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

What’s Confidential and What’s a Secret? Navigating “No Secrets” PoliciesCurt and Katie chat about no secret policies. We look at what they are, what needs to be in these policies, how to navigate secrets in therapy, the importance of these policies in relational therapy, and the complexity of “no secrets” when working with kids and teens.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about no secrets policies in therapyIn our continuing efforts to touch on all the topics that therapists need to know about, we decided to dig deeply on no secrets policies.What is a no secrets policy?·      Typically, these types of policies are created for relational therapy·      “No secrets” means that the therapist will not keep a secret that is clinically relevant from a member of the treatment unit, even when someone contacts the therapist outside of session·      This policy needs to be understood by all the members of the treatment unitHow can therapists navigate secrets in therapy?·      If there is communication outside of therapy, it is important to hold the boundaries within your no secrets policy·      Flexibility related to when and how secrets are shared (versus rigidity and immediacy)·      Explicit discussion around exceptions of the “no secrets” policy related to intimate partner violence·      It is important to have a clinical evaluation of when and how the secret is shared into the treatment unit and whether the secret is clinically relevant to the treatment unit·      Clarify the treatment unit and clinical orientation to sort through what needs to be in your secrets policy·      Determining how not to be triangulated by members of the couple or familyWhat needs to be in a therapist’s secrets policy?·      Clear guidance on who is included in the treatment unit·      What secrets will be kept or not kept (e.g., intimate partner violence)·      How secrets will be handled as they come up·      Assessment of the capacity of each member of the treatment unit to participate in these conversations about confidentiality and secretsWhat about no secrets when you’re working with kids and teens?·      Clarity on the treatment unit (individual kid or family, etc.)·      Identifying how confidentiality is held for kids and teens·      Working with the kids and teens to plan for disclosure to caregivers·      For parents of young/school-aged children, there may be work to help caregivers to disclose information appropriately over time (thus the therapist holds the secret for a period of time)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/

Dr. Amy Meyers, LCSW, is a seasoned psychodynamic psychotherapist and professor, bringing nearly 30 years of experience to her discussion on countertransference. She defines countertransference in-depth, emphasizing the need for self-awareness beyond self-understanding. New clinicians often struggle with this dynamic, misunderstanding its role in therapy. Rather than avoiding it, Amy suggests embracing it as a human aspect of care. She provides practical strategies for managing countertransference and highlights how shared experiences can be navigated thoughtfully in therapeutic settings.

Decolonizing Therapy: A Movement - An Interview with Dr. Jennifer MullanCurt and Katie interview Dr. Jennifer Mullan about decolonizing therapy. We discuss what it means to decolonize therapy and the importance of doing so, as well as the challenges therapists face when they are looking to decolonize their practices and incorporate cultural and community healing. We also explore rage, the tendency to pathologize big emotions, and the impact of historical trauma.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode, we look at what it means to decolonize therapyOver time we’ve talked with innovators who are pushing back against the status quo and the medical model. We were so excited to dig more deeply into Decolonizing Therapy with Dr. Jennifer Mullan.What does “decolonizing therapy” mean?·      Looking at accessibility to therapy and how lack of access impacts individuals·      Decolonizing therapy doesn’t work for everyone, especially folks in the global majority and/or who have the most need·      The way that therapy is practiced is not sufficiently addressing the mental health crisis·      Shifting therapy to include cultural healing practices, community healing and support·      Moving the “blame” for poor mental health away from the individual to the individual’s contextWhat can therapists do if they would like to decolonize their own therapy practice?·      Make sure you are doing your own work and have support while working in the role of healer·      Identifying and accepting that all individuals have social, political and other frames that come in with them to the therapy room·      Unlearning and embracing new knowledge, being okay with not knowing·      Looking at historical trauma and colonization as core attachment wounds·      Understanding how historical events impact your clients (and yourself)·      Looking at how historical trauma is transmitted directly and indirectly·      Learn in community·      Rethink diagnosisWhat can therapists get wrong when they are working to decolonize their therapy practice?·      Struggling to see where compliance can conflict with the needs of clients at times·      The impact of diagnosis on clients (especially behavioral diagnoses frequently given to Black and brown boys that often lead a child into the school to prison pipeline)·      Not understanding larger concepts around what is political and big questions like why are people poor?·      Deflecting questions from clients as being clinical material rather than understanding that clients are seeking a human connection·      Holding to firmly to rigid “rules” around attendance and coming on time, for exampleHow can therapists work with rage and other big emotions?·      It’s important to recognize that we are not receiving sufficient education around rage·      It is important to understand what rage and what it is not·      Grief, shame, and trauma lead to rageStay 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/

