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

Curt Widhalm, LMFT and Katie Vernoy, LMFT
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Apr 12, 2021 • 42min

Bilingual Supervision

Bilingual SupervisionAn interview with Adriana Rodriguez, LMFT, about how to support bilingual, bicultural therapists. Curt and Katie talk with Adriana about her experiences as a clinician as well as her perception of the systemic concerns that bilingual/bicultural therapists face. We also dig into common work challenges for these clinicians, the ethical and competency concerns monolingual supervisors face, and specific action steps for individuals and organizations to increase the quality of supervision and training for these clinicians.  It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.Interview with Adriana Rodriguez, LMFT (She/Her/Ella)Adriana Rodriguez (She/Her/Ella) is a California Licensed Marriage and Family Therapist, she obtained a BA in Sociology from Sacramento State and a MA in Counseling Psychology from the University of San Francisco. Adriana is a bilingual, queer, Salvadorian immigrant woman who is passionate about destigmatizing mental health. Adriana’s lens is intersectional, she is passionate about understanding how intergenerational trauma compounded with personal trauma impacts the mental health of first-generation adult children of immigrants and QTBIPOC. Adriana works with individuals and dyads in private practice in Sacramento, CA.In this episode we talk about: Adriana’s story as a bilingual, bicultural therapist who immigrated from El Salvador Experiences of immigration, learning English, and trauma Criticism, bias, and navigating a different culture The impacts of uninformed supervision on bilingual or monolingual clients The requirement to build one’s own tools (i.e., translating documents) What is getting lost in translation – linguistic, cultural, etc. The importance of understanding context The power differential within the clinical supervision How do I level the playing field and share the power? Sharing knowledge (rather than seeing the supervisor as the only person who has knowledge in the relationship) Acknowledging and talking about differences Ethical concerns and supervisor responsibility The systemic challenges that bilingual clinicians can face in getting hired or promoted The need for greater diversity in leadership roles The idea of “first generation everything” The make up of the job for bilingual clinicians Survivor guilt – immigrating, learning English, education, and making it professionally The identification and desire to empower clients that remind you of yourself, your family members The exploitation of that desire by agencies who do not have sufficient bilingual clinicians How frequently bilingual clinicians have large caseloads and not sufficient compensation or matching or curating of caseloads The risk for burnout for these clinicians The complexity of translation The need for more research around the impacts of monolingual supervisors providing supervision on bilingual clinicians (as well as the impacts on monolingual or bilingual clients) The constant need for self-awareness and re-examining your bias Making sure to understand the differences between personality and culture Adjusting case conceptualization, looking at the triad of supervisor-clinician-client
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Apr 5, 2021 • 39min

Therapy with an Audience

Therapy with an AudienceAn interview with Doug Friedman, LCSW, the host of Your Mental Breakdown, on why he chose to record therapy sessions for his podcast. Curt and Katie talk with Doug about the logistics and benefits of publicly providing therapy. We also look at how podcasting can decrease stigma and open up flexibility to learn as a therapist (rather than rigidly holding to a modality or to an expert status that doesn’t allow for mistakes).It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.Interview with Doug Friedman, LCSWDoug Friedman is a Licensed Clinical Social Worker in private practice in Los Angeles. He has spent nearly 20 years working with adults, adolescents and families with issues ranging from depression and anxiety to substance abuse, bipolar disorder and PTSD. He has supervised programs in community mental health settings and he continues to provide clinical supervision to therapists in his private group practice, Clear Mind Full Heart. Doug is the creator and co-host of the mental health/entertainment podcast, Your Mental Breakdown.Doug received a Masters in Social Work from The Catholic University of America and a BA in Study of Religion from UCLA. Before becoming a psychotherapist, Doug worked for a music management company that oversaw bands like Nirvana, Foo Fighters, Beastie Boys, and Bonnie Raitt. Doug is also the artist and songwriter behind all the music heard on the podcast, Your Mental Breakdown.In this episode we talk about: Doug’s mission of normalizing therapy and decreasing mental health stigma The importance of learning as a therapist and exploring mistakes or alternatives The experience of being a therapist on a public-facing podcast Why Doug doesn’t hold a modality sacred How therapy serves the client as a focus for treatment The logistics of setting up the podcast (laws, ethics, etc.) Navigating the relationship with the client on the podcast (dual relationships, confidentiality) The benefit of recording sessions and reviewing them later Exploration of opportunities and different choices that we can make in the room Cohost rapport and trust, inquiry, love, disagreement, calling out The comfort level in being recorded for a podcast: shifting from one on one to a public audience Creating a system to keep the work of making the podcast sustainable Being vulnerable and authentic as a value Being an expert does not mean having the right answer in the room, but knowing how to find the answer and seek additional advice How other clients respond to Doug’s podcast The possibility of the public persona and “fame”
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Mar 29, 2021 • 38min

