0:00

0:42:47

Why Therapists Stop Working with Kids and What It Takes to Stay: Sustainability, Boundaries, and Pivots for the Long Haul

Apple Podcasts Stitcher Spotify Subscribe on Android Download Leave a Review Keep me updated!

Why Therapists Stop Working with Kids and What It Takes to Stay: Sustainability, Boundaries, and Pivots for the Long Haul

Curt Widhalm, LMFT, and Katie Vernoy, LMFT push back on the idea that working with kids is the “starter home” of private practice – a place clinicians put in time before they earn a cardigan and start having existential conversations with adults. Working with kids is not entry-level work. It is some of the most clinically and physically demanding work in the field, and it has a sustainability problem that rarely gets named honestly.

In this episode, Curt and Katie examine why so many therapists who work with kids hit a wall around the five-year mark, and why that wall is rarely about clinical depth. They unpack the sensory toll, the parent communication load, the school and provider coordination, the cost of running a play therapy room, and the way a child caseload can quietly distort a clinician’s sense of what is developmentally typical. They also talk about how to build a long-haul career working with kids without becoming, in Curt’s words, “a cynical, glitter-covered shell of a human being.”

This is a conversation for therapists who work with kids, teens, or families in private practice, supervisors of clinicians who do, and anyone weighing whether to keep working with kids, scale back, or pivot.

Transcript

Click here to scroll to the podcast transcript.

(Show notes provided in collaboration with Otter.ai and Claude AI.)

In this Podcast Episode: Why Working with Kids and Teens Becomes Hard to Sustain

Curt and Katie discuss why the work tends to have a “shelf life” for many therapists, and why that pattern is usually less about clinical fatigue than about the structure of the work itself. A 45- to 55-minute session is one slice of a child’s week. The other 167 hours are shaped by parents, siblings, schools, coaches, screens, and culture, and therapists are often expected to “fix the kid” inside that one slice while absorbing the costs of the other 167 hours. The conversation moves through what makes the work depleting, what therapists can adjust without leaving it entirely, and what a real pivot looks like when one is needed.

Key Takeaways for Therapists Working with Kids, Teens, and Families

“Even if I’m the world’s greatest child therapist, in those situations, there is 167 other hours out of the week where these kids are, that spongy brain that is just absorbing everything else, and my wonderful 45, 50 minutes is not enough time to do the reparenting and do the work that is maybe being done by all of the other systems around them.” — Curt Widhalm, LMFT

Working with kids is not a lesser specialty. The field’s stereotype that “real therapists” work with adults is wrong, and it puts a tax on clinicians who do some of the most complex work in the profession.
Working with kids is family work, by another name. A child returns to a system that will shape the work far more than any single session can. Treating the child without working with the system around the child often makes the work harder, not easier.
The sensory and physical load is real. Floor work, noise, dysregulation, sand, mess, and the occasional hit or scratch all compound. So does going home from that to children of one’s own.
Parents contact therapists who work with their kids more than adult clients contact their own therapists. Without explicit policies, between-session communication can quietly become a second unpaid job.
The “village” multiplies the work. School counselors, IEP teams, psychiatrists, occupational therapists, learning specialists, and coaches all want a piece of the clinician’s time, and that time often is not built into the fee structure.
The play therapy room is an ongoing expense. Toys break, get lost, go out of style. Maintaining a room that meets current kids where they are is a real cost, financially and in time.
A clinical caseload can warp the clinician’s sense of normal. When most of the eight-year-olds in a clinician’s week function like three-year-olds or like forty-five-year-olds, “typical eight-year-old” stops being a working reference point.
Unrealistic expectations create moral injury, not just burnout. When parents, schools, and the broader system expect the therapist to “fix the kid” while the system around the child works against the change, what the therapist absorbs is not only fatigue. It is the moral weight of being asked to do what cannot be done in 50 minutes a week.
Pivoting toward adult work, parent work, or family work can be a healthy career move, not a failure. It only becomes a problem when the pivot is used to escape systemic issues that will follow the clinician into the next setting.

