Thoughts From A Psychotherapist Blog2022-08-29T08:53:27+00:00

Red Flags that a Training May not be Neurodiversity Affirming

It feels like everyone and their dogs are now offering neurodiversity training. However, many of these trainings endorse ableist language, such as high functioning or behavioral approaches that encourage a person to act in a manner that is more acceptable to society rather than accepting the client and supporting them living an authentic life. I have developed an infographic that reviews some red flags. However, I am sure I have missed some along the way, so feel free to comment and I can do a round two of this information. The big things to look for Does the instructor have lived experience as a Neurodiverse (ND) person? The community has a saying "Nothing about us without us." We must listen to people with lived experience and integrate their needs into trainings for any therapeutic topic. There are many aspects of Neurodiversity with some definitions including only ADHD and Autism, while others include a spectrum of other conditions. I identify as ND, but I do not have ADHD or Autism. I feel like it is important to be open about that. I can advocate but I will not teach an ND class because that space should could be filled by the many ND therapists out there. Does the instructor endorse Applied Behavioral Analysis (ABA)? If an instructor is currently advertising that they are trained in ABA then any training from them should be a hard no. Does the advertisement use ableist or otherwise unacceptable language? This includes language such as high-functioning, Aspie or Aspbergers, treatment, or special needs. This is not an inclusive list but has some common terms I see when people advertise their training. In addition, we should be using identity-first language such as Autistic person rather than person with Autism. Does the training focus on behavioral interventions? In the past Autism and ADHD have been focused on as an condition that needed to be cured. People were treated with ABA and taught to behave in a manner that was considered socially acceptable. [...]

By |August 25th, 2023|Categories: neurodiversity, Thoughts From A Psychotherapist|0 Comments

Measuring Dissociation Level with Clients

I have been taking Dolores Mosquera's excellent training on Treating Dissociative Disorders with EMDR: The Progressive Approach at EMDR Advanced Training and Distance Learning. This training offers two additional bundled days Day 2- EMDR Therapy for Suicidal clients and Self-harming behaviors and Day 3- Working with hostile voices and parts of the personality in complex trauma and dissociative disorders. I will be taking the Day three training next. I have learned a lot in this first day and hope to post more videos. This video today is of the Back of the Head Technique developed by Jim Knipe which Dolores brought up in her training. This technique is used to help clients show how dissociated they feel in a particular moment. Obviously different clients have different levels of ability to know when they are dissociated. If they have some ability to gauge this Back of the Head technique is a great tool to use. I hope to write up some more protocols to add to the list on my website. These are my explanations of other people's protocols written in a simple manner to help therapists better understand them. I myself, often struggle with long very detailed protocols as I work to implement them with my clients. Let me know if you have any topics/protocols you want me to cover.

By |June 26th, 2023|Categories: emdr|0 Comments

Assessing For Dissociation Is Essential

Eye Movement Desensitization and Reprocessing (EMDR) therapy is an amazing treatment for trauma. However, it is crucial to assess for dissociation before using EMDR. Dissociation is defined as a psychological defense mechanism that involves a detachment from one's thoughts, emotions, or sense of identity. Understanding and evaluating the presence of dissociation is vital for ensuring the safety and effectiveness of EMDR therapy. Below I have some tools on how to assess for dissociation. For a first-level screening, the DES II is recommended. If the score is high or you otherwise still suspect dissociation that did not show up you can then use the MID-60. Both of these tools are accessible via the links below. I recommend everyone get some training in working with dissociation and integrating parts or ego states work. My experience as an EMDRIA-approved consultant is that most stuck EMDR sessions can be resolved using parts interventions. This is also true for clients without dissociative disorders. We all have some protective parts and many times those parts need some time to prepare for processing. They may be fearful of what happens if trauma is processed. The assessment process allows us to establish an effective treatment plan for each client. A client that has dissociative tendencies may need additional stabilization work before EMDR processing. I have an online course on working with complex cases which, includes parts interventions to help with these stuck cases. Resources for Assessing Dissociation DES with color coded tabs This shows what areas of dissociation the client is scoring higher on. MID-60 instructions to clients This is an instruction sheet to use when using the MID 60 Version for client to complete – MID-60 This is a spreadsheet version that the client can fill out MID-60 pdf form client This is a pdf version of the MID-60 Clinician scoring template spreadsheet – MID-60 Dr Mary-Ann Kate’s video for the MID-60. Dr. Kate is responsible for many of the resources above and more. She shares it all on her Google [...]