Should Therapists Admit to Making Mistakes in Therapy?Curt and Katie chat about what therapists can do to effectively navigate their own mistakes in the therapy room. We look at what constitutes a mistake in therapy, the types of mistakes that therapists make, and considerations on how to address mistakes. This is an ethics continuing education podcourse.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about how modern therapists can navigate making mistakesWhen therapists make mistakes, clients can prematurely terminate treatment or fail to meet their goals. Most research on effective therapy looks at factors that minimize the therapist’s tendency to make mistakes, rather than what to do when they happen. However, focusing on the effectiveness of handling mistakes is one of the factors that clinicians can actually control. This workshop focuses on how effectively handling mistakes made by therapists and the mental health system can lead to better outcomes for clients.What should therapists do when they make a mistake?·       Looking at the humanity of the therapist·       It is important to define what is actually a mistake·       Looking at where mistakes can happen within treatment·       Mistakes can be defined based on the definition of successWhat types of mistakes do therapists make in therapy?·       Incorrect or mismatched treatment without adjustment·       Treatment failures happen for many different reasons – what is a mistake versus a work in progress?·       Mistakes can be based on the individual client or therapist factors and the focus of the therapist in the therapeutic work and relationshipWhen should therapists admit mistakes?·       Consideration of whether admitting the mistake will harm the client·       Going beyond “non-malfeasance”·       Exploring how clients like to handle a mistake·       Paying attention to therapist’s own preferences or bias·       Understanding when and how to take responsibility for what you’ve done as a therapist·       Avoiding the impact on the client that they believe that they have made the mistake·       Making sure therapists are resourced when they engage in this processWhat are the systemic errors in mental health treatment?·       Taking a global view to therapy can allow for seeing the other elements and systems·       Recognizing the limits of what therapists can do to solve clients’ concerns, including due to agency policies·       Harm caused by the profession and professional associations (statements made, research completed, etc.)Receive 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/ 

Is BPD a Genuine Diagnosis or a Dismissive Label?Curt and Katie chat about whether (or not) Borderline Personality Disorder is a useful diagnosis. We look at the difficulty in differential diagnosis, the huge overlaps with other diagnoses, and the harm caused by misdiagnosis and dismissal of these clients. We also explore whether BPD is just complex PTSD in disguise. We don’t come to total agreement, but we get a little bit closer on how we can move past the harmful elements of the BPD label. Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we explore the diagnosis of Borderline Personality DisorderAfter reading an article that suggests that there is no clinical utility to the BPD diagnosis, we decided to dig into whether or not BPD is a diagnosis worth using. We struggled to get this episode recorded as we started from a place of deep disagreement. We were able to get to a helpful conversation, we think.Why is Borderline Personality Disorder controversial?·       It is heterogeneous·       There are a lot of rule outs and overlap with other diagnoses·       There may not be clinical utility in using this diagnosis·       There is bias and judgment related to having this diagnosis·       There is a lot of harm from misdiagnosisWhat are the problems and challenges in diagnosing “BPD?”·       Overlap with autism, psychosis, complex or chronic trauma and others·       Must look at the causes rather than solely the symptoms·       The ongoing complexity of how trauma interacts with other elements of a person’s experience and personality make it hard to tease out what is really going onHow is Borderline Personality Disorder distinct from Chronic PTSD?·       First you must understand the relationship between PTSD and Chronic or Complex PTSD·       A theory is that Chronic PTSD has more relational avoidance than BPD·       Another theory is that BPD has an absence of sense of self, which CPTSD does not·       There is literature that shows that not all patients with BPD have trauma historyShould BPD remain as a recognized diagnosis in clinical practice?·       We’re still not sure and don’t completely agree·       At the very least, it needs to be renamedStay 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/

