The Modern Therapist's Survival Guide with Curt Widhalm and Katie Vernoy

The Lasting Harm of Conversion Therapy: An Interview with Samuel Nieves This interview was recorded in November 2025 in anticipation of the Supreme Court ruling in Chiles v. Salazar and released afterward. Rather than focusing on the legal details of the decision, Curt and Katie talk with Samuel Nieves about the harms of conversion therapy, how change efforts can be disguised as therapy, and what clinicians need to understand when working with survivors. Sam shares from his lived experience as a survivor and explains why the deepest harms often involve identity damage, loss of self-trust, and disconnection from one’s own lived experience. About our guest:Sam Nieves has a Bachelor’s in Psychology. In 2019, he entered grad school to become a Licensed Marriage and Family Therapist, but left the field after 6 months of clinical experience. Since 2020, Sam has used his personal, clinical, and educational background to support survivors of conversion therapy. He is now a board member of the non-profit organization Conversion Therapy Survivor Network. Sam uses the online name “CantPrayMeAway” to share his own experiences as a client of conversion therapy and advocates for the end of all conversion practices worldwide. Key takeaways: Conversion therapy is broader than many therapists realize and can show up in subtle, disguised forms SOGIECE (sexual orientation and gender identity or expression change efforts) offers a clearer framework for recognizing sexual orientation and gender identity or expression change efforts The core harm of conversion therapy is often identity damage and loss of self-trust Even well-intentioned therapeutic tools can become retraumatizing when they are used in the service of changing identity Survivors may need therapists to move slowly, stay client-centered, and understand that therapy itself may have been part of the harm Full show notes and transcript: mtsgpodcast.com Join the Modern Therapist Community: Linktree: https://linktr.ee/therapyreimagined Facebook Group: https://www.facebook.com/groups/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 Private Practice Pivot: How Therapists Are Adapting to Platforms, Agency Work, and the Changing Therapy Economy Are therapists leaving private practice - or simply adapting to a changing mental health economy? Curt Widhalm, LMFT, and Katie Vernoy, LMFT discuss a growing shift across the profession as therapists pivot between private practice, agency jobs, group practices, and therapy platforms. As referral patterns change, venture-backed platforms grow, and the economics of therapy evolve, many clinicians are reconsidering how they structure their careers. Curt and Katie explore why therapists are pivoting their practices, how platforms like Headway, Alma, and Rula are shaping the field, and what therapists can do to build sustainable careers in a rapidly changing environment. Key Takeaways • Why many therapists are pivoting their private practices • How therapy platforms and venture capital are reshaping the profession • The role of agency work, group practices, and hybrid careers • Why isolation can undermine sustainability in solo practice • How therapists can design careers that prioritize stability Full show notes and resources: mtsgpodcast.com Join the Modern Therapist Community Patreon: https://www.patreon.com/c/mtsgpodcast Facebook Group: https://www.facebook.com/groups/therapyreimagined Modern Therapist’s Survival Guide Creative Credits Voice Over by DW McCannhttps://www.facebook.com/McCannDW/ Music by Crystal Grooms Manganohttps://groomsymusic.com/

Is Independent Private Practice Sustainable? Data on Caseloads, Insurance & Income Is independent private practice still financially sustainable? Curt and Katie sit down with Lindsay Oberleitner, PhD, Director of Clinical Strategy at SimplePractice, to examine national data on caseload trends, insurance participation, income realities, and therapist burnout. Drawing from Lindsay's research at SimplePractice, they explore whether independent private practice is truly viable long term - and what clinicians need to understand to remain financially and professionally sustainable. In this episode, we discuss: • Why some clinicians are seeing declining caseloads despite high demand for mental health care • Typical full-time caseload ranges in independent private practice • How insurance participation is shifting year over year • The financial impact of reimbursement rates and overhead costs • Why burnout is both a personal and systemic issue • The significant role independent private practice plays in delivering outpatient behavioral health care across the United States Independent private practice represents an estimated 15–20% of outpatient behavioral health services. This episode helps therapists think strategically about income, sustainability, visibility, and long-term viability in today’s healthcare landscape. For full show notes and resources, visit mtsgpodcast.com. Join the Modern Therapist Community: • Patreon: https://www.patreon.com/c/mtsgpodcast • Facebook Group: https://www.facebook.com/groups/therapyreimagined • Podcast Homepage: https://therapyreimagined.com/modern-therapists-survival-guide-podcast-episodes/ Modern Therapist’s Survival Guide Creative Credits: Voice Over by DW McCannhttps://www.facebook.com/McCannDW/ Music by Crystal Grooms Manganohttps://groomsymusic.com/

