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

Navigating the Social Media Self-Diagnosis TrendCurt and Katie chat about the TikTok Mental Health and the self-diagnosis trend. We dig into what diagnosis is (and what is actually useful about diagnosis). We also explore the concerns with social media self-diagnosis as well as how we can support our clients with getting accurate assessment and treatment. Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about self-diagnosis and the impact of social mediaWe have both heard about TikTok diagnoses in our practices and wanted to talk about how therapists might navigate this new trend. What are concerns with social media self-diagnosis?“The point of having a professional be able to properly evaluate is looking through that more nuanced clinical eye in order to look at where the threshold is that actually meets diagnostic [criteria] versus actually just having some characteristics in common with [the diagnosis]. Somebody can be nervous, does not mean that they have anxiety… What is pathologizing normal feelings?” – Curt Widhalm, LMFT Focusing in on small elements and then having that frame their full life experience Seeking only confirmatory diagnosis versus allowing for differential diagnosis Clinicians who are not doing full assessments to support clients who have self-diagnosed Clients who do not need treatment taking slots from those who do need assessment and treatment Lack of nuance in the social media content that doesn’t include information on differential diagnosis Inaccurate treatments based on inaccurate self-diagnosis Malingering and factitious disorder risk Pathologizing normal feelings Being inundated with so much information Confirmatory bias How to support clients who have sought diagnostic information on social media and google?“What started the whole thing… clinicians under diagnosing, undervaluing client feedback, not asking all the right questions. And so, folks are feeling dissatisfied with what we're doing and heading to the interweb to understand better what it is that's going on.” – Katie Vernoy, LMFT Therapists need to listen to their clients, so they don’t feel the need to go elsewhere for information Identify what is resonating for clients and explore what it means to them Educate clients about differential diagnosis Walk through their research (to listen and to help vet sources) Take your client seriously and support them in getting the help they need  

What Therapists Should Know About Sexual Health, Monkey Pox, and the Echoes of the AIDS Epidemic: An Interview with Mallory Garrett, LMFTCurt and Katie interview Mallory Garrett about sexual health as well as the current concerns related to Monkey Pox. We discuss what therapists usually get wrong when working with sexual health, what therapists need to know about STIs, as well as Monkey Pox. We talk about the relevant history of the HIV/AIDs epidemic and the community responses to Monkey Pox. We also look at how therapists can be most helpful to clients within our scope of practice. Resources to stay up to date with Monkey Pox and sexual health are also included in the show notes. Transcripts for this episode will be available at mtsgpodcast.com!An Interview with Mallory Garrett, LMFTMallory Garrett is a licensed Marriage and Family Therapist in California and New York. She graduated with a BA in Comparative Literature from UCLA and an MS in Counseling from CSU-Northridge. She began working in the social services sector as a Resident Services Intern with a low-income housing corporation for people living with HIV/AIDS and other chronic health conditions. She continued working in this field during her traineeship and internships as she worked towards licensure. She loves speaking to therapists about destigmatizing HIV/AIDS and STIs and has co-facilitated a workshop through Simple Practice Learning. When not working she enjoys going to the theater and traveling.In this podcast episode, we talk about sexual health and sexually transmitted infections (STIs)We talk about sexual health broadly as well as the recent concerns about Monkey Pox and the historical context of HIV/AIDs. What do therapists need to know about sexual health, STIs, and Monkey Pox? Monkey Pox is not technically a STI, but is primarily transmitted sexually in the US The stigma and concerns of being ignored, especially from those who lived through the HIV/AIDS epidemic Gay Rights and Sexual Liberation has relevance to these diseases The extreme societal bias toward the gay community during that time, medical neglect The emergence of Monkey Pox brought back the fears, stigma, and neglect

