Bringing in two beers and chips today to hang with a teen experiencing moral scrupulosity with contamination fears (no drinking, of course). I’ve also brought a circular saw and blender for amputation fears. Always get a good laugh from my colleagues. Happy ERP-ing!!

It has been a long journey, and it is finally over. As of July 1st, I am a Licensed Professional Counselor. I graduated in 2015 from grad school, and after multiple BS jobs and long periods of time where I never thought this would happen or wasn’t worth it (or didn’t think I was worth it) I can finally say I feel like I accomplished my goal. It is quite a relief to say the least.

I never graduated high school. I was a bit of a delinquent, getting into trouble and skipping school to skateboard and smoke weed with fellow delinquents. I tried to get my life together after becoming a legal adult, and through the support of an adult from a youth i had been involved with, I was able to get my GED. A few years later there was a chance meeting with an old childhood friend who pushed me to try college, at the very least to get out of the small town I was trapped in. It was a ridiculous idea, how could I accomplish obtaining a degree when I’ve been told I will not amount to anything and I would have to pay my own way? Somehow, it worked and I am forever indebted to those who took the time to talk me into believing in myself when the world & society would say otherwise.

This post is one about celebration, but not for me. It’s for the people who never gave up or saw something in me that I couldn’t in myself. The truth is, I shouldn’t be here. But the dialect in that is I am, and the affirmation is we are all exactly where should be. So let’s all take a moment and share gratitude for the others in our lives who help us (whether they are able to hear it or not). And let us all acknowledge the opportunity we have to sit with others while they are going through it, as we are afforded the opportunity to be the person that they may need in very trying situations.

Thanks to anyone that interacted with me in this sub. It’s helped me stay sane over the last 9 months!

Thanks to Dr. Robert Witchel (RIP) who accepted me for who I was and taught me a lot of what I bring to the office everyday (even if I don’t utilize the Gestalt theories he preached). And a big “F you” to my former Vice Principal, who told me I wouldn’t amount to anything in life, that guy is an absolute jerk.

I wanted to share an important study I found while finishing up my research for my upcoming Law and Ethics CEU course on working with LGBTQIA+, Poly and Kinky Communities: Multiple studies demonstrate that therapists frequently hold unconscious biases against consensually non-monogamous clients, sometimes assuming relationship issues stem from the poly structure rather than examining other dynamics (Schechinger et al., 2018). This research highlights why specialized ethics training matters. 

Personally, I’ve heard quite a few therapists refer to polyamory as “just an attachment issue.” Sure, poly folks are not immune to anxious or avoidant behaviors, but pathologizing with a full stroke just shuts down the curiosity and the exploration of what works for them in their structure. 

How do you check your biases with LGBTQ+, poly, and kinky clients?

After over 2.5 years, I finally finished my supervision hours! Meeting with my supervisor tomorrow to sign off on my logs!

The last year has been a bit of a wild ride. Had to do it via private practice and had to overload my schedule to peak at around 28-30 clients a week, but it's finally done.

Not sure what the future holds but I'm still happy to say I accomplished this milestone!

Hey fellow therapists! I’m wondering what you all do when you get a weird feeling that something might be off. This is coming off the heels of having a quick consult with someone that just felt weird m. It was nothing about the content. It almost felt like the person I was consulting with had an agenda but I don’t know what it is.

For context, I’ve been doing therapy for about 10 years and have a small private practice on the side that’s mostly virtual. Of course, I want to suspend judgment and not jump to conclusions. I’m not scared for my safety, just curious if anyone has ever had this and what you did.

I am leaning toward closing my private practice, as it demands more than I am able to give fairly to each client. Last week, two clients explicitly stated that they sensed I was tired and not as present as I had been in the past. This confirmed for me what I had already begun to feel internally.

Most of my caseload consists of clients who are either nearing readiness for termination, would likely not be significantly impacted by this transition, or are not consistent in their attendance. Each will be transitioned with care. However, I have one client who presents a particular challenge. This individual began treatment with me and has significant attachment trauma. We have made meaningful progress together, yet they remain deeply and openly attached to me.