They unpack the hidden administrative, financial, and emotional labor stacked behind each client hour. You hear about task-switching from clinician to CEO and why that constant pivot is draining. Practical audits and weekly triage techniques for delegating, protecting CEO time, and reclaiming energy are discussed.

Burnout Recovery in a Failing System – An Interview with Shaina Siber, LCSW Therapists are navigating hiring freezes, wage stagnation, insurance instability, identity-level threats, and mounting systemic uncertainty — all while supporting clients experiencing the same instability. What happens when burnout isn’t just about workload, but about working inside a system that feels like it’s failing? Curt and Katie talk with Shaina Siber, LCSW, about moral injury, burnout as a fawning trauma response, and how therapists can move from control strategies to agency using Acceptance and Commitment Therapy (ACT) and Compassion-Focused Therapy (CFT). Shaina shares how psychological flexibility, compassionate prioritization, and values-based action can help therapists recover from burnout without abandoning their humanity. In this episode, we discuss: • Burnout as a trauma response • Moral injury in modern mental health care • The “K-shaped” labor market and therapist stagnation • Moving from overcontrol to agency • Sustainable contribution without collapsing Guest Bio: Shaina Siber, LCSW is the founder of Affirm Mental Health, host of The Affirming Minds Podcast, and author of the forthcoming Routledge book Using ACT and CFT for Burnout Recovery: The Beyond Burnout Blueprint (available for pre-order February 25, 2026). She brings over 15 years of clinical and leadership experience and specializes in trauma-informed, LGBTQ+, and culturally responsive care. Full show notes and resources: mtsgpodcast.com Join our community: Facebook Group: https://www.facebook.com/groups/therapyreimagined 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/

Should Texas Therapists Stop Treating Kids? Texas SB14, Gender-Affirming Care, and the Risks for Therapists In this episode of the Modern Therapist’s Survival Guide, Curt Widhalm and Katie Vernoy discuss a new interpretation of Texas SB14 that may place therapists at risk for providing gender-affirming care to trans youth. They explore how a recent opinion from the Texas Attorney General could broaden the law’s reach beyond medical providers to include mental health professionals. Curt and Katie break down what this interpretation could mean for therapists working with minors, including possible risks related to licensure, malpractice coverage, mandated reporting, and criminal liability. They also discuss the ethical tension between evidence-based care and compliance with state law, and the difficult decisions clinicians may face when considering whether to continue working with kids. Key Takeaways: A new interpretation of Texas SB14 may include mental health professionals as part of the “healthcare pipeline” facilitating gender transition for minors. The legal term “facilitating” could potentially include referrals, letters, or even supportive therapy conversations. Therapists may face risks related to licensure complaints, malpractice coverage exclusions, or legal consequences if their care is interpreted as supporting gender transition. Mandated child abuse reporting requirements could create additional legal and ethical concerns. Clinicians may need to assess their personal risk tolerance when deciding whether to continue working with minors. Full show notes and additional resources will be available at:mtsgpodcast.com Join our community: Modern Therapists Group (Facebook): https://www.facebook.com/groups/therapyreimaginedLink Tree: https://linktr.ee/therapyreimagined Modern Therapist’s Survival Guide Creative Credits Voice Over by DW McCannhttps://www.facebook.com/McCannDW/ Music by Crystal Grooms Manganohttps://groomsymusic.com/