It’s the Lack of Thought That Counts: Ethical Decision Making in Dual RelationshipsCurt and Katie chat about dual relationships. We talk about the types of dual relationships, how often therapists get in trouble for these types of relationships, how to manage dual relationships, and the ethical decision making process to go through to decide whether to engage in a dual relationship. This is a law and ethics continuing education podcourse.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about ethical decision making to navigate dual relationshipsWe take a deeper dive into the complex relationships that we can have with our clients, our supervisors and our supervisees.What are dual relationships? Therapists know a lot about a very specific dual relationship: having sex with your clients, which is not acceptable There are many different types of potential dual relationships (we talk about the definitions of each type) The different hats we may wear with clients and colleagues What is a strong formal process for ethical decision making? Pope and Vasquez have a 17 Step Process for ethical decision making Deeply examining the question, the impact, and exploring any bias Identifying and understanding relevant laws and ethics Consultation, documentation, and evaluation We walk through a specific dual relationship question: what happens if your client refers a friend and colleague to you? How do you decide whether to take the client or not? For more information about the podcourse: learn.moderntherapistcommunity.com/pages/podcourse 

How Can Therapists Help Couples Recover from Infidelity?: An Interview with Dr. Talal H. AlsaleemCurt and Katie interview Dr. Talal H. Alsaleem, Psy.D, LMFT about System Affair Recovery Treatment (SART) and how therapists can better address infidelity in treatment. We discuss what therapists usually get wrong when working with infidelity, the difference between typical couples counseling and affair recovery, and why infidelity happens. We also look at the SART Model as well as tactics and treatment teaming.Transcripts for this episode will be available at mtsgpodcast.com!An Interview with Dr. Talal H. Alsaleem, PsyD, LMFTAward-winning marriage counselor and researcher, Dr. Talal H. Alsaleem is recognized as a leading expert in the field of infidelity counseling. He is the author of the acclaimed book, Infidelity: The Best Worst Thing that Could Happen to Your Marriage, and the founder of the Infidelity Counseling Center. His research interests and clinical work are focused on identifying the causes of infidelity and providing the best treatment for recovery from its impact. He developed Systematic Affair Recovery Therapy (SART) ™, a method of infidelity counseling that has helped hundreds of couples navigate the challenges of the healing journey from affairs. Dr. Alsaleem is an international lecturer and speaker. His engaging talks have helped many counselors broaden their understanding of infidelity and gain the necessary clinical tools to help their clients recover from affairs. Learn more at TalalAlsaleem.com.In this podcast episode, we talk about InfidelityWe explore with Dr. Talal Alsaleem what good infidelity counseling can look like and what therapists often get wrong when approaching this type of therapy. What is the Systemic Affair Recovery Treatment (SART) Model?“So in their quest to understand why the infidelity happened, we have to accept that the unfaithful is 100% responsible for the decision that they make for being unfaithful. So even in the worst case scenario, whether there was a huge relationship deficit, and you have the worst partner in the universe, that doesn't give you permission to cheat, you can take them to counseling, you can end the relationship before you cross those lines.” – Dr. Talal Alsaleem Seven milestones with clinical objectives and interventions Setting the stage for healing Getting the narrative of the affair Acknowledging the impact of the affair Choosing a path of recovery (individual or within the relationship) Creating an action plan Implementation Sustainability Infidelity can be the “best worst thing” that happens because you directly address what has happened

Why Aren’t Men Becoming Therapists Anymore?Curt and Katie chat about the lack of male therapists and the decreasing number of male students in the profession. We look at current statistics and reported experiences of men in the field. We also dig into what needs to change to balance gender representation and increase the number of men becoming therapists.   Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about male therapistsContinuing forward within men’s health month, we are looking at the state of the profession for male therapists. Statistics on men in the mental health profession Depending on license type, mental health professionals are between 60-90% female Men and women have fairly equal parity on compensation (especially when looking at similar roles) Men are less likely to seek out these jobs as the wages stagnate, the requirements become more onerous, and due to a lack of male representation and role models What needs to change to balance gender representation within the mental health field?“Men typically have privilege in other spaces… And yet I recognize in our field, that's not the case. And so, it's this weird, complex understanding of societal privilege, but not privilege within the field.” – Katie Vernoy, LMFT Understanding the difference between societal privilege versus professional privilege Identifying why the number of men is dramatically decreasing within graduate programs and all stages of licensure The impact of feminism on the conversations about the impact of white men on the field The perception of “male bashing” and the need to nurture male voices within the profession The challenge of identifying when men are being ignored or “soloed out” The problem of stereotyping, ignoring, or isolating male therapists and students Men being automatically pushed into leadership due to mentorship by male faculty and bias toward men as leaders How do we get more men into the mental health profession?