“If the expectations of what can happen in therapy, what’s normal development, what’s the responsibility of the family, versus a fix-my-kid treatment; if those expectations are not really clear, therapists feel the weight of that. It is my job to fix this system. It’s my job to fix this kid. And that is completely unrealistic and very draining.” — Katie Vernoy, LMFT

From Working with Kids to Working with Families: A Sustainable Reframe

One of Curt’s central pivots in his own practice has been moving away from working solely with kids and toward working with the whole family system. The reasoning is structural rather than philosophical. A child spends roughly 167 hours a week outside the therapy room. The therapist’s window of influence is small. Bringing parents into the work, not as a five-minute handoff at the end of session but as active participants in regular consultations and family sessions, extends the work beyond the office.

Katie describes a related shift in her own practice toward direct parent work. When parents have what they need to parent in a way that feels good to them, many of the kids referred for therapy, particularly in the worried-well range, do not need their own therapy at all. Working at the parent layer can be a way to use the clinical knowledge built up over years of working with kids without taking on the full sensory and emotional load of doing only kid sessions.

Either path is a legitimate use of the expertise built up over years of working with kids.

Structuring a Caseload That Does Not Eat the Therapist Alive

Curt and Katie discuss several structural moves that make working with kids more sustainable over time:

Diversify the caseload. Pairing kid or teen work with adult trauma work, parent consultations, family therapy, or another niche gives the clinician different clinical muscles to flex across the day.
Group similar sessions. Stacking high-energy kid sessions back-to-back can reduce the cognitive cost of constant pivoting, as long as it is not the entire day.
Use a separate space when possible. A dedicated playroom and a separate adult office, when the practice can support it, helps the clinician’s nervous system reset between session types.
Schedule parent consultation as its own session. Curt and Katie reference an earlier conversation Megan Costello had on the show on this point: putting parent work on the calendar as a real session, not as a tail end.
Price the work to include the work outside the room. IEP input, school calls, and ongoing parent communication are part of the service. Fee structures that pretend otherwise quietly subsidize the unpaid hours.
Set explicit communication policies. Crisis vs. non-crisis contact, between-session expectations, and what gets handled in session vs. on a call all need to be named up front, ideally with parents present.

When a Pivot Is Healthy, and When It Is Avoidance

Both hosts are clear that moving from kid work to adult work, or to family or parent work, can be a legitimate and even strategic career decision. Knees give out. Sensory tolerances change. Life circumstances shift. None of that means the clinician failed the work.

What they push back on is using a pivot to escape systemic problems – parent communication overload, unclear expectations, fee structures that ignore unpaid hours, schools that treat the therapist as a free coordinator – that will simply follow the clinician into the next setting. The cardigan and wing-back chair will not save anyone whose underlying boundary structure is the problem.

A healthy pivot adjusts what the clinician does. It does not paper over what the clinician has not yet built.

Resources on Working with Kids, Play Therapy, and Sustainable Practice

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!

Association for Play Therapy
PCIT International
The Fifty-Minute Hour, consultation services with Curt or Katie

Relevant Episodes of MTSG Podcast

Meet the Hosts: Curt Widhalm & Katie Vernoy

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

Katie 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.

Join the Modern Therapist Community:

Linktree

Patreon | Buy Me A Coffee

Podcast Homepage | Therapy Reimagined Homepage

Consultation services with Curt Widhalm or Katie Vernoy:

The Fifty-Minute Hour

Connect with the Modern Therapist Community:

Our Facebook Group – The Modern Therapists Group

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/

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

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements)

… 0:00
(Opening Advertisement)

