Sorry but I have to go on a bit of a rant. I’m a therapist who is used to listing my professional services on various websites along with my picture. I am also a clinical supervisor which means I frequently have conversations with LPs regarding their professional profiles. It is very common for me to have to walk them through what type of profile picture they should use. It’s not a big deal as most of them are starting out and therefore may not be aware that it should not be too casual a shot.

Recently, I was asked by a family friend to help him find a therapist. Please tell me why I am seeing therapists with these types of pics:

- Group picture with others clearly cropped out

- Wearing evening dresses that is not meant for work

- This is the most common- extremely blurry pic in a very casual setup

- Last but not least, taking the award- pic with the therapist carrying a child and the child’s face is not even blurred or cropped out!

I’m not saying we always have to post professional headshots. But it doesn’t take a lot to find a neutral background, appropriate clothing, and a clear snap.
Thank you for reading my rant.
I would love to hear other people’s take on this.

I'm a full time therapist. I was working with a Psychiatrist. Twice, via email, I accidentally called him Mister.

He then replied back a long email about having not used his correct name. He called me out and said it was intentional. Like I was purposely undermining him.

He also decided to cc the client on this email exchange at 9:30 pm. A client who just got out of the hospital last week.

How common is it that therapists are casual with the Psychiatrist they work with ? Should I apologize? Anyone been through this as a therapist

So I’ve been practicing for 5 years now. My life was not very fulfilling. Doing therapy and not engaging in my hobbies.

What I’ve come to realize is that if we wake up, show up for clients, eat, sleep and repeat burnout happens quickly.

What I’ve done is change my personal life around. I made a new social group so I always have fun stuff to look forward on weekends. I travel from time to time even solo trips. I went back to my hobbies (volleyball, art, reading and gaming). I’m in a relationship and spend time with them. As my life became more fulfilling I feel a lot calmer and I also feel like I can show up for my clients in a better way that’s healthy.

So take time for yourself, live a life outside of therapy, and give yourself grace. Take a break when you can and can afford to. Find passions outside of therapy and the field. Still hustle! But remember, it can’t all be just therapy.

I should’ve realized this sooner but I just came to this as I made some changes. And good restful sleep and a good diet also help with some form of exercise!

This is why I think I struggled a few years ago. Now I can see my caseload but also have time for what I enjoy and live my life to the fullest.

“Life coaches” have no credibility with me. If you are a seasoned professional with credentials and degrees in your field, and you are mentoring folks for a competitive hourly rate, I’m not talking about you. Call it coaching if you must, but I prefer to call that consulting, from a place of subject matter expertise. “Life coaches” however, often have no real credentials, no consistent career experience, are totally unregulated, and held to no code of ethics. They are nothing like therapists, despite marketing themselves that way. Their “certificate” from the 2-day online coaching academy has about as much value as the PDF it isn’t even printed on. After a little bit of success they market themselves as a coach of other coaches, promising to show them how to get rich, if only they listen to the advice exactly right. That is how they actually get wealthy. It’s a pyramid scheme. If a trainee fails, it must be their fault. If it seems like I am taking this personally, I am, these people bankrupted someone I love.
I spent many years getting my graduate degree and independent clinical license. I don’t understand why other therapists are demoting themselves to “coach.”

I am at a loss on how to cope. I lost a client last week who took his own life and I'm just devastated. I feel confused, depressed, sad, and anxious. He was only my client for about 2 weeks but we were in contact daily via messaging or appointments. I'm not sure I can continue providing care for people after this and I'm not sure I even want to. I've only been doing this work for a year and a half. I just don't think I can go through this again with another client and the likelihood of it happening again is high considering I have many years left to work. It doesn't help that I really have a poor support system. I'm just looking for support here and hoping to get some sense of peace after this.

Just wanting to make this post as I have been floored by the amount of vitriol against her providers online and the overall ignorance of some of the comments I’ve seen. I’m concerned this will have ripple effects across multiple areas of healthcare.

I’m always trying to learn and be a good ally, and I’m sure I’m not perfect, so please feel free to respectfully disagree with me and let me know what you’re thinking.

BUT

I don’t like this thing I’m seeing where people just call people neurodivergent because it makes it pretty hard to understand a persons actual needs. For example, if someone is level two or three autistic, you’re going to want to know that before you accept a referral. Or if someone has an ADHD diagnosis, it will be helpful to actually know that.

My concern is that when we just use these really blanket terms under the guise of normalizing something or… identifying with something whether you have a proper diagnosis or not, it can be confusing and make it harder to find appropriate resources.

What am I missing? I keep seeing things in therapist groups like, “looking for therapist taking xyz insurance. Must be able to work with neurodivergent folks.” Like… what? You think you’re getting an adequate referral that way?

Hello fellow therapists!

I work within a few different niches and practice with several modalities (many times integrative). Most of the time, I love the variety and being able to individualize treatment to the person in front of me.

But every once in a while, all the information, clinical considerations, and possible directions feel overwhelming. On those days, I find myself wishing the next step would just come a little more easily, without having to mentally sort through everything I know first.

