Has anyone opened their own IOP program, what's it like? How did you get started? Pros and cons

I am moving across states while I am in the middle of accruing my provisional social work clinical hours. I have been on top of everything as much as possible- I hold the associate level license in both states, I have my supervisor verification form ready to go, my supervisor meets the requirements for the state I am moving to, I have logged my hours... I've done everything I can think to do in order to get my hours transferred instead of having to start over. I'm stressing now because I reached out to the Board of SW in the state I am moving to (not the first time doing so) and the person I reached out to seems to be very confused by my asking "Is there anything else I should send to the Board for approval on these hours?"

So, my question is, does anyone have experience transferring associate level hours across state lines? Do I not send the Board my outside of state hours before I accrue more hours in the new state? I am so confused because this is such different information than what I was told months ago. Any advice would be very appreciated.

My wife and I saw YCSE last week and while we both loved it (would recommend!) I found myself not loving it as much as her or seemingly most folks given what I've seen from others online in their reaction to the documentary. For the record, I would give it 3 out of 4 stars and think it was a fun/crazy/sad/interesting watch- but I feel there's definitely something I'm missing here!

The reason I'm posting this here is I wonder if part of the reason I don't seem to be as blown away by it as much as others is due to my work as a therapist. Maybe its due to having worked in addiction where I think you kind of develop a nose for bullshit, but I found myself being so unconvinced by her affect, rhetoric, and apparent confusion regarding her conviction and prison sentence.

My wife mentioned she found herself being pulled in by Holmes and was mentally building a case for her during the doc, which was interesting to me because really at no point did I ever have that feeling. I'm curious if that's due to working with people who often are either lying to themselves or others about their actions.

This is in no way meaning to dehumanize Elizabeth Holmes and not appreciate the difficulties and trauma she has endured. I think many things here can be true at the same time!

Curious as to other therapist's experience watching this doc.

I work in a setup where I mostly see young people (late teens to young adults), the population which is not known to be very inflexible to change (at least theoretically). The organisation pays me so the service is free for these people.

One thing I have noticed in some of them (that doesn't happen in older clients or clients that pay you) is that these people are so resistant to change.

Firstly, they think that therapy is a quick-fix-miracle-drug. That they could come to me and tell me about things and I will fix it all.

Secondly, the concept of insight is lost on them. Whenever they learn about a pattern that we discover or bring to awareness in a session, their response is mostly, oh we kinda already knew that.

Thirdly, they rarely implement anything you suggest. Worksheets, regulation techniques, or just any suggestion of trying out a new thing or a different way or a lifestyle change is mostly seen as "what's that gonna achieve" response.

It has gotten to a point where I had to spell it out to some of them that you have to be an active participant in this process. Low mood needs to be brought up, emotions need to be regulated, relationships are something you need to work on. It all requires work and sometimes action needs to come before motivation. But it gets so frustrating at times because I feel like I'm putting more work than they are and I know it may lead to burnout.

Have any of you encountered it? How do you deal with it and what do you think is the reason? Keeping in mind that I come from a part of the world where the concept of therapy is quite different.

I’m curious to hear your bold statements that had a purpose/positive impact.

As for me, I had a first session with a new client who 5 minutes in stated “this isn’t going to work, you’re too young for me and I have a lot of life experience” to which I replied “can you imagine if I had to be all the things my clients are in order to be helpful?”… they were bought in after that and scheduled recurring appointments.

LCSW in NY here looking for just a few more clients. Licensed in NY, CT, VT, teletherapy only. Have tried ones that aren't paying well unless you hook yourself solid (Better Help for example). I just need 4-5 that can pay at Headway rates more or less. I do my own billing right now and take Medicare. Ideas?

Just curious.

Other than you truly don't want to, of course. I'm speaking more to the people that would like to open a practice.

(I fully understand not everyone wants to and in no way am I suggesting that everybody should)

This December, I'll graduate and begin the process of registering as an AMFT. I'll be continuing at my middle school practicum site 2 days/week until May, but I would like to start looking for what's next, especially if I can have a bit of overlap in the spring.

