Latest / Psyched For Sanity / Episode 44 - Mental Health Professionals: What's the Difference?

Transcript

Episode 44 - Mental Health Professionals: What's the Difference? · Psyched For Sanity

• 0:11
  SPEAKER_03: Hello, welcome to Psyched for Sanity.
• 0:14
  SPEAKER_03: I'm one of your co-hosts, Dr.
• 0:15
  SPEAKER_03: Tara McKelvey Parker.
• 0:17
  SPEAKER_03: I am a clinical psychologist working in private practice.
• 0:20
  SPEAKER_03: I specialize in assessing and treating complex trauma and attachment wounds from childhood.
• 0:25
  SPEAKER_01: And I'm your other host.
• 0:26
  SPEAKER_01: My name is Dr.
• 0:27
  SPEAKER_01: Brendel Doss.
• 0:28
  SPEAKER_01: I'm a licensed psychologist specializing in geriatric psychology, forensic psychology, trauma treatment, and child assessment.
• 0:35
  SPEAKER_03: And we have a special guest.
• 0:38
  SPEAKER_03: We have a special guest! Another special guest! Yay! Yay guests! You want to introduce yourself?
• 0:44
  SPEAKER_03: Oh, hi.
• 0:45
  SPEAKER_00: We'll let you introduce yourself.
• 0:47
  SPEAKER_00: Okay.
• 0:48
  SPEAKER_00: I'm Erin Johnson.
• 0:49
  SPEAKER_00: I'm a licensed professional counselor in private practice, and I specialize in trauma-informed therapy, emotionally focused therapy, and I work with people across the lifespan.
• 1:00
  SPEAKER_03: Awesome.
• 1:01
  SPEAKER_03: Yes.
• 1:01
  SPEAKER_03: And I we wanted so we have talked a little bit on this show before about the different kinds of titles in the mental health field, different kinds of professionals.
• 1:12
  SPEAKER_03: Yes.
• 1:13
  SPEAKER_03: We've kind of dipped our toes into who you might see if you had a particular need or concern.
• 1:19
  SPEAKER_03: And so Erin is one of our really close friends and a really respected colleague, someone I would I have referred to because I love the way she thinks about patients and treats patients.
• 1:30
  SPEAKER_03: So we wanted to have her on because she has a different license.
• 1:34
  SPEAKER_03: She's a licensed professional counselor.
• 1:36
  SPEAKER_03: And so as we kind of talk about some of this information, who you'd see and the differences and professionals in the mental health field, we thought that her insight would be really valuable.
• 1:45
  SPEAKER_01: Absolutely.
• 1:46
  SPEAKER_01: Yeah, I think that it's it's confusing.
• 1:49
  SPEAKER_01: It's like an alphabet soup.
• 1:52
  SPEAKER_01: And it's like tricky.
• 1:54
  SPEAKER_01: And I think a lot of people don't understand the similarities and the differences and what that really means for them when they're in a therapy room.
• 2:01
  SPEAKER_03: Definitely.
• 2:01
  SPEAKER_03: Even when we were prepping for this, there were some of the licenses and titles that I was like, oh, I didn't realize about that particular professional that I don't even know because we've been kind of steeped in our own world, right?
• 2:14
  SPEAKER_03: You know, getting our PhDs.
• 2:15
  SPEAKER_03: And so it's um a lot of similarities, I think.
• 2:18
  SPEAKER_03: And then there's some like some some differences in training and um what kind of services who can, you know, that each one can provide and all of that.
• 2:27
  SPEAKER_01: So I just wanted to clarify.
• 2:29
  SPEAKER_01: And I think that's part of the challenge is I don't know if people always recognize you go to school and you get a degree, and then you apply for a license, and those processes are obviously related but separate, right?
• 2:42
  SPEAKER_01: Yes, yes.
• 2:42
  SPEAKER_01: And so depending on the school you go to and the type of program, somewhat, but Aaron's gonna talk about this hopefully, can kind of direct you towards what you can apply for.
• 2:52
  SPEAKER_01: Um things like that.
• 2:53
  SPEAKER_03: Yes, and what kinds of training and experience you have, and then what kind of um treatment you might receive from that professional.
• 3:00
  SPEAKER_03: So start with ours because it's the easiest to probably know the most about it.
• 3:05
  SPEAKER_03: Well, we do.
• 3:06
  SPEAKER_03: I do I guess we do, yeah.
• 3:08
  SPEAKER_01: But I think the biggest one that people get confused when you say the word doctor, um like like in mental health is the medication challenge, which is oh, I'm coming, I need anxiety meds or I need depression medication.