Episode 200

Episode 200: Mail Bag!Curt and Katie reflect on 200 episodes, answer questions and respond to feedback from listeners. We explore the tension between making a good living and providing affordable mental health care to consumers. We dig into paying prelicensed individuals, antitrust concerns, training centers, ethics codes, app therapy, setting fees, and therapist career trajectories.        It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.In this episode we talk about: Celebrating 200 episodes! Question about how to make money and help to provide affordable access to clients Systemic challenges and the phases of change to the system Individual responsibility and the problems of this individual responsibility to therapists The way in which we can take action to make our careers more sustainable, while also advocating for change The debate about unpaid internships, training centers, and free labor (which is against the law) Online App Therapy – whether it is hurting the field and gaslighting therapists Sliding scale, setting fees, and why therapists’ rates vary so widely Why people don’t stay therapists, feel the need to become a thought leader Reflections on 200 episodes  Resources mentioned:We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below might 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! CAMFT’s statement on Paying Prelicensees as a Best PracticeDepartment of Labor Statement on Internship Programs Robert Casares Jr. (2020): Embracing the Podcast Era: Trends, Opportunities, & Implications for Counselors, Journal of Creativity in Mental Health, DOI: 10.1080/15401383.2020.1816865
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Mar 22, 2021 • 37min

Why Therapists Quit Part 2

Why Therapists Quit Part 2Curt and Katie chat about the response from listeners to our episode on why therapists quit. We look at the differences in responses (those who felt angry and those who felt validated) as well as our reasons for doubling down. We also dig into the differences between pessimism and realism, pairing our realistic take on the current problems with a call to action that aspires to change the systemic problems we’ve started to outline.    It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.In this episode we talk about: Responding to listener feedback on Why Therapists Quit The critical feedback we received related to the “negative tone” we put forward The positive feedback from listeners who felt seen The different stages of individuals’ careers and how they responded Assessing whether we are doing the profession a disservice by speaking the truth of our experiences and the problems we see in the profession How the knowledge of the information that this job is hard can impact the relationships with our clients, consultees, supervisees, etc. “Saving Psychotherapy” by Dr. Ben Caldwell The individual responsibility that clinicians are taking for systemic issues The problem when we don’t understand the system before we’re deep into the career The expectation that therapists must be good all of the time – which is unrealistic How we’re looking for ways to improve the therapy system, the mental health profession, etc. The responsibility we feel to help change How critical it is to frame the problem before you can solve Why it is important to opt in to a job, warts and all The problem of idealizing the profession Our plan for a new series that talks about the state of mental health care Differentiating between realism and pessimism The values systems for therapists that can be challenged by the system The response from therapists who may be more pessimistic than Curt and Katie are at this time A call to action to reach critical mass in order to make a change The people who don’t make it into the profession for many different reasons The shifts in the smaller systems (improving work environments) Whether our clients listen and what they might think about what we’re talking about Our responsibility in our role in this podcast, to make the profession better How we’ll be moving forward in an upcoming series, looking for solutions
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Mar 15, 2021 • 45min