Announcer 0:00
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 0:13
Welcome back, modern therapists. This is the Modern Therapist’s Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast about what we do in our work, the ways that we go about things, sometimes a reflection on trends in the profession, or things that we hear from our colleagues. And today, we’re dismantling the myth that working with kids is just the starter home of private practice, the place where you do time in the sand tray until you’re mature enough to graduate to your cardigan and wing back chair and talking with adults about existentialism. So this episode kind of comes off of some comments about, is there a shelf life of working with kids, and is that something that can lead to premature burnout? After nearly 20 years of being in practice, going back to my pre license days, I’ve realized that hitting the five year wall isn’t usually about a lack of clinical depth, that there’s a whole host of issues that might contribute to this kind of a burnout. I’ve personally traded going from puppets to largely working with a lot of adolescent eye rolls. Partially because my knees can’t do the floor sitting anymore. Partially because if I play one more game of Candy Land, which requires no skill whatsoever, it is entirely the luck of the draw, and I have no resentment about it whatsoever. It’s not just a clean exit. This is maybe about pivoting, maybe about dealing with burnout, and how you can actually build a long haul career with kids, with youth, without becoming a cynical, glitter covered shell of a human being. So Katie, you haven’t actively waded into a playroom in what 15 or so years. When you look back at working with littles, however you define that, do you remember it as a legit clinical specialty, or does it just feel like a fever dream of something that you’ve woken up from as you start doing air quotes, real therapy with real adults.

Katie Vernoy 2:27
You’re talking about the stereotype of there’s real therapists working with adults and kid therapists are somehow both prized because we need to have you to refer to and also belittled, because somehow your clinical expertise is not as sufficient.

Curt Widhalm 2:47
I am absolutely leaning into that, and I want to point out I don’t subscribe to that, but I feel that that is one of the pressures that we have in the field.

Katie Vernoy 2:57
Yes, and I I would respond to that; I do not agree with that either, and I have sensed that from our colleagues, and so I want to tell our colleagues, stop it, and then also respond to your question. So working with kids, and we can define kids in a lot of ways, we had a wonderful episode with Bryana Kappadakunnel on working with very little littles. There’s, you know, Ofra Obejas, who came in and talked about play therapy, but then also talked about this shelf life idea. And you know, we’re going to have some teen episodes, or we’ve had some team episodes that are kind of around this. So we have a lot that we’ve talked about here and that we’re going to continue to talk about, and the more that I have been involved in it, and then now stepped away from it, the more it feels like working with littles, kids, teens, requires more skill and more fortitude than working with adults, especially the worried well. So I want to acknowledge and really say thank you Curt for continuing to do this work, because I was not comfortable doing some of that work on my own in private practice, and I had burned out on it. And there’s other reasons too, so I won’t go into all of that, but I had burned out on working with kids, because I did work with kids for a long time, and then I supervised people working with kids, and then I supervised supervisors of people who were working with kids. And it takes a lot. We can go through a lot of the issues. But I want to start with one of the pieces I think that was most relevant for me in moving away from working with kids when I was in private practice, and this is the parents that would have very strong opinions, would complain, the parents who are handing off the kids, saying, fix my kid. All of the additional work that went into interacting with the school or the psychiatrist or the educational psychologist, or whatever it is, it felt like so much, and so much of it felt out of my control, that sitting in my cardigan, in the wing back chair talking about existentialism was very appealing. And so you said something before we started, and you kind of mentioned it before you know in the intro here that I’d love for you to really focus in on which is, I stopped working with kids. I stopped started working with families. Can you talk about that transition and how you came to it? Because I think it’s a very smart transition. And in fact, was how I worked when I was back in the million years ago, when I was working with kids and families too.

Curt Widhalm 5:40
By and large, sessions are 45, 50, 55 minutes. And if I’m even the world’s greatest child therapist, which I am not, I’m not making that claim. And I know a couple of you out there like but Curt, no, I’m not. So

Katie Vernoy 5:57
I love the humility.

Curt Widhalm 6:02
Even if I’m the world’s greatest child therapist, in those situations, there is 167 other hours out of the week where these kids are that that spongy brain that is just absorbing everything else, and my wonderful 45, 50 minutes is not enough time to do the re-parenting and do the work that is maybe being done by all of the other systems around them, parents, siblings, schools…

Katie Vernoy 6:35
Coaches.