I'm interested in learning more about perinatal mental healthcare. Would it be off-putting to reach out to clinicians within this niche in my community to offer to buy them a cup of coffee to learn more (likely after the holidays)? I don't expect anything from these meetings directly, but would like to dip my toe into the real world of the field and glean enough information over the next few months to point myself in the right direction.

In addition, if you know of any resources (of any kind) that would be helpful for learning more about how to position myself and my resume in the application and interview process, I would be very grateful!

Hi! I am a relatively new, pre-licensed counselor and I have been looking for a place for support from fellow mental health professionals. I heard about the discord server, but am unable to find an unexpired link. Would someone be able to provide that? Thank you, folks!

If you are a provider with Curative, what is your review?

Has anyone else received this? I am quite irritated that they’re claiming I cleared their documentation review and still have to provide more. Every note for the next 30 days feels excessive and is definitely moving the needle more regarding leaving Headway (obviously in combination with the updated agreement fiasco).

I didn't realize how fucking scared I am of the midterms. None of my clients are talking about it either. I partly feel like I'm the minority that sees how important this vote is. But I also have this thought that we are all in a collective dissociative state, unable to process our reality.

This new lack of an ability to use a virtual background on telehealth sessions coincided with the email from the CEO. Does anyone know why?

It looks more professional to have that background as opposed to the stuffed animals on the couch behind me. 🤣

Anyway, I don't have a green screen or a tall folding screen to put behind me.

Any ideas?

If you are a licensed therapist working for a VC company like headway, grow, alma or anything of the sort, you need to leave. Not only are you getting screwed over but you are screwing everyone else over. Private practice can be successful on our own and insurance companies are taking advantage of everyone! The only way that we can combat this is by working together. Everyone needs to stop taking insurance. Everyone needs to stop working for these companies. I know starting a private practice is scary, but it is so possible and it is not hard once it is started. Everyone is going to continue to complain about pay and what mental health services look like in the future until everyone stops people pleasing and sacrificing for the billionaires. Rant over 🙄

I feel like I just keep on making mistakes as an intern. Marked a case as low risk when it should’ve been medium and it will now affect the client. Feel like shit, I don’t deserve to be at the site, all the negative thoughts. I’m wondering if anyone else has had experiences like this. How do you go about it? I know I need to be mature and grow but it’s eating me alive

Hi everyone!

I’m an intern working on a pandemic preparedness plan for a private practice with three locations, and I’d love to hear about your experiences when workplaces began returning to in-person work after restrictions were lifted.

A few questions:
Were you pressured to return before you felt safe or comfortable?
What did your employer do that made you feel supported? What could they have done better?
Were remote work, accommodations, or FMLA leave options available?
Did anyone feel forced to leave their job because they weren’t comfortable returning?
Looking back, what policies or practices would you recommend for handling a similar situation in the future?

Both positive and negative experiences are welcome!
Thanks for sharing! Your insights will help inform recommendations for supporting staff during future public health emergencies.

Quick clarification: I recognize that the pandemic is still ongoing and that COVID cases continue to flare up in different places. My questions are specifically about the period after mandates and restrictions were lifted and workplaces began returning to in-person operations.

I am a couples therapist and looking to compile resources for clients to help reduce shame around sex. A plus if it is geared towards the 50yrs old and up crowd! Thanks in advance!

