss the current state of clinical supervision, the barriers for folks becoming clinical supervisors, what makes a good supervisor, navigating online supervision, and what licensed folks might consider when seeking consultation. Transcripts for this episode will be available at mtsgpodcast.com! An Interview with Dr. Amy Parks, Founder of the Clinical Supervision Directory Dr. Amy Fortney Parks brings with her over 30 years of experience working with children, adolescents and families as both an educator and psychologist. She is a passionate “BRAIN -ENTHUSIAST” and strives to help everyone she works with understand the brain science of communication, activation and relationships. Dr. Parks has a Doctorate in Educational Psychology with a specialty in developmental neuroscience. She is a Child & Adolescent Psychologist as well as the founder and Clinical Director of WISE Mind Solutions LLC and The Wise Family Counseling, Assessment & Education in Virginia. She is also the founder of the Clinical Supervision Directory – a connection super-highway for supervision-seekers working towards licensure in counseling and social work across the US. Dr. Parks serves as a Clinical Supervisor for Virginia LPC Residents, as well as Dominion Psychiatric Hospital. Additionally, she is an adjunct professor at George Washington University & The Chicago School of Professional Psychology. Dr. Parks is a frequently sought-after parent coach and speaker for families and groups around the world.  In this podcast episode, we talk about clinical supervision for modern therapists We look at the gap in clinical supervision for prelicensed or provisionally licensed mental health professionals. What is the state of clinical supervision for mental health professionals? No consistent resources for newly graduated clinicians to find supervisors Different state to state or area to area Lack of supervisors and a lack of a mechanism to connect supervisors and supervisees What are the barriers to folks becoming clinical supervisors? Different standards in different states Sometimes becoming a supervisor is too overwhelming, complicated, or too much responsibility The need for advanced training in supervision What makes a good supervisor? Training Diverse experience Understanding the boundaries between supervision and counseling Supervisor, consultant, teacher roles Cultural humility, bias – looking at clients and supervisees Navigating Online Supervision Video supervision (rather than phone) Have supervisees record (video) their sessions for feedback Research shows that telesupervision is as effective as in person Laws related to in-person versus virtual supervision Supervision or Consultation After Licensure The value of getting consultation after you’re licensed The importance of a beginner’s mind The challenges of finding good consultation Finding the right match when seeking supervision or consultation

What is Parental Alienation and How Can Therapists Successfully Treat it? Curt and Katie chat about a controversial topic: Parental Alienation. We look at what parental alienation is, the controversies and complexities surrounding this process, how to assess for parental alienation, and how to effectively treat the family system. We talk about how traditional therapy methods are inadequate and potentially harmful in these cases and what to do instead. This is a continuing education podcourse. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we explore Parental Alienation We both have worked with families that  What is Parental Alienation? The impact a parent/guardian has over how a child interacts with another parent/guardian Complex dynamic within a family where conflict is present Breakdown of relationship based on behavior of alienating parent toward targeted parent The Four Factor Model from Baker (2020) How do you assess for Parental Alienation? Challenges with correctly identifying this process/dynamic Controversies and lack of recognition of Parental Alienation as a separate diagnosis from Parent-Child Relational Problem Identifying what Parental Alienation is not Clues that stories from kids are manufactured versus authentic stories of child abuse The need for access to the full family system to obtain sufficient information Exploring: What is alienating behavior? How does it work? Effective Case Conceptualization and Treatment for Parental Alienation The importance of a family systems approach Involvement of government systems Uncovering the generational or individual trauma for all members of the system How to engage the tools available to advocate for important treatment elements to be in place The importance of understanding scope and how to write recommendations to court Preventing therapist shopping and treatment avoidance Harmful recommendations that can hinder progress within these systems Treatment teaming and avoiding isolation Educating about Parental Alienation Supporting the targeted parent to improve the relationship with the child Working with alienating parent to prepare for improvement in child’s relationship with targeted parenting Co-parenting and conflict resolution Therapist communication with all members of the system Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide Hey modern therapists, we’re so excited to offer the opportunity for 1 unit of continuing education for this podcast episode – Therapy Reimagined is bringing you the Modern Therapist Learning Community!  Once you’ve listened to this episode, to get CE credit you just need to go to learn.moderntherapistcommunity.com/pages/podcourse, register for your free profile, purchase this course, pass the post-test, and complete the evaluation! Once that’s all completed - you’ll get a CE certificate in your profile or you can download it for your records. For our current list of CE approvals, check out moderntherapistcommunity.com. You can find this full course (including handouts and resources) here: learn.moderntherapistcommunity.com/pages/podcourse Continuing Education Approvals: When we are airing this podcast episode, we have the following CE approval. Please check back as we add other approval bodies: Continuing Education Information

The Practicalities of Mental Health and Gender Affirming Care for Trans Youth: An Interview with Jordan Held, LCSW An Interview with Jordan Held, LCSW Jordan Held (he/him/his), LCSW is a Primary Therapist and Gender Specialist at Visions Adolescent Treatment Center. Prior to Visions, Jordan was a Therapist and Intake Coordinator at Children’s Hospital Los Angeles in the Center for Trans Youth Health and Development, the largest trans youth health clinic in the USA. Jordan’s mental health practice centers around creating a trauma-informed and healing-centered space for both adolescents and their families. Jordan’s expertise is working with gender and sexual minority youth with complex histories of PTSD and trauma. Jordan speaks internationally about creating and supporting affirmative LGBTQ+ environments with an emphasis on informed consent and enhanced family communication. As a queer-identified, transgender man, Jordan brings an important dual perspective to his work as a mental health provider. Prior to social work, Jordan worked extensively in secondary school education, with a decade of experience teaching, coaching, and developing health and wellness curricula. Jordan’s work focuses on gender violence prevention, diversity, equity, inclusion, and cultivating strength and belonging for teens. Jordan is on the Board of Directors of the Los Angeles LGBT Center, the Laurel Foundation, JQ International, and Mental Health America of Los Angeles. Jordan is also a long-time facilitator at Transforming Family, a support group for gender-diverse youth and their family.  In this podcast episode, we talk about trans mental health What is gender-affirmative care? The way that “gender affirming care” is being taken out of context What is actually happening, how it has been politicized The misinformation related to what is available to children who are exploring their gender (i.e., parental consent and youth care) The role of therapists versus the role of medical providers Discussion of gender norms Different types of transition for trans individuals Social transition (name, pronouns, clothes, haircut) Medical interventions that may start during puberty (i.e., puberty blockers, progesterone only birth control) Cross sex hormones and surgeries (which actually require a long process) States are very specific for what they require for gender care (as do insurance companies) Conversations in therapy for trans youth Gender journey Meeting the kids where they’re at Lying to get what they need Letters and recommendations for surgery The gender dysphoria diagnosis and sorting that out from depression, anxiety, etc. Supporting trans youth with social transition and getting the support they need The concerns with maladaptive coping skills available online Positive resources for trans youth (scroll down to resources) Identity and impacts The Politicization of Trans Individuals Jordan grew in privilege when he transitioned Legislation Schools removing conversations related to gender and sexuality Play and sports being withheld from trans kids Bias and how being trans is perceived The actual numbers of trans folks who want to play sports or want to use the bathroom that aligns with their gender identity Advice for trans kids and families where gender care is illegal, advice for therapists Age limits and laws that don’t align with logic Culture, privilege, and being trans Increasing or decreasing privilege when one transitions Getting used to the changed dynamic within society based on external experience The complexity of the experience and the changing of the experience The concept of “passing” and how it taps into bias

Portrayals of Mental Health and Therapy in the Media: An Interview with Danah Davis Williams, LMFT Curt and Katie interview Danah Davis Williams, LMFT on the portrayals of mental health and therapy in the media. We explore responsible portrayals as well as the harmful practices that some writers and studios engage in. We also talk about the opportunities for modern therapists to have an impact on how diagnoses and mental health treatment are represented on film and television. Transcripts for this episode will be available at mtsgpodcast.com! An Interview with Danah Davis Williams, LMFT Danah Davis Williams is a Licensed Psychotherapist, an Actor, a Psychological Creative Consultant, a Podcast Host and current Past President of the California Association of Marriage and Family Therapists (CAMFT). As a therapist, Danah is in private practice in Santa Barbara, California (California Coastal Counseling) where she specializes in helping people break destructive patterns of coping through the use of practical, evidenced-based coping skills and personal process. She is extensively trained in Dialectical Behavior Therapy (DBT) and Cognitive Behavior Therapy (CBT). As a consultant, Danah provides personalized psychological consultation for filmmakers, executives and creatives committed to socially responsible, captivating storytelling through authentic characterization of mental health, its treatment and interpersonal impact. She runs a psychological consulting business helping entertainment industry leaders ensure accurate representation of mental health: working with filmmakers, writers, execs, and high-profile actors from networks like FX, CBS, ABC, NBC, Freeform and MGM. What does the media get wrong when portraying mental health and therapy? Inaccurate portrayals of diagnoses Manipulative or unethical therapists The problems with “guilty pleasures” that include inaccurate or harmful portrayals The opportunities for therapists to be creators and consultants Translating clinical work into consulting and creating Vulnerability when sharing journey as a therapist Using skills from practice building to create opportunities as a creator The process of consultation for scripts and what to consider when providing feedback Ethical thoughts related to representations How to build a network and consulting business How the storytellers look at mental health and healing The silver bullet that “heals” the client Inaccurate portrayals of therapy or healing and the impact on clients Ethics to consider (especially given you’re not acting within your profession with an ethical code) The challenges of unscripted shows Shows that get it right when it comes to mental health and treatment This is us – Toby Comprehensive and realistic, tapping into lived experience within actors and/or writers The attempts to portray diversity and the experience of marginalized communities and their interaction in the mental health system Diversifying Media and the Portrayals of Mental Health and Therapy Ava Duvernay’s Array program Michael B Jordan hiring students and mentoring the next generation Decreasing stigma for folks who have not typically sought mental health services How to advocate for accurate mental health portrayals in the media Calling things out on social media that are good and things that are done poorly (or are harmful) Content creation about shows you watch (like blogs, articles, etc.) Discussing content in sessions to help process what folks are viewing or their own experience Not watching or purchasing tickets to content that is harmful (not reinforcing “guilty pleasures”)