“If we're identifying that men need to go and get mental health treatment, and there's no men to get it from, this then has the potential for reaching critical failure as a profession in being able to provide services.” – Curt Widhalm, LMFT Reaching critical failure in trying to provide services to men (if men no longer enter the profession) Recruitment strategies for graduate programs Making the profession sustainable for all individuals Pushing back against wage stagnation due to feminization of the profession Looking at retention and commitment for male therapists The importance of representation across the mental health profession 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!Clinical Therapist Demographics and Statistics In The USNumber of women vs men in grad programs: https://www.apa.org/monitor/2018/12/datapointMen’s experiences in the field:https://www.apa.org/gradpsych/2011/01/cover-menhttps://link.springer.com/article/10.1007/s12144-021-01960-9Faculty experiences of teaching male students: https://link.springer.com/article/10.1007/s11199-015-0473-1Recruiting men into the field: https://www.researchgate.net/publication/259538918_A_Mixed_Methods_Study_of_Male_Recruitment_in_the_Counseling_Profession 

Why Men Don’t Stay in TherapyCurt and Katie chat about men’s mental health. We look at why men typically go to therapy, their experiences while in therapy, what therapists get wrong when working with men, and how therapists better support the needs of men seeking mental health treatment.   Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about men seeking therapyFor Men’s Health Awareness month, we want to explore men seeking mental health services.Why do men typically go to therapy? Others telling men to go to therapy Career or relationship issues Depression, which looks like irritability and hostility (externalized behaviors) What is the experience of men in therapy?“Some of this research [on men accessing mental healthcare] shows that while men are increasing in the numbers presenting for mental health treatment, they tend to drop out earlier than women and they tend to drop out at a lot faster rate than women. So that to me says that we as a field are doing something wrong, that we are not able to meet the needs of men. All of that great advice out of ‘hey, go and seek mental health treatment,’ is falling on people who are trying it out and finding bad experiences with it. “– Curt Widhalm, LMFT Therapy seems to try to get men to emote like women Invalidating masculine presentations and behaviors Equating masculinity with toxic masculinity Not feeling safe to express emotions beyond confidence, neutrality, or anger How can therapists better serve men seeking therapy? Understanding and honoring a range of masculinities (even within the same client) Helping men to broaden their range of emotional expression Problem-solving, solution-focused can be helpful for men who want to have a clearly defined goal to work toward Collaboratively creating treatment goals Identity work that supports self-definition of masculinity What can therapists get wrong when working with men in therapy?“There is such a broad array of understandings at this point of what masculinity and what ‘real men do’ that I think we need to be aware that whether it's traditional gender roles, or more current… there's some need for an understanding of where your client sits.” – Katie Vernoy, LMFT Framing masculinity and toxic masculinity solely as “bad” Not digging more deeply into individual development around masculinity Taking offense at their client’s gender identity or ignoring their own bias around “traditional gender roles” How therapists characterize men’s presenting problems (assigning blame, like depression being seen as anger or hostility, men being described as violent rather than traumatized) 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!Men’s mental health: Spaces and places that work for men Why it’s time to focus on masculinity in mental health training and clinical practiceMen’s Dropout From Mental Health Services: Results From a Survey of Australian Men Across the Life SpanImproving Mental Health Service Utilization Among Men: A Systematic Review and Synthesis of Behavior Change Techniques Within Interventions Targeting Help-SeekingConsultation services with Curt Widhalm or Katie Vernoy: The Fifty-Minute HourConnect with the Modern Therapist Community:Our Facebook Group – The Modern Therapists GroupModern 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 Play Therapy?: An Interview with Ofra Obejas, LCSWCurt and Katie interview Ofra Obejas, LCSW, RPT-S, about working with children in therapy. We look at what therapists often get wrong, important factors to understand, specialized training required (including play therapy), and what you actually do in therapy session with children. Transcripts for this episode will be available at mtsgpodcast.com!An Interview with Ofra Obejas, LCSW, Registered Play Therapist - SupervisorOfra Obejas, Registered Play Therapist - Supervisor level, is a professional player. She works with elementary- to middle-school aged children. She’s been called by some of her clients a “kid