Curt Widhalm 6:36
Coaches, screens, Bluey and Caillou. You know, both ends of that spectrum. It really struck me as I felt ineffective of what I was being asked to do. You know, the referral question, what are we trying to work on? What are what’s our justification for therapy here? And then giving these kids back to their parents with no real transition as far as, here’s how you do things at home. And when I started really embracing more of that very question, please take what I’m doing and do it more at home, and then, rather than just having that be here’s five minutes at the end of session, I started bringing parents into, not only consultations more regularly, but also just into the therapy room more regularly. And then I started having parents do the work alongside me. And then I thought, you know, really what I’m just doing is family therapy here, and some of it might be PCIT. Now I want you to do this or respond in this way to your child, and sometimes it was more just having them be able to see how I was interacting with your children, to be able to get them to open up more. So I largely made the decision that I am not going to work solely with children. I am not a child therapist. That is this is entirely the child space. Everything is just about the child. Here, I do maintain confidentiality when I am working with kids in that one on one space. But to me, as a marriage and family therapist, working with children is working with the family. I give them back. They go home with their parents. They spend the rest of their lives in that kind of environmental space. That’s where my mindset and my intention is.

Katie Vernoy 8:35
And to be honest, I’ve moved from working with kids and families to working with parents. It’s not the only piece of what I do, and sometimes it’s only augmenting the work that the adult wants to work on. But much like what Brianna was talking about, what Mercedes Samudio has talked about on the podcast as well, if the parents have what they need and can do parenting in a way that feels good to them, and they’re able to work through the stuff that was theirs. They’re able to parent better. And oftentimes, a lot of the kids, and this is more the worried well of the kids realm, a lot of the kids, if their parents were able to parent them better, don’t need therapy themselves. And so being able to balance that, I think, is one another thing that can happen, which is, I’m not doing 20, 25 play sessions and parent meetings. I’m doing some families, I’m doing some kid or teen sessions, and I’m also doing these parent sessions, I think that’s a way to balance what’s happening. So maybe your knees have a rest from getting up and down for play therapy, or your frustration tolerance can can withstand a few more eye rolls. I think doing some parenting work, just direct parenting work, not even with the kid present, can also be a way to use this knowledge and skill set without kind of falling prey to that shelf life.

… 10:08
(Advertisement Break)

Curt Widhalm 10:10
The next thing on my list that I really noticed in myself and part of this also was kind of in lockstep, when my own children at home became kind of of the same age of some of the younger kids I was working with, and it was really dealing with the sensory toll of what working with kids really does. So there’s the constant high octane emotional dysregulation that can end up happening. There is the constant noise, and I partially apologize to some of my former suitemates over the years, as far as the ruckus that comes from having children, but also you should have known what you were doing when you signed up in having a sweet mate who’s a child therapist.

Katie Vernoy 11:03
Sure.

Curt Widhalm 11:04
But you know the needing to clean up 62 nerf darts from behind the couch and behind the bookcase at the end of sessions, the mess of the sand tray that you know the Star Wars meme from 24 years ago, about I don’t like sand. It’s coarse and it’s rough and irritating, and it gets everywhere. That, on one hand, I love that I get to work with kids who get references even from 24 years ago, but the constant sensory toll started requiring more and more of a counterbalance in my life, and especially when I would go home to kids the same age, not only was there the developmental and the clinical content, that was a hard shift for me to do at that time, but it didn’t feel like I got the sensory downtime from being in this space all together.

Katie Vernoy 12:01
And I’ve experienced this myself when I was working with kids a million years ago, and then also in a recent conversation with a child therapist, there’s the getting hit, or even the hugs or the physical elements of this, not just the getting up and down off the floor, but the physical elements of working with kids. There’s a lot more physical boundaries that are crossed, including getting injured by some of the kids, and potentially on purpose or not on purpose, and it might be very relevant clinical material, but if you’re getting hit by a client, that can be, that can take a toll after a while.

Curt Widhalm 12:38
Yes.

Katie Vernoy 12:40
So what do we do about that? Because that’s, that’s the big one is the sensory, the sensory stuff and the physical stuff. I can’t do that anymore. So how do you navigate that? It sounds like part of it is your caseload management. But how do you manage it? Or how do you help your supervisees manage it?

