But what about...
How do I know you'll keep my information private?
I meet with clients via a HIPAA compliant telehealth platform, so you can choose a time and location that works best for your schedule. We can discuss concerns you might have about documentation of treatment and payment, and make arrangements that satisfy your need for privacy consistent with acceptable recordkeeping practices.
Will you report me to the licensing board?
As a healthcare provider, you know confidentiality is limited in cases of dangerousness to self or others, if a child or vulnerable adult is being harmed, your judgment is impaired such that it poses danger to those in your professional care, if you sue me, or when records are subpoenaed by a judge. If one of these situations occurs, we will handle it together and I will make every effort to collaborate with you, or minimally make sure you are informed before I do what I need to do as a licensed provider.
That being said, I have several years of mental health crisis response and emergency department social work. I don't flinch easily, am rock steady in a crisis, and value your autonomy. I use evidence based best practices including Collaborative Assessment and Management of Suicidality (CAMS).
I thought social workers only did discharge planning. How are you qualified to help me?
Clinical social workers are licensed in the state of Pennsylvania to assess, diagnose, and treat mental illness and challenges in functioning affecting quality of life and relationships. We are master's-level prepared and minimally must complete 3000 post-graduate supervised hours with a minimum of 150 hours of clinical supervision over no less than 2 years and pass a national board exam.
Because I was originally licensed in the state of Washington as a Licensed Independent Clinical Social Worker (LICSW), I needed to complete 4000 post-graduate supervised hours and 130 hours of clinical supervision in no less than 3 years, in addition to passing the national board exam.
Like many other regulated professions, we also have to keep current with professional continuing education, thirty hours every 2 years including 3 hours of ethics, 2 hours of child abuse prevention/mandated reporting, and 1 hour of suicide prevention.
What that all adds up to is you can rest assured that a) I did not get my degree from a Cracker Jack Box, b) I know what I'm doing when I provide therapy and know when I need to seek consultation, and c) you have recourse through the PA State Board of Social Workers and the National Association of Social Workers if you are unhappy with your care and we cannot resolve the problem ourselves.
I am also on my way to becoming credentialed as a psychiatric mental health nurse practitioner (in 2023-2024) and completed by BSN in August, 2021 from LaSalle University.
Are you going to try to "motivational interview" me into changes I don't want to make?
Absolutely not!
When a practitioner pushes for a specific outcome in motivational interviewing, this fundamentally violates "the spirit of motivational interviewing," making it awkward and ineffective.
True story: I was at a primary care visit for myself several years ago. It was VERY clear to me the provider wanted me to make commitments for my health that I was not interested in. My mission then became to tell my provider exactly what she wanted to hear so I could get out of there as quickly as possible. I walked away from that encounter thinking, "Whoah. Is this what I do to my patients as a behavioral health consultant? That's REALLY annoying."
I will ask you to let me know if I say or do things you find annoying because I would most certainly prefer to NOT do things that annoy you. It seems to work better for everyone that way.
My provider friends will see my kid/spouse. Can you treat my kid or my partner, too?
It depends. In mental health treatment, dual roles and relationships have different meaning than they might in medical or nursing care.
If I am already seeing you individually, it would be a conflict of interest for me to start seeing your child or partner individually as well, particularly because we are in a well-populated part of the country/state with access to many mental health providers. In rural or frontier areas, where there are significant provider shortages, boundaries may need to be more flexible to address the needs of the community.
If you wanted to do some couples or family work, I would most likely also want to refer you to another provider for that piece of support. This is because, as your therapist, I have an allegiance to your best interests, and it's harder to hold the space needed for family and couples work when I already have a relationship with you.
There are other people who enjoy couples counseling much more and are therefore better practitioners for couples work than I. If you're interested in primarily couples counseling, I will be happy to search my networks for possible referrals.
If we are doing individual work together, you are always welcome to bring anyone to therapy you wish. It's helpful if I know about this ahead of time, but not required.
If you and I have not started an individual therapy relationship, then I would be happy to meet your partner or child, but only if they want to meet me as well.
I barely have enough energy to get through the day. How can I have enough energy to go to therapy?
Many people have a stilted perspective of what therapy is because of how its portrayed in popular media. The "big emotional breakthrough" of Good Will Hunting, and the hours of going to a therapist's office in The Sopranos, The Practice, or In Session bear about as much resemblance to medical and nursing practice as to shows like Nurse Jackie, Scrubs, Grey's Anatomy, or, well, The Practice (also known colloquially named by my mom as "that tawdry doctor show").
I won't lie. Sometimes if people are talking about something that feels particularly vulnerable or highly-charged with emotion, they can have a "therapy hangover" or "emotional whiplash" from disclosing things they find difficult to talk about. That's definitely real and definitely unpleasant. A very poor analogy is wound debridement: in order to help set the stage for healing, sometimes we have to remove damaged tissue or foreign bodies, and that's never pleasant.
When therapy works well, however, you should start to notice smaller changes here and there that lead to improved functioning and quality of life, ultimately having more than enough energy to get through the day and start doing things that help you to thrive.