The Modern Therapist's Survival Guide with Curt Widhalm and Katie Vernoy – Details, episodes & analysis

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