Infertility and Pregnancy Loss

Infertility and Pregnancy LossAn interview with Tracy Gilmour-Nimoy, LMFT, on understanding infertility as well as pregnancy and infant loss. Curt and Katie interview Tracy, a certified perinatal mental health professional, on what the medical and mental health professions often miss related to reproductive health and pregnancy. We dig into the basics and common mistakes as well as the harm caused when therapists are uninformed. We explore trauma, grief, and the invisibility of these common struggles faced by some who want to have children. It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.Interview with Tracy Gilmour-Nimoy, LMFT and Certified Perinatal Mental Health ProfessionalTracy is a Licensed Marriage and Family Therapist and Certified Perinatal Mental Health Professional. She has a group practice in San Diego, CA, where she specializes in working with individuals who have experiences of trauma, depression, anxiety, reproductive mental health, perinatal mental health, maternal mental health, paternal mental health, grief, loss, life transitions, and relational challenges, to name a few. In addition to her love of mental health, Tracy is an avid reader and writer. Her articles have appeared on her mental health blog and other public forums, such as Scary Mommy. She writes about varying mental health topics, as well as her personal experiences of infant loss, grief, and trauma. To learn more about Tracy, connect with her on Instagram @TGNtherapyIn this episode we talk about: What we missed in our episode about navigating pregnancy How hidden infertility and pregnancy loss is in society, how the conversation is taboo The lack of trauma-informed care within the medical field The problems of assumptions around fertility and whether people want children The way that common questions can be triggering and traumatizing How dismissive of the grief people are when it deals with infant and pregnancy loss The rose-tinted lenses that hurt women during the whole process of getting pregnant and having a baby How hidden it is and how little discussed are all the stages of women’s development The gaps in therapist training related to infertility and pregnancy/infant loss The focus on the baby versus the parent Ideas for advocacy within the educational and medical systems The discomfort with sitting with these types of experiences and losses The tendency of people wanting to fix it and move forward without accounting for loss and recognizing when it cannot be fixed The shadow losses and losses of an absence Holding space for grief and loss, for how horrible it is What therapists need to know about infertility The importance of understanding the medical terminology, the financial burden, the emotional implications of the fertility process The internal focus on how the body works and what to do for your body The identity aspects related to motherhood or not becoming a mother What therapists need to know about pregnancy and infancy loss The perception of the death of their child Traditions to honor the child who didn’t come home The importance of remembering dates for individuals who have infant and pregnancy loss Acknowledging loss, using language or names that are relevant Honoring how they view their parental status after a loss
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Mar 8, 2021 • 40min

Why Therapists Quit

Why Therapists QuitCurt and Katie chat about the systemic reasons that therapists leave the profession. We look at the work environment, the infrastructure of community mental health, as well as the frequent ways that therapists set up their own private practices. We also identify changes on a systems level as well as calls to actions for individuals who would like to continue as a therapist.  It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.In this episode we talk about: Challenges in the mental health system leading to therapists quitting the profession Why therapists don’t stay therapists when they wanted to stay therapists Obstacles and lack of opportunities The lack of quality of supervision or inadequate training for other elements of the job The lack of research on therapist workforce issues Not a lot of empathy for therapists as we “chose” to do this Caseload sizes, the weight of carrying the challenges of many people Niche fatigue and hearing the same story over and over The challenge of holding the hope for clients and communities The heaviness and the boredom of hearing so many similar conversations The full workload including paperwork and other consultations, case management and advocacy Who is drawn to the work, the desire for deep and meaningful work, and the problems of the bureaucratic system in providing meaningful work The training doesn’t match the actual job The status quo and inertia in the work, while at the same time that all the changes that happen in the other pieces of the profession Productivity standards and billing, differences in philosophy Systemic problems with under and unpaid services and requirements What we’re asking from the professional organizations and the challenges that professional organizations may have in advocating for these types of systemic changes What could actually move forward in legislation The issues related to antitrust People are more concerned about our patients than about therapists Why clinicians in all settings (including community mental health, private practice, etc.) The sameness of the workload when you’re in private practice The isolation as a therapist Increased demands with higher demand, less delineated work/life balance The appeal of a job where you can just show up The weight we carry as business owners, including decision-making and responsibility to generate income The benefit of diversifying your caseload Calls to action: advocating for quality workplaces, finding peer support, setting boundaries for yourself throughout your professional journey, what we can do if enough of us make these changes The time is now to address mental health systemic problems – shining a light on how we are well-situated, making sure we are paid, and sharing messages to support the community
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Mar 1, 2021 • 41min

