Episode Transcript
[00:00:00] Have you ever felt alone in the work of being a therapist?
[00:00:04] Like no one really gets the burnout, the quiet victories, the self doubt, or the messy, complicated middle of this work?
[00:00:13] Maybe you've felt unseen, overwhelmed, or like the weight of caring for others is just sometimes too heavy to hold by yourself.
[00:00:22] You're not alone.
[00:00:24] I'm Sonja Anderson Hale, a licensed professional counselor and doctoral student in counselor education supervision and this is beyond the Chair, the Therapist Companion, a podcast for therapists, counselors and mental health professionals.
[00:00:41] This podcast exists for one simple reason.
[00:00:45] This podcast exists because therapy is a craft, one that requires ongoing reflection, skill and and conversation to do well. Whether you're a student or intern just starting out, a seasoned counselor or a supervisor supporting others, this space is for you.
[00:01:03] The intention behind this podcast is to provide different insights, spark conversation, share stories, and build community among therapists, helping those who feel lonely, unseen, burnt out, or anyone who simply wants to see things from a different perspective.
[00:01:20] Or maybe even just listen to somebody talk about therapy. Because sometimes it's nice to not just be the only therapist in the room.
[00:01:27] Since around 2020, many therapists have experienced a shift in how we practice.
[00:01:33] An example of this would be being able to do therapy online, which has made therapy more accessible to some people that might otherwise not be able to get it. But at the same time, there is a price because some clinicians aren't actually going into an establishment and getting away from home and seeing things in a different, you know, atmosphere.
[00:01:58] And even those that do in person, like myself, I still feel the shift, like how connected we feel to our clients, to our colleagues, to each other, and to people in the the outside world.
[00:02:15] It just seems like things have gotten a little bit more lonely and I'm sure there are a myriad of reasons for it.
[00:02:23] Another major reason this podcast exists is supervision.
[00:02:27] Or more specifically, the gaps in supervision that so many clinicians experience across roles. Interns, licensed clinicians, and supervisors. Research consistently shows that supervision doesn't always provide everything that we need.
[00:02:43] Growth, guidance, support, and genuine connection are often missing, even when the intentions are good.
[00:02:50] The first real staffing that I ever attended was in community mental health.
[00:02:56] I think it might have been my second day on the job and I was going to be a clinical case manager, which basically means that you have a very high caseload. I had about 150 clients and I was the person that was making sure that everything was going okay with them, making sure that they had the right services in place and checking in on them, that type of stuff. And then obviously Like, a lot of continuity of care, paperwork, blah, blah, blah.
[00:03:29] So anyway, it's probably like the first day that I meet this person.
[00:03:34] She was a therapist that I worked under, trying to figure out how to explain this.
[00:03:42] So here's what it was, and here's what I thought it should be. Basically, I'm a clinical case manager. I have a bachelor of science in psychology.
[00:03:50] I had been working on a children's psych unit for about two years at this point in time, and I'm in a master's program for counseling.
[00:04:01] So I shifted over to this facility because I was supposed to get paid internship hours, which didn't pan out. And this is, like, completely not anything that's important to the story, but I'm telling you anyway, I went there specifically for that reason. And I did end up growing and learning a lot. But that was my intention, was to get my hours and to be able to be paid for my internship, which was, I believe, like a year away at that point in time.
[00:04:30] So, anyway, the point of it is for me to be in charge of all of these clients, and then I have counselors that are technically above me who they're going to be, like, working clinically with the clients, and then I'm making sure that everything is going okay.
[00:04:49] On the surface, it sounds really simple, and it makes a lot of sense from what I'm presenting, why it would be a Bachelor of Science that would do this. But in reality, I think that it should be a master's degree, individual more. More than like a. More than likely a social work degree. And they should be paid the most because it is so much work, and there's so much you need to know how to do. And you also are doing counseling. You have expectations of running groups, and sometimes you have to come in clutch and do individual therapy. Like, there's a bunch of stuff that happens in that role that it just would make a lot more sense for someone who has a counseling degree or a social work degree to do that job.
[00:05:34] I learned so, so, so, so much doing what I did, but still gonna just keep going to die on this hill. It should have been a social worker. A licensed social worker like LCSW should have been doing that job and been paid bank to do it.
[00:05:53] But anyway, that's not how it was. So how it was was I had this boss who's brand new to me, and he comes into my office and he's like, hey, Sonia, come with me. You're going to come meet this counselor who's brand new to you, and you're going to do staffing.
[00:06:12] And I was like, cool beans. I don't know what that means, but I will do that. And he's like, yeah, just grab a pen and paper, Grab your notebook. Come on in. We're going to do this.
[00:06:25] Cool. I'm amenable. I can do these things. I go and I sit down, and then the therapist just starts saying names and what's going on with them.
