“Shame” is now a verb in therapist circles. It’s usually one we use pejoratively. We scold others for shaming, apparently with no sense of irony. We shame people for shaming other people.
As a noun, shame refers to a sense of sadness and embarrassment upon recognizing (or being told) that you’ve done something wrong. Cultures around the world understand the concept. We can safely say that experiencing shame is part of being human.
If you’re a counselor or therapist, there’s a good chance you’ve had at least one client ask you for a letter that would designate their pet as an Emotional Support Animal (ESA). There’s also a good chance they didn’t really need it.
ESAs are allowed in airplane cabins and in housing situations that otherwise do not allow pets or charge extra fees. Beyond that, very few standards govern what an ESA is or does. ESAs are not service animals and do not need any training or certification. All someone needs to have their pet be an ESA is a letter from a qualified therapist. But there’s no law or standard to help a therapist determine whether to write that letter.
I’ll never forget the speech given to me at my graduate school orientation as I was starting the journey to become a marriage and family therapist. “Get ready to say goodbye to your full-time job, goodbye to your social life, and goodbye to your boyfriend or girlfriend.” I was taken aback by the last part. Would grad school end my relationship? Turns out, yup!
It sometimes seems like labor abuses are a rite of passage for prelicensed therapists. Recent graduates are often appalled by the unpaid or underpaid positions their colleagues (and sometimes they) willingly take simply to get their hours done. Many wonder whether they will be able to support their families as they progress to licensure.
Therapists also often talk about inadequate supervision, dangerous working conditions, unrealistic and inappropriate demands, and a variety of other serious labor concerns on the road to licensure. Some drop out of the field altogether.
If so many therapists experience labor abuses, then why do the problems persist?
Read moreFighting illegal labor practices as a prelicensed therapist
The website STAT, which focuses on news in health care, published an editorial last month under the headline, “Physicians aren’t burning out. They’re suffering from moral injury.” Almost all of its conclusions appear fully applicable to psychotherapists as well. Could it be that we’ve been talking about therapist burnout from the wrong framework?
The mental health professions have long recognized that with our positions and our expertise comes a great deal of responsibility. In exchange for our professional status and the trust we are given to work with vulnerable people in private, we agree to act not just on behalf of our clients, but also on behalf of the larger communities who grant us that very trust. This means maintaining awareness of the laws and policies that impact our clients and communities, and working to change those policies that are not in the community’s best interest.
While each professional organization phrases this obligation differently, they agree that it is part of being a counselor or therapist. Simply put, you are expected to use your specialized knowledge and training to benefit the larger community. It is part of holding the title of a mental health professional.
Read moreWhy advocacy work is important for mental health professionals
In the world of private education, it isn’t uncommon for universities to be bought and sold. But recent years have seen a spike in the acquisition of private universities offering graduate degrees in mental health fields. Many students may not even be aware that their universities are now parts of larger corporations.
Three specific companies serve as case examples.
Ben recently published an article on the shortage of therapists in California. He discussed the “supply-demand disconnect” and why it’s so difficult to meet the needs of clients across the state. Toward the end of the article, he remarked that due to this shortage, “more of our functions will be turned over to substance abuse counselors, peer counselors, and other professionals and para-professionals.”
What did he mean by that? How can therapists possibly be replaced by individuals who haven’t earned a master’s degree, aren’t registered with the Board of Behavioral Sciences, and aren’t supervised by a qualified mental health professional? Unfortunately, I can cite examples from my own personal experiences in the workforce that support Ben’s claim.
If you’re a therapist in private practice, you’re probably listed on Psychology Today. For better or worse, it’s the 800-pound gorilla of therapist directories: It gets a ton of traffic, which means its pages show up high in search results, which generate even more traffic.
Despite owning the market, the Psychology Today directory is not necessarily well-liked. Its user experience looks and feels dated. While advanced searches are possible, the main search page only allows searches by name and location. Therapists and clients alike sometimes grumble that the information therapists can share on their profiles is limited.
For a new generation of online therapist directories, the failure of Psychology Today to improve its product represents a tremendous opportunity.
Read moreThese new therapist directories aim to beat Psychology Today
California suffers from a severe and worsening mental health workforce shortage. In fact, much of the US is in the same boat. There simply aren’t enough qualified mental health professionals to meet our country’s needs.
At the same time, therapists in private practice often complain about their local markets being saturated. There are so many therapists in some places, it seems, that it’s hard to get a career off the ground.
As it turns out, there’s truth to both of these perspectives.
Read moreTherapist shortage, or saturation? Depends who (and how) you ask