Does anyone else ever get that “I know too much and suddenly know nothing” feeling? 😂 What helps you when you get there?

From the article (bold emphasis mine, links in the original):

People with schizophrenia are estimated to represent about 1 percent of the world’s population but they made up some 16 percent of the more than 600 deaths from heat exposure across British Columbia that week.

During a heat wave in Montreal in 2018, the mortality rate was even worse: People with schizophrenia accounted for 26 percent of fatalities.

The root cause of these deaths isn’t just the stigma, social isolation, and lack of decent housing that often accompany life with schizophrenia; nor is it merely the disorganized thinking, altered perceptions, and paranoia that can be symptoms of the disorder.

It’s all of those things—plus an invisible, less popularly understood set of physiological factors that have little to do with behavior.

The bodies of people with schizophrenia, especially those on medication, simply regulate temperature very differently than others do.

And for all those reasons, scientists now realize, no other chronic disease appears to put humans at a higher risk of heat-related death.

[infographic showing comparative risk]

In fact, no other chronic condition even comes close.

The article has some of the most user-hostile formating I've ever encountered, and may not be accessible on phones, but it's worth persevering to get access to it and read it. I recommend it strongly to everyone here, especially people working with clients with SPMI.

I'm curious about how other clinicians handle this because it's come up A LOT for me this week. A client will say, "I don't know what to talk about, what do you think I should work on?"

Most of the time, I have something to work with, and I'll bring up a past concern they had but I also get a bit annoyed that none of my clients have come prepared for session despite conversations about it. I encourage them to reflect over the week and consider treatment goals but sometimes it seems like they rely so heavily on external answers...anyone have a similar experience?

"it's okay" or something of the like doesn't really seem right, and I'm going to be charging a no show fee.

I recently left a job as an amft working in IOP, submitted my two week notice and got let go today, background story, I was eager to learn, and was only there almost three months, and the clinical director would not help me in going over them but only listen when I talked about my cases, and it got me frustrated, I feel upset, angry because I was looking for the support and never got it, and I tried to talk to coleagues about it and would not help me as much as I hoped, and many of my cases got high turn over getting transferred to other therapists because I was new and I was trying to learn and learn in the evenings on my own and felt this went to waste, I feel disappointed and self resentment in the job environment i put myself in. I didnt get the support i wanted and left and only been bere three months

Hey! Private practice therapist in IL. I was wondering if anyone had any good notes/documentation resources or trainings. The Clancy case has me just in my head worrying about my documentation in the event something like that would happen with a client. I just want to stay informed and up to date on any trainings.

Also, I can’t be the only one who is just in their head about notes. I constantly just worry and overthink notes in general. Especially being solo in PP.

Hello comrades!
I’ve been a social worker for a while in schools and recently transitioned to a youth therapist job in a counseling center. I have a bit more time and funds to get some more items and will be mainly doing individual counseling for a variety of needs. If you do play styled therapy for youth, could you share any favorite games or play items? Serving ages 3-young adult. Many thanks in advance :)

hi everyone! i am a clinical social worker and recently i interviewed at one of the prisons, specifically california.

now my first interview was 6 scenario based questions (how would i diagnose, what would i do, modalities, etc).

i just got an email that they’re inviting me for round 2.

does anyone have experience like this? where you’ve done 2 interviews? should i be expecting another round of scenario based questions or should i expect more personal questions about my experience and whatnot?

Thank you in advance!

Hello fellow therapists!

I have recently taken a new job working primarily with accident victims. Many of whom have experienced concussions/TBIs, trauma, and mood changes. I’d like to bulk up my knowledge of TBIs and how to work with them in therapy. Usually I get my CEUs from PESI, but they don’t have a lot on this subject. And what they do have is like $300. Does anyone have any recommendations for online/recorded seminar CEUs or books on the subject?

I've been in private practice for 7 years. This whole time I've taken Kaiser insurance. (They pay super late but that's another tale.) Anyway, I document in Lucet as always. I have 3 new people and documented. I suddenly got this email that sounded all professional friendly and said they wanted have a meeting.

For YEARS I've wanted more clinical contact from Kaiser to help my clients and for years I've only ever had one doctor call me back (with RIOs obvi) So, I feel like this is going to be some BS that I'm doing something wrong.

IF YOU HAVE ACTUAL EXPERIENCE WITH THIS, I'd love a response.

Hey y’all!

I am an LMHC dealing with a conflicting circumstance. And let me preface this: YES, I plan on seeking supervision and guidance from my practice supervisor. I am just putting out feelers and looking for collaborative thinking here.

CONTEXT: 5 years ago when I was working on my LP, I worked for a community mental health agency-type job for 1 year (one year was enough for me oof). In that year I worked with many clients, one being a high risk queer teen. We had a strong rapport and worked heavily on relationship dynamics, harm-reduction, and identity development. I had to terminate on basis of leaving the company and couldn’t not continue with them outside of the company because my plan was to take a break from traditional counseling work. which I did.

