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When Clients Have to Manage Their Therapists

Curt and Katie chat about the work (or mental load) therapists often give to clients that is really ours. We talk about requiring our clients to do things that are not helpful to treatment like: manage our time, do excessive paperwork, negotiate through our money stuff, be guinea pigs, or teach us about their culture or other differences. We also look at the impact of these abdications of responsibility on the therapeutic relationship and the clinical work.

It’s time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.

Transcript

Click here to scroll to the podcast transcript.

In this episode we talk about:

  • When we give more work to clients (that isn’t really good therapy)
  • The mental load or emotional labor that therapists can unwittingly add for clients
  • Time management and the impact of poor practices on clients
  • Being late, managing the shape of the session, scheduling
  • The difference between being authentic and being irresponsible
  • The care you show when managing rescheduling and the impact on the relationship
  • What can come up, especially related to attachment wounds
  • The problem when you consistently forget to get back to your clients
  • Paperwork as a burden on clients, especially when clinicians don’t read the paperwork
  • The message you give when you don’t follow up on a client’s homework
  • When outcome measures feel like paperwork that is solely for the benefit of the therapist, rather than something that feels relevant to the client
  • Feedback Informed Treatment (FIT) poorly implemented
  • Delayed billing, not providing superbills timely
  • Allowing a balance to accrue
  • The power dynamic and power imbalance when clients owe therapists a sizable amount
  • The labor we’re giving to our clients when don’t have structure on payment (sliding scale fees and payment plans)
  • How our own money stuff might come into these conversations
  • Adding new theories or trying new interventions on clients without a strong clinical rationale
  • The danger to the client’s trust in the process if we throw new interventions in each week
  • The mental load of asking our clients to teach about their own experience or navigating therapist bias
  • Identifying a lack of fit or when treatment is over (rather than forcing our clients to do so)
  • Own our humanness and set ourselves up for success
  • Why this work sometimes gets handed to clients (rigidity, therapy culture)

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Simplified SEO Consulting

Simplified SEO Consulting is an SEO business specifically for therapists and other mental health providers. Their team of SEO Specialists know how to get your website to the top of search engines so you get more calls from your ideal clients. They offer full SEO services and DIY trainings.

These days, word of mouth referrals just aren’t enough to fill your caseload. Instead, most people go to Google when they’re looking for a therapist and when they start searching, you want to make sure they find you!  That’s where Simplified SEO Consulting comes in.

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Resources mentioned:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

Very Bad Therapy: A Clinical on Unprofessionalism

Relevant Episodes:

Work Harder Than Your Clients

Clinical Versus Business Decisions

How to Fire Your Clients Ethically

How to Fire Your Clients Ethically Part 1.5

Diversity and Cultural Competence

Special Populations

Connect with us!

Our Facebook Group – The Modern Therapists Group

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The Fifty-Minute Hour

Who we are:

Picture of Curt Widhalm, LMFT, co-host of the Modern Therapist's Survival Guide podcast; a nice young man with a glorious beard.Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Picture of Katie Vernoy, LMFT, co-host of the Modern Therapist's Survival Guide podcastKatie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

Stay in Touch:

http://www.mtsgpodcast.com

http://www.therapyreimagined.com

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Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano http://www.crystalmangano.com/

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Curt Widhalm  00:00

This episode is brought to you by Simplified SEO consulting.

Katie Vernoy  00:03

Simplified SEO consulting is an SEO business specifically for therapists and other mental health providers. Their team of SEO specialists know how to get your website to the top of search engines so you get more calls from your ideal clients. They offer full SEO services and DIY trainings.

Curt Widhalm  00:21

Stay tuned at the end of the episode for a special discount.