Beware of Scams Targeting Therapists Curt and Katie discuss common scams that specifically target therapists. We look at how to identify scams or sketchy business practices that can be very confusing as well as dangerous to clinicians. We also talk about how to protect yourself as well as solid business practices that you can implement to stave off some of these scammers.  Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about scams that target therapists We have heard about a lot of scams in our careers. We figured it was time to do another “survival guide” episode on how to protect ourselves as therapists. What are the most common scams targeting therapists? Information used from popular therapist directories Claiming to be a law enforcement professional, missed court date, or the IRS Image copyright infringement Businesses that target you to charge them for things that are free or with another company Clients or people seeking therapy for family members and then overpay and ask for a refund Text messages or emails with unsolicited links that can leave malware on your computer Phishing schemes Testing stolen credit cards or stolen identities How can modern therapists protect ourselves from these scams? Get into wise mind (avoid responding to false urgency) Go through official channels (contact actual officials) Contact an attorney if unsure Understand how legal notices are properly delivered Caution with financial systems and not allowing people to pay upfront Requiring person seeking services to contact therapist Cyber security trainings Communicating appropriately and consistently Holding to systems and boundaries Make sure to share these scams with professional organizations, the official entity, or your licensing board Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Abundance Practice Building Article on Copyright Infringement From Joe Borders: Currently Active Scams Targeting Therapists From APA: Protect your practice from scams targeting psychologists From APA: More reports surface of telephone scammers targeting psychologists From the SF Chronicle: ‘He held me hostage with no gun but with his words’: The phone scam gaslighting therapists From Counseling Today: Technology Tutor: Scams aimed at counselors From Psych Today: The Phone Scam That Targets Psychologists From CPH & Associates: Scam Targeting Therapists: What You Need to Know From 10News.Com: The jury duty scam you should know about

Beyond Reimagination: Improving your client outcomes by understanding what big tech is doing right (and wrong) with mental health apps Curt and Katie chat about the big tech “disruptors” in the mental health space and what therapists can learn from their tactics to support clients. We look at who is using mental health apps, what mental health apps are getting right (and wrong), and how therapists can take what is working and work differently to more effectively serve our own clients. This is a continuing education podcourse. Looking at the gaps in mental health treatment and how big tech is working to “fix” them Exploring the goals from the Rand report on fixing mental healthcare in the United States Mental Health apps (with many broad definitions) Access to lots of different types of services and self-help A one stop shop with a full range of services Direct negotiation with insurance companies The types of technology used in mental health apps and the risks and benefits of these advances Algorithms Geo location data Complex payment structures Outcomes and feedback What mental health apps are doing well for clients Getting clients into therapy much more quickly Decreasing costs for consumers Increasing flexibility and availability Not requiring for things to happen in real time (asynchronous therapy) What mental health apps are getting wrong McDonaldization and commoditization Proprietary treatment methods and incentives for specific worksheets or staying within the app Misalignment between the goals of the client and the goals of the corporation Self-driven, leading to folks to potentially getting insufficient resources Individual versus community focus Caseloads and potential for therapist income (as well as burnout and poor care) Concerns about the additional risks that can happen with mental health apps The apps are not bound by HIPAA, but instead the SEC Data sharing and Alexa suggesting supplements to address client mental health concerns Additional legal and ethical risks Who is using app-based mental health services? Therapy veterans are moving to apps Access is not actually improved The reasons that clients are moving from a traditional therapist to therapy apps Outcomes across different types of apps and different types of clients Niche apps are more effective than generalist apps What we can do to move our therapist practices forward? Using the benefits of technology to decrease friction for your clients accessing therapists Increasing flexibility and creativity Be a better therapist and understanding the digital therapeutic alliance Paying attention to laws and ethics, scope of practice, and treatment planning Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide Hey modern therapists, we’re so excited to offer the opportunity for 1 unit of continuing education for this podcast episode – Therapy Reimagined is bringing you the Modern Therapist Learning Community!  Once you’ve listened to this episode, to get CE credit you just need to go to learn.moderntherapistcommunity.com/pages/podcourse, register for your free profile, purchase this course, pass the post-test, and complete the evaluation! Once that’s all completed - you’ll get a CE certificate in your profile or you can download it for your records. For our current list of CE approvals, check out moderntherapistcommunity.com. You can find this full course (including handouts and resources) here: https://learn.moderntherapistcommunity.com/pages/podcourse Continuing Education Approvals: When we are airing this podcast episode, we have the following CE approval. Please check back as we add other approval bodies: Continuing Education Information

On The Move: How Run Walk Talk Therapy Reshapes Mental Health An interview with Sepideh Saremi, LCSW Curt and Katie interview Sepideh Saremi, LCSW, on her therapy model, Run Walk Talk. We look at the practicalities and clinical benefit of including movement (specifically running and walking) in therapy. We talk about the principles of movement as method, movement as modulator, and movement as metaphor. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode, we explore running in a therapy session We invited Sepideh Saremi to talk about how she works as a therapist. She started running and walking with her clients in 2014 and is now teaching other therapists how to effectively bring these types of movement into therapy.  How does it work to add running or other forms of movement to therapy? ·      Movement as method (nuts and bolts, practicalities) ·      Movement as modulator (addressing the nervous system) ·      Movement as metaphor How can a therapist explain running or walk and talk therapy to a client? ·      The purpose of running or walking in therapy is not for the cardio benefits ·      Running and walking in therapy can help clients to connect to self and therapist ·      Run Walk Talk can also make therapy more accessible for some clients What are the practicalities and benefits of running in a psychotherapy session? ·      Running at a conversation pace ·      Paying attention to the physical interaction ·      Creating an embodied experience ·      Assessing pace and self-care ·      Mindfulness and awareness ·      How to address confidentiality ·      Using the environment clinically ·      The benefits of being outside ·      The relational elements are important in this type of therapy ·      Handling liability when working with clients outside and movement Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement: Our Linktree: https://linktr.ee/therapyreimagined Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/

The Risks and Consequences of Failing to Report Child Abuse Curt and Katie discuss the CA Board of Behavioral Sciences case against Barbara Dixon, LMFT who failed to report child abuse for Gabriel Fernandez and Anthony Avalos who both subsequently died from abuse by caregivers. We look at what this therapist missed as well as appropriate child abuse reporting, including the nuance of when to report. CW: details of child abuse discussed. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about the importance of child abuse reporting We talk about the failure to report abuse by Barbara Dixon, LMFT that has recently been in the news related to the deaths of Gabriel Fernandez and Anthony Avalos. The case related to the child abuse death of Gabriel Fernandez Content Warning: Details of the case, including the actions taken (and not taken) by Barbara Dixon, LMFT The decision-making process with child abuse reporting Who is responsible to decide to report child abuse – the clinician or the supervisor? When supervisors or agencies tell clinicians under supervision not to report child abuse report The individual responsibility that each clinician holds The myth that you’re working “under” your supervisor’s license How do you decide whether you should report child abuse? Clarity from child abuse reporting laws Hesitation based on systemic response, the therapeutic relationship, and the paperwork hassle Where there are gray areas and nuance The consequences of failing to report child abuse or adequately document services or risks Your agency or supervisor may not be held liable for your actions (especially if you don’t document what you did) Incomplete documentation hurts – it doesn’t help you hide from liability Appropriate Child Abuse Assessment and Reporting Interviewing the child separately Following up on what you’ve asked for Understanding at what point it becomes our responsibility (i.e., having sufficient information) Documenting each stage and make sure to appropriately close out treatment file when needed Consultation and not making the decision on your own Defining the injury and assess from there Understanding normal childhood response to typical life events (and noting changes) Navigating the gray areas in child abuse assessment Looking at impact, intent, and injury Using the context to help decide when there isn’t a definitive line Adequately documenting, even when you aren’t sure you’re making the right decision, is important and necessary Looking at what needs systemic intervention and what needs family therapy Getting past the discomfort to report child abuse report It is your responsibility Taking a moment to understand the purpose of reporting Reducing your own liability Obtaining resources for families Understanding the risk for families of systems getting involved Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Los Angeles Times Article: Counselor who didn’t report abuse of Gabriel Fernandez, Anthony Avalos put on 4-year probation Citation/Enforcement Decision on Barbara Dixon LA Times Article: Charges dismissed against social workers linked to Gabriel Fernandez’s killing Relevant Episodes of MTSG Podcast: Now Modern Therapists Have to Document Every F*cking Thing in Our Progress Notes? Do Therapists Curse in Session? Toxic Work Environments Giving and Getting Good Supervision Make Your Paperwork Meaningful: An interview with Dr. Maelisa McCaffrey Hall Noteworthy Documentation: An interview with Dr. Ben Caldwell, LMFT CYA for Court: An interview with Nicol Stolar-Peterson, LCSW