Curt Widhalm 12:58
Some of it is being able to be selective about the cases to the best of your ability that you take on and some of the burnout that I hear from people who maybe have too many kids on their caseload at a given time is that the alliance is different in working with kids than it is with even teens. Teens, it’s less about what is going on in play and what is being taught through the play, and it’s more about the relatability. It becomes just kind of a pivot that is something to strategically move into an out of. For people who listen to the podcast and know a lot more about my practice, I also do a lot of trauma work, and a lot of trauma work, not only with kids, but with adults. And part of that is being able to flex some different clinical muscles. It helps to balance out my day and not have the threat of, you know, being bitten or being punched by some of my adult clients, that…

Katie Vernoy 14:10
I would hope not.

Curt Widhalm 14:13
But I’m also kind of lumping my schedule together as best as I can, to where some of the more ruckus type clients are back to back, so I’m not making the pivot back and forth. But that’s also not the only types of clients that I’m seeing day in and day out, and so having a couple of different niches and ones that don’t necessarily seem like they go together does help me to not just be in the same physical and sensory exhaustion all the time. It took me 15 years into my career to get really good training and good experience with a couple of these different populations and marketing both is a nightmare, but, but it is something where the day to day aspects of it helps me to have my adult office and my playroom office too. That helps to kind of even keep the space somewhat different as far as the overall just environment that I’m sitting in all day.

Katie Vernoy 15:19
That strategic element of caseload planning and even niche planning and all of that, I think it’s really, really good. It pairs with the next thing that I have on my list, which is the boundaries and systems. And I feel like when we when we’re trying to put together a practice, many therapists start with, how do I take care of my clients? It’s about the client comes first. A lot of self sacrificing, all the sacrificial helping I’ve talked about in the past, and doing what you described right there. I have, you know, these different things, and I put people in place, in different in different places, so that I have sensory overload for a couple of hours, and then I shift, and then I have my my cardigan, existentialist conversations. That is self focused in a good way, and not necessarily something that a lot of therapists think about, especially if they’re deciding I want to work with kids. I’m going to be there. I’m going to put all the kids on my caseload. I’m going to be responsive to the parents. I’m, you know, it’s I’m available, 24/7, and that boundary setting, obviously, that’s no boundary setting. But being able to set boundaries around how you help kids and families is really tough, because adults may be hesitant to call their therapist about their own stuff. You know, it’s kind of 50-50, you know, some of the really dysregulated adult clients will call me periodically, but I don’t have a lot of clients calling me after hours. I don’t have a DBT coaching call practice. I do have clients that ask for extra sessions, but it’s minimal. I’ll have a client come in to session the next week and they’ll tell me all this stuff, and I’ll be like, Why did you not call me? But adults will call therapists about their kids, and they will figure out, you know, the best way to make sure this therapist is going to call back, they’re going to see this as I must do this for my kid. And so setting the after hours, on the weekends, in between session boundaries is really important and making sure that you have very specific things that you respond to and not respond to. And this is I’m going to again cite this with something that you had mentioned that resonated with me before we hit record, but having very clear parameters on how to take care of parents so that they’re active in the treatment in the family, the family systems work that maybe you’re doing, and also that you don’t become their de facto crisis manager, slash even admin call the insurance company, or when is my appointment, or whatever it is. And so when I was working in community mental health, a lot of that work had to happen up front, even though we were a 24/7 crisis team. These are the types of things you call about. This is this is the type of response you can expect. And these are the things that have to wait until the next session. And if you’re frequently calling in between session, we’re going to up the number of sessions, and one of them is going to be with you, mom or dad or other caregiver. And so it’s it’s structuring it so it actually feels sustainable, versus feeling that you’re constantly on.

Curt Widhalm 18:53
Want to hear something funny?

Katie Vernoy 18:56
I do.

Curt Widhalm 18:58
Since we have hit record on this episode, I have five notifications from parents about things going on with their kids.

Katie Vernoy 19:06
Oh, my goodness. Absolutely, right?