My boundaries remain intact, and I have consistently engaged in supervision regarding this case. Still, I experience a sense of grief when I imagine ending our work together. This client has expressed fear of losing me on multiple occasions. It is the first time I have worked with someone whose attachment to me feels this profound outside of my relationship with my own children. Their willingness to work hard and engage fully has made the process deeply moving for me as well.

I am aware of the transference dynamics at play, which is part of why I have leaned so heavily on supervision in this case. While I know that an ethical transition is possible, I wonder if it would ever be appropriate to consider maintaining treatment for just this one client until they are clinically ready to graduate. I have reflected on whether my inclination to continue is for myself or for the client, and I have concluded that while I care deeply for them and experience an ache at the thought of causing harm, my desire to continue treatment is grounded in the client’s needs rather than my own. The client has stated that they have never before felt this degree of safety and comfort in a therapeutic relationship, nor experienced such consistent progress and forward movement. If it is ethically appropriate, my preference would be to maintain treatment until a clinically suitable time for termination.

Any perspectives or advice are appreciated. Please be kind, I never saw myself ending what I have worked so hard for.

Just wanted to drop a pic of my office in here because I saw others have as well. S/O to my gf for all the incredible art. I work with teens/young adults at a homeless shelter and many of them really appreciate the art and cozy vibes🤙

Hey all! I am prelicensed and have been working in a community mental health agency for the past 4 months. I previously worked for a different CMH and left due to extremely unethical burnout. Though the caseload at this job has been more manageable, I have come to the realization that the CMH model is not sustainable for me personally, for a variety of health and mental health reasons, and would likely lead to me leaving the field. My agency also just aligned itself very closely with some political and government practices that I feel directly conflict with my personal and professional ethics, and I feel the repercussions of staying far outweigh the benefits. I work part time for a private practice therapist and they have offered to help me expand my hours there. I also have applications in with several group practices and feel I can make things work while I build up my caseload. My concern is that I would like to submit my resignation, but I am about to take time off for my wedding and honeymoon starting next week. I am not sure the best way to go about submitting my resignation, as I don't want to be unprofessional, but I also don't want to spend a month after I get home - my caseload is small and will not require that kind of transition time. Any advice is welcome about the best way to go about this!

Ok I know I must be the only person here who has not previously read ‘ man’s search for meaning’

• what a book, what an amazing read. I’m so tired as I couldn’t put it down. I’m supposed to be re-styling my office today and I have been up for most of the night going ninja through his pages.

I have read Primo’s work. But something about Viktor is almost transcendent. There is almost a learning with each page.

Anyway, though I am a very late comer to his work I feel blessed to have finally picked it up from my shelf :)

I started my PP in May of this year. I was not getting clients at the rate that I wanted to so I signed up to be a therapist in better help to supplement my income. My partner (also a therapist) did this some years ago for the same reason. I’ve been with better help for 6 weeks and still have yet to have a session. I put my availability up and have been matched with several people. I’ve only had one respond and they wanted a Spanish speaking therapist (not me) so referred them elsewhere.

When I did the onboarding I was supposed to have a “mock session” just so they knew I could run the program. On the day of this mock session (which was a Saturday and I have a toddler so I wasn’t thrilled) I couldn’t get it going, thought it was a tech error (which happens and is understandable) I contact support. 3 days later they get back to me saying they canceled the mock session because I was already listed as available to clients, would have been nice to know.

Their pay system is trash and they don’t allow 60 min sessions only 30-45 min. So though you are making “$30” an hour you only get a percentage of that for your sessions.

I knew it wasn’t a great program for therapist but I thought I would at least get a session in 6 weeks. No advice, just a rant. And maybe a warning for those thinking about using it.

EDIT TO ADD: I lost my job back in May, the company I worked for closed permanently. Decided to open my own PP because I wanted a flexible mom schedule. Started the whole process in April before I lost my job. There is a natural dip in clients in the summer in general (don’t recommend starting a PP at the beginning of summer for this reason). Under normal circumstances, I would never accept $30 an hour. My whole goal with better help was to get clients quickly so I could have some sort of paycheck while I slowly built up my own practice. That totally backfired because I haven’t really gotten a paycheck from them.