Announcer  00:26

You’re listening to the Modern Therapist’s Survival Guide, where therapists live, breathe and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm  00:41

Welcome back, modern therapist, this is the modern therapist Survival Guide. I’m Curt Widhalm with Katie Vernoy. And this is the podcast for therapists about therapy about our practices, things that we do to have more successful practices and leave our clients in better places promote healing in the worlds. And today’s episode is inspired by a client’s comments about the work that therapists make clients do outside of the work that therapists make clients do. And this is the ways that we make our clients do some of the practice stuff for us, or that our bad practice habits end up giving people bad therapy experiences. So this is not necessarily about the clinical work, but things that we do that potentially start to affect the clinical work. And going through kind of some brainstorming on this. And we posted this question the night before recording this out on our Twitter feed, we got exactly zero responses from anybody. So this is a list of things to

Katie Vernoy  01:55

Maybe we should have put it in our Facebook group, where we get responses. Next time guys next time.

Curt Widhalm  02:01

But we came up with a list of things, this is probably a non exhaustive list. And you can go to our effort mentioned Twitter or Facebook group and continue to add meaningfully to this list. But things that clients have identified are also the importance of being on the other side of the couch things that we’ve identified, the end up just being bad therapy experiences. So Katie, what first comes to your mind on this.

Katie Vernoy  02:33

I think the the thing that comes first to my mind is probably the way that we manage time. Because for me, I worked in a clinic mental health clinic, a mental health clinic where time seemed very dynamic and fluid and things just never started on time. And it was something that bothered me, I equally participated in it. But it’s something that I found is important for me, I want to make sure I’m on time that if I tell my client that we’re going to reschedule that I have a time available for them and, and that I manage time properly within my session. But I have heard from clients that that is not always the case. In fact, I’ll link to this in the show notes, there was an episode that I supported very bad therapy on where a client who reported on their story was given tons of paperwork after their therapist was 30 minutes late to the intake session. And just the types of things with that are just hugely problematic. But like if we’re not respecting your client’s time, if we’re not rescheduling and like managing the rescheduling process, if we’re going over which I have to admit, sometimes I go on that one where we don’t manage time properly. In this session, we’re forcing our clients to kind of work around us or manage the time for us. I know as a therapist, I’m always tempted to manage the time for my therapist, she actually is good with it. But like I still am like, oh, well, I know we need to finish. You know, like, I feel like when that’s happening there is there’s work that the client must do that doesn’t seem fair.

Curt Widhalm  04:21

And the way that this plays out is I’ve had people describe this to me as we understand that therapists have their own lives, have their own reactions have their own shit that just comes up and a lot of things that we encourage therapists to be out about, you know, hey, I’m going to a conference that’s gonna affect our sessions that we need to reschedule things. But I’ve heard statements around this as far as like, Oh, I’m going to a conference. I need to reschedule. I’m needing to move a couple of people around I’ll get back to you in a couple of days with what your options for rescheduling for next week might be. And then not following up with the clients that ends up putting the clients in positions of do I need to call back is my therapist actually going to follow through. So these are really kind of small afterthought things that can have a great deal of impact on our clients as far as pushing some of the scheduling responsibility back over to them. Now, parts of the ways of getting around this is if you have a good, you know, scheduling system that allows for clients to be able to put themselves on your schedule, hey, you know, I’m going to this conference next week, we could spend a few minutes right now doing this or set a reminder for, you know, tomorrow to check back and I’ll have my availability up there, and you’ll be able to book an appointment for what’s available. And that can be one way of helping to alleviate this problem.

Katie Vernoy  06:08

Yes. And I think that the message that we send, if we don’t immediately take care of it, or, or have a solution for it, I think is one of I don’t care about your session. I mean, to me, it’s respectful to take the time to to do the rescheduling, especially if you’ve got a couple of minutes that aren’t going to take away from clinical time. And I think the the message of I’ve got a few things to move around, and then I will get back to you and not getting back to kind of put somebody in a in a hierarchy of how important they are to you. And to me, it just feels, I think it hurts the relationship when you disregard them. And you don’t get them scheduled immediately. Or you don’t show the importance of getting them scheduled and taking care of their time immediately. In my opinion.

Curt Widhalm  07:00

You know for some of the clients that I’ve seen that have described this, it’s their people who seem really high functioning in many areas of their lives.