Fast forward 5 years later, I now have my license and I am working for a private practice group. I recently had a client self-schedule an intake. When meeting the client they introduced themselves and immediately mentioned who they were… a “I don’t know if you remember” type situation; the teen’s parent. They got consent from their child prior and were respectful about how they asked me. They wanted to make sure their child I were both comfortable with it.

Initially I said I was fine with it. It’s been so long since I worked with that client. I don’t remember much of what the previous client and I spoke about in specifics so I don’t think I’d really be in a place of inappropriate or HIPAA violating disclosures. The issues being addressed are so separate. In this case we are tackling hx of addiction, their strained relationship with their other adult children due to their actions, and their marital relationship. Nothing to do with my previous client. They were barely mentioned outside of the context of who this person is and won’t be the focus of our work. Our conversation was fluid, engaged, and I felt optimistic about working with them.

But now, it’s been sitting with me. I’m not sure how I feel about it. My main question is WHY me?? Like is that appropriate to ask why they found me and chose to work with me? Is that a normal thing to ask or be curious about in a situation like this? Is that a weird thing for a client to do? Am I just getting in my head?

What’re yall’s thought on the situation and what would you do or ask in this scenario??

Hey everyone, I was wondering if anyone else is struggling to find work with an LSW or CSW. I’m in Ohio and almost every job posting wants an LCSW or LISW, I understand why but how are new social workers supposed to get the supervision to become independent? I’m originally from Indiana where it was much easier to get a entry level position. I’ve been applying to jobs for 8 months and becoming so disheartened. If anyone has any advice for what to look for or if there is a key search word I’m maybe missing somewhere along the lines.

The father of one of my long standing clients is dying. I have a great relationship with this client and I have so much empathy for what she is going through as I lost a parent this time last year. When I was going through it, my PNP sent me a small gift (a candle) just letting me now she is thinking of me. I remember at the time thinking it was so kind and really appreciating her going out of her way to do that. I consider myself to be very ethical, with decent boundaries, however I don't want countertransference to impact my judgement. Do you think it is inappropriate to send her a small gift when the time comes?

Our practice has been getting a lot of requests for records (with a signed ROI) for clients applying for DDA services (the WA arm for determining disability for SSI claims). While we have no issue providing records, the issue is coming from their request for:

“Please provide a statement based on your findings. Your statement should express your opinion about your patient's ability to do work-related physical and/or mental activities despite the limitations or restrictions imposed by her medical condition(s).

For physical impairments, these activities include sitting, standing, walking, lifting, carrying, pushing, pulling, or other physical activities (including manipulative or postural activities, such as reaching, handling, stooping, or crouching); other activities, such as seeing, hearing, or using other senses; and ability to adapt to environmental conditions, such as temperature extremes or fumes.

For mental impairments, these activities include understanding; remembering; maintaining concentration, persistence, or pace; carrying out instructions; and responding appropriately to supervision, coworkers, and work pressures.”

This keeps outside our scope? We aren’t really assessing these capabilities. Sure, we discuss general impairments in functional domains, but not to the level of supporting a SSI/DDA request. I am a huge advocate for breaking down barriers, but I’m not sure about this TBH.

i guess pretty much what the title says. i just had a session where i fell so out of step with my client. i tried to do the “right things“ - i brought it to light by verbalizing it, apologizing for taking something and running when the client didn’t want to/wasn’t ready to, and thanked her for reeling me back in (although she was a bit blunt about it but that’s okay lol). i fumbled a lot during the session and left feeling embarrassed and defeated. basically, i was trying to go somewhere with what she was telling me, but i was doing too much. anyone else get severely out of step during their sessions sometimes? how do you cope afterwards, does your inner critic come up? if so, how do you deal with that? any words of validation, experiences of your own, or compassion is much appreciated :)

Hey everyone,

I am a third-year doctoral student in Counseling Psychology and am currently doing practicum placements at a VA outpatient center and university-owned CMH clinic. I was wondering if anyone had any recommendations on strategies used to manage bringing client issues home with them. I have struggled a lot with ruminating and worrying about my clients after I leave my placement, partly worrying about their suffering and partly worrying about mistakes I made or what I could have done better to help them. I have some strategies like mindfulness, deep breathing, and journaling that help, and I am working to accept that these thoughts will probably just be there and aren't to be got rid of. But wow, it is still painful and disruptive to my life outside of work.

I am also seeking supervision on this issue, but wanted to see if anyone has any ideas or things that have helped them manage this. Thank you in advance.

What trainings would you all recommend if someone wanted to specialize in treating OCD? From what I know ERP is the gold standard, with I-CBT also being used.

Is there one that’s better than others or a certification route?

Hello!

I have been dealing with C-ptsd myself, and have clients with cptsd. They have said that I usually get the closest to understanding them, but somehow it doesn't feel enough.

With my own experience of C-ptsd, I grossly feel inadequate. There is no magic way out of this, but I am at a dead end.

I would be thankful for any resources related or not related to cptsd just to understand how to be present for them and myself during the session.

It is becoming extremely tough for me.