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

Your Modern Therapist Ethics Questions Answered: Digging into the mail bag to identify how to behave ethically in modern times
Curt 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 therapists
Too 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 necessity
How 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 dependent
What 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 clients
What 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 session
Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide
You can find this full course (including handouts and resources) here: https://moderntherapistcommunity.com/podcourse/
Continuing 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/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/

Family Therapy: Not Just for Kids - An Interview with Adriana Rodriguez, LMFT
Curt 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 therapy
Our 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 culture
How 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 gifts
What 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 treatment
How 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 opponents

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Our Linktree: https://linktr.ee/therapyreimagined
Patreon
Buy Me A Coffee
Podcast Homepage

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/

Modern Therapist Reflections on Preventing a School Shooting
Curt 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 shooting
Recently, 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 school
What 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, frustration
What 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 incidents
Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:
Our Linktree: https://linktr.ee/therapyreimagined
Patreon
Buy Me A Coffee
Podcast Homepage
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/

Why Do Therapists Feel They NEED to be Coaches? An Interview with Jo Muirhead
Curt 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 trend
We’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
·        Mentorship
What 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 clients
How 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 industry

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

Humor in Psychotherapy
Curt 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 teams
Anecdotal 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 situations
What 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 therapy
What 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 facilitation
How 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 humor

Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide
You can find this full course (including handouts and resources) here: https://moderntherapistcommunity.com/podcourse/
Continuing 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 Week
Curt 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 week
During 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 clinicians
How 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 helpful
How 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 week
What 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 treatment
What 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 expectations
What 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 client

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