The Licensing Racket: Therapist Licensing, Discipline, and Access to Care – An Interview with Rebecca Haw Allensworth Who does licensing protect - the public or the profession? Curt and Katie talk with Rebecca Haw Allensworth, law professor and author of The Licensing Racket, about how professional licensing boards actually function, and what that means for therapists, discipline, and access to care. After attending licensing board meetings across professions and states, Rebecca identified a troubling pattern: entry requirements that continually “ratchet up,” while discipline decisions can lean toward giving professionals the benefit of the doubt. The result? Higher barriers to entry, workforce shortages, and inconsistent public protection. This episode explores therapist licensing reform, self-regulation, professional turf wars, board funding structures, and the tension between prestige, professional identity, and public safety. About Our Guest:Rebecca Haw Allensworth is the David Daniels Allen Professor of Law at Vanderbilt Law School and author of The Licensing Racket: How We Decide Who Is Allowed to Work and Why It Goes Wrong. Her research focuses on antitrust and professional licensing and has been cited by the U.S. Supreme Court. Key Takeaways: • Why licensing requirements tend to increase over time • How self-regulation can create blind spots in discipline • The impact of licensing barriers on workforce shortages and access to care • Why complaints about unlicensed practice may be prioritized over client complaints • How professional identity and funding structures shape board decisions Full show notes and resources: mtsgpodcast.com Join our community: Facebook Group: https://www.facebook.com/groups/therapyreimagined Patreon: https://www.patreon.com/c/mtsgpodcast 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/

A deep dive into how AI can create the illusion of clinical competence and quietly erode core therapeutic skills. Discussions cover the systemic causes of deskilling, the need for struggle and ambiguity in learning, and supervision strategies to preserve clinical judgment. Practical ideas include adversarial critique of AI outputs, naked practice without tools, and requiring trainees to trace clinical logic.

Why Food Anxiety Is Not Always About Dieting: Understanding ARFID and Intuitive Eating - An interview with Robyn L. Goldberg, RDN, CEDS-C Diet culture often dominates conversations about eating disorders, but not all struggles with food are driven by weight, body image, or dieting. In this episode, Curt Widhalm and Katie Vernoy talk with registered dietitian nutritionist and certified eating disorder specialist Robyn L. Goldberg about Avoidant Restrictive Food Intake Disorder (ARFID), intuitive eating, and how therapists can recognize when food anxiety requires a different clinical approach. Robyn explains how ARFID differs from more familiar eating disorders, why it is often mislabeled as “picky eating,” and when intuitive eating principles need to be adapted or set aside. This conversation offers therapists practical guidance for assessment, referral, and collaboration with eating-disorder-informed dietitians. Key Takeaways ARFID is not driven by weight or body image concerns and is often rooted in sensory sensitivities, trauma, or fear of aversive consequences Intuitive eating is not a one-size-fits-all model and may require significant structure for some clients Rigid food rules and avoidance can be protective for clients but may also limit functioning and quality of life Exposure-based approaches are often central to ARFID treatment and require specialized training Therapists should refer to eating-disorder-informed dietitians when food restriction significantly impacts health or daily life Guest Bio Robyn L. Goldberg, RDN, CEDS-C, is a registered dietitian nutritionist and certified eating disorder dietitian and consultant with over twenty-eight years of experience. She is the author of The Eating Disorder Trap, host of The Eating Disorder Trap Podcast, and a nationally recognized expert featured in major media outlets. Full Show NotesRead the full show notes and resources at: https://www.mtsgpodcast.com Community and SupportJoin our Facebook group: https://www.facebook.com/groups/therapyreimaginedSupport the podcast on Patreon: https://www.patreon.com/c/mtsgpodcast Modern Therapist’s Survival Guide Creative Credits Voiceover by DW McCannhttps://www.facebook.com/McCannDW/ Music by Crystal Grooms Manganohttps://groomsymusic.com/

A deep look at how public disclosures can retraumatize survivors and trigger moral injury. Discussion of common trauma presentations like numbness, irritability, and newly uncovered disclosures. Practical clinician strategies for containment, grounding, and pacing processing. Exploration of justice fatigue, systemic mistrust, and ways to support survivors and professional boundaries.