Should Therapists Correct Clients? Curt and Katie chat about whether therapists should correct clients who use offensive language. We look at what we should consider when addressing what clients say (including treatment goals and the relationship), how therapists can take care of themselves to be able to treat clients who hold a different worldview, and how (and when) therapists can address problematic language appropriately. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about whether therapists should call out their clients on words they find inappropriate We decided to address the language that clients use in session and what to do when we find the language offensive or harmful. Should therapists correct clients when they use language we find offensive or harmful? Blank slate or “join your clients” approaches Whether the language should be addressed when it doesn’t align with a client’s stated treatment goals Showing up as a human and addressing the therapeutic relationship Judgment or shaming that can happen with clients What should therapists consider when addressing what clients say? The relationship between the therapist and client Relevance to clinical goals The impact on trust in the therapeutic alliance The importance of using the client’s language to affirm their experience The power differential between therapist and client How can therapists show up with clients who see the world differently than they do? Addressing objectification of therapist’s identities Assessing when therapists are centering their own experience versus responding to what is in the room Using the relationship to process client’s perspective What can therapists do to appropriately address problematic language with their clients? Process what is being said before correcting specific words Address within the relationship and within the treatment goals Using our own coping skills to be able to navigate what our clients bring to session Where social justice plays a role (and maybe shouldn’t) Education and supporting the client’s whole development Assessing the impact of these interventions (both positive and negative) Assessing the harm in not pointing out bias or harmful language    Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Therapist–Client Language Matching: Initial Promise as a Measure of Therapist–Client Relationship Quality Feedback Informed Treatment   Relevant Episodes of MTSG Podcast: Do Therapists Curse in Session? How to Fire Your Clients (Ethically) How to Fire Your Clients (Ethically) part 1.5 When is it Discrimination? Conspiracy Theories in Your Office

Is the Counseling Compact Good for Therapists? Curt and Katie chat about the brand-new Counseling Compact and what therapists may not know or understand about these interstate agreements. We explore the proposed benefits as well as the potential risks and complications like regulatory discrepancies and a lack of consumer protections. We also look at how big tech can benefit while individual clinicians may be left unable to compete in a larger market. In this podcast episode we talk about the new Counseling Compact and Psypact The counselors got their 10th state and officially have Counseling Compact to practice in other states. We thought it would be a good idea to talk about what that means (and what we might want to pay attention to). What is the Counseling Compact? Opportunities for practicing privileges (not licensure) in other states The complexity of putting together these interstate compacts Implementation and regulation hurdles Scope of practice discrepancies and concerns Law and Ethics practices across states Benefits of Interstate Compacts for Mental Health Providers Continuity of care Ease of meeting with clients who are moving around the country Bringing clinicians to areas where there is a workforce shortage Potential Problems with the Counseling Compact Not bringing more clinicians, if only states with workforce shortages join Doesn’t solve the infrastructure problems (i.e., stable Wi-Fi) for rural areas that typically don’t have local therapists The people who most benefit: the big tech companies like Better Help The FBI is opposing this legislation due to lack of federal background checks Lack of consumer protection or consistency in what consumers can expect from their therapist Costs for the therapists to get practicing privileges Large gigantic group practices and tech solutions will contract with insurance and leave smaller practices unable to compete and required to be private pay Solving the Problems with the Counseling Compact Overarching regulation and expectations at a national level Federal bodies to oversee background checks and consumer protections Expensive, time-intensive We don’t have universal healthcare, so insurance parity will need to be addressed (and not just by big tech) Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Counseling Compact Psypact Very Bad Therapy Podcast Relevant Episodes of MTSG Podcast: Special Series: Fixing Mental Healthcare in America Fixing Mental Health in America: An interview with Dr. Nicole Eberhart, Senior Behavioral Scientist, and Dr. Ryan McBain, Policy Researcher, The RAND Corporation Online Therapy Apps Why You Shouldn’t Sell Out to Better Help  

Clinical Considerations When Working with Asian Immigrants, Refugees, and Dreamers: An Interview with Soo Jin Lee Curt and Katie interview Soo Jin Lee, LMFT on the clinical implications of working with Asian American immigrants, refugees, and dreamers. We explore how best to assess these clients, specific clinical considerations related to the immigration experience (and legal status in the country), and ideas for working with these clients clinically. We also talk about the impact of societal views, media portrayals, and representation on AAPI clients. An Interview with Soo Jin Lee, LMFT Soo Jin Lee is a co-director of Yellow Chair Collective and co-founder of Entwine Community. She is a licensed marriage and family therapist in CA and has a special focus on training and consulting on Asian mental health related issues. She is passionate about assisting individuals find a sense of belonging and identity through reckoning of intersectional identity work and those that are navigating through difficult life changes.   In this podcast episode, we talk about what therapists should know about Asian American immigrants, refugees, and dreamers In preparation for Asian American Pacific Islander Heritage month, we wanted to dig more deeply into specific issues relevant to the AAPI community that are often not discussed in grad school or therapist training programs. What assessment questions should be included for AAPI immigrant clients? How to assess and ask about the immigration story (including about whether someone is documented or undocumented) The assumption of citizenship status during the assessment Exploration of cultural values and family dynamics The definitions for refugee, asylum seekers, immigrant, undocumented immigrant, dreamer Looking at reasons behind coming to the United States as well as legal status in the country   What is the impact of societal views and media portrayals of Asians on AAPI clients? The common stereotypes and the gap in the representation in the Asian diaspora The typical portrayal of undocumented immigrants from Latin America, Mexico, etc. Lack of representation in the media of the broad experience of being an undocumented immigrant or refugee The misrepresentation of families being all documented or undocumented (it’s actually a mix of statuses) Language, cultural and values differences between the generations   What are the unique clinical issues for refugees and undocumented immigrants? The uncertainty of staying in the country The hidden traumas and the fear of being kicked out The lack of planning for the future Education and financial barriers to pursuing the future Trauma and PTSD are key elements, but sharing the story means that their survival is at risk   How do therapists more effectively work with refugees and undocumented immigrants in therapy? The fear and risk involved in disclosure and the challenge of talking about identity Exploring their story creatively, without nitpicking or having to interrogate or make them verbalize their story The importance of building trust and building a safe space within therapy Bringing the mainstream media into the session Addressing fear and decision-making Soo Jin Lee’s healing journey to become a therapist and advice for other dreamers 

Reflections on Content Creation and the Therapy Profession Curt and Katie chat about our principles and philosophies as they relate to the work we do, including podcast creation. We also reflect on the feedback we’ve received on episodes with large listenership as well as other typical responses we get to the work we do. Considering content creation as part of your business? This isn’t a how-to, but it certainly can give you things to consider before you dive in. In this podcast episode we talk about how we put together the podcast We’ve received a lot of feedback recently about our episodes and we wanted to talk about how we make decisions on what we talk about, who we interview, whether we call folks out on the podcast, and how we edit the episodes. Our Philosophy and Principles for creating content for the Modern Therapist’s Survival Guide How to navigate the career as is (tools and strategies to survive in this field) The importance of advocacy in moving forward with our field How to strategically time advocacy for best effect How we take in feedback and respond Responding to Feedback from our Audience on our “What’s New in the DSM-5-TR?” Episode The concern about the Autism diagnosis changes Whether we should have called out Dr. Michael B. First and the impressions of what was said Grappling with the tension between protecting our audience and getting our guests on record and/or advocating for change in the larger systems How people can impact what becomes DSM 6 (and the efforts we are advocating for) The feedback we received and how we sort through it and improve The limits of our capacity Our plans for additional interviews to address the changes A Broader View of the Feedback We Receive on the Modern Therapist’s Survival Guide Podcast The depth of the conversation and our ability to deepen conversations with additional episodes Audience members anchoring on the title or episode artwork and not looking at the whole episode when pieces of the content resonate in a different way Our Plan Going Forward with the Podcast Advocacy, information, and focus on the profession Not as much of a focus on business building, money mindset, and side hustles Real conversations about the realities of working in this profession Working to leave the profession better than we find it  Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! The Therapy Reimagined Mission Our Patreon Buy Me A Coffee Relevant Episodes of MTSG Podcast: What’s New in the DSM-5-TR? A Living Wage for Prelicensees Mission Driven Work Therapists are Not Robots Why You Shouldn’t Sell Out to Better Help Advocacy in the Wake of Looming Healthcare Shortages

What is Eco Anxiety? An Interview with Dr. Thomas Doherty Curt and Katie interview Dr. Thomas Doherty about Eco Anxiety. We look at the history of eco anxiety, what therapists should know about the environment, the concept of environmental identity, and how we can support clients with Eco Anxiety in therapy. We look at ways to bring these topics up with our clients as well as empower them to take action. An Interview with Dr. Thomas J. Doherty Thomas is a clinical and environmental psychologist based in Portland, Oregon, USA. His multiple publications on nature and mental health include the groundbreaking paper “The Psychological Impacts of Global Climate Change,” co-authored by Susan Clayton, cited over 700 times. Thomas is a fellow of the American Psychological Association (APA), Past President of the Society for Environmental, Population and Conservation Psychology, and Founding Editor of the academic journal Ecopsychology. Thomas was a member of the APA’s first Task Force on Global Climate Change and founded one of the first environmentally-focused certificate programs for mental health counselors in the US at Lewis & Clark Graduate School. Thomas is originally from Buffalo, New York. In this podcast episode we talk about what therapists should know about Eco Anxiety In preparation for Earth Day, we wanted to understand more about Eco Anxiety and what therapists can do to support our clients and the planet. What is Eco Anxiety? The history of Eco Anxiety, including worry about the use of chemicals, climate change The importance of words, personal experiences, how the client sees the world The diagnoses that align with this area, the types of impacts on clients What Should Therapists Know About the Environment? Resources related to climate change How to explore Environmental Identity Understand our own Environmental Identity The 3 basic psychological impacts from the environment (disaster, chronic, or ambient) The benefits of nature and how people in all environments can access them What is your Environmental Identity? Relationship to the natural world Significant experiences in the outdoors The nuance of bringing these ideas up in Urban areas What “nature” means to each of us How Can We Support Clients with Eco Anxiety in Therapy? Understanding the basics on the environment and climate change Building capacity to be with these issues Reeling in the anxiety, imagination Understanding the waves of emotions and completing the anxiety cycle Giving clients permission to talk about the environment and how to open up the conversations Coping strategies specific to Eco Anxiety Suggestions for activism and what clients can do to improve the environment Helping clients to identify if they are doing enough Where to find resources on environmental efforts How therapists can employ climate awareness in their practices Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Dr. Thomas Doherty's Practice Sustainable Self Climate Change and Happiness Podcast Dr. Thomas Doherty’s Consultation and Training Program on the Environment The Psychological Impacts of Global Climate Change by Thomas J. Doherty and Susan Clayton NY Times: Climate Change Enters the Therapy Room Climate Psychology Alliance Project Draw Down Relevant Episodes of MTSG Podcast: What’s New in the DSM-5-TR with Dr. Michael B. First What You Should Know About Walk and Talk Therapy part 1 What You Should Know About Walk and Talk Therapy part 2 (Law and Ethics) Shared Traumatic Experiences