Mental Health Entrepreneurship

Mental Health EntrepreneurshipAn interview with Lawrence E. Shapiro, Ph.D. about lessons learned through serial entrepreneurship. Curt and Katie talk with Dr. Shapiro about how to identify whether your idea for a product or service is good, the importance of solving a problem, and what business models are strongest for therapists. He also talks with us about why we shouldn’t fall in love with our products, why we shouldn't expect to make money writing books, and why building apps don’t make sense. It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.Interview with Lawrence E. Shapiro, PhDLawrence E. Shapiro is an internationally known psychologist, recognized for his innovative and practical approach to helping people with mental health problems. Dr Shapiro has written more than 75 books and developed more than 100 therapeutic board and card games. His work has been published in 28 languages.Dr. Shapiro has developed a broad understanding of mental health problems in various professional positions as a teacher of emotionally disturbed teens, a school psychologist, a Director at the National Children’s Center in Washington D.C., and in private practice in Washington DC and Philadelphia.Dr. Shapiro is also considered a pioneer in using technology to address mental health problems. He has developed a number of apps for mobile devices, including an award-winning app to help prevent suicide among military personnel. He is the Founder and President of Between Sessions Resources, a company that develops clinical software for therapists and counselors and publishes therapeutic homework that professionals give to their clients to accelerate their growth.Dr. Shapiro’s books include:For Parents: How to Raise a Child with a High EQ: A Parents’ Guide to Emotional Intelligence; The Secret Language of Children; The Baby Emergency HandbookFor Kids and Teens: The ADHD Workbook for Kids; I’m Not Bad, I’m Just Mad, Stopping the Pain: A Workbook for Teens Who Cut and Self-InjureFor Adults: Overcoming Depression, The Panic Disorder Workbook, Taking Care of Your Mental Health During the COVID-19 PandemicDr. Shapiro is a frequent media guest, and has appeared on CNN, NPR, The Today Show, and many other national and local outlets.In this episode we talk about: Shapiro’s forays into entrepreneurship and alternate revenue streams The importance of getting used to making mistakes The lack of follow through that leave ideas as ideas (and not businesses or products) The need to actually be solving a problem, not pursuing an interest Finding something that has value to other people Writing books and self-publishing The goal for self-publishing a book (it’s not the profit) A book as a business card Strongest business models The need for on-going work and learning as an entrepreneur Protecting your work (copywriting, registered copywriting, trademarking) Ideas are just ideas and may not actually need protecting The perspective of improving on what others have done, rather than coming up with a unique idea or doing what has “never been done before” An iterative process to find your product, incremental innovation Leveraging the success of others How to learn what to do, following the recipe of what is worked Selling a business and moving onto the next idea Different places that people can shine – ideas, implementation, marketing The benefit of having partners to have different skill sets Marketing as building your platform and audience Why Dr. Shapiro advocates for email marketing The concept of a sales funnel and adding value along the way
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Feb 22, 2021 • 47min

Negotiating Sliding Scale

Negotiating Sliding ScaleCurt and Katie chat about the pros and cons of sliding your fee for therapy services. We look at the theories around fee-setting, sliding fee scales, and conversations around money. We discuss what actually makes a difference in determining if clients are invested and will benefit from your services. We also dig into the laws, ethics, and practicalities if you choose to offer sliding scale in your practice. It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.In this episode we talk about: Feedback from our conversation with Tiffany McLain Clinical theories on how fee impacts the clinical relationship The different ways that people enter into therapy, different financial situations, etc. A more nuanced conversation about sliding scale fee Freud’s views on having direct conversations with clients on fee How clinical orientation can impact how therapists view fee-setting The idea that fee must be set at an “uncomfortable enough” that clients invest in therapy How fee paid impacts attending the last session Different types of investments that might impact how much people benefit of treatment Practical ways to assess what fee would be in the sweet spot for sliding scale (e.g., written out scale, financials, etc.) Do therapists show up differently for clients who pay more or less? How fees average out among larger caseloads Incorporating outcome measures and practice-based evidence to assess whether you are showing up differently for clients who pay more or less Mythology around what we have to do and what is best to do Laws and ethics, practical considerations Usual and Customary fees Advertised fees Philosophy related to how you set your fees The impact of insurance on our profession related to sliding scale Ethical codes on fee setting related to services provided and client ability to pay Models of subsidy for mental health services The need for a standard justification The risks for insurance fraud related to fee-setting and accepting copays The ability to adjust usual and customary fee as needed as long as it doesn’t violate state law What we have to do and what the softer, virtue ethics might recommend The importance of accurate billing and justification The tension between the equity argument and the practicalities of business Are you unfairly treating clients who are paying less? The need for pro bono work, but not sliding scale work The need for clinician-led discussions and opt-in from the client Check your insurance contracts, advertise your fees correctly, written basis for a range of fees Options for sliding scale Other models for addressing access How to create a sliding scale practically Why you need to identify what you need to make on average per session Moving your sliding scale or pro bono work outside of your practice Our recommendations for Open Path Psychotherapy Collective and Give an Hour
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Feb 15, 2021 • 38min

