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

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/

Modern Therapist Reflections on Preventing a School ShootingCurt and Katie chat about an incident within Curt’s practice. We look at how therapists are called upon to make challenging risk assessments. We look at threat to other assessments including threats of serious violence. We explore the therapist’s experience during these intense risk assessments and the tasks that follow. We identify action steps for trauma informed support.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we explore a therapist’s role in preventing a school shootingRecently, Curt was called upon to make an intense risk assessment that required administrative steps to prevent threats of violence. We thought it would be helpful for other modern therapists to understand the experience from a therapist’s perspective, so we can support each other and get the support we need.What is involved for therapists to complete risk assessments for threats to self and others, including threats of serious violence?·      Both harm to self and others assessments are indicated·      How to determine whether a homicide assessment is appropriate·      Calming the situation, decreasing dysregulation·      Understanding plans and current thought processes·      Going through the protocol related to duty to warn, including calling law enforcement and the schoolWhat is the experience of a therapist during and after an intense risk assessment?·      Deep mindfulness·      Goal driven conversation (toward safety planning)·      Frustration and overwhelm related to required reporting to law enforcement·      Having to switch gears for the next session·      Potential rupture and loss of client·      Trauma response, anger, frustrationWhat kind of support is important for therapists when they have responded to threats of a school shooting?·      The question of “how are you doing” is less effective in these crisis situations than “what are you going through?”·      Using a trauma informed approach to provide adequate, planned support·      The tendency of therapists to compartmentalize that requires more attention from colleagues than others facing these types of crisis situations·      Plans and best practices for managing these types of incidentsStay 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/

Why Do Therapists Feel They NEED to be Coaches? An Interview with Jo MuirheadCurt and Katie interview Jo Muirhead about the increasingly common trend of therapists becoming coaches for other therapists. We talk about what coaching actually is, mistakes therapists make when pursuing coaching, how therapists can identify if someone is a good (or bad) coach, problems with some coaching for therapists, and how therapists can future-proof their business (rather than turning to coaching for the answer). Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode, we look at the therapist-coaching-other-therapists trendWe’ve received feedback from listeners that they are overwhelmed and disillusioned by some of the business coaching available for therapists. We reached out to our friend, Jo Muirhead, to talk through the current landscape and how therapists can find (and be) better business coaches. What is coaching?·        Coaching is working with someone to help them become the person, professional, etc. they would like to be·        A Coach is someone who helps you with your mindset or helps you with how you think·        Coaching is not training·        MentorshipWhat are mistakes that therapists make when pursuing coaching for themselves?·        Unreasonable expectations·        Lack of implementation support·        Seeking out lots of free consultation (versus paid consultation)How can therapists identify whether someone is a good or bad coach?·        You need to know how you learn, so you can find someone who matches your learning style·        Coaching should make you feel uncomfortable·        Understand whether you’d like a done with you approach versus a done to you or for you type of program·        Avoid people who focus only on themselves and what they’ve accomplished versus helping you find the right path·        Find someone who can help you think (not tell you what to think)What are some problems with coaches who work with therapists?·        They create a program based on a single success·        They believe that they have to tell people what to do·        Marketing practices, manipulation·        Urgency as a tactic works, but can feel manipulative at times·        Fake friending is not effective and pretty awful·        Failing to deliver on promises·        Becoming a business coach because they are tired of listening to peoples’ pain·        If you’re too tired to be a therapist, don’t coach·        There is a problem with their relationship to work·        Needing coaching clients rather than identifying best match clientsHow can therapists future-proof their businesses?·        We need to listen to the experts who are focusing attention on how the business is advancing·        Understand that we’re not “fit for purpose” based on the changes in the industryStay 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/ 

Humor in PsychotherapyCurt and Katie chat about the benefits and challenges of using humor in the therapy room. We look at the research exploring how humor is used, potential risks, and best practices. We work to infuse humor, even as we take our therapeutic humor pretty seriously. This is a continuing education podcourse.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we talk about how therapists can best work within treatment teamsAnecdotal evidence suggests that humor can have positive effects on therapeutic relationship development and as a skill that can be used for interventions. Concerns that humor may be used incorrectly or be potentially harmful make many clinicians wary of utilizing humor in therapy and empirical research is in its infancy about how it can be used effectively. This podcast episode explores the themes of therapeutic humor, which populations might present with different humor styles, and cultural considerations when using humor.What are the beneficial uses of humor in therapy?·      Authenticity versus rigidity·      Serious versus humorous interactions·      Irreverence in DBT·      Humor must come from within your own personality, it is not something that is teachable·      Within the relationship and the therapeutic alliance, humor can increase connection·      Using humor as a therapist can address power imbalances·      Opportunities to challenge beliefs and shift behavior with a lighter touch·      Diffusing situations, gallows humor, and moving on from challenging situationsWhat are the risks of using humor in therapy?·      When clients don’t understand the humor, it can cause iatrogenic harm·      Confusion on the intent of humor·      Confusion regarding the connection fostered by humor (i.e., could be seen as seduction)·      Humor can be a distraction or a way to deflect from the therapeutic work·      Humor can be seen as reinforcing power imbalances, especially when the client sees the humor as an insult, criticism, or the therapist putting the client down·      Clients may not be able to give feedback on their reactions to humor·      Self-deprecating or self-pitying humor is not recommended in therapyWhat is in the research on using humor in therapy?·      Not a lot of research·      Research on humor in therapy is usually done with western therapists and clients·      It is important to understand the different cultural impacts on humor·      There is research on the 7 stages and themes of humor within therapy·      Assessing the use of banter in therapy·      Identifying whether aggressive humor can improve outcomes in therapy·      Misapplication of humor as confrontation versus using it for facilitationHow can therapists use humor effectively in therapy?·      Assess jokes and humorous interactions from the lens of it being for the benefit of the client·      Focus on “reading the room,” so you’re not using humor inappropriately·      Connecting and affirming your understanding of the client’s experience·      Balancing activities in session (business time versus fun time)·      Using humor as a diagnostic tool·      Addressing ruptures or potential ruptures caused by humorReceive 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.Modern Therapist’s Survival Guide Creative Credits:Voice Over by DW McCann https://www.facebook.com/McCannDW/Music by Crystal Grooms Mangano https://groomsymusic.com/