Therapists Are Not Robots: How We Can Show Humanity in the Room Curt and Katie discuss how big life events (a big diagnosis, a huge personal loss, injuries and medical conditions) can show up in the room. We explore how much humanity is okay to share with our clients. How do we decide what we tell our clients (and how do we manage their reactions)? We also look at how we take care of ourselves while also taking care of our clients. Therapists aren't robots, but we certainly need to be aware of our clients when life happens.  In this podcast episode we talk about appropriate self-disclosure practices for modern therapists going through life events As therapists it’s important that we hold a professional exterior during therapy. But can it be helpful to share with clients the big moments in our lives? How can we be human in the room? What are some considerations for therapists when deciding to self-disclose? Showing your humanity can help bond a client with the therapist. Self-disclosure may be different for planned or unplanned life events and whether they come into the room or private/hidden and in the background of your life Deciding when and whether to tell clients Clients often will use the therapist as an example on how to handle big life events. Not all settings are appropriate for therapist disclosure. Clients do not have the same confidentiality requirements as therapists; if you self-disclose to a client, it could be known by others or other treatment team members. In self-disclosing, the therapist will need to process the disclosure with the client. Processing difficult personal material with multiple clients could be difficult for the therapist. How much you disclose will depend on the client, but you might share more with a long-term client than a newer client. Are there ethical considerations for therapists sharing about our lives? There are no BBS outlined ethical considerations for sharing personal disclosures in therapy. The therapeutic environment should encourage a client to question the therapist. The therapeutic environment should encourage clients to participate in self-advocacy. Remember that certain self-disclosures might be triggering for clients; be mindful of what you share with who. Document all ruptures in relationships in your note and what you did to help heal the rupture. Be mindful - clients could be retraumatized or try to care take after a therapist’s disclosure. Not all clients need to know everything; know your population. What should new counselors and therapists know? Therapists are human! Life will continue to affect you even while working. It is important for therapists to take time off when they need it. Ruptures in the therapeutic relationship will happen; it’s all about how you handle it. New counselors often want hard rules for how to act, but it gets easier with experience. The most damage happens from not acknowledging or apologizing for ruptures. When ruptures occur, be honest and accountable to your clients. Sharing our human moments with clients can create a deeper and richer relationship. Don’t forget you don’t have to do this alone – always consult if unsure on disclosures! Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Struggles of the Novice Counselor and Therapist by Thomas M. Skovholt and Michael H. Rønnestad Abstract: Shared Trauma: The Therapist’s Increased Vulnerability by Dr. Karen W. Saakvitne

What You Should Know About Walk and Talk Therapy and Other Non-Traditional Counseling Settings – Part 2 Curt and Katie chat about non-traditional therapy settings like outdoor walk and talk therapy as well as home-based counseling. In the second of a two-part, continuing education podcourse series, we look at law and ethics, accessibility, informed consent, navigating confidentiality, dual relationships, and what therapist might want to consider before getting started. In this continuing education podcast episode, we look at the laws and ethics related to non-traditional therapy settings For our fourth CE-worthy podcourse, we’re looking at the laws and ethics of bringing therapy into non-traditional settings, including walk and talk therapy and home visits. We cover a lot of topics in this episode: Debunking the hesitations of using non-traditional therapy settings Minimizing liability and concerns related to these environments Is it unethical to not consider these environments? Access and payment, including insurance/managed health care concerns and fee setting Unpredictability in the environment Scheduling and permission for services Business practices and systems that support this type of dynamic practice Accessibility of walk & talk and home-based therapies Financial, physical or other types of accessibility (and navigating those) Ways to make sure you clients can access the service and are prepared for the environment Extending boundaries and the consequences of these situations Documentation of any concerns that arise Clinician comfort and preference, do no harm, and do good Informed Consent for non-traditional therapies Client choice and appropriateness, including informed opt-in (and opt out) Health conditions, screening or attestation related to risk and liability Clinician safety and how to talk with your client about these concerns Cancellation policies and back up plans Ability to terminate (both passively and actively) Collaboration and communication Confidentiality when you’re meeting outside of the therapy office Managing the risks of the limits of confidentiality in these other settings Collateral consent forms for additional members of the treatment Release forms for others in the home Co-creating the plan to manage these situations Ideas for how to explain the relationship, if needed Active and passive loss of confidentiality (and how to talk about these risks) Boundaries versus confidentiality (for example where in someone’s home to meet) Documentation and consultation Dual Relationships that can happen during walk and talk or home-based therapies Professional therapy never includes sex Casual nature of the relationship in these settings and the threat of friendship vibes Not all dual relationships are problematic Host/guest dynamics as something to pay attention to, but not necessarily harmful Navigating the potential medical needs of home-bound clients (helping and/or advocating for more help) What therapists should assess before getting started Liability and malpractice Logistics and planning Assessing client vs clinician benefit Assessing competency for these types of services Training, consultation, supervision, documentation

What You Should Know About Walk and Talk Therapy and Other Non-Traditional Counseling Settings Curt and Katie chat about non-traditional therapy settings like outdoor walk and talk therapy as well as home-based counseling. In the first of a two-part, continuing education podcourse series, we look at the basics, including why therapists should consider these settings (and may not), clinical and cultural considerations, and best practices. In this continuing education podcast episode, we look at non-traditional therapy settings For our third CE-worthy podcourse, we’re looking at the basics of bringing therapy into non-traditional settings, including walk and talk therapy and home visits. We cover a lot of topics in this episode: What are non-traditional therapy settings? The focus of this episode is walk and talk and home-based therapy Client’s locations like home, school, or work; community-based settings Anything beyond the typical therapy office or telehealth settings are worthy of consideration Creativity and collaboration in creating the space How different the therapy can be when opening up more settings as possibilities Why should therapists consider these non-traditional therapy settings? Logistical considerations that can lead to these settings being the ideal choice (or only choice) Clinical indications that walk and talk or home-based therapy is a better choice The impact on changing settings on the therapeutic relationship and the therapeutic work Specific modalities that are best served by client-centered spaces Assessment, treatment teaming How access, attendance, and attrition are impacted The therapeutic impact of the settings and movement What are the hesitations therapists have in considering alternative settings for therapy? The challenges in creating systems and managing the logistics Lack of alignment with the medical model Lack of training and guidance Legal and Ethical considerations (that will be talked about in next week’s episode) What are the clinical and cultural considerations when doing therapy outside or in someone’s home? Navigating the shifting relationship and boundaries Cultural differences between therapist and client, and assumptions made about the relationship The importance of leading the conversation about these relationships Hospitality and others who may be present at a client’s home The unusual space, the level of confidentiality, and emotional containment and depth of conversation Treatment planning based on where you meet and how the client interacts with the space The importance of the clinician holding the therapeutic space and attention Creating the space and the contract for how therapy will happen Cultural norms for the activities and for the client and family – more complexity to discuss Clinical How-To for Non-traditional Settings Assessment considerations Client and clinician characteristics Alignment with treatment goals and presenting concerns Presenting issues can vary and assessment can be important Initial assessment appointments and making the decision early in treatment Treatment Formulation related to active versus passive interaction with the space The importance of true informed consent and the dynamic nature of process contracting Introducing predictability Risk assessment Knowing your scope and what types of professionals you might consider consulting

Now Modern Therapists Need to Document Every F*cking Thing in Our Progress Notes?!? Curt and Katie discuss a recent citation from the California Board of Behavioral Sciences (BBS) to a therapist for cursing while in session. We explore: How do we document ruptures during the therapy session? Is the BBS over-reaching by controlling what therapists document? What are the best practices for note taking? All of this and more in the episode. In this podcast episode we talk about appropriate documentation practices for modern therapists As therapists it’s important that we take accurate notes. But what is important to include in the notes, and how much should we really be documenting? Wait – Is it alright to use curse words in session? Therapists should be first and foremost aware of the client and their potential reaction. Note the therapeutic relationship with the client, their history, and how the client empowers themself when making language selections. If considering using casual language, consider the client’s vernacular. Follow the client’s lead when it comes to their language in session, including cursing. The BBS has no specific statute related to cursing or swearing. What should modern therapists document in clinical notes? It is important to document any bold interventions or ruptures in the therapeutic relationship and repair attempts for ruptures. In note taking, it is important to follow the clinical loop: assessment, diagnosis, treatment plan, intervention, use of intervention, and the client’s reaction and progress. Your notes will be a balance of covering your liability and creating notes that help you remember the session. Therapists should consider documenting the use of any language that could be deemed not clinically appropriate, even positive statements like “I’m proud of you,” or “Yes, my dear.” Does the California Board of Behavioral Sciences (BBS) outline what we should say in our notes? In the 300-page PDF outlining the statutes for LPCCs, LMFTs, LCSWs, and Educational Psychologists, notes are only mentioned 10 times. There is no mention in the statutes of what can be said and what can’t be said in notes. Some agencies and institutions will stress writing very little to ensure protection from liability, but as this citation showcases, this might not be best practice. The BBS wants to ensure the protection of clients and you might need to justify your words, just as you would justify the use of an intervention. This is a reminder that the BBS can and do look at therapist’s notes. Support The Modern Therapist’s Survival Guide on Patreon! If you love our content and would like to bring the conversations deeper, please support us on our Patreon. For as little as $2 per month we're able to bring you more content, exclusive offerings, and more opportunities to engage in our growing modern therapist community. These contributions help us to expand our offerings for continuing education events and a whole lot more. If you don't think you can make a monthly contribution – no worries – we also have a buy me a coffee profile for one-time donations support us at whatever level you can today it really helps us out. You can find us at patreon.com/mtsgpodcast or buymeacoffee.com/moderntherapist. Thanks everyone.

