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

When Your Client is a Super Fan: Exploring parasocial relationships and their effects on mental healthCurt and Katie chat about parasocial relationships. We talk about what parasocial relationships (and break ups) are, who is most likely to engage in these relationships, and the positive and negative impacts of these one-sided relationships. We also look at how to use these relationships within therapy. This is a continuing education podcourse.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about parasocial relationshipsPeople develop relationships with celebrities, TV personalities, and others in the public eye. But do therapists assess the impact these relationships have on their clients and their mental health? This episode explores the ways that clients interact in one-sided relationships, the mental health benefits and drawbacks to engaging in these relationships, and ways for therapists to assess the potential impacts on client mental health and behavior.How can parasocial relationships show up (and be utilized) in therapy?·      How to help clients identify appropriate role models·      Using parasocial relationships as practice for social relationships·      Ask what content clients are consuming to identify what messages they are receiving·      Get very direct: ask about all of the content they regularly consume·      Look especially at the content or influencers talking about things relevant to their presenting problems·      Explore how clients with social anxiety are interacting with potential parasocial relationships·      Staying abreast of news stories related to parasocial objects·      Listening for certain types of unhealthy messages (like toxic masculinity)·      Helping to expand your clients’ critical thinking and influences in their lives·      Understanding why they are choosing these relationships and the meaning they are making from them·      Using these relationships as practice or places to seek self-awareness and insight, especially related to identity and values·      Grief work when there are parasocial breakupsReceive Continuing Education for this Episode of the Modern Therapist’s Survival Guide Continuing Education Information including grievance and refund policies.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 Is It Like To Be a Medicare Therapist? An interview with Gabrielle Juliano-Villani, LCSWCurt and Katie interview Gabrielle Juliano-Villani, LCSW, about what it looks like to take Medicare. We talk about common myths and what the actual experience is like. We also explore the business case for taking Medicare and why (and how) therapists can grow their practice by opting in as a Medicare provider.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode, we talk about taking Medicare as a therapistCurt and Katie asked Gabrielle Juliano-Villani, LCSW to come in to talk about what it is like to take Medicare as a therapist. What is involved in being a Medicare provider?·       Clientele on Medicare include elderly and disabled·       There is a huge need to clinicians to take Medicare·       You will get a lot of referrals – Gabrielle filled up her caseload and made 6 figures in her first year in private practiceWhat types of clinical expertise is necessary for therapists who take Medicare?·       Loss of independence and aging issues·       Grief and loss·       Chronic health conditions and illnesses·       Loss of mobility·       Dementia and cognitive issues·       Family dynamics and estrangement·       Understanding later in life logistics·       Caregiver concernsWhat are the business or day-to-day elements of taking Medicare?·       Referral sources are medical doctors, care managers, and other therapists·       Website content designed with caregiver or family member in mind (who would be searching for the services)·       Sorting through Medicare and Medicare Advantage (i.e., commercial insurance Medicare replacement) plans – clients don’t know the difference between Medicare and Medicare Advantage·       Ask to see all of their insurance cards to identify what coverage they have:o  Bill Medicare directly for patients with Medicare – you are a Part B provider (outpatient) – you will get 80% from Medicare and the other 20% from the patient, a supplemental plan, or Medicaido  Bill the commercial insurance plan for Medicare Advantage patients (like regular insurance billing)·       Audits are not common and are navigable with good notes and ability to make corrections·       Audits are more likely if you’re doing unusual billing practices·       The application process is probably the most challenging part of taking MedicareStay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:Our Linktree: https://linktr.ee/therapyreimaginedModern 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 Can Therapists Do When They Get a Life-Threatening Diagnosis? An interview with Patricia Ravitz, LMFTCurt and Katie interview Patricia Ravitz, LMFT, on how she navigated her pancreatic cancer diagnosis as a therapist. We talk about what happens when a therapist must take time away from their practice without notice, what therapists can do to navigate seeing clients while in treatment, and how you and your clinical work can change when you’re facing mortality. We also talk about support and resources. Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode, we talk about how therapists can manage their practice when facing a potentially life-threatening diagnosisCurt and Katie asked their dear friend, Patricia Ravitz, LMFT to come talk about how she handled her practice after getting a cancer diagnosis. What happens when a therapist must suddenly take time away from their practice for medical treatment? Determining how long will be needed to take time off (if that can be predicted) Identifying how to notify patients and what to share with patients Understanding whether you can have these conversations with patients (or not) Choosing a method for notification  Consulting with a colleague who can help with notification and/or follow up What can therapists do to continue to see clients while in chemotherapy? Assessing your response to chemotherapy and when you might be able to work Identifying days that you typically are able to be present and focused for your clients Determining who you can effectively see as a therapist and who you need to refer out Scheduling therapy around your treatment schedule as well as their clinical needs How might your clinical work change when you’re facing mortality as a therapist? The reality of the precariousness of life can impact the sense of urgency Sorting through what each client wanted to hear about or needed to talk about Focus and sharpening the therapy, moving away from complacency The emotions and care from the clients to the therapist Processing the relationship in a different way What kind of support or resources should therapists use when facing a challenging diagnosis? Personal support, therapy, consultation groups A professional will Understanding how this impacts other relationships and how you look at the world These types of experiences transform how we operate Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:Our Linktree: https://linktr.ee/therapyreimaginedModern Therapist’s Survival Guide Creative Credits:Voice Over by DW McCann https://www.facebook.com/McCannDW/Music by Crystal Grooms Mangano https://groomsymusic.com/

Want to Fix Mental Health Workforce Shortages? Speed up the Licensing Boards: An interview with Dr. Ben CaldwellCurt and Katie interview Benjamin E. Caldwell, PsyD, about licensing board inefficiencies leading to incredible delays in folks getting licensed. We talk about the impacts of paperwork processing delays as well the inadequate infrastructure of most licensing boards. We also explore policy and individual options to mitigate or address these problems.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode, we talk about how the mental health workforce shortages are exacerbated by licensing boardsCurt and Katie decided to invite Dr. Ben Caldwell back onto the podcast to talk about how licensing board inefficiencies are exacerbating mental health workforce shortages.Impacts of delays of paperwork processing on clients and clinicians·   Delays of folks increasing income as a licensed clinician·   Lack of mental health clinicians in the work force·   Prospective clinicians dropping out of the process to become licensed due to the time and financial burdenLicensing board infrastructure is often inadequate to get individuals licensed timely·   Computer systems that licensing boards use are not typically modern·   The contracts for streamlining processes are often restrictive to specific systems or to how quickly these improvements can move·   There is little that is automated, but rather includes manual entry which is inefficient and introduces opportunities for errorWhat are potential solutions for the pervasive inefficiency found in licensing boards?·   Scanning and using optical recognition software for applications and counting hours·   Contracting with private technology companies that are already gathering this data·   Finding automated systems that are set up properly from the beginning to minimize training needs·   Legislation to put pressure on state licensing boards to update computer systems·   Hiring more people to take on these tasks·   Using financial reserves to improve systems·   Mitigating the effects of the delays on the workers (i.e., being able to take required exams for licensure while accruing your hours)·   Simplifying processes wherever possible (i.e., less buckets of hours with minimum and maximum hours that need to be met)·   Simplifying applications to make them more understandable for both applicants and reviewers·   Policy analysis related to the rules – boards make the inaccurate assumption that if a rule exists it must be good·   Using the legislative process to hold licensing boards accountable for not getting through applications timely and potentially even giving folks provisional licenses while waiting for the application to be reviewedWhat can individual therapists do to address the delays in processing licensing paperwork?·   Be as clear as possible in applications and communication to the board to decrease confusion·   Don’t apply for licensure early (i.e., before requirements are completed)·   Show up to board meetings and let the licensing board know that delays are a huge problem·   Advocate with your professional org and/or to your legislatorsStay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:Our Linktree: https://linktr.ee/therapyreimaginedModern Therapist’s Survival Guide Creative Credits:Voice Over by DW McCann https://www.facebook.com/McCannDW/Music by Crystal Grooms Mangano https://groomsymusic.com/

REPLAY - Structuring Self-Care We’re still on vacation, but wanted to share another one of our favorite episodes with all of you. We start with a quick reflection on the episode and what we’ve learned since it originally aired. Today’s replay is of Episode 141: Structuring Self-Care. We talk about structuring self-care into your business practices. We look at how to incorporate self-care best practices into the way you build your work day. We also talk about common challenges to taking this advice. You can find the original show notes and transcripts here: Structuring Self-Care.