This weekend we were out of town. I worked Friday morning and we flew out in the afternoon, then flew back today, so I didn’t work. In my mind I had cleared my schedule for this date and had done the PTO form. Had I? Nope. Found out today on my way to the airport in another state that I had a full schedule today and clients were showing up for their appointments. I was actually shocked.

The thing is though, I look at my schedule frequently, and at the end of every appointment confirm the date of the next appointment. So I knew. At least part of my brain knew. I even filled out my paper calendar for this week on Friday, including my full day today. But it didn’t register to me that it was wrong because I was going to be out of town. I was floored and so confused when I got this call.

This has literally never happened to me before, and I’ve been a therapist for 13 years. What’s different now? This trip was originally supposed to be something fun, then my aunt who I grew up with got diagnosed with pancreatic cancer in May and the last month has declined significantly. We’re pretty sure she won’t make it to Christmas, so it became the fun thing + sadness. My sister who lives in the Midwest came out with my BIL and baby nephew so my aunt could see all 4 small kids in the family together (she hadn’t seen the baby yet). Anyway, I think I became too consumed with that and the pieces never clicked.

I guess what’s different now is I’m devoting too much energy to figuring out how I’m going to explain my aunt’s death to my almost 4y/o daughter who adores her great aunt. How I’m going to support my dad living out of state when he has to bury his sister. Wondering if getting the kids with her was the motivating factor for her to keep fighting that we were hoping it would be or if she will feel ok to let go now because she got to see them one last time.

In the meantime, I just ghosted my clients, some who were new, some I’ve been seeing for years so this was weird for them for sure. It’s been like 8 hours since this happened and I can’t wrap my head around how that could happen. Now I’m rambling. Just needed to get it off my chest.

Hey everyone,

I have had 3 male patients in their 30s recently presenting as seemingly motivated, but later they admitted (or I found out via context clues) that their partner strongly encouraged/harshly told them to get therapy. It’s frustrating because it clearly affects the treatment, and if I knew this piece of information ahead of time, it would affect the way I approach the patient. Do people have similar experiences? How do you approach this when you find out? Do you do specific screener questions in the intake for this?

Thanks!

I know many therapists give their clients “homework” in between sessions. I haven’t done this much but am not against it. I’m curious if people have opinions for or against using homework with clients.

And for those of you who do, how do use it? What types of homework do you find most effective in helping your clients?

I’m thinking about doing the narm training but with how expensive it is, I wanna do my research. I had a few colleagues that took the Narn basics training and we’re not super impressed by it. I haven’t been able to find anyone that has taken the narm therapist training and I’m really curious if anyone here has taken it and what their thoughts are on it it’s just so expensive. I wanna make sure it’s worth it any insight would be helpful thanks.

I have an adult client who is reporting being emotionally abused and experience dangerous situations with unstable staff and other unstable patients, which has led to ptsd flashbacks. These incidents occurred last year in a residential facility in another state. What ethical and legal responsibility, if any, do I have now as his current therapist to report this? Thanks for sharing any insight you may have. ETA: I’m in the US (Virginia).

Hello everyone.

I’ve been working in SUD for a few years. First few at an MAT program outpatient, and now currently at a residential. Back when I was working in outpatient, It was a very slow bleed. I performed great and I loved my job, but the part didn’t perform well was taking care of myself. I think I was too invested. Before long I didn’t realize how messed up I had really gotten. I was mostly dealing with FYL and MET users. Mid assessment ambulance calls, crisis intervention for a client who barged in after being awake for 4 days on a meth binge and she has no idea where her kids are, overdoses you name it. It seemed like these all became the norm. I thought I dealt with all these situations pretty well. I never lost my composure and provided support in whatever way I felt necessary at the time. The problem was I don’t think I was dealing with these things at all. I COULDNT really. No time. The outpatient felt like a war zone. It’s so connected to the street, and I became so connected to it that I had such a hard time recognizing my own problems or people in my life. After all, how could I give a shit about such and such’s marital issues? My client just relapsed and crashed her car, killing her child in the backseat.