Katie Vernoy  07:11

Sure.

Curt Widhalm  07:11

But this does bring out a lot of attachment wounds, especially if there’s been relational traumas in their lives. And it might not be something that is at the forefront of your mind as a practitioner, when you’re managing your practice of looking at just how deeply impactful those between session contacts or absence of contacts can end up happening with clients from all walks of life, but particularly from these clients.

Katie Vernoy  07:41

And I want to cover another element of this because there was a period of time, not lately because of the pandemic. But when I was traveling a lot, or I was doing a lot of things, I did reschedule a lot. And some people would say that de facto is disrespectful to clients, and you set your weekly time and you keep it and that kind of stuff. And for me, and maybe that’s why I’ve gotten very comfortable with rescheduling. But if the communication is open, and there’s a clear value that you hold for them and their session time, I think you can reschedule maybe not as much as you want. But I think that you can still do it. But I think if you forget to call them back, and you make them be the ones that reach out, I think that’s when it gets problematic. I think folks can live their lives travel all they want, do what they want. I think it’s just take care of your clients in the process. Hold those times make sure that you make it available for them, and help them to reschedule don’t make them do it.

Curt Widhalm  08:36

So is kind of shifting gears here a little bit. But also speaking on responsiveness. You brought up paperwork. So first of all, there’s just the sheer amount of paperwork. Yes, and depending on the kind of practice that you have, sometimes agencies are going to have mountains and mountains of paperwork. And from a bureaucratic standpoint, it might be because there’s multiple people within the agency who are interacting with a client if there’s a medical component of the agency justifying paperwork, and I don’t want to do that. But for, you know, more private practice II type places that there can be a lot of good intentions with paperwork, but a complaint that I hear from some of my students, some of my clients about other therapists experiences is does that paperwork ever actually end up getting used for anything or is it just filling stuff out for filling it out sake?

Katie Vernoy  09:42

Yes, yes. I think that’s the piece that I that really bothers me. I know. Like when I go to a doctor’s office, you know, whether it’s an intake or an annual appointment or whatever, so much paperwork, and they clearly don’t have time to read it and then they asked Be the Same questions right afterwards. And I know that that happens with therapists as well. I personally probably have a couple too many pieces of paperwork that I feel like I need to have. And they are really just kind of forms that people sign. But all of the assessment stuff I do read, and I am, it’s clear when I see my clients that I read it, but I think there are a lot of folks that feel like they have to have all of this information. But there’s arguments about having it at intake before intake after intake, you know, like people can argue clinically when they want to ask for all this information, but having so much paperwork to get through to walk in the door, and then have it clear that my clinician has not read it drives me bonkers.

Curt Widhalm  10:46

I was at a presentation several years ago at this point that the speaker was a psychiatrist who was talking about the last days of one of their parents being in a hospital, end of life sort of things. But every doctor that was making their rounds, they learned after a couple of days that they just needed to ask the doctor before saying anything like have you read the chart that. So this is this is not just particular to therapists experiences that overall in healthcare we can get, especially when we’re busy really into that habit of just kind of making our clients catch us up on things rather than going back through notes, you know that that P part of SOAP Notes of even just going back and following up on what I also hear from a lot of clients, which is following up on homework, that we assign clients to do things. But if we don’t bring it back up in session, we’re giving them a pass to not do it. But yeah, it also backs up the quality of our work, or the emphasis on the suggestions that we make when we do ask and follow up on referrals on homework tasks on different ways of doing things that if clients are like, alright, I don’t need to do this, or if they’re the ones like I did the homework, do you want to talk about it? But the answer, probably Yeah.

