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

Religious Trauma and High-Control Religion: An Interview with Anna Clark Miller, LPC, LMHC
Curt and Katie interview Anna Clark Miller about religious trauma. We explore what religious trauma and high-control religions are. We look at common mistakes therapists can make when working with religious trauma survivors as well as what therapy and healing can look like for these folks.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode, we talk about religious trauma and high-control religion
We were interested to learn more about how therapists can support religious trauma survivors, so we reached out to an expert, Anna Clark Miller, to share her wisdom.
What is religious trauma?
·      Complex trauma over a long period of time
·      Impacts to the nervous system
·      Traumatic beliefs about religion and the after life
·      Following rules and conforming to a religious group’s idea of how someone should live
What mistakes do therapists make when working with religious trauma survivors?
·      Therapists becoming the client’s new spiritual authority
·      Clients using therapy to tell them how to think and live
·      Clients need to own themselves and their own minds, not work to please the therapist
What does healing after leaving a “high control” religion look like?
·      The loss of so much, including social support, identity, etc.
·      Complex PTSD healing
·      How will I fit into the world? How will I talk with people?
·      Building hope for someone who is needing to completely remake their life and identity
·      The client needs to create a sense of safety within themselves
·      You can’t “rip off the Band-Aid” with leaving a high control religious group
·      Helping clients with their judgment around their emotions (starting with observation before judging if it is good or bad)
·      Working with clients to examine their beliefs (over time)
What is included in the treatment for religious trauma survivors
·      Noticing one’s body
·      Exploring and reimagining healthy relationships
·      Identity work
·      Deconstruction of topics based on what the client is thinking, feeling, etc.
·      Addressing spiritual bypassing
·      Not just “mindfulness” due to concerns about secular psychology
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
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How Much Autonomy Do Therapy Clients Deserve? Balancing client autonomy with therapist skill
Curt and Katie chat about client autonomy. We look at what patient autonomy is and what therapists need to understand about this very complex topic. We explore how therapists can overstep or abdicate their role in supporting their clients in making decisions. We also look at what true informed consent is and the dimensions of client autonomy. This is an ethics continuing education podcourse.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode we talk about client autonomy
Therapists are faced with balancing their professional knowledge with the needs and desires of clients. At the core of this issue is the principle ethic of client autonomy. How much autonomy do therapists need to give clients? What do therapists do when clients don’t have the capacity for autonomy in the first place? This workshop explores the considerations that therapists must face when balancing the needs of clients with professional mental health services.hen
What is patient or client autonomy in mental health?
·      Clients making decisions about their treatment based on solid information and an understanding of that information
·      There is a debate related to whether we defer to clients’ decisions no matter what versus standing in the role of professional therapist
What do therapists need to understand about client autonomy?
·      There is a lot of complexity and nuance related to therapist responsibility as professionals versus when therapists can become too paternalistic
·      There is a not a lot of discussion within the ethics codes related to client autonomy, they are usually in the preamble, so it is more important while also be less discussed
·      Freedom (or liberty) to make choices versus agency (or capacity) to understand the choices
·      Therapists need to clarify for clients the options and make sure they can make informed decisions
How is informed consent related to client autonomy?
·      If clients don’t know what their therapists are doing, do they have client autonomy?
·      Evaluation of whether someone has the capacity to make treatment decisions can be impacted by bias, but is the role of the therapist within the mental health treatment
·      We don’t want to equate autonomy with autonomous decision-making
Dimensions of client autonomy and the therapist’s responsibility
·      Decisional dimension – being able to plan and make decisions about their mental health treatment
·      Executive dimension - being able to follow through on the plans made
·      Therapists need to be able to step forward and provide additional support to clients to bring them back to autonomy or hold a line in treatment that will and will not be offered
·      Informed dimension - understanding the difference between informed consent and informed assent and being able to give instructions ahead of time if have a mental health crises
·      Looking at a “Mental Health Advanced Directive” – one example is the Wellness Recovery Action Plan (see the resources section in the show notes).
Paternalism and client autonomy
·      Not all “paternalism” is wrong – when clients are unable to care for self, they may need some paternalism to be able to be safe or get the treatment that they need
·      Asymmetrical versus libertarian paternalism is discussed
·      The importance of understanding your own bias and how the way you frame options can be manipulative
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What’s Confidential and What’s a Secret? Navigating “No Secrets” Policies
Curt and Katie chat about no secret policies. We look at what they are, what needs to be in these policies, how to navigate secrets in therapy, the importance of these policies in relational therapy, and the complexity of “no secrets” when working with kids and teens.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode we talk about no secrets policies in therapy
In our continuing efforts to touch on all the topics that therapists need to know about, we decided to dig deeply on no secrets policies.
What is a no secrets policy?
·      Typically, these types of policies are created for relational therapy
·      “No secrets” means that the therapist will not keep a secret that is clinically relevant from a member of the treatment unit, even when someone contacts the therapist outside of session
·      This policy needs to be understood by all the members of the treatment unit
How can therapists navigate secrets in therapy?
·      If there is communication outside of therapy, it is important to hold the boundaries within your no secrets policy
·      Flexibility related to when and how secrets are shared (versus rigidity and immediacy)
·      Explicit discussion around exceptions of the “no secrets” policy related to intimate partner violence
·      It is important to have a clinical evaluation of when and how the secret is shared into the treatment unit and whether the secret is clinically relevant to the treatment unit
·      Clarify the treatment unit and clinical orientation to sort through what needs to be in your secrets policy
·      Determining how not to be triangulated by members of the couple or family
What needs to be in a therapist’s secrets policy?
·      Clear guidance on who is included in the treatment unit
·      What secrets will be kept or not kept (e.g., intimate partner violence)
·      How secrets will be handled as they come up
·      Assessment of the capacity of each member of the treatment unit to participate in these conversations about confidentiality and secrets
What about no secrets when you’re working with kids and teens?
·      Clarity on the treatment unit (individual kid or family, etc.)
·      Identifying how confidentiality is held for kids and teens
·      Working with the kids and teens to plan for disclosure to caregivers
·      For parents of young/school-aged children, there may be work to help caregivers to disclose information appropriately over time (thus the therapist holds the secret for a period of time)
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/