Eventually I became so depressed even my colleagues noticed. I took PTO, then came back, felt an immense amount of anxiety and incompetence when before I felt very confident in my work, and realized PTO wasn’t going to cut it, I’m only dealing with this now, but this must’ve been happening to me for months. Couple talks with HR, then I went to Mental Health Inpatient.

I will say, sometimes I miss inpatient. Choose my meals, Make my schedule. I didn’t care at the time. I just liked that I didn’t have to decide. I liked that nothing I did mattered. I yearned for insignificance I felt like. Following this, I was unemployed for a VERY long time. Almost an entire year. I guess you could say it was extended mental health recovery. Badda bing badda boom, I’m motivated, I wanna work. Shot after shot after shot, nobody’s hiring me. Turns out, the one place that did…SUD residential. At this point I’m somewhat comfortable setting foot in this setting again. I’m thinking, the setting is different, maybe the approach/feeling is much different. Things are much slower there it felt like, but I kept having this urge to go go go. The longer I stayed the more I saw things I didn’t like. How disconnected a lot of SUD services are, MAT programs, etc.

Eventually I got to the point where I am now thinking maybe I need to leave this behind forever. Working at that outpatient, I think it did something to me that can never be undone. And although nothing has happened to me at residential so far, I think a part of me already knows I can’t do this anymore. In the beginning i got burnt out, but I came back stronger (thought). Somehow I became a workaholic and it wasn’t until HR basically sent me home that I really fell apart. I still really care about the drug issue here in America. It’s something that I care very much about, but I think I NEED to find a new way. I know there are certain military jobs that do drug interdictions. I think I’m tired of playing defense in this drug situation. I want to play offense. I don’t know if I’ll feel better that way, but I know I can’t do it the way I am now.

I'm a counselor at an outpatient PHP/IOP facility and I do a lot of groups. So far, I've been getting a lot of worksheets from taketheescalator.com and therapistaid.com. But I'm looking for more activities to do that my clients would find interesting and engaging. Any ideas?? My clients are a mixture of substance abuse and mental health issues represented.

Thanks in advance!!!

I first want to add that I'm family-oriented. Originally, I was aiming for becoming an embalmer, but then I read that morticians barely have any family time.

Then I thought forensics, but I don't know if the hours are just as bad.

So now I'm thinking school counselor, or maybe just a field in therapy, but I don't know much about that either.

I just know that these have been things that I have always had an interest in, but I am family-oriented, and now I'm feeling conflicted.

Repost as previous post was wrongfully removed.

Hi all. Folks have talked about this in the past on this subreddit but I still wanted to ask about my situation.

I (f30) just got engaged 2 weeks ago. I had told my clients (in private practice) in advance that I’ll be gone for a week but did not tell them the reason of course - just said personal circumstances. In India, specifically in Punjabi Hinduism, we exchange the ring(s) in a ring exchange ceremony. So I currently wear a 1.78ct diamond ring as well as a plain gold band. I wear the band at all times while I wear the diamond only sometimes like when I’m outside and for special occasions, and sometimes at work - still figuring out my preferences and comfort around that. I work completely in telehealth from my home office.

Last week I had a session with a fairly long term client and I was only wearing my gold band because I forgot to put on my diamond ring that day. No big deal. Today I saw her again and I was wearing both the rings. Towards the end of the session there was a moment of lightness and she changed topics from what we were discussing prior. She smiled, looked down and said “well I can finally tell my mom I was right. When you were gone for a week, I was telling her that you’re definitely getting married because how is it that there are no slots for the entire week hehe”

At this point I smiled sheepishly and said yes, I got engaged. She chuckled and congratulated me and said “i noticed last week that you were wearing a band but I wasn’t sure if it would be right of me to ask. I noticed your nails too. Before you left you had polish on your nails and I’ve literally never seen you wear nail polish. And now you have nail art.”

She is right, this was the first time all year that I wore nail polish (my own personal journey of wanting to do more than the bare minimum in taking care of myself), and the first time in my life that I’ve professionally gotten my nails done or worn acrylic nails.