Dealing with “Therapy Doesn’t Work”Curt and Katie chat how to engage with people who doubt the efficacy of therapy. We look at how to address general skeptics, mandated clients, hesitant prospective clients, and uncertain longer-standing clients. Spoiler alert: validation, understanding, and coming back to the relationship go far.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we explore how to talk with folks who don’t believe in therapyIn response to a Reddit thread asking how therapists can respond when someone says they don’t believe in therapy or that therapy doesn’t work.How can therapists respond when someone says, “therapy doesn’t work?”·      Therapy is not for everyone·      Validating concerns·      Work to understand their previous experiences in therapy·      Acknowledge problematic elements in therapyHow do you approach clients who are mandated or forced into treatment?·      Working with resistance·      Going back to the relationship and shared goals·      Meeting client where they areWhat can therapists do when parents don’t believe in therapy for their kid?·      Understanding fear or concerns·      Joining and building rapport·      Exploring their goals for their child·      Seeking engagement and involvement·      Don’t throw evidence-base at them·      Explaining how therapy works for kids·      Avoiding defensiveness on the part of the therapistHow can you explain therapy to a hesitant client considering therapy for the first time?·      Validation of fears and concerns·      Acknowledging challenges in coming into therapy·      Identifying what would be most helpful to address in therapy·      Trying to break through preconceived worries about it not working·      Exploring how to find a good match·      Describing what therapy can look like·      Explain that therapy might not be the only answer (e.g., coaching, social work, meds, etc.)The importance of being able to describe what therapy is like with you·      Curt’s suggestion of having a casual conversation with a colleague to describe what your therapy look like·      Know how to describe your approach to people who don’t know what therapy is·      Not every client is best for you·      Focusing on the relationship you will provide to the clientWhat are the options for talking with long term clients who are doubting therapy?·      Use the concerns clinically·      Validating concerns·      Coming together related to expectations and goals·      Acknowledging when therapy isn’t working·      Reframing incremental progress·      Therapists seeking consultation and supervision, so these conversations don’t feel painfulStay 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/ 

Is Your Therapist Website ADA Compliant? An Interview with Anita Avedian, LMFTCurt and Katie interview Anita Avedian, LMFT about her recent experiences related to an ADA complaint on her website. Anita shares with us how she has navigated this lawsuit and what she’s learned about ADA Compliance for websites. We also talk about the predatory lawsuits on small businesses in California and the benefits of becoming ADA compliant for therapists.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode, we look at what therapists should know about ADA compliant websitesOur friend, Anita Avedian, LMFT, just went through a legal complaint related to her website. It was found to not be ADA compliant, meaning that she had to pay some fines and update her website. She wanted to share what she learned, so we thought – let’s bring this conversation to the podcast! What is needed for a website to be ADA compliant?·      Images have to have alt text·      Videos have to have closed captioned at 95% accurate·      Videos need both closed captions and transcripts·      Contrast colors need to be far enough apart for visibility·      Appropriate font sizes·      Buttons and navigation system have to be ADA compliant·      You cannot have PDFs on your website, you must have documents·      When you are cited, you have to make corrections and keep it upWhat goes into an ADA compliance lawsuit against a website (including therapist websites)?·      There are predatory lawyers who are seeking out noncompliance to open lawsuits with small businesses·      There are thousands of lawsuits·      Your liability insurance doesn’t cover these claims because it is considered discriminatory·      Oftentimes you don’t know that you’re being sued·      There is not an opportunity to make corrections, you are fined and must make corrections immediately·      There is usually oversight and monitoring for 5 yearsHow can therapists make their websites more accessible?·      Accurate transcripts and closed captioning for videos·      Making sure that you are at least 95% compliant by doing a free scan·      Using some of the resources listed in the show notes on our website at mtsgpodcast.com (in the resources section)·      Having a deep scan to identify how close you are to compliance·      Making sure that your web developers know how to make your website ADA compliant·      There are attorneys to help with this process and can provide training on how to make a website ADA compliant·      Side benefits of improved SEO and Google standing·      There isn’t currently a widget to make your website ADA compliant and website themes and templates do not have these requirements built in structurallyStay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:Our Linktree: https://linktr.ee/therapyreimaginedPatreonBuy 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/