Curt Widhalm 19:09
Right.

Katie Vernoy 19:09
I have zero notifications from any of my adult clients. So just to compare.

Curt Widhalm 19:16
Just to compare.

Katie Vernoy 19:17
Yes.

… 19:18
(Advertisement Break)

Curt Widhalm 19:19
Now there’s a couple of different pieces in this, and I’m going to take this out from kind of the highest level, and then get down to some of the specifics of the questions, and then the high likelihood of my excitement, where I will forget something. Please circle back to anything that I have not responded to.

Katie Vernoy 19:38
Will do. I’m on it. I will organize your thoughts for you, Curt.

Curt Widhalm 19:43
So working in the youth space for as long as I have, there has been some massive shifts just in all of the ways that we conceptualize working about kids, and some of this involves a lot of air quotes, unpaid time outside of session that requires responsiveness. Not only is there the parent calls that we’re speaking about here, but there’s a lot more dealing with school districts and IEPs. There’s when there’s a village to raise a child. Not only is it case consultations with the psychiatrists, which happens a lot with the adult clients that we have too, but there’s also potentially a school counselor, and in some cases, also a school social worker, and there might be a learning specialist or an occupational therapist that it would be great if we could all just have one meeting for 15 minutes together and say, here’s the updates. But instead, it becomes those people…

Katie Vernoy 20:48
27 phone calls.

Curt Widhalm 20:50
Yeah, 27 phone calls, or it becomes six people on an email chain, and the one person that we need responses to who’s putting out all of the fires on their end. So there’s a lot of extra just time and cognitive task shift that needs to happen between I’m seeing the child and, you know, the child might be doing play therapy with me, or doing something that doesn’t necessarily deal with all of the bureaucracy, and in our quest to deliver better mental health to people, there’s more and more of these layers that get added on. And if you could work with an adult instead, it’s one one session, and hopefully contained within that one session, or by comparison, it’s just a lot more work.

Katie Vernoy 21:46
Yeah.

Curt Widhalm 21:47
So some of the things that I do in my practice, that you’re talking about is, if there are parent consult things that need to happen, those are scheduled for parent consults sessions, and sometimes that might be just a regular, hey, it’s once a month, and we’re checking in with parents outside of the kids sessions. And Megan Costello talked about that and episode years ago. And some of this is also if you’re especially if you’re in private practice and private pay, charging enough money for the sessions so that way you’re at least kind of mentally trading off. Okay, this is what the session fee is. But that also includes my responsiveness for being able to book time to input for an IEP or book time in for a 10 minute phone call per week with the client’s parents. So that way things are all part of, you know, kind of a package in delivery, rather than it being here is my charge for this 50 minute session.

Katie Vernoy 22:56
Yeah, and I want to acknowledge that we’ve framed this as a private practice focused session. How do you remain a kid therapist in private practice? And I want to acknowledge that for folks in agency work, some of that is understanding how to bill effectively, to meet productivity, how to set up the work there, there’s there’s stuff that you can do in community mental health that either aligns or is very different. But if there is interest, jump into the Modern Therapist’s group and tell us, how do you sustain an agency work? And we will do another episode. So just I wanted to acknowledge that we’re really talking about being able to continue to see kids in private practice.

Curt Widhalm 23:43
One of the other things that I want to talk about is the play therapy industrial complex.

Katie Vernoy 23:50
You are not the first person that has said some interesting things about the play therapy industrial complex.

Curt Widhalm 23:58
So registered play therapy is a thing. It is a really incredible in depth process that is a fantastic education on how to do registered play therapy TM with kids, and I’m very specific about this, and I do say it with all respect for registered play therapy and whether you go through a very rigorous training for certification or not. Personally, I have not but have lots of respect for it. It’s expensive. It is, just like any other certification, very expensive and potentially very time consuming, it’s an intentional choice that you have to make. But whether you go with that credential or you just have play therapy in general, and the non TM, the underground play therapy.

Katie Vernoy 25:00
Underground play therapy. All right, all right.