I chuckled a bit and protested that no I do paint my nails sometimes but I’m definitely not consistent with it. She looked surprised and said well I’ve never seen you do it. So I smiled and then we moved on in the conversation.

The thing is, something about her observing so much about me made me feel very uncomfortable. I do know that I have issues with ‘being seen’ by clients and with showing up as a full human in my therapeutic relationships, often editing and censoring parts of myself that I feel are not “professional enough”. It’s something that’s come up in my supervision often.

Anyway, after that interaction I thought I saw her looking at the diamond often but I could be wrong. We spoke about her curiosity and I asked her what stopped her from asking me last week. She said she felt it would be intrusive and I reassured her that she is allowed to say or ask me anything in session. I told her that I might not be able to answer all her questions but that her curiosity is fully welcome in session and she will never be judged or rejected for it basically.

I want to ask her what it was like for her to wonder about my absence and my relationship status. She does have a history of relational challenges so I’m curious what this was like.

Idk what I’m really asking yall here. I know it’s a subjective decision for me to wear my diamond in sessions or not. Is it ostentatious? Yea. Should I censor myself by default? Prolly not? Does it create distance or act as commentary on privilege? I think so?

I don’t know. Please help me understand what I’m feeling and what yalls thoughts are on this.

I would love to hear the way you handle this question (and its many variations) during sessions!

Hi, Just wondering if anyone ever advertised their private practice via Reddit and their adds? If so, what were your experiences, did it create engagement? Equally, if you haven't, do you think it would be a good idea providing I create a business profile rather than using my own reddit account? Thanks!

I work for a non-profit spinning up a BSFT program in the coming months through our state DCF. Part of the licesning and fidelity monitoring involves recording client sessions and reviewing with trainers/supervisors.

Our org has run similar EBPs that require audio recordings, but this is our first experience with video recordings. I was curious if folks had suggestions for affordable solutions ($100-$150 ideally) that would be decently high quality and not require having a computer on during the session.

Hi everyone!

I am struggling pretty intensely with questions of whether to quit my current job and would love feedback.

For context: I came into private practice directly out of grad school (was also in PP for my internship) and have been in the field full time for around a year and a half.

The first part of working full time was extremely stressful due to building my caseload and struggling financially because of it. And I mean EXTREMELY stressful. Like desperate financially and taking on every client I could and then working hours I wouldn’t typically ever work. I almost left previously to pursue something salaried but decided to stay to see things through to getting a full caseload. Around 6 months ago my caseload got to a healthy point, so I have finally had the chance to see things more clearly.

But, as things has moved along I feel like I am struggling with INTENSE feelings of confusion about whether I am in the right setting and now even career.

The bottom line there is just some things about my practice and private practice in general that I’m just not sure are conducive to my needs as a human. Below are some thoughts:

1. Lack of structure- I thought I would like the flexibility but I struggle with motivating myself to get up and do anything in the mornings if I don’t have to be at work. This makes my mornings feel extremely lazy and unproductive. I feel like I need more discipline.
2. Working late hours- my practice has a heavy child population and adult or day-time referrals are slim. This means I work until 7-7:30 most nights other than Friday if I want to make ends meet. Although I don’t get to work until around 12 most days, I typically spend the morning agonizing and frozen over the fact I have to go to work so they don’t feel productive.
3. Working with kids. This one is tough. I truly love children and have had lots of success with child clients but working with parents stresses me out beyond belief. I feel immense pressure at all times. I much much MUCH prefer teenagers since arenas are less involved but love young adults the most. Unfortunately, most of the referrals we get are for elementary schoolers.
4. Direct payment- this is imposter syndrome speaking but knowing that my clients pay such a high fee and that it’s solely for MY service is so so so so much pressure. Yes, they pay my practice, but for some reason it feels like they are just paying me and it just feels like so much pressure.
5. PP structure in general- being lonely at work, lack of collaboration / teamwork between people, lack of oversight. I have great supervision once a week and she is always ALWYAS accessible when I need it but sometimes I’m like wtf am I doing and wish I wasn’t just alone all the time. Sometimes I also just feel so lonely at work. I go there and basically only see my clients and then leave. I do see the other therapists and we say hi and chit chat, but still. It just doesn’t feel like a lot.
6. No benefits, 1099, not knowing how much I’ll make every year etc. Yall know the drill bit this is extremely stressful as a single, young adult navigating the world for the first time out of school.
7. Extremely diverse caseload. I see people of all ages with SO many different presenting problems. I feel like I never can possibly know enough and feel like I’m going through a roller coaster every day. I’ve tried to focus more on anxiety, but it’s hard since I now have a full caseload and would be discouraged / feel extremely guilty to refer out my cases that aren’t aligned as much with my interests.