Katie Vernoy  12:19

Yes, yes. And I know I’ve had that happen, where I either failed to write down the specific homework assignment in the progress section of my note, or the plan section of the notes, sorry, or I was kind of waiting to see if it was relevant. And I think in truth, that means that the client may feel responsible to bring it up and feel like they have to manage it, and or they just start start disregarding it. So I think that’s a really good one. And I think being able to manage our own documentation properly, so that we can have that continuity of care from session to session, I think is really important. And if we’re not managing the continuity of care, you know, I think we joked and a few probably in a few different presentations and conversations about self care, just like, Oh, what was most you know, what was most, you know, resonant with you last week, you know, when you don’t remember what you talked about like that that’s really making the client, it puts them in the driver’s seat? I think there are clinical reasons to do that. But I think if you’re structured enough that you’re actually asking for homework, follow up.

Curt Widhalm  13:33

And you don’t want to be that therapist, it’s kind of doing the, you know, the psychic out in front of the audience, like I’m sensing, sensing an H over here. Was there something in your last week that that starts to age? Hey, speaking of things that we can overload clients with your this is from your list, lots of outcome measures without either buy in about it, or showing what you’re doing with those outcome measures.

Katie Vernoy  14:06

Yes, yes. Yeah, I think the thing for me is on my therapist for a while was doing feedback, informed treatment. And I was like meh and and she did drop it. So that’s good. Maybe I shouldn’t say that outloud

Curt Widhalm  14:21

maybe they weren’t doing feedback, informed treatment. It was just feedback informed treatment flavored therapy.

Katie Vernoy  14:28

Maybe No, I we did talk about it a little bit. But I was also anyway, that’s a whole other conversation that I can have with my therapist. But I think when I’m thinking about that, that was my experience of like, I don’t want to do feedback informed treatment. I’ll tell you if I need something different. Stop asking me questions. Stop spending time in my session on this paperwork that you want me to fill out is kind of how it felt to me. So I’m, and I knew what it was like I didn’t need her to explain it to me. So I also was having my own experience of it. But back in Community Mental Health, there were tons of outcome measures that were put together to, for funding streams, like we had to show progress, we had to do this stuff. And, you know, we had to do them quarterly or different things like that. And theoretically, if you actually use those, clinically, I could see the benefit. But most of the clinicians didn’t, they just had to get it done. And so it had that piece of like, here, fill out these 27 different scales. And then we’ll be done. And we can get back to the business of therapy versus actually using them clinically. And so to me, first off having 27 different scales, and I exaggerate a little, I think is is overkill, and I think not using them clinically is is just bureaucracy at its worst.

Curt Widhalm  15:48

And don’t just blame this on agencies. There are people who, if you are some of my fit people out there, you know what I’m talking about, but it’s for the people who think that they’re doing fit that aren’t, that are just kind of taking up session time, they’re not explaining how they’re using this information with clients that really just ends up Compounding this problem. Yeah. Now, on the opposite end of too much paperwork is maybe not giving enough paperwork, and not necessarily just assessments, but this is following through on things like super bills. And yeah, letting you know, months and months stack up before clients are reaching out to you and saying, Hey, I’m thinking that, you know, my insurance company isn’t going to reimburse me for things that happened last year, that you’re getting that far behind. Yeah, you know, the this is things that now start to impact potentially the the contracts that you got clients into your practice with, as far as, you know, if part of clients decision making processes, I’m coming to you because at least I’m getting a few dollars back on my therapy sessions, because of a super bill. This is something that starts to have a financial impact on clients.

Katie Vernoy  17:20

Yeah, I definitely have had clients that I forgot I was doing a super bill for and they reminded me fortunately, it was not too far out. And we were still able to get it done. But I think that’s, that’s hard. I mean, that’s part of the process that we say we’re going to do. And if we don’t do it, and they and they have to remind us, I mean, granted, this is them getting their money back. But if we’ve said, Hey, I will provide you with a super bill, we need to live up to that into the bargain. I think there’s also courtesy billing and different things. We talked about some of this stuff in work harder than your clients on ways that you can show up better and and maybe even in some of the other conversations we’ve had on kind of the highest level of customer service, I’ll look back and see what we’ve actually done episodes on, then put those in the show notes. But I think, to me, I think if we’re not billing timely, and like with insurance, billing, if we’re not billing timely, and we don’t get paid, I think we just hold that. Like, if we didn’t do it, we don’t get paid. But if we’re billing really late, and we’re also not collecting payments until we know what the copay is going to be, or until we know how much has been covered. We can end up with big balances that clients have. And we know there’s there’s a lot of guidance around that. But I think that can start to happen. Even if you don’t bill or don’t charge them a reasonable copay. Like, except like once a month. That means for some clients, that’s fine, and you can figure out the cadence with them. But I think if we’re not doing things timely, and all of a sudden a client owes like 1000s of dollars or hundreds of dollars for some clients, it’s it’s overwhelming, and it creates a little bit of a rupture within the therapy relationship.