What Can Therapists Do About the Loneliness Epidemic? Curt and Katie chat about loneliness as a presenting problem in therapy. We explore the misconceptions about loneliness and how therapists often go to fix the problem rather than understand the problem. We also look at the clinical considerations, including gender differences, the impact of Covid-19, and the changes in how people socialize. Finally, we identify treatment strategies to support individuals struggling with loneliness.   Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about how therapists support clients who are lonely There is a loneliness epidemic that is coming into the therapy room a lot and we’ve heard from clients, colleagues, and friends that the first response is “fix it.” We don’t think that’s the strongest move, so we dive into how therapists can more effectively support individuals who are lonely. What are misconceptions about loneliness? ·      It is a normal human feeling and doesn’t always need to be fixed ·      Loneliness is not always related to major depression ·      Loneliness is not the same as isolation, nor is it the same as solitude What are considerations related to loneliness and socialization? ·      The impact of Covid-19 on individuals and on socialization ·      The changes in how people socialize in the modern age ·      Cognitive distortions when one socializes ·      Attachment wounds and differences in how people relate to others ·      Gender differences in connection and expectations about roles in relationships How can a therapist explore with a client their relationship with loneliness? ·      Looking at what people need when feeling loneliness ·      Exploring how understood and seen one feels within their relationships ·      Sorting how one can get their needs met with what is available to them What are the practical considerations needed to address loneliness? ·      Identifying ways to connect with others that fits into time and money parameters ·      Going beyond similar interests and how to find people to truly connect with ·      Exploring coping skills, rejection sensitivity, and self-confidence to set one up for success ·      Looking at how to test new experiences, fail and rebound or succeed and build Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement: Our Linktree: https://linktr.ee/therapyreimagined Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/

Do Therapists Curse in Session? Curt and Katie discuss a recent citation from the California Board of Behavioral Sciences (BBS) to a therapist for cursing while in session. We explore: Can therapists swear in session? Should they? Are there times when cursing is appropriate in session? Are therapists allowed to make errors without the fear of citation from their board? We explore these and more in this episode.  In this podcast episode we talk about the ethics and responsibilities of cursing in session. After hearing about the citation for a clinician who had cursed in session, we wanted to explore what is acceptable related to using curse words in session. We know as therapists that what we say matters, and now more than ever our choice of language matters. Who is allowed to curse in the therapy room? We tackle this question in depth: Is swearing or cursing ever appropriate in session? Both Curt and Katie swear in session when appropriate Swearing in session can create a more authentic therapeutic rapport with some clients Sometimes clients will ask for permission to swear in session Follow the client’s lead when it comes to their language in session, including cursing It is mostly important to reflect the client’s language without judgement Clients might be looking for more humanity in their therapists Therapists are people; curses can slip out when therapists feel depleted and without resource Cursing based on your own humanity can cause therapeutic rupture and clinicians should be mindful of the therapeutic alliance and make repair attempts What does the research show us about swearing? Some research suggests that cursing out loud decreases pain “Professional language” is often rooted in whiteness with a goal of excluding people of color When not accurately reflecting a client’s language, you run the risk of editing them Swearing speech is primarily meant to convey connotative or emotional meaning with emphasis What do professional organizations say now about cursing in session? The BBS recently cited a therapist for swearing in session as unprofessional language Only one professional organization, The National Association of Social Workers, officially bars cursing in session – specifically derogatory language Swearing speech is primarily meant to convey connotative or emotional meaning with emphasis Therapists have a responsibility to make sure they are emotionally equipped to deal with clients Is there an ideal language for therapists to use? … I caution against blanket rules. – Curt Widhalm Slurs are never acceptable to use during session, especially when there are cultural differences between client and therapist Considerations related to expressing your humanity, using curse words, and the clients you see Ethically, we have guidelines of client beneficence and avoiding maleficence, meaning don’t harm the client Technically cursing is allowed, but only with reason and while remembering that some folks are litigious Support The Modern Therapist’s Survival Guide on Patreon! If you love our content and would like to bring the conversations deeper, please support us on our Patreon. For as little as $2 per month we're able to bring you more content, exclusive offerings, and more opportunities to engage in our growing modern therapist community. These contributions help us to expand our offerings for continuing education events and a whole lot more. If you don't think you can make a monthly contribution – no worries – we also have a buy me a coffee profile for one time donations support us at whatever level you can today it really helps us out. You can find us at patreon.com/mtsgpodcast or buymeacoffee.com/moderntherapist. Thanks everyone.

Thriving Over Surviving: Growing a Practice without Burn Out Curt and Katie interview Megan Gunnell, LMSW, coach, and Founder and Director of Thriving Well Institute. We explore: What changes are therapists facing as they grow their practice in the telehealth age? How do therapists scale their businesses and what should they be aware of? Can a therapist and their practice thrive, or does something have to give? All of this and more in the episode. Interview with Megan Gunnell, LMSW and Founder & Director of Thriving Well Institute Megan Gunnell LMSW, is Founder and Director of Thriving Well Institute which aids therapist in building the private practices of their dreams. Megan offers a series of courses and individual coaching to aid therapists in expanding their private practices through building group therapy programs, building online courses, creating in person retreats, and even how to build a group practice. Megan teaches therapists how to build not only their practices but themselves up. Megan has been a practicing clinician for over 20 years working as an individual therapist in addition to her coaching and advisory work. Megan started her work as a music therapist, a passion which she still carries to this day.  In this podcast episode we talk about how therapists can build their practices without burning out. With the increase in telehealth therapy options, therapists are confronted with a unique problem. How does a therapist build their practice with so many therapeutic options out there, while simultaneously avoiding burn out? Curt and Katie connect with Megan Gunnell to discuss how therapists can make sure they, and their practices, thrive. How can therapists’ network as telehealth therapists? Your potential client base has now become the whole state. Focus on designing your online real estate and increase your SEO. Joining local Facebook groups of therapists can help expand your referral base. Speak to specific client issues on your website that you specialize in. Avoid template and more generalized language in websites and marketing material. Make your website unique but clear in what you work with. What is scaling and how does it avoid burn out? For many therapists, caseloads have increased dramatically over the past couple years Scaling is more about pivoting than it is creating passive income. Looking to expand your practice into a group practice can help alleviate referral loads. Some therapists can avoid burn out by diversifying their workload and reintegrating natural talents such as creativity. Getting into community, especially with other therapists, is a great way to avoid burn out. There is still a need for single-focus private practices. What can therapists do to scale their businesses? Be in tune with out motivated you are to scale your business; ask how committed am I? Consistency is key. Have a willingness to make mistakes and take risks. Don’t be afraid of failing; use moments of failure to motivate you. Be open to learning new things like tech, marketing, or automation. Be realistic of your capacity to take on learning sometimes complicated or frustrating systems that might help your business. Don’t be afraid of showing who you are as a person as you build out your practice. It can be scary to expand your practice, and many therapists want assurance, but there is no one way to expand – it’s individual to your unique practice. It can take support to expand your practice; reach out to your community for help.

What’s New in the DSM-5-TR? Curt and Katie interview Dr. Michael B. First, MD, editor and co-chair of the American Psychiatric Associations’ DSM-5 Text revision, coming out March 2022. We explore: What are the differences between a full update and a text revision? What changes have been made (and how were these changes decided)? What new diagnoses can we expect? Can clinicians continue to use the older DSM-5? How can clinicians advocate for changes in future versions of the DSM? All of this and more in the episode. Interview with Dr. Michael B. First, MD What changes have been made in the new DSM-5-TR? Text revisions occur to avoid letting the text become stale while supporting ongoing updates. New disorders, specifically Prolonged Grief Disorder, have been added. New codes, modeled off symptom codes, created for documenting suicidality and non-suicidal self-injury with another diagnosis. New categories of Unspecified Mood Disorder. New Criteria set for Autism Spectrum Disorder which is more conservative. How are cultural differences addressed in the DSM-5-TR? Starting with DSM-IV, there has been a special committee created for culture and culture related issues Hypothetically, the criteria sets should apply to everyone, but in the text, there is a section on Culture Related Features which is more specific. The impact of the George Floyd protests inspired the creation of a new committee to look for systemic racism, lack of nuances, and prevalence issues within the DSM. There are conflicting opinions if “transness” should be included in the DSM and if it’s even a mental disorder. As the DSM is a diagnostic tool to code for insurance, the DSM takes the stance that the Gender Dysphoria diagnosis stay included so individuals can have access to medical intervention and treatment. The Steering Committee for new diagnosis is small, but there is diversity. Before a diagnosis is approved, it is posted for 45 days on the DSM website for all, including people with lived experience, to comment and advocate for diversity What is the Process for Accepting New Diagnose? The steering committee accepts proposals through the DSM portal for new diagnosis Some diagnoses are qualified based on the United States’ continued use of ICD-10, whereas the ICD-11 is more progressive. With Complex Post Traumatic Stress Disorder, some of the criteria from the ICD have been incorporated into the DSM diagnosis of PTSD Proposals are floated around often, but they often don’t have enough empirical research yet. Proposals need to show a pool of patients who don’t fit other diagnoses, a gap in treatment, and a difference from other possible similar diagnoses. New diagnoses will be approved on a continuum, making the electronic DSM-V-TR the most up to date resource.