I am obviously suffering from burnout, but feel like I have done all of the general things recommended for this (self care, vacation, reducing caseload, stop taking on new referrals, my own therapy). I just don’t seem to have the same excitement or joy about this filed that I did when I first started. I also feel that this has heavily influenced my personal life and I have much less bandwidth to connect socially and with kindness and compassion to people in my real life because work takes so much of that energy.

I honestly deeply regret going into private practice as a new grad but I feel like I have now dug myself into a hole i can’t get out of. My supervisor seems to think that I will be here forever and from seeing other people at the practice leave / from other conversations I’ve had with her, I feel that the only way to leave would be to blindside her and say I have a new job once I get something else. It causes me extreme agony and stress to think about leaving because in my experiences with her on more serious issues (finances, contracts, etc), she tends to take things personally and gets upset/defensive/accusatory. For reasons I don’t want to fully get into, I also feel that I can’t talk to her about being burnt out, which is another issue. She is a great GREAT clinical supervisor, but it is harder to navigate the “boss” and director part. I had signed a 2 year contract so I would have to break it to leave. Although, there isn’t really any consequence to that other than potentially burning a bridge with her, which really pains me to think about. I also have 40 clients on my caseload, some of which I brought from my internship (so, over 2 years), so the thought of leaving them causes me immense guilt and shame.

One other note is that what REALLY sucks is that I actually think I’m a good therapist. I have had a lot of success with clients and deeply care for each of them. Unfortunately, I have gotten to the point though where I feel that I would rather be anywhere else than in sessions and am jealous of literally every other job on earth. Everything is going well in my life except for my job because I feel so depressed and stressed about going to work every day. Like, I’ve started fantasizing about what it would be like to be the most random jobs ever and find myself resentful of people who love their jobs. I just wanna lay on the couch all day and bury myself underneath the blankets. I want to believe this hasn’t gotten to the point of impacting my clients, but who knows. Overall, this makes me sad :(

So, all of this to say, do I stick it out and see if I can get out of burnout? Do I leave now and potentially burn a bridge? I feel so unbelievably lost. Is it the setting? The population? Or am I just not cut out to be a therapist? Or- do I just need more time and training the field? I’m also worried if I switch into a different setting I’ll be even more depressed but then not have the flexibility I DO have with PP to take time off whenever and how ever much I want.

Also- I am an LMSW, so have other social work jobs as a back up. I still would really like to work towards independent licensure since I think it opens up more doors.

One other note is that I feel like I have completely failed by getting to this point. I don’t know how others are able to do this job with so much more resilience. I have always been extremely well-adapted and was always a great student, athlete, etc. This is a topic for my own therapy- but I’ve always been successful in things I’ve set my mind to and now I am feeling like I am totally failing this thing that I set my mind to. Everyone seems to be aligned that private practice is the best, most cushiony place to be, so how am I failing so miserably at it? This feeling sucks!

I began my application process for my LMHC in Florida in June. I have an LPC in PA that I obtained 11/2024.

The board told me that they need letters from my supervisor with proof of clinical hours and supervision.

They said my application is still under review from a committee of one. I applied for a telehealth LMHC which was approved.

It is now 9/9/2025. No one is able to provide me with updates except that it is under review.

I’m frustrated as this is a barrier for me to work in Florida. I’m also worried that I am waiting so long and might get denied.

Has anyone had this experience when applying for a Florida license?