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

Should We Stop Badmouthing Evidence Based Practice? An interview with Jessica Tappana, LCSW
Curt and Katie interview Jessica Tappana, LCSW about evidence-based practices (EBPs). We talk about what EBPs actually are and how to implement them in clinically sound and ethical ways. We look at what therapists usually get wrong about EBPs and what they can do to improve their practice.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode, we talk about how Evidence Based Practices work in the real world
Jessica is a long-time listener of the show and a good friend of ours and has been talking with us about how we have spent too much time bad-mouthing EBPs. We decided it would be good to hash out the ideas around “manualized treatment” and how you can actually bring yourself as a clinician into the work, even when using these interventions that are backed by science.
What are Evidence-Based Practices?
·      Using well-researched interventions
·      Using the expertise of the clinician
·      Understanding the needs of the clients
What should therapists know about evidence-based practice?
·      There is room to implement EBP without full adherence
·      Contrasting “eclectic” from “meeting a client where they are” and pulling from other evidence-based interventions
·      The ways that EBPs are trained and studied (due to funding sources) lead to strict adherence
·      How you teach or implement the EBP can be unique to the clinicians
·      Contrasting fidelity of the model with adherence to model
·      You can bring yourself as a therapist into the room AND provide evidence-based interventions
·      Training and supervision is more challenging when you are not seeking strict adherence
·      It’s important to have time to practice therapy outside of sessions with clients
What data or assessments should therapists use with Evidence Based Practices?
·      Feedback informed care (e.g., FIT)
·      Assessments of depression or anxiety consistently to see progress
·      Screening tools and measurement to track progress
·      It is important for clinicians to believe in and use the data collection

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
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Two Years In: Is 988 Actually Helping People Facing Mental Health Crises?
Curt and Katie check back with the now two-year-old program and identify what’s working and what’s not with the crisis hotline. There is data that it is 98% but there are also concerns that have been raised. We look at reports of data sharing without transparency, increases in police involvement and involuntary hospitalization, and inconsistently (and potentially inadequately) trained hotline workers. We also explore what therapists can do to support clients who might need this resource.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode we talk about what is work and what is not working with 988
Katie became concerned about data use and how well 988 is working after seeing some articles from Mad in America. Curt and Katie thought it would be good to dig a little deeper into what is actually happening with this newer crisis hotline.
What are concerns being raised about 988 at this point?
·      Data sharing with a lack of transparency
·      Different definitions of confidential and confidentiality
·      There is not really a guarantee that you can remain anonymous
·      Increase of involuntary hospitalization and police involvement
·      Lack of infrastructure and lack of local resources to manage crisis response
·      Callers may be routed to the call center nearest to their area code, not current location
·      Not advertising 988 in high population areas because they will get calls no matter where their community members are due to their area codes
·      Training of the hotline workers is inconsistent and may not be sufficient
·      Lack of funding to make improvements and develop new resources
What are the risks when someone calls 988?
·      The call center staff may not have training to deal with the caller’s issues
·      Responses on the call line may be overly focused on psychoeducation
·      Lack of time for each caller (without assurance that callers get time to talk through the concerns that led them to call)
·      There is a possibility that there will be responses that are truly unhelpful to the caller
·      Incarceration or involuntary hospitalization
·      Inconsistent follow up if calls are dropped or callers disengage
What should therapists be aware of as they navigate 988 at this time?
·      They are reporting a 98% success rate, so this is a resource worth considering
·      Make sure your clients understand what to use 988 for
·      Help your clients to assess the risks and benefits of calling
·      Work to increase the transparency about data sharing, confidentiality and anonymity
·      There is advocacy needed to improve 988 as a resource

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Our Linktree: https://linktr.ee/therapyreimagined

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/

 