Is This My Stuff? How therapists can sort through countertransference: An Interview with Dr. Amy Meyers, LCSW
Curt and Katie interview Dr. Amy Meyers on countertransference. We talk about what countertransference is, how therapists typically struggle when working in the transference and countertransference, how the profession’s relationship to countertransference has changed, and what therapists can do to better understand themselves. We also talk a bit about the blank slate.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode, we look at countertransference
We’re talking about a topic we haven’t touched on yet: countertransference. We are joined by an expert in countertransference, Dr. Amy Meyers, LCSW
What is countertransference?
·      Beyond self-awareness and understanding oneself
·      We have experiences and make them our own and expect people to respond to me in the same way as others have in the past
What do therapists struggle with when addressing transference and countertransference?
·      When therapists don’t know themselves well enough, they will not be able to identify when countertransference is coming up
·      Therapists will often avoid conflict or put too much of themselves in the room without full assessment
·      Therapists misunderstand the utility of countertransference and try to avoid it
·      Simplification of the blank slate. Dr. Meyers’ understanding is that it is avoiding unintentionally putting your emotions in the session, which gets in the way of clients’ projecting emotions on the therapist (transference)
How should therapists be taught to use countertransference?
·      Looking at how you feel about the interactions with your clients and your feelings about your clients as individuals
·      Treating therapists as human beings with emotions and explore how their humanity interacts with their work with their clients
How has the field changed its relationship with countertransference?
·      People have moved into quicker therapy and more manualized treatments
·      There is less focus on longer term, relationship based treatment rather than tools and strategies
·      Supervisors and trainers are less focused on training therapists in this element of the work
What can therapists do when they become aware of their countertransference reactions
·      Considering other options rather than what is familiar
·      Using the relationship in therapy as a corrective emotional experience
·      We discuss a couple of case examples to explore how to work with countertransference with real clients
·      Sorting out what is self-disclosure versus use of self in session and how are each can be helpful
·      Go to therapy
·      Go to supervision
·      Learn and read more about countertransference

