Lessons From My Mentors

Written by Brandy Price Klingman, LCSWBACS

In my career thus far, I’ve been blessed to have some great mentors, supervisors, and colleagues. These leaders have helped shape me into who I am today through their generosity and knowledge of wisdom. In the spirit of sharing the wealth, here are my favorite tips for new or developing therapists that I have learned from many mentors and supervisors (P.S. I’m naming these great masters to honor them.)

1. Strangers on a Train

An early tip from a great mentor came from my internship’s first supervisor, Butch Robicheaux, LCSW, BACS. I was excited to be interning at this site and had prepared a beautiful binder full of handouts for my clients, covering every topic from coping skills to grief and loss. 

I asked him, “What should I do before going into my first individual session?” He looked at my color-coded binder and was kind enough to say, “That’s very nice, but you won’t need that. You will have a conversation in this session. You will speak to this person with sincere curiosity and compassion like a stranger on a train. You don’t need to have anything wise to say because the connection is good enough to start the relationship. You won’t connect with a handout from that binder.” 

I often reflect on this “strangers on a train” guidance and smile because I’ve now made my career off of this simple piece of advice. The importance of a connection that comes from the simplest of conversations filled with compassion and curiosity can change the session’s dynamics from ‘therapist driven’ to the ‘client here and now.’ It’s helpful because there are so many problems a client could bring into a session that are out of anyone’s control, and I could never create enough handouts for all those stressors. But, I can always go back to the idea of a conversation with a stranger on a train.

2. Crisis Is Contagious, So Prepare Yourself

One of my first jobs required me to provide psychotherapy to groups of 10-12 people in a partial hospitalization program. I loved this work. I enjoyed and feared these groups. Often these settings had many personalities and a shared struggle of emotion regulation. The job was simple in my mind – find the problem with all the clients, and fix it. 

But the issue was complicated because there was always a crisis. Luckily, I’m good at crisis management, and during this time, I considered myself a professional firefighter (always looking for small fires to put out, as I was feeling better and better about my skill set). However, I was exhausted at the end of the day, week, or month, and I knew I would quickly be spent by the end of my career. This must be what they taught us in school about burning out. I understood at this point. 

When I discussed this with my clinical supervisor Karen Travis, LCSW, BACS, CGP (even more letters behind her name), I told her how well I was managing these crises, and she asked me how I felt. I described myself as tired, overwhelmed, and anxious. She then told me, “Crisis is contagious girl, and you are catching it.” She discussed the importance of understanding the client’s crisis separate from the therapist’s. She reviewed the importance of not meeting their situation with my crisis of “managing,” “fixing,” or “resolving.” She taught me how to help them explore their concern and process their feelings around it. 

Karen also told me the importance of allowing them to sit in the crisis until they were ready to move on. I will forever hear her voice when I think of rescuing my clients in crisis. I now even reposition myself the same way she did when I notice this happening in a session (very relaxed, arms casual on the chair, shoulders back and low, and voice soft, calm and confident). I’m grateful for this lesson as a professional and as a person. It turns out to be great advice for parenting, too!

 3. Permission to Feel in the Session

In school, I had a professor, Sherry Smelley, LCSW, who taught a Grief and Dying Class. The class was particularly difficult for me to remain in my cerebral safety zone due to all of the presenters’ vulnerability in sharing their experiences of grief or loss. At one point, I remember a speaker sharing something so sad, the entire class (including me) became tearful. When I asked my professor, “How are we supposed to hear these kinds of stories and not feel too much?” She smiled and said, “Well, honey, you are supposed to feel…you are human. It’s what you do with these feelings that’s important. You’re permitted and even encouraged to feel in these sessions.” She said this with a soft, buttery voice and a southern accent that reminded me of my grandmother. 

Permission to feel is vital in our daily work. It is our job in individual therapy to serve our clients in the ways they need, and one of those is by checking in with our feelings, thoughts, and judgments as a barometer of the room and the world concerning them. Our emotions are important and helpful in figuring out ways to serve our patients best to achieve their goals. 