Invisible and Scrutinized

Invisible and ScrutinizedAn interview with Dr. Sheila Modir on racial trauma and identity within the Middle Eastern North African (MENA) population. Curt and Katie talk with Sheila about how MENA individuals are impacted by racial profiling, prejudice, and the lack of data on the MENA community. We also explore typical coping strategies as well as how therapists can support MENA clients.    It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.Interview with Dr. Sheila ModirDr. Sheila Modir is a pediatric psychologist at Children’s Hospital of Orange County (CHOC). She obtained a combined doctoral degree in Clinical, Counseling, and School Psychology at the University of California, Santa Barbara and her master’s degree in social welfare at UCLA. Prior to coming to CHOC, Dr. Modir completed her doctoral internship at the UCLA Semel Institute for Neuroscience and Human Behavior where she worked at the UCLA Stress, Trauma, and Resilience Clinic. Her research interests include racial trauma and understanding risk and resilience factors in the context of trauma, and she has presented at conferences and published articles on this topic. Most recently, she has written a children’s book (coming fall 2021) called The Proudest Color, which is a timely and sensitive introduction to race, racism, and racial pride for children.In this episode we talk about: MENA (Middle Eastern and North African) clients The common mistake of assuming that all MENA clients are Muslim A lack of data on immigration and the demographics of these clients The lack of clinical research and education on MENA clients An invisible community that is greatly scrutinized due to profiling The layers of racial trauma Bronson Brenner’s ecological model: Sociopolitical discrimination, Institutional discrimination, Relational discrimination due to “cultural ignorance” The consistent portrayal of MENA individuals as terrorists, the Middle East as war-torn MENA individuals called terrorists versus white individuals called “lone wolves” who are “mentally ill” The impact of how the insurrection in January is viewed as “white terrorism” What influences racism and bias against MENA clients The typical coping strategies for MENA clients related to racial trauma Resignation, cowering, “getting used to it” leading to depression and anxiety Coping strategies, including education and being a cultural representative The contrast between the Asian American community pushing back against the “model minority” while MENA clients are aspiring to be a model minority The importance of identification of MENA individuals on the census How the Muslim Ban has impacted MENA individuals’ relationship with the government Clients minimizing, denying, not disclosing racial trauma The thirst for appropriate and accurate information on culture The benefit of affinity groups How non-MENA therapists can best support MENA clients The nuance of asking a MENA client to educate you as a therapist Collectivist culture and how it shows up in the room, how it can be complicated The challenge of cultural sensitivity when there is little research A call to action regarding research and education
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Feb 8, 2021 • 36min

Understanding Polyamory

Understanding PolyamoryAn interview with Dana McNeil, LMFT, about polyamory and ethical non-monogamy. Curt and Katie talk with Dana about the basics that every therapist should understand about polyamory. We cover some of the vocabulary, the values and perspectives within the polyamory community, as well as the biases many therapists hold and what therapists often get wrong when working with polyamorous clients. It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.Interview with Dana McNeil Licensed Marriage and Family Therapist and Co-Founder of Confident Couples TherapistDana McNeil is a Licensed Marriage and Family Therapist and is the founder The Relationship Place, a group practice located in San Diego, California. Dana’s practice specializes in couples’ therapy and utilizes an evidence-based type of couples’ therapy which is known as the Gottman Method. Dana is a certified Gottman Method therapist and Bringing Home Baby instructor. Dana’s practice works with all types of relationship issues from pre-marital counseling, dealing with the aftermath of extramarital affairs, partners working through addiction recovery, military deployed families, parents of special needs children, LGBTQ, and polyamorous clients.Dana has been featured on many relationship podcasts and in publications such as the Business Insider, Authority Magazine, Eat This-Not That, Parade, Oprah Living, Martha Stewart Living, Ladders, AARP, and is the resident relationship expert on the Cox Communications show “I Do.”Dana is also the co-founder of Confident Couples Therapist, a consultation and training program. She and her partner Nancy Ryan teach the tips and techniques to build a successful cash pay practice working with couples.In this episode we talk about: Polyamory and ethical non-monogamy (ENM) The faulty assumption that therapists don’t have skills to work with polyamorous clients The complexity of the non-monogamous relationships Jealousy versus compersion Metamour, Polycule, and new relationship energy The goals and aspirations within the polyamorous community The underlying reasons for entering into polyamorous relationships The poly identity and lifestyle Typical biases therapists hold related to ethical non-monogamy The difference between boundaries and rules and agreements The negative tone that can express bias to client Dana’s use of the Gottman method with ENM clients The reality of how ENM relationships – emotional and practical logistics The importance of transparency, clear communication within these relationships Considerations related to when members of the polycule are parents, who and how they are introduced to children Sex, fluid bonding, protection and testing Swingers have sex as sport, open relationships are sexual, poly relationships may be for love and romance and not sex The stigma and misunderstanding that these individuals may face

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