What I Learned During My Third Year As A Mental Health Therapist

These weekly newsletters will have therapy deep dives, effective coping skills, mental health tips, psychology info, LinkedIn tricks, and business bits. For some reason, each of these areas appears to connect in my mind and I'd like to share them with you. Cheers to actionable insights!

**The following is an annual article I write for aspiring and current mental health professionals**

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Today marks my third year as a mental health therapist.

If you're interested in how my first and second year was, check them out.

Here are the top 5 things I've learned this past year.

1. Start with the end in mind

In my second psychology class, the professor told me that a good therapist "will not keep you sick."

This was over a decade ago.

What he meant was that there are bad apples even in the field of mental health that may keep you in treatment longer than you actually need it.

Big no-no.

In therapy, a primary goal is to help clients reach what we call graduation.

This means they have completed the goals they had in mind for treatment.

Said another way: healing actually happened.

In all seriousness, it is not my job to keep them in treatment as a lifer, although there is a future article coming out soon about that.

What I want to get across is that there is a life past graduation, if you allow it.

Justification

There are three reasons why graduation is a good idea in treatment:

1. Their life continues
2. Your life continues
3. New clients

As a client, graduation is a reminder that you've completed something important and have the ability to continue on without your therapist.

As a therapist, it's a reminder that my life will also continue so that I do not force my clients to stay in treatment longer than needed.

And if it's the case where original clients were to remain on my caseload, then all I'd have in the future is an unlimited waitlist of people that are ready for treatment and can't be seen.

See how this becomes a slippery slope?

What to do

Starting with the goal in mind can help get you and your client get on the same page.

This can look like identifying treatment expectations, how you work, how they work, education, tasks, homework, style, now show appointments, medication, and...

how graduation is an ongoing conversation that continues till the end of treatment.

Clients may not know where to go at the beginning of treatment, which is fairly normal.

Over time you will develop tools and practices in guiding clients in finding their way.

It's also important to remember that your words as a therapist carry a lot of weight.

What you say matters. Here's an example:

If you were to tell a client this...

“When you get better, then...”

That seemingly harmless statement primes clients with the idea that healing comes in the distant future.

When = uncertain time.

This is what I call a low-level change.

Alternatively, if you were to tell a client this...

“As you get better, you'll notice…”

This sort of statement primes clients with the idea that healing is already happening in the present.

As you = present signs of change.

Let's face it, I don't think practitioners give clients enough credit when they simply show up for their appointment.

That's a degree of healing in my book. A high-level change.

Full circle

That psychology professor was right 10+ years ago:

If therapists don't keep the end in mind, it's likely we are enabling a standstill in their healing.

That treatment with that single therapist is forever.

Many therapists, including myself, don't have the explicit intention to do this.

It just happens sometimes.

You hope there are no bad apples in your profession too, but that isn’t realistic either.

There are regulations and guidelines for many reasons, one of which is to hold people like me accountable to help clients reach their goals for treatment.

Often, when my clients do graduate I thank them for their time, and share this:

Just because this relationship is coming to a close doesn't mean your work is over. Take what you learned about yourself with you and continue to grow, because you are your longest relationship in this lifetime.

It's an honor to see clients from beginning to end of treatment. Take a moment to think if you are holding on to this relationship more than you should.

Clients are more resilient than you think.

Remember, they are people, just like you.

And if no one has told you before, clients graduate and come back to therapy all the time.

There's always a failsafe when you work as a therapist.

2. Tandem Adventures Await

It felt like only yesterday I was told something that haunted me for years.

A student in my grad school program told me to get rid of all my social media accounts.

Why?

Here were their rationale:

• “Jake, it looks unprofessional as a therapist.”
• “Dude, your clients could find you!”
• “You could get into trouble.”

As much as I appreciated their concerns, there was a part of me that was unsure what to do next.

I was stuck.

Back then, it was considered normal to make sure you remain anonymous with any online social media accounts.

Heck, many of my colleagues during that time had privatized their social media by creating a pseudo name for friends and family, scrubbing their names off the internet, or by only keeping a psychology today profile.

And it appears to work for them, which is awesome. And I totally get why.

But some of this didn't sit well with me because I had other plans in mind.

Hidden talents

Let me first say that it is important to have professional boundaries with current and past clients. For many reasons.