We Answer the Question: Is EMDR a Pyramid Scheme?Curt and Katie chat about an episode of Very Bad Therapy that asks the question, Is EMDR a Cultish Pyramid Scheme. This is our response to that question. We talk about what EMDR is, common misconceptions of the model, the concerns with people doing EMDR poorly, and the benefits of this model. We also talk about clinician factors that impact whether someone can do EMDR well. Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we explore EMDRWe decided to respond to an episode of Very Bad Therapy. Curt is an EMDR clinician and consultant in training, so he wanted to respond to the criticisms of EMDR that were brought forward in that episode as well as a related article in The Therapist magazine.What is EMDR?·      Eye Movement Desensitization and Reprocessing·      The mechanism of action is hard to study due to not being able to cut open the brain·      EMDR is a well-defined 8-stage protocol·      The “greatest hits” of other theories put togetherWhat are the misconceptions related to EMDR?·      “It’s expensive,” but the training (which is intensive and comprehensive) breaks down to $35 per CE – a usual and customary rate for continuing education·      There is an argument that the only things that are different from other theories are the eye movements or bilateral stimulation, but it is more of an integrative model·      “EMDR” is manualized and only taught in one way – which is not true. There are a number of stages in the protocol that are taught very differently and there is more nuance·      The criticisms about EMDR may be related to clinician factors, not necessarily model factorsWhat are the concerns with people doing EMDR poorly?·      Only getting the EMDR certification to be marketable·      Not doing EMDR soon enough and forgetting the model·      Lack of confidence that leads them to revert back to theories they are comfortable with·      Not fully learning the theory and trying to use it outside of the model·      Clinicians with less training or less experience may struggle to adapt the model to complex trauma or relational traumaWhat are the benefits of EMDR?·      Intensive training with deliberate practice being built into the certification·      Consultation and support in learning the model·      Strong research base for single incident trauma·      For stronger or more experienced clinicians, there are uses of EMDR for complex trauma and/or transdiagnostic purposesStay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:Our Linktree: https://linktr.ee/therapyreimaginedPatreonBuy 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/ 

