10 years of blogging: Jeff’s favorite posts

Nicole de Khors / Burst / Used under licenseI can hardly believe that Psychotherapy Notes has been around now for a decade! For 10 years, we’ve challenged you (and ourselves) to think differently, reconsider professional boundaries, and actively work to improve the field of psychotherapy. Since long before I started here, Psychotherapy Notes has had a positive impact on my professional career and the way that I interact with both clients and colleagues.

I want to start my list of favorite Psychotherapy Notes posts by highlighting some of those that were also covered by Ben and Emma. First is “Why we’re launching #PostThePay,” which advocates for employers to post the salary or salary-range for perspective jobs. The #PostThePay campaign continues to have a significant positive impact on employment postings on social media. That launch post serves as a useful reminder of how easy it can be to create meaningful change in our field.

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The TV therapists who do the job well

Petr Kratochvil / PublicDomainPictures.net / Licensed under Creative Commons ZeroAt the risk of being exposed for the nerd I am, I’ve been closely following the TV show The Flash. It tells the story of the superhero dubbed “The fastest man alive.” When I sat down to watch a recent episode, I read the description before starting. That description noted that the main character was going to be attending a therapy session with his wife. I immediately became skeptical. Most movie and TV therapists act unprofessionally, unethically, or some combination of the two (for example, the therapist in 13 Reasons Why).

I didn’t know whether to continue watching, for fear that a bad therapist would ruin the entire show. I recognize the irrationality in that thought, but I’m proud of my education and my profession. I have a hard time supporting those who portray it poorly.

I decided to stick it out and give the show a chance, and I am glad that I did.

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Boundaries, apps, and dispensaries: Seeing clients in public

Brodie Vissers / Burst / Used under licenseAs mental health clinicians, we all know the importance of setting and maintaining boundaries with clients. We have several posts on this blog about setting boundaries online, specifically in regards to social media use (1 2 3). One boundary that we have not discussed is how to manage situations when you see a client outside of the regular therapy setting.

Therapists generally agree that we do not to approach clients outside of therapy, out of respect for the client’s confidentiality. If someone else knows that you are a therapist, they may make the connection that the person you are interacting with is a client. If a client approaches the therapist first, however, engaging is often considered appropriate. Even so, many therapists agree that it is difficult to maintain professional boundaries while also engaging clients socially.

Legal and technological changes are further complicating the potentially uncomfortable situations where we might encounter clients outside of the office. More specifically, we may see clients in settings that were not previously socially acceptable or accessible. Therapists today are at risk of seeing clients on dating apps, at meet-up groups, and at marijuana dispensaries. The potential for seeing clients in social situations has always been present, but there is added risk that those interactions will reveal private details about your personal life.

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Getting (and giving) better answers to legal questions on Facebook

Matthew Henry / Burst / Licensed under Creative Commons ZeroFacebook is a great resource for gathering information. Often, and for the right reasons, we turn to social media in hopes of gathering information we need in a short period of time and with little effort. But for therapists going to social media with legal questions, that convenience may not be worth it. Many of the answers therapists give peers for legal questions on Facebook are incorrect.

We reviewed 20 recent posts that included legal questions in therapist groups on Facebook. We looked strictly at legal questions where there was a clear correct answer that we could easily reference. So anything requiring interpretation of law was purposefully left out. Our review was by no means comprehensive — it falls more closely in bar-napkin-math territory. But we still think this quick review offers some valuable information.

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AA should not be the frontline referral for every client with alcohol issues

12-stepA couple of weeks ago, we took a quote about alcohol treatment (AA, specifically) from Saving Psychotherapy and put it in an Instagram and Facebook post. It didn’t go well!

You can see our post there to the right. That was the image we shared. Here’s a sampling of how people responded:

  • I find this to be a dangerous overgeneralization.
  • Be careful with this. Lives are at stake.
  • This is just wrong!!
  • Dangerous, irresponsible statement!

Not only do we stand by the quote, the finding itself isn’t especially controversial in the world of research on treatment for substance use disorders. It’s mostly controversial among professionals who don’t want it to be true.

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Even when marijuana is legal, therapists who use it face risks

foggy leavesWe have all heard it before. The classic argument. “If you can go home and have a glass of wine or a beer after work, why can’t I smoke a joint? Why can’t I have an edible?” We tend to roll our eyes when we hear this from clients who may be minimizing their marijuana use or its effects. But what do you do when you hear that argument from your colleague, or from a supervisee?

Many therapists have been discussing the impact of marijuana use with clients for years, but have only recently begun to question using themselves. With the increasing number of states legalizing medical and recreational marijuana, therapists now must consider the impact that using marijuana can have on themselves and therapy. While the legalization of marijuana does not appear to lead to increased use, those therapists and counselors who have been using marijuana all along may now be able to be more open in discussing it.

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