By |June 14th, 2023|Categories: emdr, Thoughts From A Psychotherapist|0 Comments

Why Gender Exploratory Therapy is a BAD thing

Recently the California Association of Marriage and Family Therapists printed a letter to the Editor promoting Gender Exploratory Therapy. For those of us in the community we saw the language and knew this was a bad thing. But if you go to their website they state things in a gentle way that does not show their true agenda. Their agenda is clearly to not allow children to transition at all. That is conversion therapy which is illegal in CA. Many of us let CAMFT know what we thought about them publishing such a horrific letter. I am grateful to be a social worker our professional organizations would never publish something like that. However, for a parent seeking out therapy for their gender-curious kid, this therapy might look like a good thing. It plays up all the reasons that a parent might be thinking about. A parent might worry it is a trend or their kid was influenced by others (there is no scientific evidence to back this claim). A parent will of course want there to be a thoughtful process with their child and they want to make sure that their child is not influenced. And although that is what good gender therapists do the right-wing extremists claim otherwise. A parent worries about what transition would be like for their child and fears that they will change their minds (again the rate of de-transitioning is very low and has not been studied alongside family support). So a parent can easily be sold on this group of therapists.  Questions a parent might ask a gender therapist for their child How many clients have you supported through transition? What are the main obstacles you see for a child struggling with gender? How do you feel about puberty blockers? What is your training in working with gender-diverse children? How do you collaborate with parents, medical providers, and the schools? A good therapist will collaborate with other providers. A good therapist will be open to puberty blockers at [...]

By |May 3rd, 2023|Categories: Gender identity, Thoughts From A Psychotherapist|0 Comments

Why you cannot get a therapist that takes your insurance

I often hear potential clients tell me how hard it is to get a therapist that accepts their insurance plan. I get it. I accepted insurance for over 20 years and when I moved to PA I was not allowed to stay on CA insurance plans so I decided I did not want to make the huge effort to get on PA panels. The trade-off was no longer worth it. I suspect the general public does not understand this concept. Or they blame therapists for being greedy. I mean many of us have price points well above $100 a session and often above $200 in urban areas. They wonder why we need or deserve that much money a session. It is a fair question to some extent. And unfair in others. To become a Master Level therapist (which is the "lowest" level of education needed) you must go to graduate school. Then to get licensed you must do many hours (I had to do 3500) of supervised practice. In places like California, many people do those hours at little to no pay. After graduating with student debt, therapists have to work an additional two years with no real income. Then you have to choose between working for a non-profit, government program, group practice, or going out on your own. Non-profits do not pay well. Most people choose to do private practice. If you do that you are starting your own business with all the financial and emotional commitment that takes. Of course, they do not teach any of those aspects in graduate school. Many therapists are good a providing therapy but not so great at running a business and marketing. I now spend several hours a week marketing my business through blog posting and social media interactions. When I started my practice in 2001 this was not at all how I expected my time to be spent. If you accept insurance there are additional hours spent on record keeping. If you have your [...]

By |April 13th, 2023|Categories: Thoughts From A Psychotherapist|1 Comment

Building EMDR Confidence-How To Effectively Use EMDR With Complex Cases

I am teaching a class Building EMDR Confidence-How To Effectively Use EMDR With Complex Cases. This class will be online on May 20, 2023, from 9-12 PST and 12-3 pm EST. It will be videotaped and available afterward as a distance learning class. This class is to help therapists better serve their clients with complex trauma. We will discuss stabilization techniques, how to know when a client is ready for EMDR, and interventions for when processing gets stuck. I will teach you some practical strategies for integrating parts/ego states work into your EMDR work. The goal is for you to have new tools to bring to the office the following Monday. Register here.  Here is a brief video of me talking about the class.   This class is for licensed therapists who have completed EMDR Basic Training Levels One and Two and have completed the associated 10 hours. This class is presented by Cathy Hanville, LCSW They/She EMDRIA Credit Provider #23010 EMRIA Certified Therapist and Approved Consultant This class is approved for 3 EMDRIA Credits  #23010-01 This class complies with EMDRIA Standards for EMDR This class will be recorded and available to all registrants after the course for 60 days. If you do not attend the full live presentation you will have to complete a post test to obtain EMDRIA credits.

By |April 12th, 2023|Categories: emdr, Thoughts From A Psychotherapist|0 Comments
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