How Therapists Can Deal with the Crisis of the WeekCurt and Katie chat about a typical dynamic that can happen in therapy sessions, namely the “crisis of the week.” We look at how this dynamic comes up and what therapists can do to deal with it more effectively. We identify both clinician and client factors and suggest strategies to improve therapy sessions.Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we explore how therapy can get stuck responding to the crisis of the weekDuring one of our Patreon coffee hour/Q+A sessions, we got a request from a patron to talk about how to navigate client sessions that were mostly focused on worrisome incidences from the week, rather than on treatment goals.What is “Crisis of the Week?”·      When therapy gets stuck with only talking about what has happened in the week·      Crises take precedent over treatment goals·      There are also biases in how this topic has been brought up during training or supervision for early career cliniciansHow do therapists determine whether the “crisis of the week” conversations are helpful·      If conversations are repetitive or there is little progress made, these conversations are likely not helpful·      “Crisis of the week” can be conversations from clients and (for kids) their parents·      If the conversations align with treatment goals, they are more likely to be helpfulHow can therapists mitigate the concerns related to “crisis of the week”?·      Making sure to talk about the therapy and determine whether the treatment goals are appropriate for the client·      Providing structure on how to work on therapy goals can help make therapy more effective·      Making sure that you’re hearing the client and then redirect to treatment goals or the client’s hopes for therapy·      Making sure that everyone is on the same page with how the treatment progresses·      Insight into why there is a tendency to go to the crisis of the weekWhat are the clinician factors in getting stuck in a “crisis of the week” conversation?·      Feeling uncomfortable with structuring therapy·      Allowing the client to lead, when they are not ready to do so·      Potentially not taking responsibility for the session due to laziness, burnout, or other concern·      Therapists not clarifying expectations early enough in treatmentWhat are the client factors in getting stuck in a “crisis of the week” conversation?·      Clients are fearful and potentially using a decoy issue to avoid discussing a more relevant·      Clients may be having a trauma response that leads to speaking about safer topics·      Clients are not yet comfortable enough with the therapist to dig deeper·      Clients do not have the skills to manage the topic·      Cultural factors could impact communication and expectationsWhat conversations can therapists have with clients related to avoiding crisis of the week?·      Setting up structure for sessions·      Addressing the relational elements related to attachment and getting to the clinical work·      Identifying how to address it when “crisis of the week” happens·      Determining how best to start your session with each clientStay 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/ 

Making Sense of Insurance Billing and Client Referral Services for TherapistsCurt and Katie chat about a lot of the different services that therapists can sign up for to provide therapy. We talk about Alma, Headway, TalkSpace, BetterHelp, etc. We also look at what therapists should consider when deciding which service to sign up for (or whether they should). Transcripts for this episode will be available at mtsgpodcast.com!In this podcast episode we explore therapist insurance referral services like Alma and HeadwayWe’ve been asked to weigh in on insurance referral services like Alma and Headway. We explore the different things to consider when choosing a service to sign up for.What client referral services should therapists sign up for?·      Betterhelp and TalkSpace models do not include insurance billing and pay therapists very little. We do not recommend therapists sign up as providers on BetterHelp and TalkSpace.·      Alma, Headway, and other similar models get therapists credentialed, bill insurance, etc.·      These services are very different and there are a lot of choices for therapists to makeWhat are questions therapists should consider when deciding which therapist referral service to sign up for?·      Can I actually use these platforms?·      How quickly am I credentialed and how many different panels can I sign up for?·      Will this service get me clients?·      How many clients are they going to get you?·      Are the insurance benefits checks accurate?·      What does customer service look like?·      What are the rates they pay therapists?·      Is there a minimum number of clients you’re expected to see?·      What benefits are included for therapists (like CEs, group meetings, EHR, etc.)·      What do you want your practice to look like?·      What purpose will this platform serve for my practice? For example, are you wanting to get more clients or are you wanting to add insurance billing capacity (or both)?Concerns about digital therapy platforms and insurance referral services·      The tendency for things to change as startups grow·       Privacy concerns from app-based therapy apps (like BetterHelp and TalkSpace, etc.)·      Systemic impacts of tech companies negotiating with insurance companies instead of therapists·      Most are set up as 1099 businesses versus W2 employee models and seem to skirt some labor laws and put liability on the therapistStay 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/