Curt Widhalm 25:04
It’s expensive. It is constantly buying toys that you have bought before. It is fixing broken things. How many copies of UNO do I have? Probably eight or nine. The game is Uno. There should only be one. But it’s something that takes up a lot of space. I’ve grown up and I’ve got an office suite now where we have a dedicated play therapy room, and it’s wonderful to be able to work with my adult clients in a room where there is not a stack of board games and sensory toys that is just kind of sitting next to them that serves as Wait, are you taking me seriously because the Ninja Turtles are looking over at us? But there can be an incredibly high expense to keep the room stocked with a lot of stuff that is going to help maintain what is in vogue that, you know, I know that there’s a lot of emphasis to have a lot of neutral play therapy toys and stuff. And yes, that should happen. But there is also what was cool 15 years ago, when I first started building out my toy chest is not the same kinds of toys that kids today are wanting to play with. They’re playing with them in the same way, but just the zeitgeist of the larger universe requires updating things, otherwise you become maybe not the stuffy old person therapist, but the therapist who doesn’t have anything that is new and kind of garners attention. So there’s a potential to spend a lot more money than what you might be doing if you have a practice that focuses just on older people.

Katie Vernoy 26:55
It’s interesting, because the thing that came to mind when you were talking about that is the necessity to understand and keep up with the generational differences. I mean, there’s all the jokes about the different language for Gen Alpha or Gen Z, and I think that is another piece. I’m eight years older than you and have and don’t have kids. There’s no place for me to start learning organically about these things. I would have to do the research. I would have to pay attention to a different, a whole different segment of the population. Whereas with my clients, there’s generational differences within my client caseload, and they are less different than what I experience anyway, of being between a an adult and a Gen Alpha person. And so I think there’s, there’s a lot to be able to pay attention to, and it’s the financial and it’s also the time commitment of figuring this stuff out.

Curt Widhalm 27:59
Well on that point, it’s also expanding beyond what you would normally consume, as far as media for an adult, but also getting into at least knowing what some of the Tiktok trends are.

Katie Vernoy 28:12
Yeah.

Curt Widhalm 28:13
Not because you need to do them, but because being able to at least partially immerse yourself into the world of the children that you’re working with is a way to relate to them. But even that has a double edged sword, because there’s a really fine line between being a relatable child or teen therapist and having the unresolved needs to be liked by a 13 year old.

Katie Vernoy 28:44
Oh, I felt that mostly with nieces and nephews, but yeah, I felt that.

Curt Widhalm 28:49
So sometimes being able to sustain the work is, on one hand, not necessarily fixing kids, but being able to show them that they can have a healthy relationship with at least one adult. The other side of that is if your whole identity relies around being the one adult who gets it, you might be unintentionally triangulating yourself into other problems in the kid’s life. And this is something that does take some step back, some reflection on the ways that you practice, but it’s really kind of something that helps you to work with the clinical narrative, and to be able to really operate in a way that helps. I started my practice when I was 26 and in some ways, some of the communications that I gave to teens did fall into a little bit of, hey, I’m the adult who gets it. I just went through that phase of life. Your parents are old. Now that I am in an age where I was, I’m now around a lot of the kids that I work with their parents ages. I don’t necessarily describe it in the same way, but I describe it to them as I still hang out with a lot of teens. I have an adult’s perspective on stuff, but I do hang out with enough teens that I’m really more of a recycled teenager than I am somebody who’s just trying to get it.

… 31:06
(Advertisement Break)

Katie Vernoy 30:17
One of the things that you said before we hit record that I thought was very interesting, and I’d love to talk about it before we run out of time, is this element of you spending all this time with kids and teens in sessions and potentially losing grounding with traditional or appropriate development. And so talk about that a little bit, because it feels like I’ve had the same experience when I’ve gone through periods of time of having a lot of women survivors of sexual trauma, and I have I lose trust for men very quickly, for a couple of weeks, and then I am able to re ground myself in my own reality, but being with kids that have big emotions and all that stuff for a very big portion of your day, I would imagine, has a similar impact.