Curt Widhalm  19:02

It really does heighten the power imbalance that not only are the traditional therapist client power balances there, but then it’s also this is somebody that I’m indebted to, and especially if it’s multiple sessions that for whatever reason, that therapist hasn’t built the client, then clients might not actually be bringing that up. And, you know, not everybody’s great at budgeting their money. So if they get hit with multiple sessions of Yeah. You’re then putting yourself into, at best trying to work out a payment plan with them. versus, you know, potentially, it being the end of the therapeutic relationship and somebody that owes you money just as potentially gone.

Katie Vernoy  19:56

Yeah, I mean, I think that is loss of money for clinicians, and I think we should be pretty motivated to not do that. But I think about like setting up payment plans or even like a sliding scale when there’s not any structure to it’s like kind of pay what you can. There is a clinical element to this, I think. But I think there’s also some emotional labor that we’re giving to our clients to try to figure out what they can say they can afford that feels acceptable to you, or what their timeline is for the payment plan, or whatever it is, and all of a sudden, this relationship has become very different. And I feel like the more structure that the therapist can give, the less we’re putting our money stuff on our clients, because I think sometimes sliding scales and pay payment plans and stuff like that are very needed. And sometimes they’re because clinicians aren’t willing to turn folks away or refer folks to appropriate resources. And so then it becomes this weird push pull of, well, if you can get high enough, then maybe I can see you. And, you know, it’s it really becomes this weird dynamic. And maybe that’s overstating it, but it feels really strange to me, I feel like it’s been a lot, it’s a lot easier when someone has a specific copay, or I say, This is my fee, and they say yes or no.

Curt Widhalm  21:13

Why longer that I practice, because of some of these points, the more that I look at things from a practice management, and that it simplifies things. And I look at it from a legal and ethical end to that, it’s acknowledging that as the providers, we have the responsibilities to set boundaries, especially around kind of more taboo sort of things in polite society that we don’t talk about money in this way. It puts us in the position of even if we’re very equal, driven in the way that we approach the work that we do with our clients that this is just kind of handing off all of that responsibility as you described.

Katie Vernoy  22:02

Yeah. I mean, I feel like there’s probably a mechanism to have a Pay What You can practice, and I am thinking of someone in particular, and I have a sense that she’s probably doing it very well. And so maybe I’m gonna reach out to her so you know who you are, I’m reaching out to you. But I feel like it has to be handled very, very well. And there needs to not be kind of this ulterior motive around it, because then it’s like, I’m putting my stuff on you versus really opening up my practice to exactly what you can pay. If you can pay $2, or you can pay $250, you’re in the door is a very different thing, then, what can you pay? Can you pay this? Can you pay that? Well, I can only do this, can you do that? Like it just this the bargaining, I feel like just creates a completely different relationship. And maybe maybe I’m too in my own money stuff and need to solve it. But I feel like that’s putting our stuff onto the clients.

Curt Widhalm  22:58

So switching gears here, some, a lot of us love to add new skills to our practice, add new tips, add new interventions, add new theories, and you’re encouraged to practice them. Yes. But clients who know that they’re the ones who are being practiced on, it should be done in a way that they are buying into, it’s not just, I came from this workshop this weekend, and this is the first time that I am using all of these interventions, that that is doing therapy that is not practicing therapy, and that is doing therapy poorly. And

Katie Vernoy  23:40

yeah,

Curt Widhalm  23:41

go ahead.