Don’t Let TikTok Fool You – Being a Therapist is Hard Work: An interview with Sandra Kushnir, LMFT and Anita Avedian, LMFT
Curt and Katie interview Sandra Kushner and Anita Avedian about how the therapy business works now. We talk about how the profession and those who are entering it has changed over the years. We look at what new therapists can expect when they join a group practice, pushing back against some of the broadly held misconceptions of what it is like to be a therapist today.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode, we talk about what new therapists can expect when entering the field
We invited Anita Avedian and Sandra Kushnir to come talk about their latest endeavor: a course called Degree to Practice.
What are the misconceptions new therapists have about what it looks like to work as a therapist?
·      There is a difference between desired caseload and the capacity to earn money and hours toward licensure
·      Expectations don’t seem to be realistic and seem to be impacted by conversations about burnout
·      These expectations are being set by grad school, social media, coaching programs
·      There doesn’t seem to be an understanding about what it takes to build a practice and what group practice owners are doing to create these workplaces
·      Therapists will need to learn how to work with clients that they are not comfortable with
·      Developing expertise is essential for attracting clients – be the best at what you do
·      Part of developing expertise is learning how to address higher risk with all clients
What can therapists expect when they join a group private practice?
·      The best group practice owners will have transparency and clarity around expectations
·      Often there will be a minimum caseload (Sandra and Anita both require a minimum of 20 clients per week)
·      There is an overhead for each therapist, so therapists will not earn the full amount they are charging
·      Insurance or sliding fee practices will need to pay therapists less than private pay practices due to the income available
·      In many private practices, it will take some time to build a caseload, which means that it will take time to gain consistent income
·      Some group practices will teach you how to run your own practice, some will just provide a space for doing clinical work
·      Looking at practical limits as “task conflict” rather than “relational conflict” – for example, pay is a factor of the business’ needs and capacity, not a personal evaluation of someone’s worth
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Our Linktree: https://linktr.ee/therapyreimagined
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/

No Cap: It’s Time to Glow Up Your Teen Therapy Skills
Curt and Katie chat about how to work effectively with teen clients. We look at what adults often get wrong about teens as well as how therapists can develop real relationships with their teen clients. We also look at the differences that can show up in how you do therapy with teens.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode we talk about effective therapy with teenaged clients
Curt and Katie have both specialized in working with teens at different points in their careers and figured they should share what they’ve learned to support other therapists who’d like to work with teens.
What do therapists (and caregivers) get wrong about teenagers?
·       You won’t reach teens if you treat them like behavioral problems to solve
·       It is helpful to show teens that they will be listened to, rather than just subject to whatever their parents or caregivers want them to do in therapy
·       Therapists can seem less authentic if they try to be “the cool therapist”
What is needed in an effective therapeutic alliance with teen therapy clients?
·       Identifying what the teen needs from the therapist (e.g., confidant, older sibling, parental type)
·       Authenticity is key as teens will often see through it if you’re not
·       Defining boundaries of the relationship
·       Looking toward client autonomy
·       Showing stability and constancy
·       Encouraging safety and agency
·       Being a trusted, consistent adult
What are differences in therapy with teens and adults?
·       Having caregivers involved in schedule and decision-making, having a huge impact on teens
·       Therapy for teens is often a relationship where identity can be tested
·       Therapists can be an outside voice for both teens and adults, but teens may need this more
·       Caregivers are more likely to be a part of treatment for teens
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Our Linktree: https://linktr.ee/therapyreimagined
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/