There are strict guidelines provided to therapists through the state they work in. Continue to follow those guidelines and seek consultation from colleagues too.

But to remove your entire online presence removes the opportunity for therapists like you to make more of a difference in your corner of the world.

Let me explain.

A reason I chose to become a therapist was because of my many interests:

1. Listening and problem-solving are fun for me
2. Teaching and researching are purposeful
3. My role wears many, many hats
4. I have talents and work hard
5. Challenges fill my cup

I have the interest and energy to do more than my 40-hour week job (which I love btw).

Some therapists are completely happy with their day job.

Working one job doesn't fit with me though.

I wanted to do more and make difference, such as writing articles like the one you're reading right now.

Decide and move forward

With all this in mind, I had two roads to choose from.

Road one is to pull the plug, be offline, and do my day job.

Road two is the keep my day job and see if I can make a difference online.

I chose road two:

1. Got my full-time job
2. Began writing nonstop
3. Gave away a free ebook
4. Started doctorate program
5. Writing my first online course
6. Finishing and selling 2nd ebook
7. Make hours of free TikTok videos
8. (Coming soon)

This may all look like I don’t have a life outside of work, but I do.

I chose a job that fit me well, and love what I can give back online.

And I've learned to structure my day in a way that makes it all easy.

Your turn

Many therapists I meet have a few things in common:

• They are quiet creatives
• They are business-minded

As a therapist, you can do much more than what I do already:

You could write an online course, a book, or start a podcast.

You can open up a group practice, a dual practice, or a solo.

You can teach classes at a local university or online institution.

You can hold workshops, seminars, or an annual local event.

Now sure where to start? Keep this in mind:

Whatever gives you energy outside of work may be a good place to start.

Get those creative juices flowing and see where it takes you.

The world is changing. You can keep to your single mode of work, which is fine if it works with you, your family, or something else you use your time for.

Or, you can expand your work in a way that enriches you and others you thought you’d never reach.

(That's my goal)

3. There Are Gains & There Are Losses

I lost my dad to Covid on 11/22/21 at 11:59 PM.

This was one of the hardest moments ever.

Here's the post I made a week later.

In life, you will lose some of the most important things to you. For me, it was a parent.

Not only did I lose my dad, but there was a colleague of mine who had passed away.

There were also many people who left their jobs due to unforeseen circumstances as well. Not to mention that therapy burnout is the real deal in my neck of the woods.

Have you seen the cascade of changes in employment since Covid?

And as far as I can tell, losing people and working through grief puts a number on your soul if you're not paying attention.

But there is a silver lining. Trust me.

You have gains with loss

Many may tell you that having a better perspective helps with loss. I too think this is the case to some degree.

You’ll see in my last therapy post I discuss how the pandemic changed everything in how therapy was provided.

It was a loss of environment. It was isolation. It was strange.

Yup, it was Covid-19.

But with that loss and even a loss of life, can also be a gain of insight.

As impersonal as it may seem for some, when I lost my father it was as if I gained an angel in the process.

Someone special who continues to watch over me.

And boy do I feel he's watching over me.

Even if he's gone physically, the memories are more than alive, and appreciation for the smaller things in life became much more important.

Losing professional colleagues and supervisors also meant that I was gaining a friend in the process.

You know, someone as a friend without all the workplace boundaries.

The lesson

You don't necessarily get over the grief and loss.

That's now how it works. It's a process.

Losing my dad continues to teach me how to carry heavy things as I move along this path called life.

I’ve explained before that grief has its own timeline, and I wasn’t kidding.

Grief has a way of working itself out in its own way, in its own time.

You think you’d get through this life sometimes without a scratch. But that's not realistic.

Keeping that in mind, hold loved ones close.

Make memories with your family and colleagues.

And attempt to see if it's possible to explore gains in moments of loss.

4. To Niche, Not To Niche, Or Something Else

For years I’ve been told to niche down as a professional, and I get it.

Become an expert in one specific area that you’ll be that go-to person moving forward in that specialty.

Seems reasonable, right?

The problem is, that’s never been me.

A book I’d suggest to any new therapist read is Letters to a Young Therapist by Mary Pipher.

In one of the chapters, Pipher made a few statements dedicated to the idea of niching down or being a master of all trades.

She believed that therapists are too important to move forward as a one-trick pony (Google that).

This process may appear contradictory because for years I share with friends and colleagues to find their lane and practice consistency.