REPLAY - Therapists Are Not Robots: How We Can Show Humanity in the RoomWe’re on vacation, but wanted to share one of our favorite episodes with all of you. We start with a quick reflection on the episode and what we’ve learned since it originally aired. Today’s replay is of Episode 255: Therapists Are Not Robots: How we can show humanity in the room. We talk vulnerably about how we have managed some pretty challenging life crises while also being therapists. You can see the original show notes and transcripts for episode 255 here: Therapists are Not Robots.

What Do Therapists Need To Do About Medicare? Opting in or out for 2024: An interview with Joy Alafia, CAECurt and Katie interview Joy Alafia, Executive Director of California Association of Marriage and Family Therapists, on the journey for MFTs and Counselors to become eligible to be Medicare providers. We look at the high-level tasks that every therapist needs to take. We also talk about the decision-making process for whether you should opt in or opt out, providing some basic guidance and resources on the steps you need to take now.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode, we talk about MFTs and Counselors becoming Medicare ProvidersCurt and Katie have spent hours in advocacy efforts for MFTs and Counselors to become Medicare providers through their past involvement in the California Association of Marriage and Family Therapists (CAMFT). And it’s finally gone through! We asked Joy Alafia to come join us to discuss this journey as well as what therapists need to do now that we’re eligible to be Medicare providers. We answer the following questions and have a step by step guide in our show notes at mtsgpodcast.com:What was the process for MFTs and Counselors to be included in Medicare?Now that Marriage and Family Therapists and Counselors are eligible to bill Medicare, what do we need to do?What do therapists need to do if they would like to Opt In to provide Medicare services?What do therapists need to do if they would like to Opt Out of billing Medicare?What should therapists consider when deciding whether to take Medicare?·      Clinical specialty – if you work with folks 65 and older or with disabled folks, you will want to strongly consider taking Medicare as these clients are typically eligible and would like to use their insurance·      Access – if you have the ability (i.e., space in your caseload) to see Medicare patients, there is a huge need for providers who accept this insurance·      Credibility – there is increased credibility as a provider when you are able to take Medicare·      Rates – check out what the rates are for the areas where you see clients. To do so, look for your locality on the Physician Fee Schedule and multiply the rates by 75% if you are a masters level provider. If the rates are sufficient, you will consistently get clients and will consistently get paid. If the rates are not sufficient for your business, you will want to consider opting out and remaining private pay for these clients.·      Documentation requirements – the documentation requirements are similar for most insurance plans, especially Medicaid. If you’re able to keep clean, efficient documentation, this should not be a deterrent for taking Medicare·      Billing complexity – you will want to make sure to take trainings available (see below) to understand how you will need to bill this insurance plan and/or hire a biller who does·      Consistency and recession-proofing your practice – Medicare is known to pay consistently and provide a lot of clients for your practice. As the population ages, this will be a larger and larger portion of the folks seeking mental health services. You may want to consider taking Medicare.Resources for Modern Therapists mentioned in this Podcast Episode:We’ve pulled together LOTS of resources mentioned in this episode and put together some handy-dandy links.California Association of Marriage and Family Therapists (CAMFT)California Association of Marriage and Family Therapists (CAMFT)CAMFT’s Medicare Corner (for CAMFT members)CAMFT’s Medicare WebinarsA TON of other Resources can be found on our website at mtsgpodcast.com.Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:Our Linktree: https://linktr.ee/therapyreimaginedModern 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 Can Therapists Take a Real Vacation?Curt and Katie chat about how therapists can take extended time away from their therapy practices. We talk about how to budget time and money for vacation as well as what therapists need to have covered when they’re gone. We also look at how to mitigate foreseeable risk and manage continuity of care.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about how therapists can get time away from workWe’ve heard too many people talking about the challenges of taking time off when you’re working as a therapist.How can therapists budget for time off?·      Determining fees based on time you’re actually working (i.e., charging more or determining number of weekly sessions based on when you can be away)·      Scheduling based on diminishing the number of actual missed sessions (i.e., scheduling vacations when your clients are on vacation and/or taking long weekends and moving clients within the week to take partial weeks off)What do therapists need to cover when they go on vacation?