Your Modern Therapist Ethics Questions Answered: Digging into the mail bag to identify how to behave ethically in modern timesCurt and Katie discuss tricky ethics questions we’ve received from listeners and colleagues over the years. We look at dual relationships, documentation, therapists in the public eye, fee setting, and when (and whether) we should report each other to the board. This is a law and ethics continuing education podcourse.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we answer complex ethics questions from modern therapistsToo often in groups of therapists, you’ll hear confusing situations being described as “unethical” or illegal without any other explanations. Big feelings about complex situations often lead to therapists avoiding them all together. We dug into our listener mail bag (and gathered our own questions) to sort through more complicated and modern questions that don’t often get talked about in grad school or ethics courses. We discuss dual relationships, documentation, therapist performers and influencers, fee-setting, and our responsibility to correct each other. We look at ethics codes and the philosophy behind ethical decision-making to sort through complex situations.What do therapist ethical codes say around less typical dual relationships?·       Ethical codes do vary, so it is important to look at your own code·       We must avoid harmful dual relationships·       It is important to address foreseeable concerns·       Concerns related to muddying the mechanism of change (the relationship)What is actually required in therapist documentation?·       Electronic documentation is recommended, but probably not required·       We need to accurately reflect what is happening in therapy·       Diagnosis may not be required if you’re not using insurance and don’t need to prove medical necessityHow can therapists show up in public spaces?·       Therapists can have public personas and will need to navigate how what is public may impact the therapeutic relationship·       Therapists can be influencers – you want to make sure you’re aware of how it is impacting your brand and relationships with your clients·       How you interact with your clients around your public persona becomes very context dependentWhat are the special rules for therapists setting fees?·       You have to come to an agreement with your client on your fee before services start·       Looking at sliding scale, pro bono expectations·       There are so many interpretations on what is expected by your ethics·       We cannot take advantage of clientsWhat is a therapist’s responsibility when they believe another therapist has done something wrong?·       There is a strong recommendation in most ethics codes to go to the other therapist first·       It is difficult to get proof and/or get actual records and be able to release them·       There are potentials for confidentiality breaches if therapists move forward with concerns·       Supporting clients to report concerns if it comes up in sessionReceive Continuing Education for this Episode of the Modern Therapist’s Survival GuideYou can find this full course (including handouts and resources) here: https://learn.moderntherapistcommunity.com/pages/podcourseContinuing Education Approvals: Continuing Education Information including grievance and refund policies.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/

Family Therapy: Not Just for Kids - An Interview with Adriana Rodriguez, LMFTCurt and Katie interview Adriana Rodriguez, LMFT about the tendency of therapists (even Marriage and Family Therapists) to avoid working with couples and families. We talk about the challenges in working with groups rather than individuals, how to identify the most appropriate treatment unit, and the benefits of working with adult families. We also discuss the importance of assessing power, privilege, intersectionality, and global context when working with both individuals and families.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode, we look at relationship therapyOur friend, Adriana Rodriguez is returning to the podcast to talk about therapy for relationships, including couples and adult families.Why do therapists avoid working with families and only work with individuals? ·      There seems to be an aversion to working with groups rather than individuals·      Avoiding overstimulation and conflict·      Concerns about a lack of training·      Not seeing adult family therapy as a typical treatment unit·      Insurance and the medical model suggest that treatment is for an individual·      Individualistic society of western cultureHow can a therapist identify the most appropriate treatment unit?·      Making sure to recognize that everyone has people that impact them·      Working to identify the context and root causes of current concerns·      Gathering the people around for accountability and vicarious healing·      Identifying intergenerational transmission of trauma and of giftsWhat can therapists do to support their clients most effectively?·      Understanding the systems within which clients move·      Looking at privilege, power, marginalization, and intersectionality·      Understanding what is typically missed in treatment: that the system needs to be addressed before change can really occur·      Looking for opportunities to engage family members in treatmentHow can therapists better understand adult families?·      Move away from compartmentalizing couples or family work·      More in-depth genograms, with more context and self-reflection·      Looking at how we interact with our clients and how we interact with the systems·      Eco-map – the context around the client·      Timeline – historic events happening during your client’s life around them·      Incorporating accountability and compassion·      Increasing understanding and compassion before inviting in the family members into session·      Recognizing that many cultures have a strong focus and value related to family and honoring that in their healing process·      Helping families and couples come together as “team” members rather than opponentsStay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:Our Linktree: https://linktr.ee/therapyreimaginedPatreonBuy Me A CoffeePodcast HomepageModern Therapist’s Survival Guide Creative Credits:Voice Over by DW McCann https://www.facebook.com/McCannDW/Music by Crystal Grooms Mangano https://groomsymusic.com/