How Therapists Promote Diet Culture: An interview with Rachel Coleman Curt and Katie speak with Rachel Coleman, LMFT, CEDS about what therapists should consider in working with clients who have eating disorders, the impact of society on body image, and how clinicians can increase their competency in an area many feel they are lacking. Why do so many clinicians feel under trained in treating eating disorders? How do societal views impact our client’s body image and what is the impact of diet culture? Does a lack of graduate education in eating disorders ethically impact our ability to treat eat disorders in a non-specialized practice? What’s missing from our understanding of eating disorders? All of this and more in the episode. Interview with Rachel Coleman, LMFT, CEDS What do clinicians do when therapeutic interventions might trigger eating disorder behavior? Many interventions call for physical activity that might trigger eating disorder behavior or feelings in clients. If a client wants to participate in a physical activity intervention, consider their motivation. Ensure that a client has multiple tools in their anxiety toolbox. Be mindful if the modalities and treatment recommendations are based in fat phobia or weight stigma. How can clinicians assess their clients for an eating disorder? Eating disorders can present meeting full DSM-V criteria or, in many cases, seem at the “subclinical” or mildly clinical level. Evaluate how your client feels about societal messaging and the impact it might have on them. In assessing clients, look to determine the impact of behaviors and patterns on daily functioning. If client’s are sacrificing other values to focus on weight or body, it should be discussed. How can clinicians increase their education in treating eating disorders? Clinicians need to do their own work surrounding their bodies and internalized messaging. Therapists should focus on learning about the complexities of eating disorders and the social justice movements that surround weight stigma and fat phobia. Familiarize yourself with the ideas of body trust, body neutrality, and health at every size. Many treatment centers offer free webinars to educate clinicians in eating disorder treatment. What are the ethical and legal considerations in treating eating disorders in a non-specialized private practice? Always get consultation. Some clients might present with “subclinical” or mildly clinical levels of an eating disorder. There is a difference between asking questions and treating the answers. Clinicians should encourage clients to see a medical doctor when necessary. Working with dieticians and medical doctors to create a holistic team, best serves the client. Clinicians should be aware when to refer to a higher level of care. Therapists should limit self-disclosures How does Diet Culture impact our clients? Diet culture is a mindset and system of theories we all exist in, that credits a person’s shape and size as the primary indicators of health and moral superiority. When bodies don’t meet these “standards” of beauty as societally defined, they are often oppressed. Messaging about dieting and our bodies is inescapable in our society, so it’s easy for subconscious beliefs about food and bodies to infiltrate sessions. Therapists’ self-disclosures should be limited and focus on affirming client’s experience.

What to Know When Providing Therapy for Elite Athletes Curt and Katie chat about the specific competence required to work with elite athletes. We explore how elite athletes present (including diagnosis) as well as what treatment looks like for elite athletes. We also talk about the training cycles and periodization, developmental stages, and identity formation for competitive athletes. We also look at what healthy training environments include and how athletes can take care of their own well-being.  In this podcast episode we look at what therapists need to know about working with elite athletes For our second continuing education worthy podcast, we wanted to support therapists in understanding what they need to know (or know that they don’t know) about working with elite athletes. The differences between being a fan and being competent to work with elite athletes The types of competence needed to support athletes who are at an elite level Sports psychology and other areas of specialty to support athletes The stringent criteria to be called a sports psychologist What diagnoses do athletes present with when they enter therapy? Not necessarily anxiety, but it can be anxiety related or unrelated to sport Diagnoses can be related to the sport due to body, substance, or changes in circumstances Diagnoses can also be related to other elements of their life and transitions What does treatment look like for elite athletes? High school and college athletes are most likely the clients we’ll see The integral nature of their team and who is best to be included in the treatment team Logistics and scheduling due to games and practices, obtaining required consents Training schedules, food information is relevant to therapeutic work The different goals for elite athletes than for other folks who enjoy sports Looking at in the moment frustrations versus a desire to leave the sport Sports assessments to identify athletic coping skills Helping athletes to make decisions for themselves and identify when it’s burnout and when it’s a mismatch Understanding training cycles and the impact on athlete clients Specific language that athletes may use Periodization, micro, meso, and macro cycles in training The importance of planned growth and rest as well as peaking at the right time The focus of timing for everything How injuries or changes in schedule (like with covid) can impact this timing and what that means for athletes Developmental factors for young athletes The focus of training for younger children as well as the investment phase for youth Developing one’s identity as an athlete What can positively impact and negatively impact the future commitment to sport Other developmental factors related to being a teen interacting with these developmental elements What a balanced life looks like for elite athletes Who athletes spend time with, share their life with The hobbies that complement the sport Understanding how maintenance impacts the rest of the schedule The factors that improve an athlete’s well-being Myths related to the tangential benefits of being an elite athlete (i.e., I’ll get college paid for) The importance of having a therapist who isn’t just a “fan” The differences between team and individual sports The competency needed related to understanding the sport to understand all of the dynamics What good social systems around athletes have in common The understanding of how each person in the athlete’s circle interacts with the goals The culture created within the team and with the people around the athlete Simone Biles and Naomi Osaka – a look at how they have been taking care of themselves The transition out of being an elite athlete Injury and unplanned retirement Planning for an intentional retirement Moving out of the athlete identity into something new

Antiracist Practices in the Room: An Interview with Dr. Allen Lipscomb Curt and Katie speak with Dr. Allen Lipscomb, PsyD, LCSW about what therapists should consider in working with Black clients, common mistakes, and implementing anti-racist procedures into practice. What can therapists do better? Where is graduate education lacking? How do we respect and explore our Black client’s narratives? Who can work with Black clients? How can therapists help clients heal from race-based trauma? How can we do better with our Black male clients? Black male grief shows up in different ways than other client’s grief might show up. When assessing Black males for psychosis or conspiracy theories, ensure that you look at the context of their lived experience before determining psychosis The traumatic experiences of racialization, trauma, and mistreatment that many Black people can sound like lead to thoughts that might sound psychotic to an uneducated clinician. Listen to the client’s narratives. Question what the themes and patterns are and if the thought is maladaptive to their functioning and well-being. Utilize FIDO: frequency, intensity, duration and onset in questioning clients If a clinician is unsure if a thought is a conspiracy or legitimate threat, assess for how the client’s community is responding to the client’s narrative Ask clients how the session was for them. How was it for you to meet with me? Acknowledge your cultural limitations and create an invitation for the client to let you know when you can do better. Be mindful, Black male clients might be minimizing their experiences to be “less threatening.” This is the cultural congruency dichotomy that clients often have to take to avoid further potential trauma. What does it mean to be antiracist? Clients might be resistant to bringing up a clinician’s whiteness in the space. Black clients might not think that a white clinician has the capability or desire to talk about race. It is the responsibility of the clinician to actively establish the openness of the space to discuss race and the client’s lived experience. This should be a continuous conversation that is led by therapists, to make the topic open until it feels naturally open. It’s affirming to have someone who is white in a position of power to say to me – hey I recognize we’re racially different and we could have a different experience how that shows up in this space. You can catch moments where anti-racist action could’ve been taken or acknowledged in the next session, if missed during a session. The need to revamp our graduate programs to be anti-oppressive and anti-racist How to show up as an ally in the room, without centering your own experience What is Dr. Allen Lipscomb’s BRuH Method? The BRuH Method, or BAT, stands for BRuH Approach to Therapy. BRuH stands for Bonding through Recognition to promote Understanding in Healing when providing therapeutic services to Black men specifically. The approach is modeled off of other therapeutic approaches like CBT and DBT Phases include: Bonding Phase, Recognition Phase, Understanding Phase, Healing Phase The clinician is always doing aspects of the various phases throughout the course of treatment This is not an evidence-based practice but an honoring based practice The evidence of efficacy in this practice comes when you see your clients continuously returning to receive more sessions, from the feedback they give you, and the improvements in day-to-day life. Who can work with Black male clients? There can be an urge for white therapists to refer clients of color, especially Black men, to Black clinicians These referrals are unnecessary. A therapist of any background, if holding the space correctly and connecting with the client’s felt experience, can work with a client of color, specifically Black men. It’s important to be mindful that questions asked to clients are not investigative or for the purpose of educating the therapist.