Hello all! I’m here to spread OCD awareness. I’m attaching an article and an excerpt below

https://www.centerforanxietydisorders.com/blog/adult-ocd-symptoms/

“Generalized Anxiety, Health Anxiety, and the ‘Just a Worrier’ Label
If a therapist ever told you that you have generalized anxiety disorder (GAD)and left it there, you are far from alone. It is one of the most common swaps clinicians make when OCD is not obvious 8.
The overlap makes sense on the surface. You worry a lot. Your worries feel excessive. You have trouble letting them go. That description fits GAD, and it also fits OCD, which is exactly the problem.
The difference lies in the texture. GAD worry tends to move across real-life concerns like money, family, or work deadlines. OCD worry sticks to a specific fear and demands a specific response. You do not just think about the stove; you go back and check it. Or you picture it, in your mind, until the image feels safe.
Health-focused OCD gets mislabeled as hypochondriasis or health anxiety even more often 8. Take the marketing director who has been told for years she is just a worrier about her health. She is not. She has a compulsion loop around body sensations, and no one has ever asked the follow-up question that would have caught it.”

People will never understand the struggles of being a therapist unless they are one. The job choices are not very good and it has nothing to do with the clients and everything to do with the companies. The low pay, the high case load, some micromanment, hard to get jobs its ridiculous. I still love being a therapist but this year has been tough. Worked for a private practice with a beautiful office all management was virtual. It was good at first but the pay... omg it was one that only pays when the insurance pays. They were so supportive at first with good retention rates. But when going through some unexpected traumas then health issues they didnt care what the reason was then gave fewer and fewer clients until saying they ended my contract. My hemoglobin was dangerously low and had to get a blood transfusion but they did not care or try to understand. Then trying to get a job after this has not been easy i was also at a hospital but it closed down a few months before the private practice ended the contract. Finally got a job then the pay is low. Almost no job job is w2 and if it is the pay anywhere from $40 to about $50 per client. Then it takes forever to start seeing clients because of the insurance panels. You would think in a large city in Texas this wouldn't be the case but it is.

Hi everyone! I recently started my own private practice and have been getting new clients, and I’m looking for some fresh approaches and tools to bring into my sessions. I’d love recommendations for live, interactive online trainings that offer CE credits for LCSWs licensed in Virginia, ideally with something starting in November.

My client population tends to struggle with attachment and relationship issues, trauma, limiting beliefs, feeling stuck in life, and difficulty shifting longstanding emotional and behavioral patterns. I’m hoping to find an approach that will give me some new ways to work with these clients beyond traditional talk therapy.

I’m currently considering a few options:

• EMDR refresher or integrative training: I’ve completed basic EMDR training but haven’t used it much lately, so it’s been sitting on the shelf and I've started to feel a bit anxious about using it since I'm rusty. I am interested in a refresher especially through a training that integrates EMDR with another approach.
• IFS: I’m interested in learning more about parts work and how to help clients work with protective parts, internal conflict, and limiting beliefs.
• EFT: I’m particularly interested in Emotionally Focused Therapy, particularly for attachment wounds and relationship patterns.
• ACT: Also open to Acceptance and Commitment Therapy, especially if it offers practical tools for helping clients who feel stuck.

For those of you who have taken trainings in these approaches, what has actually made a difference in your clinical work? Are there particular trainers, institutes, or upcoming live online trainings you’d recommend?

I’m looking for trainings that are experiential and interactive rather than just watching prerecorded lectures. I’d also love to hear if there are other approaches I’m overlooking that have been particularly helpful for your caseloads.

I’d really appreciate any recommendations or personal experiences.

As stated above, I am a new therapist at an inpatient facility that assists kids who have behavioral or intellectual disabilities. I am an LMSW (I’ll be starting my hours soon with this job), but I feel nervous. I’ve never worked in a setting having to document so much, and work on treatment plans WITH a team. I come from the nonprofit world. Anywho, is there any advice you can give me? I am taking in my first clients this week.

Let's say the individual client is fairly new (less than 4 sessions) so you're still building rapport. They came to therapy to navigate the relational challenges they are experiencing (partner has complaints about them). When they start to describe the relationship history you hear stuff that sounds to you like love bombing, hoovering, cycles of idealization and devaluation, cheating, and emotional abuse -DARVO, double standards, lying/gaslighting, efforts to isolate client from friends.

Client doesn't use any clinical language like I have to describe these things nor have they ever said they think the partner could be abusive. Client overall seems like they are trying to present all the information in a balanced way and not trying to make the partner look like the bad guy.