Katie Vernoy  23:41

I was just gonna say, I know that I’ve been guilty. Sometimes I’m like, this is such a cool intervention. And I was thinking about you the whole time. And I think it would be great. And then we try it. And sometimes it’s cool. And sometimes it’s like, Oh, I was way more excited about that than I really thought about it. So I know I’m guilty of this.

Curt Widhalm  24:01

And I think it’s natural, especially earlier in our careers to want to try out and especially as you’re trying to find what your theory is that part of getting a theory is just trying things out and being able to see what works for you. But I’ve had clients respond back or heads supervisees clients that this ends up becoming discussions and supervision of, well, that’s nice, but what’s your success rate with this that makes them even just question the effectiveness, whether they’re, whether the clinician is good at it or not. That just kind of devalues the belief that it’s actually going to work from the clients end.

Katie Vernoy  24:47

Yeah. Yeah, I think the longer I work with a client, the more we’re able to kind of play around with new things, see what’s happening, but like if it’s especially a newer client, where it feels like I’m coming in each week with a completely new theory. Without a lot of understanding, yeah, it feels like I’m just grasping at straws. And so I think it is important, regardless of how excited you are of an orientation, or a new new intervention that you really, how does that flow into the work that’s already happening? Is it relevant? Or is it just does it just sound like fun? I think some of the folks who read us putting a mental load on our clients will probably think this is what we were going to talk about. So I want to make sure we do talk about it. This is what we talked about all of the podcasts, I didn’t want to miss it. What I put together my little list, which is us, not having knowledge, especially cultural or specific demographic kind of information, and asking our clients to teach us, I think this across all of our clinical episodes is basically what every clinician who’s talking about a population of folks that we didn’t necessarily learn about in grad school, says is that what they get wrong, is that they make clients teach them. And they also make bad assumptions and all of that. And so then the clients, if they stay has to do the work of teaching us they have to do the work of navigating our bias, they have to determine if it’s if we’re the right therapist for them. And so I think, I don’t know that we have to go deeply into this topic, because like, probably three quarters of the episodes of our podcast, maybe that’s an exaggeration, half of the episodes of our podcast on this very thing. But I think what we’re requiring our clients to teach us about that, all that makes them them from the ground up versus coming from a place of I have some knowledge, and how does that impact your life? And tell me a little bit more about your particular perspective? I think that is an emotional load that I think is extremely harmful for us to put on the clients.

Curt Widhalm  26:56

And I think if you approach that as more likely to be harmful than not from that approach. Yeah, it’s not to say that it doesn’t work. And you know, despite all of the experience that I have in my career, that sometimes it’s even just owning my side of the street of here’s my experience with this particular presentation, this particular culture, even sharing with them from session to session. Here’s what I’ve been reading about since last time, as it pertains to this area that demonstrates a better way of handling this, as opposed to, hey, why don’t you teach me about your fill in the blank difference of culture from mine, that assumes kind of that dominant thing. So if that dead horse is not already beaten.

Katie Vernoy  27:54

But we’ll, we’ll, a link to a section of our podcast episodes that has a lot of those types of beginning beginner information that you can start with if you’ve got a client that has some differences that you don’t know much about.

Curt Widhalm  28:09

And I think that that goes into the next thing on your list here, which is identifying a lack of fit overall, yeah. With and this doesn’t have to be just immediately before the first session, but even in the first session or so appropriately, being able to say, I don’t think that I can help you. Or there’s somebody who is better at helping you or my skills, don’t line up with what you need out of therapy at this point. And then providing a warm handoff to somebody who can, that, you know, it’s hard enough for many clients to, especially first time therapy seekers find a therapist that meets many of their requirements, costs, location, specialty, this kind of stuff. And then to just kind of throw those clients back to the beginning of the process is a very difficult aspect of just where our healthcare system is. But this is part of why we build the networks that we do to say, Hey, I know somebody who might be a better fit for you on this than I am. And being able to own that in a non shaming way.

