Category: Clinical Supervision

Therapists: Are you READY?

3/12/2015

One of the most rewarding experiences I've had over the past year is helping a few therapists bolster the courage to take steps forward building their private practices. I decided to formally offer this as a service to others who might be considering taking this step for their careers.

I know it can be anxiety-provoking and overwhelming for independently licensed therapists to "take the jump" into private practice work and over the past year, I have learned a great deal to make things work. I continue hearing the same concerns from therapists I'm working like:
Where do I even start?
How do I get referrals?
Will I be able to make it? What are the REAL costs?
How do I use an electronic health record and get reimbursed by insurance companies?
How do I manage the business end? I know how to provide therapy, but I'm not an entrepreneur!
How do I build a website? Can you help me with that?
How do I pay taxes?

I believe I can continue to help other therapists in the area strategize and develop plans. Consulting is very rewarding for me, and I think in assisting others to build their dreams and answering questions honestly. These are the areas I can support with:

Offering a packet of "first steps" and a "how to" guide of considerations to make the process less overwhelming.
Developing marketing materials + website design. I remember a professor in grad school stating that all past experiences can be a useful tool in your future as a social worker. This comment has served me well. Before my work as a therapist, I built websites and took many classes in graphic design and computer science. I still enjoy this part of my life, and it's been enjoyable to mesh this skill set together in my life.
Networking you with others in the Des Moines community to help you get this off the ground. You don't have to do all of this yourself, and the costs are reasonable.
Cutting costs. With a little ingenuity, you can go a long way. I have some tricks to help.

I've spelled out details on my services page if you're a therapist and interested in consultation work with me, shoot me an e-mail on my contact page.

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Radical Acceptance

7/24/2014

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cc photo credit: goldene zeiten berlin

A concept from the DBT skills manual I have found particularly useful mirrors an old 12-step slogan in the serenity prayer. "God grant me the serenity to accept the things I cannot change and the courage to change the things I can." Many models of treatment all encompass similar philosophies but present ideas in different terminologies. In my experience, clients have found "radical acceptance" a little easier to grasp and something helpful with practice.

Many people are aversive to the language of "God" and "radical acceptance" removes this as a criterion. Accepting life on life's terms is another catch-phrase that mirrors radical acceptances..

But that's really what it is about. Accepting life on life's terms. It doesn't mean agreeing with it. It doesn't mean liking it. It doesn't even mean you won't kick and scream initially about the unfairness, or lack of justice. Radical acceptance is for YOU and not for the situation or the other person. Marsha Linehan says "suffering is optional, pain is not." Being human is to have and experience pain. Suffering occurs when pain continues based on the lack of accepting the pain. It takes practice, it takes being mindful, it takes courage.

It also takes practice. A lot of practice.

It can be very helpful for a person to begin by learning to "sit with themselves". Slowing down, reminding yourself that in this moment you're alive, you're breathing. The thoughts you have are exactly them - thoughts. The feelings you have are exactly that... feelings.. Work on noticing and describing them, non-judgmentally. Sit with your breath and open your palms to the world. Let whatever needs to come in move through you and notice. You can feel any amount of pain, any amount of annoyance - notice your thoughts.

Mindfulness is simple but not easy and it takes practice. Digging your heels in and "cutting your nose off to spite your face" is what causes misery. You can't change pain but in time, you can learn to sit with yourself and notice without judgment.

This is a good article explaining more on "radical acceptance" and defines exactly what it is and how to use it.

photo courtesy of elephantjournal.com

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Letters to new therapists - Part II

7/15/2014

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Letters to new therapists - Being Brave.

Dear Therapist,

It’s less about what you say and more about what people feel when they are with you.

Go into waters that may be scary. I’m not suggesting you operate out of your scope of practice. For example, you don’t want to try EMDR when you’re not certified and comfortable with a treatment approach. However, you can get into the Seeking Safety curriculum and modify it to something you can teach and discuss as an alternative. There's more than one way to approach something or a problem. It’s important that you don’t create more damage to a person – go with your intuition and gut and know your limits. However, pushing yourself and trying new things is what learning and growing means. You’ll fail, you’ll succeed, you’ll walk away feeling like you learned something new regardless. Hopefully your clients will see this in you as well. You want them to be brave, right? You've got to be brave yourself.

I remember being thrown into a DBT group and imploding in my head when the therapist wanted me to teach a chapter to the clients. I had to memorize the material - every little bit of it when getting 50% of it would have been more than what my clients came in with. I put more pressure on myself than what my clients were expecting out of me. Our clients don’t expect us to be perfect and are generally more accepting of our mistakes than we are. It’s also empowering to acknowledge the mistake, name it, ask for forgiveness. They will likely forgive you because they ultimately know you're doing your best and trying to help them. There is grace on both sides but carefully analyze if you’re doing harm.

Whatever you’re trying for the first time will be uncomfortable. Any new skill or strategy is going to feel awkward and this is what we are most often asking our clients to do. Throwing yourself in and moving forward while holding your head high and laughing when you make a wrong move is ok. You’ll make wrong moves. You’ll apologize to your clients when necessary and this will be healing and modeling to them about what being a human being really means. We don’t know all of the answers, we know how to “be” and “think” about oppression and that’s a great starting place.

Keep reading

Find things that interest you. Be curious. Ask other therapists what they have found helpful. You may not feel like you have the time with the stress of work and you’ll also probably think you’re tired after work and can’t take anymore “psychology stuff”. I promise it will be worth it and energizes you, even if you read 10 pages before bed.

My list of most helpful books:

Trauma and Recovery by Judith Herman, M.D. is a wonderful read for those really wanted to get an overview of trauma.
Motivational Interviewing by Miller and Rollnick
Becoming Solution-Focused in Brief Therapy by Walter and Peller is one of the first books I read that gave me a handle on what I was doing and why. Learning exception questions and capitalizing on what is going well can be a great avenue for motivation
The Power of Losing Control – Joe Caruso
Drinking: A Love Affair - Caroline Knapp
On Grief and Grieving…. Good stuff. Anything by Elizabeth Kubler-Ross will help you understand complex grief and more than just the stages of death and dying themselves
Read Man’s Search for Meaning by Viktor Frankl
The Body Bears the Burden: Trauma, Dissociation, and Disease by Robert C. Scaer
Healing the Shame that Binds You - John Bradshaw

Be you. You're good enough, you're talented and you have the right spirit. For those I supervise, you have it in you and your compass is strong.

Jill

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Therapists: Are you READY?

Radical Acceptance

Letters to new therapists - Part II

Jill Lehmann, LISW, ACSW

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