This advice is incredibly useful these days due to the overwhelming stressors of current times. I encourage my staff to be mindful of their stress, grief, worry, fear, anger, etc. as they walk into a session. This personal awareness improves their ability to connect to the client in the here and now. 

As I write this, I am mindful of so many things my early mentors and supervisors have taught me – I could go on and on. For now, I will stop here, flooded with gratitude for so many great lessons from the masters who took the time to reach out to me. #blessed

About the Author

Brandy Klingman, LCSW-BACS

Brandy Klingman, LCSW-BACS, is a skilled psychotherapist with a small private practice, as well as an owner and operator for mental health and addiction clinics. Her mission is to improve behavioral health standards of care and decrease barriers to accessibility for all. She does this through direct patient care, professional supervision, academic/university affiliations, professional consultations, public speaking, business development, and legislative advocacy. She is a coveted speaker in professional workshops, academic settings, and trainings.

Who Are The Trusted Providers On Our Network?

As a behavioral health professional, it’s known that life challenges may make it difficult for people to cope without seeking help. Patients start asking, “Where can I find a behavioral health provider?” However, clients may not know about all the different types of resources available. They may understand that to be a behavioral health professional, you have completed some training in a field related to psychology, but they may not understand the various education and training levels required for specific credentials and the high degree of specialization involved. In this blog, we will go in-depth about the multiple licensed professionals our subscriber directory consists of; as there are many fine distinctions among the various practice areas that may help you to refer the patient to the right professional.

This information varies from state to state

Counselors

These professionals have at least a master’s degree in psychology or related fields, such as family counseling. Their specific training allows them to evaluate a person’s mental health and apply therapeutic techniques to help with addiction, job issues, conflicts in families, general stress, etc. If you have a client who is grappling with a particular problem, such as addiction, you may have to refer them to a counselor with specific training addressing that particular problem.

Psychologists

Psychologists need to have licenses and training in clinical psychology; psychology is a pretty broad field and only certain training paths can do therapy. Psychologists don’t go to medical school, but receive their advanced degrees in different psychology or counseling programs. If you have a client struggling with problematic thoughts/behaviors or having difficulty coping with stressors, it may be beneficial for them to see a psychologist who takes a specific approach. For example, dialectical behavioral therapy and cognitive behavioral therapy are mainly designed to teach coping skills and help clients change problematic behaviors and thoughts.  Child psychology is different from that of adults. If you have a pediatric client, it may be helpful to find a psychologist with specific training in dealing with this age group, whether in education or counseling.

Psychiatrists

If you have a client whose issues seem to stem from an underlying medical problem or whom you believe would benefit from a psychiatric evaluation, you may need to refer them to a psychiatrist. A psychiatrist starts by going to medical school to earn an M.D. or D.O. degree. To become a psychiatrist, the newly minted medical doctor has to undergo additional training in the specific field of psychiatry.

Like psychologists and counselors, psychiatrists may complete additional training to treat specific types of patients primarily. For example, some psychiatrists specialize in treating conditions in patients of a particular age, such as the elderly or children and adolescents. Psychiatrists can provide the same types of services that psychologists and counselors do related to diagnosing, assessing, and treating mental health disorders. However, because they also have medical degrees, psychiatrists can also prescribe medication to patients, which most behavioral health professionals cannot. The ability to prescribe medication can be incredibly helpful in treating patients with substance use disorders. A psychiatrist may provide medication-assisted treatment programs for addiction that combine FDA-approved medications that block the effects of illicit drugs with behavioral therapy and counseling, taking a whole-patient approach.

Nurse Practitioners

A nurse practitioner has undergone advanced nurses’ training and is licensed to provide general health care services. Working under the supervision of a medical doctor, a nurse practitioner has the authority to examine patients, make diagnoses, and prescribe medication. A Psychiatric Mental Health Nurse Practitioner receives training specific to the practice of mental health. Like nurse practitioners in other specialties, a PMHNP works under a doctor’s supervision, in this case, a psychiatrist.

