Therapists often fear manualized treatments in psychotherapy. If the therapy process is boiled down to a script, the fear goes, the actual therapist becomes interchangeable with anyone else following the same script. Taken to its logical end, if therapy is just a set of manualized techniques, we could easily be replaced by robots.
The overwhelming majority of therapists are women. So are most clients. Men are often reluctant to attend therapy voluntarily. As we discussed in the last episode, even well-intentioned therapists and counselors can make men feel unwelcome simply by how they frame men’s presence in the room. Sometimes, changing how you work to better respond to men’s needs and expectations of therapy can make the process a lot more effective.
My first six months of seeing clients while in graduate school felt pretty crazy, though at the time I didn’t realize how crazy. When we are on a significant growth trajectory and learning curve, it’s challenging to see through the fog of all the factors involved in adjusting to becoming a therapist. It seems whenever we are in an important and difficult phase of life — potentially transformational — it’s hard to see what growth is actually occurring.
Looking back on those first six months of clinical work has taught me some valuable lessons. When I was seeing my first clients, I wish I had known how to intentionally let go of the pressure I felt to make something happen or employ technique.
Language fascinates me. As therapists, we use language to reframe situations, craft metaphors, and ultimately instill feelings of hope. We recognize how powerful this tool is, so we carefully select our words when in sessions with clients. If only we did the same outside of sessions.
I love speaking with associates, trainees, and students at various events and settings. I’ve heard about the highs and lows of the journey to licensure, the successes and struggles, the hopeful and (seemingly) hopeless situations. One of the statements that always gets to me is “I’m just a(n) ___” (student, trainee, associate).
“Just.” As in “simply,” “only,” “no more than.” Imagine how quickly you would point out the use of this word to a client, drawing their attention to the potential consequences of viewing themselves in a negative light. Unfortunately, we’re not always good at catching ourselves when we do this.
It is advised early on in our schooling to practice self-care as a means to prevent and combat burnout. Preventative self-care is usually along the lines of making sure you are staying healthy. This can mean eating right, working out, or finding something you enjoy in every day, like listening to music or reading before bed. Ideally when you are burned out, self-care would include taking a day or two off to recharge, maybe going on a weekend getaway, or getting a massage.
Realistically, for many therapists that isn’t possible. As Ben discussed here last week, far too much discussion of self-care ignores the practical and financial reality of being an early-career therapist. This recent Counseling Today cover story is a great example of talking about burnout in ways that put responsibility for it on counselors’ and therapists’ own shoulders, without mentioning several of the systemic reasons why mental health professionals early in their careers actually get burned out.
From the time you were in graduate school, your instructors and supervisors have likely emphasized the importance of self-care. Burnout is a real risk in the world of counseling and psychotherapy, and you have to be able to take care of yourself in order to avoid it.
These messages come from a good place. But they ignore reality for many therapists, especially those early in their careers. And those messages often come with dangerous assumptions and a dark undercurrent: If you’re having a hard time, it’s your own fault.
We’ve spent the last two episodes talking about student loan debt. It’s reshaping the mental health professions. Two doctoral students were kind enough to share with us their own personal stories. In this episode, we talk about the great hope for many who are in the deep end of student loan debt: Public Service Loan Forgiveness.
There is a huge gender gap in the field of psychotherapy. At least 80% of psychotherapists in the US are women. So when a man pursues therapy, unless he specifically seeks out a man, he will most likely get a woman therapist. The dynamic of a male client with a female therapist can be both beneficial and problematic to the therapy. It can spark discussion over issues the client did not realize were there until working with a woman. It can replicate his relationship with another woman in his life. It also can reveal sexist beliefs.
In our last episode, we talked about how student loan debt is crushing the mental health professions. This time, we get a lot more personal. For this episode of the Psychotherapy Notes podcast, we interviewed two graduate students working on their doctorates at a private university in southern California. By the time they both graduate, they will together owe more than half a million dollars for their education.
It’s a sea change. And we don’t just mean the cover, which finally lets go of the pathway-in-the-forest image that graced the first four editions. The fifth edition of Basics of California Law for LMFTs, LPCCs, and LCSWs, which is available now for preorder, is the biggest change since I wrote the first one.
The new edition is updated to 2018 law and professional ethics codes, and includes new material on:
- Employment Law, including wages, sick leave, termination, and more
- Family Law, including marriage, separation and divorce, custody, and more
- Supervision, including supervisors’ legal responsibilities
- Some of the biggest current controversies in state law for psychotherapists