What Can Therapists Say About Celebrities? The ethics of public statements Curt and Katie chat about whether therapists should make public statements and diagnose public figures. This is our first continuing education eligible podcast, discussing the ethics of speaking out about the mental health of people in the public eye. We explore the origins of the Goldwater rule, a group of psychiatrists who purposefully broke it, and how masters level organizations address this concern. We also provide you with some ideas about how you can make this decision for yourself. In this podcast episode we look at the ethics of modern therapists diagnosing public figures For our first continuing education worthy podcast, we wanted to address something that is becoming more and more prevalent in our field: therapists speaking out about the mental health of public figures. What is the Goldwater Rule? The history of the Goldwater Rule The impact of DSM II (and the update to DSM III) The original intention of the rule versus the current interpretation of the Goldwater Rule Fears from the American Psychiatric Association that seems to have driven the development of (and on-going commitment to) this rule How the Goldwater Rule (and Similar Ethical Principles) Have Shifted Over Time Perspective from one of the original framers of the Goldwater Rule Moving from teleological to deontological interpretations How the internet and social media has changed the landscape The American Psychiatric Association expanding their commitment to the Goldwater Rule, stating reasons psychiatrists should not assess The Goldwater “Caveat” or “Principle” versus Goldwater “Rule” or even Goldwater “Doctrine” Beyond diagnosis to restricting any comment on the behavior or mental health of a public figure The stance on this ethic from American Psychological Association and the large Masters Level Organizations (AAMFT, ACA, NASW, and CAMFT, for example) The Dangerous Case of Donald Trump – the Public Diagnosis of an American President The group of psychiatrists who pushed back on the Goldwater Rule The Duty to Warn – does it apply here? What are the challenges of accurately diagnosing Trump? Where expertise is helpful (and how the public can water down diagnosis) Current Guidelines for Modern Therapists Whether diagnosis is required for a duty to warn The tactic of putting forward information without drawing conclusions (and why we don’t like this strategy) Specific guidance from the professional organizations on what therapists can and cannot do Taking special care in how one decides what they say about an individual in public settings Using one’s professional judgement and special care Cautions When Using Your Professional Judgment The potential harm of discussing diagnosis on social media Bias, cultural factors, and other information that could make an inaccurate or harmful diagnosis Mental health stigma and other concerns related to diagnostic language (ICD-10, DSM-V) Speaking outside of your professional expertise Questions to ask yourself before making a public statement

Working with Trans Clients: Trans Resilience and Gender Euphoria An interview with Beck Gee-Cohen, MA CADC-II, about how therapists can be better clinicians for trans people. Curt and Katie talk to Beck about gender identity (and why every therapist should do their own work around gender), historical perspectives on masculinity and femininity, the concepts of trans resilience and gender euphoria, the real problems with the DSM diagnosis of gender dysphoria and considerations for providing therapy to trans clients.  Interview with Beck Gee-Cohen MA CADC-II Director of LGBTQ+ Programming In this podcast episode we talk about trans mental health We invited Beck Gee-Cohen, MA CADC-II to come talk with us about providing therapy for trans individuals. Modern therapists need to keep learning when working with trans clients Getting pronouns correct is a basic expectation at this point Finding the balance between focusing on a client’s trans identity and other elements of their identity and experience Understanding trans identity 101 is a basic level of knowledge that all therapists should have What you do need to learn from your trans clients Therapists need to do their own work around gender The work that therapists must do around gender The role that society plays in defining gender and the binary The privilege cis folks have in not being asked to assess/address their gender “Women’s” and “men’s” issues Societal expectations related to gender The history of gender expression and how what is acceptable has shifted Cultural and generational differences related to gender  The Concept of Trans Resilience The tendency to focus on the pain of being trans The bias and hate that trans folks face, and how they continue to show up The importance of celebrating who you are as a trans person “You’re so brave” doesn’t see the full picture How hard it is to show up – and what it means that trans folks continue to do so Moving away from just focusing on gender dysphoria versus looking at gender euphoria   Gender Dysphoria versus Gender Euphoria and the problems with the DSM How the DSM is used for the medical needs of trans folks The problem with assigning the diagnosis of Gender Dysphoria to an individual Internalized gender dysphoria (it is not my dysphoria, it is the dysphoria of the people around me about my gender) Playing around with gender shouldn’t be a diagnosis, it is so culturally bound Trans individuals have to know what to report so they can get hormones (i.e., they may have to lie about being dysphoric in order to “check the boxes”) The problem with gatekeeping and the hope that trans folks being in work groups to help shift these guidelines   Better Therapy for Trans Clients Therapeutic alliance is the most important How therapists can appropriately use vulnerability when a client comes out as trans The likelihood of someone coming out initially versus after trust is built and how to handle it Sharing the therapeutic process and how you will learn and educate yourself The problem of signaling that you are capable of working with LGBTQ+ people when you are not trained Awareness of how being trans impacts the client in front of you When the client is coming into therapy due to their gender identity Understanding the back story and how someone identified that “something is different” Looking at what they want to do next (which may be very little or a full plan on how they handle being trans).

Who’s in the Room? Siri, Alexa, and Confidentiality Curt and Katie chat about how therapists can maintain confidentiality in a world of AI assistants and smart devices. What duty do clinicians have to inform clients? How can we balance confidentiality with the reality of how commonly these devices are involved in therapy? Can telehealth therapy be completely confidential and data secure? We discuss our shift in clinical responsibility, best practices, and how we can minimize exposure of clinical data to ensure the confidentiality our clients expect and deserve. In this podcast episode we talk about something therapists might not consider: smart devices and AI assistants We received a couple of requests to talk about the impact of smart devices on confidentiality and their compliance with HIPAA within a therapeutic environment. We tackle this question in depth: What are best practices for protecting client confidentiality with smart devices? Turning off the phone, or placing the phone on “airplane mode” Warning clients about their own smart devices and confidentiality risks The ethical responsibilities to inform about limits of confidentiality and take precautions It’s all about giving clients choice and information What should therapists consider when smart devices and AI assistants are in the room?  – Curt Widhalm Whistle-blower reports on how often these devices are actually listening Turning off your phone is a lot cheaper than identity theft Consider your contacts, geolocation, and Wi-Fi connection Some of this, as we progress into a more technological world, might be unavoidable How do Alexa and Siri impact HIPAA compliance for therapists? The importance of end-to-end encryption for all HIPAA activities (and your smart device may not be compliant) The cost of HIPAA violations if identity theft can be traced back Understand the risks you are taking, do what you can, and remember no one is perfect What can modern therapists do with their smart devices? GPS location services can be left on for a safety reason, emergency services use GPS location Adjusting settings for voice activation, data sharing, when apps are running, locations, etc. Turning off and airplane mode are also options Always let the client know the limits of confidentiality Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Psychotherapy in Ontario: How Confidential is my Therapy? By Beth Mares, Registered Psychotherapist The Privacy Problem with Digital Assistants by Kaveh Waddell Hey Siri and Alexa: Let's Talk Privacy Practices by Elizabeth Weise, USA Today Patient and Consumer Safety Risks When Using Conversational Assistants for Medical Information: An Observational Study of Siri, Alexa, and Google Assistant, 2018 Hey Siri: Did you Break Confidentiality, or did I? By Nicole M. Arcuri Sanders, Counseling Today Alexa, Siri, Google Assistant Not HIPAA Compliant, Psychiatry Advisor Hey Alexa, are you HIPAA compliant? 2018 Person-Centered Tech  

How to Understand and Treat Psychosis: An interview with Maggie Mullen, LCSW Curt and Katie interview Maggie Mullen, LCSW, a national trainer on culturally responsive, evidence-based care for psychotic spectrum disorders. We talk with Maggie about their anti-racist and disability justice framework of psychosis, understanding psychosis on a spectrum, what to do when psychosis enters the treatment picture, assessment of psychosis, and treatment using Dialectical Behavior Therapy (DBT). We also talk about how society defines “normal” and pathology, exploring cultural differences in these definitions. Interview with Maggie Mullen, LCSW In this podcast episode we talk about looking at psychosis differently Maggie Mullen’s anti-racist and disability justice framework of psychosis Maggie came from a community organizing background Inequity and lack of resources for people who experience chronic psychosis The focus on medication rather than other forms of treatment for psychosis BIPOC individuals being shot by police when psychosis shows up in a public space “Psychotic spectrum” versus the segregation of psychosis as “other” “We are often the least prepared to deal with our most acute clients” The continued segregation of psychotic disorders Cultural considerations when determining what is psychosis or other types of experiences The lack of inclusion of psychosis in the research Psychosis is not “other” but is actually a spectrum of behaviors and are very common The symptoms of psychosis are not constant, they fluctuate for every individual The importance of following the model and voices of the disability justice movement Including education on the treatment for psychosis, rather than allowing therapists to opt out Folks with psychosis are often not included in the research, which needs to change What to do when psychosis comes into the treatment picture for our clients We need more training on psychosis to feel confident Normalizing the experience of psychosis Helping to make peace with psychotic symptoms (i.e., making friends with the voices) to decrease distress Looking at treatments beyond medication How to identify psychosis and assess for impact and impairment The myth that all elements of psychosis are distressing and bad Why Maggie Mullen is using Dialectical Behavior Therapy (DBT) to treat psychosis “People with psychosis deal with emotion dysregulation, actually more so than the average person…that's where we know DBT is really effective” We frequently underestimate the ability to help folks with psychosis Using DBT skills for emotion regulation concerns that frequently come up in psychosis Psychosis and PTSD oftentimes occur together and aren’t always diagnosed Trauma can influence the onset of psychosis AND psychosis can be traumatic Maggie’s pilot program with DBT for psychosis The concrete and straight forward nature of DBT skills make them very accessible Understanding psychosis differently, including the cultural differences of what is “normal” How to identify what is “real” and what is psychosis How do you define what is normal for someone? What do we decide what we pathologize? Breaking up the binary of normal or not normal – reframing as “experience” The importance of understanding what is negatively impacting the client and how to keep clients safe Take the lead of your client and trust that they know themselves best The tension between taking the lead of the client and mandates and requirements as a therapist The Dialectical Behavior Therapy Skills Workbook for Psychosis by Maggie Mullen, LCSW Maggie wrote a book to democratize DBT skills Using DBT, but making the skills more concrete and accessible 