[00:06:37] And I was like, okay.
[00:06:40] Like, I don't know what I'm supposed to do with this information.
[00:06:43] And either the.
[00:06:47] The supervisor left the room or. Or he just sat there and didn't say anything. I do not recall at all. I feel like maybe he just left. Maybe he was like, you guys got this. Like, I don't got this, though, because I don't know what I'm doing. Like, what am I even listening to and why am I listening to it? So, yeah, in my mind's eye or my memory, I feel like I just wrote down what she was saying and scribbled it on a paper and hoped for the best. Like, maybe this will mean something to me at some point in time.
[00:07:18] And I can tell you in all honesty, I don't think it actually ever did because I think it was so much information that was coming at me. I was just like, fake it until you make it. I guess in this specific scenario, staffing meant I tell you what the client's name is, I tell you what's been going on with them, I tell you what I've been working on, and that's it.
[00:07:47] And I'm not gonna lie, I feel like even right now, as I'm recounting this, I'm not sure how helpful that would have been, even with a counselor that I am at this moment sitting here right now to know names, ages, no clue what this person looks like.
[00:08:09] Cool. That's what you're working on in therapy.
[00:08:12] But, like, what?
[00:08:14] So if I'm the clinical case manager, what.
[00:08:18] What am I doing? If you're doing these things in therapy, like, what do you need me for?
[00:08:25] I don't actually know that that information was helpful at all because, like, we can work on so many different things in therapy and it not actually like, apply to what it is when you're doing case management, I think it probably just make more sense to tell me, like, these are the high acuity people.
[00:08:45] This is kind of what we've been dealing with for a while now. And maybe these are the first people to outreach. But I can also say that when I was Working in community mental health. At that point we were doing a thing called oh my God, what are they called? Like they're one minute staffing notes. So that means that you only had to discuss a client's whole situation for a minute and then you got to bill for like a 15 minute note or something like that. So of course the establishment that we were working for is pushing that because you can make so much money if you're billing, if you're, if you're staffing 150 clients. Oh my God, I hope we didn't staff 150 clients in that time frame. But anyway, so 150 clients over 150 minutes, that's like insane money.
[00:09:37] So yeah, that's like one of my first experiences with supervision. I had not been told what it was.
[00:09:43] I didn't get told why it's important to do it.
[00:09:47] It's absolutely pushing billing.
[00:09:50] I think, I think it probably was just trying to justify having me there in the establishment and the establishment paying for me to be there while I'm doing basically no work. Because the other part of it was that I had to do all this insurance based trainings that like they're just paying me to do.
[00:10:12] So it makes sense. Let's give you a crap ton of information about these clients that you're not going to remember ever.
[00:10:19] And then we can justify billing for you.
[00:10:27] And as I recount this, I'm like irritated all over again. It just is so counterintuitive. It doesn't make any sense. And it was so overwhelming and not the, the best introduction to staffing. And I think sometimes that supervision gets used as a term, like a blanket term for so many different things that can happen when discussing clients, counseling the practice, the rules and expectations of the establishment.
[00:11:00] Like it can be a blanket term for so many different things.
[00:11:05] And people be like, this is staffing, this is clinical supervision.
[00:11:10] Like sometimes, sometimes I think clinical supervision and community mental health actually got better when our insurance company for the state decided that those notes needed to be seven or nine minutes. I can't remember which one. But like you couldn't just bill a one minute note.
[00:11:32] I think they probably got wise to the fact that people establishments were saying like just whatever. The point of talking about clients is to help you when you're stuck, help you move forward, help you figure out what the barriers are. Or if we're talking about a case manager, they're doing it so that they can establish like here's what's going on with this situation, here's what it is that I'm planning on doing.
[00:12:01] You know, they're now more high acuity, or maybe they're a lower acuity acuity than they were. And so we're, we're trying to figure out how, how best to work with this individual. Essentially, that's what clinical supervision should be. So how do you best work with this person? Let me gain some insights and help these clients move forward. Because ultimately, what we do want to do is to work ourselves out of a job, right? Like, we want them to get healthy so they go and like, flourish in the world.
[00:12:32] And essentially what we're doing when we're staffing or doing clinical supervision, the idea is that we are talking it out to figure out how do we move this person forward to get them to where they need to be.
[00:12:47] And honestly, that first experience, it was kind of confusing, overwhelming, and pretty funny.
[00:12:55] I had no idea what I was supposed to do, who needed what, or why it even mattered.