Social Workers

Social workers are trained to help people cope with challenges in every stage of their life such as child abuse or neglect, domestic violence, unemployment, housing situations, etc. A licensed social worker focuses on clinical skills and developing relationships with clients while operating under an agency’s authority to deliver intervention.Further education and supervision can grant a licensed social worker with the qualification of a clinically qualified social worker (LCSW). These professionals work in a wide variety of settings to provide emotional support, mental health evaluations, therapy and case management services to people experiencing psychological, emotional, medical, social and/or familial challenges. Their scope mirrors an LPC and can individually practice.

A measure of overlap between the services provided by different behavioral health professionals may be confusing to clients. When patients seek help, clinicians have a responsibility to assist. Fortunately, when you subscribe to Trusted Provider Network, you gain access to resources that aid referrals to reputable and trustworthy behavioral health providers in multiple specialties.

The Dual Role of Faith in Gambling Disorder

Written by: Ramon Zelaya, LPC-S

The addiction treatment field is often rich with broad and diverse themes, often containing hidden meaning waiting to be discovered by the perceptive clinician. One such theme – faith – often intersects with the wisdom touted by the 12-step recovery tradition and emerges frequently throughout the treatment and recovery process.  Faith, I have found, plays a dual role in the world of disordered gambling: it is the manner by which gamblers remain bound to their gambling habit, yet it is also a means by which they may escape their bonds.

For many disordered gamblers, a key component of their inability to stop or control gambling behavior is a misplaced faith in the outcome of the bet. More accurately, it is their perceived outcome that becomes problematic, a “cognitive distortion” that is self-reinforcing and difficult to challenge. Each bet is an attempt to resolve problems that result from previous, failed bets: financial losses, strained relationships, emotional consequences, etc.

These problems accumulate as gambling inevitably yields more losses than wins. Yet the gambler infuses each attempt with hope: hope of breaking even; hope of making a fortune; hope for a better life, a mended marriage, or relief from the pain of every loss experienced thus far. The gambler keeps following the same path hoping that everything will get better, that everything will be okay again. They persist despite all of the physical evidence suggesting that continued gambling is a bad idea, and everyone’s insistence that they are doing the wrong thing. They continue to hold onto real, albeit misguided, faith.

The profound wisdom of the serenity prayer offers a solution to the problem of misguided faith. It calls the individual to find and employ the strength to change for the better all things within their locus of control. In therapy, the cultivation of autonomy, self-efficacy, and positive self-regard leads to a new type of faith for the disordered gambler: faith in oneself. The goal here is for the individual to learn how to take responsibility where responsibility is due, and to make active efforts toward recovery and personal growth.

Additionally, the serenity prayer guides the individual to seek acceptance, challenging them to become comfortable with the experience of powerlessness in affecting certain outcomes. In this regard, faith must be held in the providence of the individual’s higher power, as they understand it. With an addiction wherein so much is left to chance, it is ironic that disordered gamblers have such difficulty letting go of their attempts to control. Nonetheless, letting go is crucial to recovery, and inherently requires faith.

As treatment providers, we often tell our clients to “have faith in the process” of therapy and recovery. I would ask all who read this to pause for a moment and consider the depth of that statement. For many whom we treat, we are asking for a monumental shift: to relinquish faith in a substance or behavior and gain faith in us, in recovery, and in themselves. This is not a step to be taken lightly, and should be approached with as much care and compassion as we can muster.

About the Author

Ramon Zelaya, LPC-S

Born and raised in New Orleans, Ramon began studying psychology during his senior year of high school. Never deviating from the subject, he completed a BA in Psychology from Loyola University and an MA in Counseling Psychology from Lewis and Clark College (Portland, OR). Ramon has been working steadily in the mental health field since 2003 in various settings: inpatient, outpatient, university, and private practice. Over the years he also culminated an interest in and knack for technology, pursuing ways to enhance therapeutic practice with state-of-the-art solutions. This pursuit brought Ramon to TPN Health where he accepted the position of Clinical Outreach Liaison, then moving on to become Clinical Outreach Director. Ramon hopes to continue his contribution to the clinical community by helping others discover new dimensions of practice through the TPN Health platform.