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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“At least it’s not cancer.”

Courtesy Emma JaegleI was working in a residential treatment center for teens. It was a typical mid-week day, and I was supervising “school time,” a period where clients are able to work on their treatment assignments and homework from their schools back home. Often during this hour, the primary therapists would pull the clients for individual sessions. I happened to know that today was the day that Nicole* was going to be given her diagnosis of depression, and I was prepared to help her process her emotions should she need coaching after her return from session. Sure enough, Nicole returned from her therapist’s office with a solemn look on her face. When she sat down away from her peers, I walked over to her and asked, “How did it go?”

She let out a sigh, “Well, I found out my diagnosis.”

I nodded. “I see. What’s that like for you?”

“I guess it’s better to know what’s going on and have an explanation for everything. At least it’s not like I have cancer!”

That comment gave me pause. I thought: But I have cancer.

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Talkspace forces therapists to break rules. The rules may be the problem.

Matthew Henry / Burst / Licensed under Creative Commons ZeroApp-based therapy platforms may well represent the next evolution of psychotherapy practice. I praised Talkspace a few years ago for offering access to mental health care for many who otherwise would never find their way to a therapist’s office. But the platforms — Talkspace, Betterhelp, and the like — have run into controversy over their confidentiality policies. Therapists using these apps may have little to no ready access to the client’s full name, address, or other information necessary in an emergency.

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