More Than Cogs in the Machine: Bringing trauma-informed principles into the workplace
Curt and Katie chat about trauma-informed workplaces. We explore what a trauma informed workplace is, why it is important to implement, and how best to do so. We also explore some practical challenges to creating a trauma-informed workplace and ideas for how to handle these challenges. This is a continuing education podcourse.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode we talk about how to create a trauma-informed workplace
People affected by trauma are expected to perform in the workplace, but often have difficulty with environments that treat them as replaceable. This can lead to employee underperformance, burnout, and turnover in the workforce. Healthy interactions with the workplace can help both the individual and corporate performance. This workshop addresses principles and practices that allow for employers to create a trauma informed workplace.
What is a trauma-informed workplace?
·       Remembering that all workers are human
·       Collaboration and encouraging autonomy for employees
·       Acknowledging that trauma exists for everyone
·       Trauma is addressed in the workplace (e.g., mitigating secondary or vicarious trauma)
·       4 R’s of Trauma can give guidance to how to identify and respond to trauma
·       Supportive policies go beyond self-care
·       There is a systemic mechanism to support staff and improve
·       Based in trust and trustworthiness
What are the risks of not having a trauma-informed workplace?
·       Lower employee productivity, lower quality work
·       Higher levels of burnout, absenteeism, presenteeism
·       Recreating past traumas when we’re not aware of the dynamics in play
How can therapists create and benefit from a trauma-informed workplace?
·       Create supportive policies and procedures
·       Evaluate how well trauma informed principles are being implemented
·       We discuss an evaluation tool for this purpose
·       CTIPP Toolkit (Campaign for Trauma Informed Practice and Policies)
·       Acknowledge shared humanity
·       Creating connection and collaboration between team members
·       This may be something that needs to be repaired or built within a workplace that has problems
·       Understanding how to build, sustain trust, and effectively take feedback and implement it
·       Transparency and accountability
What are some challenges in implementing a Trauma-Informed Workplace?
·       Very challenging conversations needing repeated repair
·       Avoiding conversations about trauma
·       Digging deeply into emotional life of employees (i.e., with the potential of HR violations)
·       Practical limitations to what employers can provide to their employees
·       Us versus them mentalities and not seeing opportunities to collaborate
Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide
CAMFT CEPA: Therapy Reimagined is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LPCCs, LCSWs, and LEPs (CAMFT CEPA provider #132270). Therapy Reimagined maintains responsibility for this program and its content. Courses meet the qualifications for the listed hours of continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences. We are working on additional provider approvals, but solely are able to provide CAMFT CEs at this time. Please check with your licensing body to ensure that they will accept this as an equivalent learning credit.
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Pursuing Happiness as a Therapist: An interview with Stevon Lewis, LMFT
Curt and Katie interview Stevon Lewis, LMFT, about how he makes his career more sustainable. We look at his current philosophies around low effort, alignment, and fun. We also explore how he was able to initially able temper his expectations, work through misaligned paths, and pivot when needed. Finally, we talk about what it looks like behind the scenes to pursue a number of different revenue and marketing streams.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode, we talk about how to make a sustainable therapy career
We invited Stevon Lewis back to talk about creating a sustainable career, even if it means pivoting and rebuilding your career or your brand.
How can you build a positive and sustainable career as a therapist?
·      It’s important to assess your performance, your level of happiness, etc.
·      Don’t be afraid to pivot
·      Assess if you are working too hard or are misaligned with the work
·      Determine whether your unease is due to lack of skill or misalignment
·      Frame assessment based on practical evaluation versus moving to “I’m a failure”
When can you actually make choices that serve you better as a therapist?
·      Initial career choices may not be as ideal as one would like
·      It is important to temper your expectations to your current situation
·      Many therapists start in community mental health and may not be able to choose who we see and what we do
·      Be flexible and open to working with less than ideal clients, identify the learning opportunities
·      There is a ramp up and a building up of a caseload and career that takes time
·      Understand that pivoting is part of the journey because we don’t know what we’re good at or what we’re going to like
How do therapist influencers work effectively?
·      There can be a lot of effort behind the scenes
·      Delegating and contracting out elements of the work can be helpful
·      Efficiency is important to be able to do a bunch of different things to be successful
·      Stevon talks about how he does his “low effort” version of social media posting and interaction
·      Looking at the minimum effort for maximum result
·      Accept doing what you need to do to get the results you would like (not comparing to all others)

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Our Linktree: https://linktr.ee/therapyreimagined
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/