Katie Vernoy  29:27

We’ve talked about this a few times, and we have a couple of episodes on how to fire our clients ethically, if you’ve started down the path and recognize that you’re not the right therapist for them. And so being able to, you know, whether it’s identifying that you’re not a fit anymore, or they might need somebody else at this point, I think that’s our responsibility and not our clients kind of fading away. And to that point, we need to be the ones that identify the end of treatment, when it’s clinically relevant. If it’s like, Hey, I’ve got what I need. I’m going to come back later, or those types of things that can be either collaborative, or the clients choice, the client can always choose to end treatment. But if you’re recognizing it’s time to end treatment, and you don’t say it, because you don’t want to lose a client, then the client has to say it later. And that’s not fair to them.

Curt Widhalm  30:19

So all of these are extra considerations for helping your clients having good experience with your management of your practice of being able to come to therapy for the reasons that they think that they’re coming to therapy for. And, you know, I think that we’ve probably got a upcoming episode here to be recorded, but helping to talk with clients about what realistic expectations of therapy are, yeah, that if we’re really honest about it, it’s, you know, realistic expectations. If your honest list is, I’m going to be late on emailing you things, or I’m going to be chaotic and scheduling you. But we encourage you to own your stuff. If you wouldn’t feel comfortable owning that to potential clients. These are ways of being able to consider the impacts and really being able to look at your own therapeutic relationships with your therapists of what goes beyond just what’s happening in the therapy room.

Katie Vernoy  31:31

And I think there are many of these things that probably each of us, you know, I’m talking about you and me, as well as, as all of our listeners, we there’s many of these things that we’ve all done at some point. And I think part of it is being human, we get excited about a treatment and we try it before we really think through the whole clinical plan, or we’re late or we forget to get back to our client or whatever it is like I think all of us have at least a few if not all of these somewhere in our history. I’ve been a therapist for 20 years. So of course these things have come up. But I think if we can own our humaneness and set ourself up for success, we minimize these things. Yes. And I think if we don’t get overwhelmed, we don’t, you know or don’t aren’t consistently in a state of overwhelm, I think we can manage these things a lot better. I think the reasons that I came up with it, sometimes these things happen that I think are worth investigation, and maybe in another conversation about clinical orientation, or how we view ourselves in the profession. But I do feel like there is a rigidity that sometimes happen. And I’ve seen this in in some different kinds of topics. And we talked about it a little bit in some recent episodes. But when we feel like our clients need to take on this emotional load, because it’s their responsibility, or it’s part of the clinical element of things, you know, clients must do this, because it’s their thing. I just, I feel like I need to remind folks like, therapy is a weird beast, we do things in a particular way. And is there’s a culture that we’ve created around what therapy is what the relationship looks like, all of these things that our clients may not know. And so the fact that they should remember their appointment time, or they should do, they should always be the one managing their scheduling, or whatever it is, you know, like, if there’s something that they should do that if they don’t do it, then it’s clinically indicated. And I create sometimes there’s clinical communication that can happen there. But when we when we put our filter of what a good therapy client does over someone who maybe has never had therapy or has never had therapy with you, you’re putting stuff on them that I don’t think is necessarily accurate.

Curt Widhalm  33:54

So, we’d love to hear your thoughts on all of this stuff you can let us know on our social media or come join our Facebook group, the modern therapist group. And until next time, I’m Curt Widhalm with Katie Vernoy.

Katie Vernoy  34:08

Thanks again to our sponsor Simplified SEO Consulting.

Curt Widhalm  34:12

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Katie Vernoy  34:35

Visit simplified Seo consulting.com forward slash modern therapist to learn more. And if you do decide to try your hand at optimizing your own website, you can get 20% off any of their DIY SEO courses using the code modern therapist. Once again, visit simplifiedSeoconsulting.com/moderntherapist and use the code modern therapist all caps.

Announcer  35:00

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