Curt Widhalm 31:12
When you work with kids, your perception of child development can become really warped, and especially in the intimate way that we work in therapy, we might see kids who have a lot of delays as far as emotional development, but on the other end, kids who have been abused who have developed this really developed sense of how the world works as a trauma response, and so

Katie Vernoy 31:48
For adulthood, almost.

Curt Widhalm 31:50
Right. And so you can, I’m just going to pick an age here. You can pick three eight year olds, and one is going to be kind of the typically developing Oh, this is how most eight year olds are. But if more of your experience is operating with the eight year old who operates as a three year old or the eight year old who operates as a 45 year old, you spend a lot of time with more of the latter two in this example.

Katie Vernoy 32:21
Yeah.

Curt Widhalm 32:22
And so there have been times where I work with a lot of kids, and especially as I have shifted my practice largely to working with more teens. And as my kids reach adolescence, and then they start bringing their friends over, and I start to see them all interacting, and I even still catch myself from time to time saying, oh, that’s normal adolescence, right there. It does take having a reality check to stay grounded in what is appropriate and not discounting concerns or discounting parent concerns or teacher concerns, because most of your experience is with a clinical population rather than a general population.

Katie Vernoy 33:09
Yeah, that’s a really important point. It speaks to the last point I want to make, which is about expectations, both for yourself and for the families that you’re working with. Part of how kids develop and get through a lot of different things, it takes time. Some of it requires intervention, and some of it takes time, and parents, caregivers, even clinicians, are wanting fast results, because kids in pain. Kids having a hard time. Kids being irritatingly in pain is hard. It’s hard to see, it’s hard to look at. And I think if the expectations of what can happen in therapy, what’s normal development, what’s the responsibility of the family, versus a fix my kid treatment. I think if those expectations are not really clear, therapists feel the weight of that. It is my job to fix this system. It’s my job to fix this kid, and that is completely unrealistic and very draining. You end up with compassion fatigue and burnout, most likely, but also the moral injury of I’ve got this kiddo, the parents want me to fix them, and the system, whether it’s the parents, the caregivers, the school, the world at large, is against the work that we’re trying to do and so and you made that point earlier, but just leaning into setting reasonable expectations and then revisiting the issue of end boundaries so that you can do the work that you can without diminishing yourself in the work that you cannot do.

Curt Widhalm 35:01
And, you know, call back to something that we talked about at the beginning of the episode, is shifting to adult work is if it’s a pivot for survival, it’s a pivot for survival, but…

Katie Vernoy 35:15
And that’s fine.

Curt Widhalm 35:16
It shouldn’t be an escape from these systemic issues that happen around kids. This is really around having good boundaries and following them.

Katie Vernoy 35:29
Yeah.

Curt Widhalm 35:30
And just because you want, finally, a client who will sit there and talk with you for 45 minutes, rather than bouncing up and down off of the couch and talking about anything else other than what you’re supposed to be talking about in that session. That’s part of the clinical presentation. And as I’ve been exposed to more different specialties and seeing populations, every population has their own special quirks, and with kids, it really is being able to embrace some of it is really going to be non linear. And this doesn’t have to be, you know, just another glitter project that you find stuck to yourself for days afterwards that like, Why is this still on me? This can be a population that you can work with and can work with successfully for years, and some of the things that we can do as professionals in the field is not have the condescending tone about people who work with kids because, oh, you just That’s cute. You’re a child therapist. It is incredibly important work, and it doesn’t mean that just because we’re not having these great existential discussions with four year olds doesn’t necessarily mean that it’s not important. So you can find our show notes over at mtsgpodcast.com. Follow us on our social media. Join our Facebook group Modern Therapists Group to continue on with this and other conversations, and until next time, I am Curt Widhalm with Katie Vernoy.

… 37:13
(Advertisement Break)

Announcer 37:14
Thank you for listening to the Modern Therapist’s Survival Guide. Learn more about who we are and what we do at mtsgpodcast.com. You can also join us on Facebook and Twitter, and please don’t forget to subscribe so you don’t miss any of our episodes.