And here I am telling you to think more about this alternative. Why?

There are a few reasons.

Take a self-audit

If you have a keen interest in working with complex PTSD in young adults, have at it. That's totally your lane.

You’re definitely needed.

If you'd like to cast a wider net and treat all ages who experience complex PTSD, be my guest. That's your special lane.

But if you want to be considered the primary care physician of mental health, county mental health is the place for you in the long run.

That's actually my place at this point in my life:

To be the that generalist who works with anyone that comes through my door.

And I thrive in it.

However, as I've already eluded to in my second lesson in this article, you may be that special type who has an interest in something more.

Such as maintaining a full-time job and niching down while you're at it.

If you want to work a 40hr job in community mental health (CMH) and moonlight in private practice (or something else) with a specialization, it’s likely you’re more like me.

Ask yourself where you align as you continue reading. This is a simple self-audit.

Security + Novelty = Calculated Outcomes

Security is having a position that brings home the bread from your full-time job.

Novelty is attempting a newer route (e.g., private practice) with a bit more risk, yet more meaning.

As far as I can tell, I’ve enjoyed both worlds.

I will be licensed in a few months; however, I view my security position as a novelty too.

Here's why.

Many CMH positions provide a menu of training. Great training if I'm being honest.

Said another way, many counties in your state may purchase programs that provide professionals with hundreds of thousands of hours of training.

Please, if your county has this, use them.

Make it a practice to practice what you learn.

You'll be a much better clinician for it.

Niche within it

Although today marks my third year in community mental health, I actually specialize in a few areas already.

I'm not all talk ;)

I’m EMDR trained, DBT trained, and will be CBT trained and SFBT trained soon.

Oh, did I mention I am certified as a Feedback Informed Treatment provider?

That's fancy for using scientific measurements that tell both you and your clients where they are in their progress without having to make educated guesses. #quantifiable

The hybrid life

The fact I see many sorts of clients with complex lives requires my training to be top-notch.

I work with an amazing team that agrees we must all be equipped to provide high-quality services to the community.

If you niche down, great.

If you generalize, great.

Make sure you're in the place where you feel you're most purposeful.

That will give you the energy and heart to keep at it.

I chose the hybrid route: niching down while providing generalist services.

5. Someone Needs To Get Called Out

If there's a single theme that's appeared during all three years of being a therapist in the real world, it's this:

Therapists screw up and need to do something about it, now.

Let me explain.

I was 15 minutes late to an appointment the other day.

If a client were that late then the protocol is to reschedule.

When this happens, I used to say “sorry for the wait,” and now I say “thank you for waiting.”

But today was different. I pulled back this client who was so patient with me.

You see, this particular client distrusts the medical realm as they’ve not been treated so kindly. For decades.

And today of all days, they shared that someone inputted their appointment information wrong and they felt they had to just “deal with it.”

They've already dealt with a decade of this, what's another bad experience?

Take your own sword out

The novice therapist in me could have gone the route of working through this tough experience by exploring past times of feeling less than, forgotten, and left out by the medical industry.

The therapist I am today pointed out the elephant in the room:

I too was adding to my client's distress by being late for their appointment.

This unintentionally sends the message of “you’re forgotten.”

I could have gone down the route of "pulling the root" of the pain, but that didn't seem appropriate due to how present this particular moment was.

We had the talk. I called myself out.

This is what you'd call a corrective emotional experience.

And that was a healing dialogue that my client has been wanting to see from a professional for decades.

Afterward, they kindly shared that "no professional has done that for me before."

Calling yourself out so others don’t have to is what I call a falling on your sword moment.

In other words, you're essentially sacrificing saving face by pointing out how you wronged someone.

And you're willing to put in the time and effort as a legitimate apology .

The silent message

Falling on my sword enhanced our relationship because it told my client that professionals make mistakes and have the empathy enough to own them and identify how this wrongs others.

And we have the ability to devise a plan on how not to continue this behavior in the future.

So that stuff like this happens less often and that you can call yourself out more often.

That’s what healing relationships look like in my book.

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Wrapping things up

This past year felt like a tiring blur of emptiness where success felt impossible, also known as languishing .

I am thankful there was enough energy to pump out this long-winded article for other therapists and for those interested in joining the mental health field.

My hope is that you were able to get something out of this.

Fourth-year as a therapist, here we come.

Take care.

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