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/

Decolonizing Therapy: A Movement - An Interview with Dr. Jennifer Mullan
Curt and Katie interview Dr. Jennifer Mullan about decolonizing therapy. We discuss what it means to decolonize therapy and the importance of doing so, as well as the challenges therapists face when they are looking to decolonize their practices and incorporate cultural and community healing. We also explore rage, the tendency to pathologize big emotions, and the impact of historical trauma.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode, we look at what it means to decolonize therapy
Over time we’ve talked with innovators who are pushing back against the status quo and the medical model. We were so excited to dig more deeply into Decolonizing Therapy with Dr. Jennifer Mullan.
What does “decolonizing therapy” mean?
·      Looking at accessibility to therapy and how lack of access impacts individuals
·      Decolonizing therapy doesn’t work for everyone, especially folks in the global majority and/or who have the most need
·      The way that therapy is practiced is not sufficiently addressing the mental health crisis
·      Shifting therapy to include cultural healing practices, community healing and support
·      Moving the “blame” for poor mental health away from the individual to the individual’s context
What can therapists do if they would like to decolonize their own therapy practice?
·      Make sure you are doing your own work and have support while working in the role of healer
·      Identifying and accepting that all individuals have social, political and other frames that come in with them to the therapy room
·      Unlearning and embracing new knowledge, being okay with not knowing
·      Looking at historical trauma and colonization as core attachment wounds
·      Understanding how historical events impact your clients (and yourself)
·      Looking at how historical trauma is transmitted directly and indirectly
·      Learn in community
·      Rethink diagnosis
What can therapists get wrong when they are working to decolonize their therapy practice?
·      Struggling to see where compliance can conflict with the needs of clients at times
·      The impact of diagnosis on clients (especially behavioral diagnoses frequently given to Black and brown boys that often lead a child into the school to prison pipeline)
·      Not understanding larger concepts around what is political and big questions like why are people poor?
·      Deflecting questions from clients as being clinical material rather than understanding that clients are seeking a human connection
·      Holding to firmly to rigid “rules” around attendance and coming on time, for example
How can therapists work with rage and other big emotions?
·      It’s important to recognize that we are not receiving sufficient education around rage
·      It is important to understand what rage and what it is not
·      Grief, shame, and trauma lead to rage

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/

Should Therapists Admit to Making Mistakes in Therapy?
Curt and Katie chat about what therapists can do to effectively navigate their own mistakes in the therapy room. We look at what constitutes a mistake in therapy, the types of mistakes that therapists make, and considerations on how to address mistakes. This is an ethics continuing education podcourse.
Transcripts for this episode will be available at mtsgpodcast.com!
In this podcast episode we talk about how modern therapists can navigate making mistakes
When therapists make mistakes, clients can prematurely terminate treatment or fail to meet their goals. Most research on effective therapy looks at factors that minimize the therapist’s tendency to make mistakes, rather than what to do when they happen. However, focusing on the effectiveness of handling mistakes is one of the factors that clinicians can actually control. This workshop focuses on how effectively handling mistakes made by therapists and the mental health system can lead to better outcomes for clients.
What should therapists do when they make a mistake?
·       Looking at the humanity of the therapist
·       It is important to define what is actually a mistake
·       Looking at where mistakes can happen within treatment
·       Mistakes can be defined based on the definition of success
What types of mistakes do therapists make in therapy?
·       Incorrect or mismatched treatment without adjustment
·       Treatment failures happen for many different reasons – what is a mistake versus a work in progress?
·       Mistakes can be based on the individual client or therapist factors and the focus of the therapist in the therapeutic work and relationship
When should therapists admit mistakes?
·       Consideration of whether admitting the mistake will harm the client
·       Going beyond “non-malfeasance”
·       Exploring how clients like to handle a mistake
·       Paying attention to therapist’s own preferences or bias
·       Understanding when and how to take responsibility for what you’ve done as a therapist
·       Avoiding the impact on the client that they believe that they have made the mistake
·       Making sure therapists are resourced when they engage in this process
What are the systemic errors in mental health treatment?
·       Taking a global view to therapy can allow for seeing the other elements and systems
·       Recognizing the limits of what therapists can do to solve clients’ concerns, including due to agency policies
·       Harm caused by the profession and professional associations (statements made, research completed, etc.)

Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide
Continuing Education Information including grievance and refund policies.

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Patreon
Buy Me A Coffee
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/