When Doing “No Harm” Isn’t Good Enough: Bringing beneficence to your clients Curt and Katie chat about ethics again. We look at how therapists decide what is beneficial for clients. We also contrast the concept of “beneficence” (doing good) versus “nonmaleficence” (doing no harm). We specifically explore how to identify when something is in the therapist’s interest versus the client’s interest as well as what therapists can do when clients hold harmful, untrue beliefs. This is a law and ethics continuing education podcourse. Transcripts for this episode will be available at mtsgpodcast.com! In this podcast episode we talk about how therapists do good, beyond “do no harm” Therapist healthcare ethics are often taught from the perspective that the professional’s role is to “do no harm” when providing treatment to clients. Lost in the teachings is that therapists have other obligations to address when providing treatment. This workshop focuses on examples of bringing the principle healthcare ethic of beneficence to therapy to help determine “doing good” for the client’s benefit. What is beneficence in the context of psychotherapy? ·      Do what is good for the client and for treatment ·      “For the benefit if the client” ·      Comparing this with the idea of non-maleficence (“do no harm”) which is don’t do bad things, but also try to prevent bad things from happening How do therapists decide what is “good” for their client? ·      Assessing the risk of overtaking client autonomy and becoming paternal or parental ·      Balancing all of the core ethical principles and putting them in context for the unique situation for each client ·      Looking at whether therapist self-disclosure is in the benefit of the client ·      Identifying what is therapeutic and beneficial ·      Making sure that therapists move beyond what is comfortable (and not “harmful”) to something that may be less comfortable (and more beneficial) ·      Looking at who therapists choose to work with, balancing therapist self-care and self-protection with what is beneficial to the client and society What are specific concerns to consider when deciding whether a therapist is working for the benefit of the client? ·      Therapy dogs (are they certified and registered, is it in the treatment plan) ·      Contact between sessions initiated by the therapist (who is the contact for? What does the treatment model say about this type of contact?) ·      Have a thought process and document that thought process when deciding what to do as a therapist What can therapists do when clients hold distorted beliefs? ·      Identify: Do the distorted beliefs that the client holds cause (or could cause) harm? ·      Understand: What laws or ethics are relevant to whether the distorted belief should be addressed? ·      Get client consent (or not) to talk about the distorted belief and potentially change the course of therapy ·      Is it necessary to discuss the belief at this time? ·      What countertransference issues could impact the efficacy of the conversation with the client? ·      Will the conversation be helpful and potentially change the client’s view? ·      How will the conversation change the course of therapy? ·      Does the therapist have appropriate expertise and training to address the distorted belief? Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide Continuing Education Approvals: When we are airing this podcast episode, we have the following CE approval. Please check back as we add other approval bodies: Continuing Education Information including grievance and refund policies. Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement: Patreon Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano https://groomsymusic.com/

Which Theoretical Orientation Should You Choose? Curt and Katie chat about how therapists typically select their clinical theoretical orientation for treatment. We look at the different elements of theoretical orientation (including case conceptualization, treatment interventions, and common factors), what impacts our choices, the importance of having a variety of clinical models to draw from, the types of practices that focus on only one clinical theory, and suggestions about how to approach choosing your theories for treatment, including some helpful assessments. In this podcast episode we talk about how therapists pick their theoretical orientation We received a couple of requests to talk about clinical theoretical orientation and how Curt and Katie chose their own. We tackle this question in depth: Choosing a clinical theoretical orientation The problem with the term “eclectic” when describing a clinical orientation How Curt and Katie each define their clinical orientations “Multi-modal” therapy The different elements of clinical orientations Case conceptualization Treatment interventions Common Factors and what actually makes therapy work What impacts which theoretical orientation we choose as therapists Clinical supervision Training Personal values and alignment with a theoretical orientation Common sense (what makes sense to you logically) Choosing interventions that you like The importance of having a variety of clinical theories that you can draw from Comprehensive understanding is required to be able to apply and know when not to apply a clinical orientation Avoid fitting a client’s presentation into your one clinical orientation Deliberate, intentional use of different orientations Why some therapy practices operate with a single clinical model Comprehensive Dialectical Behavioral Therapy (DBT) therapists run their practices and their lives with DBT principals Going deeply into a very specific theory (like DBT, EMDR, EFT, etc.) while you learn it Researchers are more likely to be singularly focused on one theory Suggestions on How to Approach Choosing Your Clinical Theoretical Orientation Obtain a comprehensive understanding of the theoretical orientation Understand the theory behind the interventions Recognizing when to use a very specific theory or when you can be more “eclectic” in your approach Deciding how fluid you’d like to be with your theoretical orientation Find what gels with you and do more of that The ability to pretty dramatically shift your theoretical orientation later in your career Instruments for Choosing a Theoretical Orientation Theoretical Orientation Scale (Smith, 2010) Counselor Theoretical Position Scale Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Institute for Creative Mindfulness Very Bad Therapy Podcast Petko, Kendrick and Young (2016): Selecting a Theory of Counseling: What influences a counseling student to choose? What is the Best Type of Therapy Elimination Game The Practice of Multimodal Therapy by Arnold A. Lazarus Poznanski and McClennan (2007): Measuring Counsellor Theoretical Orientation Relevant Episodes of MTSG Podcast: Unlearning Very Bad Therapy Interview with Dr. Diane Gehart: An Incomplete List of Everything Wrong with Therapist Education  

The January 2022 Surprise of Good Faith Estimates Requirements Curt and Katie chat about the No Surprises Act, specifically how to navigate the requirement for clinicians to provide Good Faith Estimates to clients. We talk about the impact of Good Faith Estimates on the intake process, potential complications when providing these estimates to your patients, and suggestions for how to simplify and systemize this requirement.     In this episode of the Modern Therapist’s Survival Guide we talk about the No Surprises Act and the Good Faith Estimate Requirement When we heard about the planned implementation of these new requirements, we decided to dive into the legislation and articles from professional associations to understand what we actually need to do starting January 1, 2022. What is the No Surprises Act and the Good Faith Estimate (GFE) Requirement? The goal of the No Surprises legislation is to avoid surprising patients with large medical bills There are benefits and challenges with the requirement to provide good faith estimates to our clients The Good Faith Estimate requirement is to provide the estimated cost of services (fee times number of sessions) at the beginning of treatment (if asked) and at least annually, if needed How will the Good Faith Estimate Requirement impact the Intake Process for Therapy? We are required to determine whether someone is hoping to get insurance reimbursement We must communicate the ability to obtain a written good faith estimate from providers We are required to estimate the number of sessions and total cost of treatment We talk about when you may need to provide a new good faith estimate (and explain changes) We provided a suggestion to start with a GFE for the intake session and then provide a second GFE after that initial session Potential Complications Curt and Katie see for Therapists Providing Good Faith Estimates The requirement for diagnosis very early in treatment The requirement for a diagnosis written on paper – both for folks who don’t know or have not asked before, as well as for folks who do not want a written diagnosis Concerns related to putting forward the total cost of therapy for the year The elements of bureaucracy that could negatively impact the therapeutic relationship The No Surprises Act legislation isn’t finalized and may have additional components or changes Our Suggestions to Systematize the Good Faith Estimate (GFE) Requirement for Therapists Consider coordinating the timeline for updating GFEs, treatment plans, frequency of sessions, progress in treatment, and a reassessment of the sliding scale Think through how you talk about diagnosis and treatment planning ahead of time The idea to create some sort of mechanism for folks to either decline a GFE or to request an oral versus paper GFE Use recommended language to create your notice for your office as well as on your website Create your own template to simplify the process, including a boiler plate GFE for your intake Create a template for GFEs for on-going treatment Resources for Modern Therapists mentioned in this Podcast Episode: We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! APA Article: New Billing Disclosure Requirements Take Effect in 2022 Suggested Notification Language for Good Faith Estimates Template for a Good Faith Estimate Good Faith Estimate Legislation Language from the No Surprises Act Federal Register: Requirements Related to Surprise Billing; Part II CMS.gov: Requirements Related to Surprise Billing; Part II, Interim Final Rule with comment period Relevant Episodes of MTSG Podcast: Should Private Practice Therapists Take Insurance? Make your Paperwork Meaningful

How Can Therapists Actually Retire? - An interview with David Frank, financial planner for therapists Curt and Katie talk with David about managing finances, including student loan debt and retirement. We look at when to start saving, what to do when you’re starting to save for retirement later in life, and how much is too much to save. David also shares his concept of a Money Date and how you should start looking at your financial picture. He also talks about financial planning and when to seek a professional for support. Interview with David Frank, Turning Point Financial Life Planning In this podcast episode we talk about: Managing Personal and Professional Finances How perfectionism can get in the way of saving The importance of “just getting started” in saving for retirement Saving money is a practice, not something you figure out once Why it is important to save money as soon as you can Navigating Student Loan Debt Student loan debt and how overwhelming it is to look at these debts The desire to pay off this debt as quickly as possible David’s advice to save at least one time your annual income before aggressively paying off your student loan debt The comparison of interest rates on your debt versus returns on investing money Retirement and Investing in your Future “Starting to save and invest young is such great advice… and… it’s advice for time travelers” For younger folks, the advice is to save as soon as possible What to do if you are closer to retirement age and you haven’t started saving for retirement How to determine when you can retire “No one does this money thing perfectly, even if we start out of the gate pretty strong.” What to do when life happens and you have to start over David’s own story of having to start over Societal fear due to 2008 and the Great Recession David Frank’s Concept of “Money Dates” Reserve time each week to look at your money Start understanding how much you need to save Idea: go to the Social Security Administration Website to see what you’re entitled to in social security How Much Money to Save The money mindset concerns that can get in the way of saving (or even looking at) your money How much money is too much money to save? Emergency funds and the feeling of safety and security The risks of saving too much money Quality of life questions when you are underspending Online tools to identify what you need in retirement, so you know when you’ve saved enough Actual numbers of what to save for retirement and what you can spend now Financial Planning – When and why to seek help with your money The complexity of the decisions related to paying debt versus investing The number of options available to each person when making decisions on our money Get feedback on how well you are doing on your practice financials and saving for retirement Risk planning, financial planning, estate and incapacity planning The importance of understanding your values when you look at how to spend your money Financial planning when you don’t have a lot of money Choosing what you sacrifice when you decide to invest in shiny objects The problem of “shoulds” and getting financial advice from other therapists