·      Clinical coverage within your practice or with colleagues·      Identify when you’re on-call and how you navigate that within your vacation·      Supervision coverage planning·      Understanding when you can respond to clients or supervisees (i.e., being in wise mind)·      Safety planning with clients, including coverage plan and/or when you’re availableHow can therapists mitigate the clinical risks for taking longer vacations?·      Determining when you should stop taking new clients before a longer vacation·      Teaching your clients to be okay without you·      Flexibility on when you take time away and how to take time away from the office·      Planning for foreseeable risks·      Homework or other resourcesWhat does a hybrid work vacation look like?·      Virtual work as needed·      Creating times/spaces for clinical sessions and follow up·      Make sure you have sufficient wifi or cell reception and privacy·      It’s important to make sure you get downtime and aren’t constantly workingWhy is it important to take time off when you’re a therapist?·      Getting rejuvenated and living life·      Working to prevent burnout·      Renewed sense of energy within the profession·      Our job is to talk about pain and suffering and there is so much pain and suffering in the world, so it is important to get restorative breaksStay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:Our Linktree: https://linktr.ee/therapyreimaginedModern 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 podcast explores religious trauma and high-control religions with expert Anna Clark Miller. Topics include the impact of religious trauma, common therapist mistakes, and healing after leaving high-control religions. The discussion covers therapy approaches, rebuilding lives post-religion, rigid thinking, LGBTQ+ trauma, and therapist training for religious trauma.

How Much Autonomy Do Therapy Clients Deserve? Balancing client autonomy with therapist skillCurt and Katie chat about client autonomy. We look at what patient autonomy is and what therapists need to understand about this very complex topic. We explore how therapists can overstep or abdicate their role in supporting their clients in making decisions. We also look at what true informed consent is and the dimensions of client autonomy. This is an ethics continuing education podcourse.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about client autonomyTherapists are faced with balancing their professional knowledge with the needs and desires of clients. At the core of this issue is the principle ethic of client autonomy. How much autonomy do therapists need to give clients? What do therapists do when clients don’t have the capacity for autonomy in the first place? This workshop explores the considerations that therapists must face when balancing the needs of clients with professional mental health services.henWhat is patient or client autonomy in mental health?·      Clients making decisions about their treatment based on solid information and an understanding of that information·      There is a debate related to whether we defer to clients’ decisions no matter what versus standing in the role of professional therapistWhat do therapists need to understand about client autonomy?·      There is a lot of complexity and nuance related to therapist responsibility as professionals versus when therapists can become too paternalistic·      There is a not a lot of discussion within the ethics codes related to client autonomy, they are usually in the preamble, so it is more important while also be less discussed·      Freedom (or liberty) to make choices versus agency (or capacity) to understand the choices·      Therapists need to clarify for clients the options and make sure they can make informed decisionsHow is informed consent related to client autonomy?·      If clients don’t know what their therapists are doing, do they have client autonomy?·      Evaluation of whether someone has the capacity to make treatment decisions can be impacted by bias, but is the role of the therapist within the mental health treatment·      We don’t want to equate autonomy with autonomous decision-makingDimensions of client autonomy and the therapist’s responsibility·      Decisional dimension – being able to plan and make decisions about their mental health treatment·      Executive dimension - being able to follow through on the plans made·      Therapists need to be able to step forward and provide additional support to clients to bring them back to autonomy or hold a line in treatment that will and will not be offered·      Informed dimension - understanding the difference between informed consent and informed assent and being able to give instructions ahead of time if have a mental health crises·      Looking at a “Mental Health Advanced Directive” – one example is the Wellness Recovery Action Plan (see the resources section in the show notes).Paternalism and client autonomy·      Not all “paternalism” is wrong – when clients are unable to care for self, they may need some paternalism to be able to be safe or get the treatment that they need·      Asymmetrical versus libertarian paternalism is discussed·      The importance of understanding your own bias and how the way you frame options can be manipulativeReceive Continuing Education for this Episode of the Modern Therapist’s Survival GuideContinuing Education Information including grievance and refund policies.Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:PatreonBuy Me A CoffeeModern Therapist’s Survival Guide Creative Credits:Voice Over by DW McCann https://www.facebook.com/McCannDW/Music by Crystal Grooms Mangano https://groomsymusic.com/