Psychotherapy Notes

The TV therapists who do the job well

June 11, 2018 by Jeffrey Liebert

At 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.

Boundaries, apps, and dispensaries: Seeing clients in public

June 13, 2018June 6, 2018 by Jeffrey Liebert

Brodie Vissers / Burst / Used under license As 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.

Podcast episode 9: Measurement with Casey Meinster

June 4, 2018 by Ben Caldwell

Psychotherapy Notes podcast Casey Meinster is the Director of Evidence Based Practices at Hathaway-Sycamores Child and Family Services, a major mental health services provider in Los Angeles. In that role, she wrangles a lot of information. But one piece of information I learned from her changed how I think about the importance of measurement in psychotherapy.

Hathway-Sycamores serves thousands of clients a year through more than a dozen programs. They fund those programs through a variety of sources, including government contracts, grants, and other sources. And it is now the case that every single program they run now has to produce outcome data on its clients. Their payors demand it.

Therapist shortage, or saturation? Depends who (and how) you ask

May 30, 2018 by Ben Caldwell

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.