[00:13:02] But looking back, I can definitely see why I've got this spark in me to help others get things out of supervision that they might not otherwise get or help those who already went through this whole situation with clinical supervision, didn't get really anything they needed or didn't get as much as they needed, and have a platform to hear different insights, gain new skills, new ways of looking at situations, and really start to hone their craft in ways that they might not have thought possible. And honestly, maybe it's just a landing pad for some of you to just keep exercising that skill, keep learning new things, keep getting insights into different situations. Like, I don't know exactly why you're here, but any one of you is welcome. I don't know what exactly you're going to gain from this, because I don't know you personally. But my hope is that everybody that listens does gain something.
[00:14:08] I do have to throw a disclaimer in here. This is not at all to replace clinical supervision. This is just a place to gain more insights, to hopefully help make it more effective for you, your own clinical supervision, or fill in some gaps that might have happened along the way.
[00:14:28] Talking about a myriad of things.
[00:14:31] Because we need to talk about a myriad of things when we're talking about counseling and being a counselor and what it all entails.
[00:14:41] So hopefully you're up for this journey, because I certainly am. And I'm really excited.
[00:14:47] I'm excited. I'm really excited to start, I don't know, just start the conversation, I guess.
[00:14:57] Okay, so here's how, beyond the chair, the therapist Companion is going to work. I've decided to do it in two ways. First, there's a free version. And this will give you the main episodes enough to follow along and get the core content. But it's really just a smaller taste of the full experience.
[00:15:14] It's like a little appetizer. You get the basics and some stories and some reflections, but not all the extras. And then there's a paid subscription version, which is where we get the full meal, full episodes, bonus content, deeper dives, and interactive exercises.
[00:15:32] At the start of each month, I'll present a case. It could be something from my own experience, a guest story, or even a documentary. And we'll explore it together. You'll get a chance to think about how you would approach the situation, answer some questions along the way, and at the end of the month, you'll get insights from me or a guest about how we would handle it.
[00:15:52] It's interactive, timely, and designed to help you grow as a clinician or even just exercise your clinical muscles and reflect on your practice in a way that the free version can't offer.
[00:16:05] And just a little bonus. The first hundred people who sign up will get this special introductory rate of $30 a month. And. And the discount lasts as long as you keep your subscription. It's totally optional, of course, but I just wanted to give you a heads up so that you know what's coming and you can decide what's best for you.
[00:16:24] Okay. And I'm kind of telling you this part so that it puts me in a position where I have to load this episode. I cannot tell you how many times I've recorded this stupid introduction because I just feel like there's so much I want to talk about. And now it's like, okay, just rip the damn band aid off.
[00:16:43] So my plan is right now to upload this on December 19th. Friday, December 19th. And I'm recording this on the 17th, so two days from now.
[00:16:56] And really the only reason that I'm telling you this is because if I do load it then, then that means that our episode where we go and do a deep dive will need to be on the Friday, the 26th.
[00:17:10] Yeah. So like right after Christmas.
[00:17:13] But never fear, friends, that one's already been recorded. That one's been recorded for like a whole month. I am so excited about the deep dives. They are super duper fun sounding to me. So this deep dive is going to be completely free, and I'm telling you about it so that you can kind of prepare for it, so that you can kind of get the experience of what it's going to be like to do some of our deep dive cases.
[00:17:37] So here it is. Next week we're going to dive into a case from Brilliant Minds, a show that I believe you can only see on Peacock now cuz we're doing season one. I have not actually watched season two.
[00:17:52] We will be focusing on a character named Dr. Carol Pierce.
[00:17:57] I feel like the likelihood of people listening to this before that episode is even loaded, like, you know, within that time frame is slim to none. But I will try and create an email address that you can write to me at if you happen to find this program before I load that other episode. And you are more than welcome to email that email and give me your insights. But basically right now what I'm going to do is give you the questions that I want you to be considering when you watch that show.
[00:18:40] So first and foremost, what feelings or reactions come up for you as you watch the interactions between Dr. Pierce and her client, Allison?
[00:18:50] Are there moments where you notice red flags in the relationship?
[00:18:55] What are they and why?
[00:18:57] If you were in Dr. Pierce's shoes, how might you respond differently to the unfolding situation?
[00:19:05] And finally, how does the media's portrayal of therapists shape your perception of what is acceptable in therapy?
[00:19:13] Remember, there are no right or wrong answers. This is just an opportunity to participate and exercise your clinical thinking.
[00:19:22] In the next episode, we're going to explore some of the sticky ethical issues that arise when personal and professional boundaries collide. We'll talk about the importance of supervision, what we can learn from situations that go off the rails, and I'll share my perspective on how I would handle these challenges.
[00:19:39] Plus, we'll discuss what guidance supervisors and boards might provide in real life.
[00:19:45] Trust me, you won't want to miss it.
[00:19:48] That's a wrap on episode one.
[00:19:51] I'm glad you're here. Stay tuned for more stories, insights, and a little chaos from the world of counseling.
[00:19:57] Have a great one.