grownup.” (That’s her rapper name.) She’s taught at the University of San Diego Play Therapy program and presents webinars and courses on clinical topics related to children’s issues.In this podcast episode, we talk about Play TherapyWe reached out to our friend, Ofra Obejas to talk with us about how to work with kiddos and what additional training is needed to work effectively with children.What do therapists get wrong when working with children? Treating children like mini-adults Not understanding the skill involved in play therapy What are important factors for therapists to understand when working with children? Children have a different culture (i.e., the tooth fairy is real) The therapist’s role as translator for what children are saying Children will make you feel what they feel (e.g., powerlessness, never getting anything right) The importance of showing feelings to children as a therapist (versus remaining a blank slate) What do you do with children in therapy sessions? Psychodrama and re-enacting situations Therapists can use any theoretical orientation Ways to interact with the child Paying attention to transference and countertransference Case conceptualization, including family therapy and work with parents What specialized training is most effective for working with children? There are specialized protocols for working with children with many different orientations Identifying which orientation suits you How to understand what is being reenacted and how to respond: Notice it, sit with it, make meaning of it; Observe it, name it, model how to cope with it What boundaries should therapists set when working with children and families? Unit of treatment (family, individual, who was showing up to the session?) Treatment goals (what are we working on?) What children are allowed to do in the session Interactions with caregivers and the responsibilities caregivers have during sessions What does online therapy look like with children? The challenges with working with children online Online sand tray, online dollhouse, online puppet theater Creating a virtual play room New trainings for VR therapy for children Watching children play video games online How has the pandemic impacted children? This was dependent on how well parents were able to self-regulate and stay within the window of tolerance (was there someone who could help the child to regulate) Lack of socialization and difficulty in having conversations 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! Ofra Obejas’ website: redondovillagecounseling.comOfra on YouTube UCSD - Play Therapy Program 

How Therapists Can Really Help Kids Who Are Being BulliedCurt and Katie chat about how therapists can support the targets of bullying. We explore what bullying actually is as well as what can be problematic in how it is typically addressed. We also discuss individual therapy strategies for kids who have been bullied. Curt and Katie also debate about whether the targets of bullying should change what makes them different to avoid getting bullied.   Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about how therapists can effectively treat bullying in therapyFor Bullying Prevention month, we decided to dig into what bullying actually is and how therapists can treat bullying in therapy.What is bullying actually? The definition of bullying and how it is described currently (i.e., teasing versus bullying) Target and aggressor (versus victim and bully) as more appropriate language to describe participants Three essential elements of bullying: ongoing behavior, behavior is intended to be harmful, and there is a power differential between the aggressor and the target The relevance of impact versus intention of behavior Numerous types of power imbalances that can be present Types: physical, verbal, social or covert, cyber bullying What is problematic in how bullying is typically addressed?“Aggressors have a more robust set of social skills. And it's being able to adapt more quickly to things that are socially changing, even in the moment. This also plays a role in the reporting on the people teasing them because the more socially adept kids are then better able to convince the adults around them. Oh, no, we were just playing. We were teasing back and forth.” – Curt Widhalm, LMFT Most bullying is not observed by adults Not moving past holding space Looking toward community interventions rather than individual Lack of understanding of what cyber bullying actually looks like (when you haven’t grown up as a digital native) Aggressors have a more robust set of social skills Strategies for kids who have been bullied“I think we also need to recognize that if we go too far in telling people not to be different, we are invalidating their identity. And if we don't go far enough, and we don't help them to be part of society, they may continue to get really harshly bullied, but either one is damaging.” – Katie Vernoy, LMFT Beyond ignoring (especially if there is an audience) Understanding what the target’s response means to the aggressor Not playing into what the aggressor is doing, escalating to forceful “stop,” seeking out a trusted adult (or multiple adults) Debate on whether a target should shift their behavior and change what makes them different Building confidence versus masking Safety now versus identity