Typically I think I would tread lightly and not be super direct about it at first since I don't have the rapport quite yet. I would probably focus on their own experience and what is healthy relationship dynamics and let them draw their own conclusions about the treatment they are receiving.

However there's another part of me that feels pulled to be more direct and to do that "faster" than I usually would. If it looks like a duck and sounds like a duck, why can't we just say hey I might be wrong but it seems like it could be a duck? I am also aware that my own bias or personal experience could be clouding my clinical judgement. It took me a really long time to name what I was experiencing as emotional abuse in my own relationship but once I finally did, that clarity in naming it was really important and helpful as far as me establishing boundaries etc.

Thank you for any feedback & 2 cents!

Hello Reddit Therapist. I am not sure how pervasive this issue is in our field as I’ve only had two anecdotal accounts of it throughout my career so far. I ran into two colleagues, one recent one in the past who are overly biased in an absolutely harmful way the patient.

A brief explanation of one patient involves myself being in group supervision during my residency in the past and one of my colleagues brought up difficulties associated with a patient who’s been accused of sexual assault that he says he didn’t do and it’s ruining his life and he’s seeking therapy to deal with the stress. When this was brought up in group supervision, our group Supervisor without any evidence or any inquiry, asked my colleague how she’s going to help him admit to what he did and stop trying to avoid guilt based on nothing more than a case, presented vignette stating what I just mentioned above.

Needless to say, my jaw hit the floor as I watched my other colleagues squirm around and find ways to agree with her as to not disappoint their supervisor who has evaluated authority over them. I tried to chime in with his guilt is irrelevant to his stress and reason he’s coming to therapy and was shot down and dismissed as myself being biased as a man.

The second one was more recent. A military psychologist/ colleague of mine does not want to provide what appears to be needed PTSD treatment because the patient did not mention it in his initial session with him, stated he had a hard time connecting with him, and because he only has so much time left in his enlistment believes he is seeking secondary gain without even evaluating the patient for PTSD at all. When I mentioned to him that there are many military service members who do not bring this up for fear it will ruin their career and only bring it up to the end of their enlistment because they are at the end of their career he simply stated that it’s not possible because everyone getting out must want something. He’s much younger and less experienced than me and I recognize it was not my place to teach and train him so I let it go with the caveat of knowing he cannot be referred to for future patients I see.

So my question really is has anyone else run into things like this and how do you navigate these waters?

My late cancellation and no-show were $75 for 48hours. It used to be $50 for 24 hours notice.

I’m reassessing the fee. Even wondering if I will have a late cancel fee at all, or move it back to $50. And do $100 for no show.

What about you what has worked? (Including those who don’t charge, and are in private practice!) have you reassessed along the way?

Hello all!

I’m noticing something about my therapy style sometimes, and want to check it as opposed to making an assumption.

I suppose I am what you would call an HSP with SPS, according to Elaine Aron, which is part of why I became a therapist in the first place. That said, I also am emotionally quite sensitive. It’s an aspect about myself that I truly cherish and it has wonderful results a great deal of the time. However, there are occasions in session where we will be discussing heavy trauma around needs for the self (I am a mostly trauma focused clinician, or at least, it seems that is what finds its way to me) and I notice a significant emotional response from myself.

It is never overwhelming, never dysregulated, and there are times clients do not notice that I have shed a quick tear or needed to dab my nose. Sometimes I will call attention to it, in the sense that I will check in with my clients to see what they are feeling around the experience and the responses so far have been overwhelmingly positive. I model that my emotions belong to me and the session is their session, meaning I will always be regulated and holding space within it, however I am also very human and feel moved by their experiences.

That said, I don’t want this to be a stumbling block one day, for any client who may feel uncomfortable. It hasn’t happened yet, but I want to make sure I’m putting in the work to keep the environment the absolute safest for any and all. Does anyone have any suggestions for internal grounding that might help with managing those moments?