development Practicing responses to potential bullying statements in session Including targets in the planning process with adults The challenges with mediation within school settings (and the importance of follow up) Systemic or prevention programs that also address bystanders OResources 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!Article: Parent-Assisted Social Skills Training to Improve Friendships in Teens with Autism Spectrum DisordersArticle: The 411 on BullyingConsultation services with Curt Widhalm or Katie Vernoy: The Fifty-Minute HourConnect with the Modern Therapist Community:Our Facebook Group – The Modern Therapists GroupModern 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 Modern Therapists Should Know About Law Enforcement Mental Health: An Interview with Cyndi Doyle, LPCCurt and Katie interview Cyndi Doyle on the mental health of law enforcement officers. We look at how being a cop impacts their mental health as well as specific incidents and the chronic desensitization. We also explore the feelings in law enforcement related to calls to defund the police and how society views the cops. Content warning: potentially traumatic incidents (violence, death)Transcripts for this episode will be available at mtsgpodcast.com!An Interview with Cyndi Doyle, LPCCyndi Doyle is a Licensed Professional Counselor, group practice co-owner, founder of Code4Couples®, podcaster, and author of Hold the Line: The Essential Guide to Protecting Your Law Enforcement Relationship. She has spoken nationally and internationally including at the International Association of Chiefs of Police Conferences (IACP), the FBI National Academy Association (FBINAA) Conference, keynoted at police spouse conferences throughout the country, and at trained various police departments. While much of her work focuses on first responders, Cyndi’s stories of embracing and wrestling with living her own bold and authentic life have resulted in her being a sought-after speaker for other mental health professionals. Her message of humanizing struggle, compassion, courage, and resilience has resulted in her speaking nationally and even keynoting at the 2020 Texas Counseling Association Professional Growth Conference. That same year, the American Counseling Association awarded her the Samuel Gladding Unsung Heroes Award for her work with first responders and contribution to the field of counseling.In this podcast episode, we talk about Law Enforcement Mental HealthWe reached out to our friend, Cyndi Doyle to explore a population of folks who we typically don’t think about as our patients: Law Enforcement Officers (LEO).What should modern therapists know about the mental health of Law Enforcement Officers and their families? Different dynamics than typical couples The definition of cynicism How training impacts the mental health of officers Misinterpretation of control versus abuse Over diagnosis of trauma The negative impacts on police officers of the heightened scrutiny and criticism Hypervigilance and the impact of cameras on police offers performing their jobs The lack of support from the community (or the legislators or even law enforcement leadership) for officers Lack of compassion satisfaction, considering quitting their job, PTSD The impact on Law Enforcement Officer (LEO) families Exploration of the calls to defund the police and fund other resources Looking at the law enforcement response to defunding the police Exploring community policing and how that could help decrease abuses The cultural shifts and education happening at police departments The potential for mental health resources being added to policing When staffing is down, there is less time to recuperate and be prepared for work Mental Health Concerns that bring law enforcement officers and their families into therapy Stress, Anxiety, Depression, Addiction Relationships, family and couple Incident, critical incident, trauma Desensitization to violent incidents, injuries, and death The personalization in incidents that can cause more of a trauma response The insufficient training to build resilience for law enforcement officers The shifting culture that is now recognizing mental health as health, but the ongoing stigma for seeking support Cynicism, lack of empathy, and bias in Law Enforcement The mindset that narrows down to “everyone” behaves Working to make officers more human, so they can see more good in the world The importance of supporting the resilience and empathy within LEO (while recognizing that some of these things are not helpful “on the job”) Cyndi Doyle.com

Medical Assistance in Death (MAiD) in Canada: Mental Illness and Assisted SuicideCurt 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 CanadaWe 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 dyingRelevant Episodes of MTSG Podcast:Part 1: Risk Factors for Suicide: What therapists should know when treating teens and adultsPart 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 SuicideConsultation services with Curt Widhalm or Katie Vernoy: The Fifty-Minute HourConnect with the Modern Therapist Community:Our Facebook Group – The Modern Therapists GroupModern Therapist’s Survival Guide Creative Credits:Voice Over by DW McCann https://www.facebook.com/McCannDW/Music by Crystal Grooms Mangano https://groomsymusic.com/