• 3:19
  SPEAKER_01: Yeah.
• 3:20
  SPEAKER_01: And so the biggest thing that I think is the misconception and the distinction between a psychologist and a psychiatrist, and that they both are in the mental health field, but they have very vastly different routes, and they do, I believe, caveats everywhere in this episode, guys.
• 3:36
  SPEAKER_01: Caveat, caveat, caveat.
• 3:38
  SPEAKER_01: They do different things, um, but there's overlap.
• 3:42
  SPEAKER_03: Yeah, for sure.
• 3:42
  SPEAKER_03: Yeah.
• 3:43
  SPEAKER_01: So a psychiatrist um has gone through medical school and has a residency that focuses on psychiatry um and mental health, and they are trained and can treat um most of the time with medication.
• 3:57
  SPEAKER_01: Historically, some do psychotherapy or therapy, but generally speaking, now most medication um prescribers come through a medical school route, and we'll talk about that um in a little bit.
• 4:08
  SPEAKER_01: But that's a big question that I get, I think.
• 4:11
  SPEAKER_01: Like, can I can I have medication for my schizophrenia?
• 4:13
  SPEAKER_01: And so yes, yes.
• 4:14
  SPEAKER_03: Yeah, I get I get quite a few medication questions.
• 4:17
  SPEAKER_03: Um and I'm really lucky to work with someone who is a psychiatrist, she prescribes med meds and does psychotherapy from a like dynamic um sort of psychodynamic uh formulations, which is it's super interesting.
• 4:32
  SPEAKER_03: So I get to hear her perspective a lot in case consultation, but it is more rare, certainly, to have a psychiatrist who's also doing the therapy.
• 4:41
  SPEAKER_02: Right.
• 4:41
  SPEAKER_03: Um but if you're wanting medication, then a psychiatrist is definitely someone you would see.
• 4:47
  SPEAKER_03: A psychologist, we Dr.
• 4:49
  SPEAKER_03: Doss and I can't prescribe medication at all.
• 4:52
  SPEAKER_01: And Aaron, when we were kind of prepping and re- and researching this, you had brought up a really interesting point point in your practice.
• 4:57
  SPEAKER_01: You actually seek out a certain type of medication provider.
• 5:00
  SPEAKER_01: I do.
• 5:00
  SPEAKER_01: Oh, interesting.
• 5:02
  SPEAKER_00: Um, I really look for uh psychiatric nurse practitioners.
• 5:06
  SPEAKER_00: Oh, and I think it's becoming a little more popular.
• 5:09
  SPEAKER_00: Um now, uh, you're seeing a lot more or nurse practitioners working with psychiatrists.
• 5:16
  SPEAKER_03: I've certainly seen them like in psychiatry practices.
• 5:19
  SPEAKER_00: Right.
• 5:20
  SPEAKER_03: So what why do you refer or look for that more?
• 5:23
  SPEAKER_00: So um, so their specialty is in nursing.
• 5:28
  SPEAKER_00: Um, that's where they started.
• 5:29
  SPEAKER_00: And then when they go to get their um to become a nurse practitioner, then they specialize in psychiatric the psychiatric field.
• 5:37
  SPEAKER_00: The psychiatric field.
• 5:38
  SPEAKER_00: So um neurology, um, mental health, that's their primary emphasis versus the traditional route of a psychiatrist, which is med school, and then a four-year residency in a psychiatric field.
• 5:54
  SPEAKER_00: And so it's just a little bit different.
• 5:56
  SPEAKER_00: And um, in my experience and the feedback from my clients um over the years is that they're able to spend more time with them.
• 6:04
  SPEAKER_01: Interesting.
• 6:05
  SPEAKER_00: Um and they feel overall, um, you know, I have referred to some great psychiatrists as well, but um, the feedback has been that uh they feel seen, more seen, more heard, um, more they they're able to, they're not just a number, they're able to be um, you know, it's a little more therapeutic, um, I think for the most part in terms of um a less clinical setting sometimes, less sterile, a kind of doctor's office setting.
• 6:36
  SPEAKER_00: Um, and I've found them honestly to be a little more um open to consultation.
• 6:41
  SPEAKER_00: Open to consultation, thank you.
• 6:43
  SPEAKER_00: Yes.
• 6:43
  SPEAKER_00: Yeah.
• 6:44
  SPEAKER_03: Yeah.
• 6:44
  SPEAKER_03: I do think I I yes, and it certainly depends on the psychiatrist and their training.
• 6:49
  SPEAKER_03: Um, but if they're just doing medication management, then those appointments tend to be shorter.
• 6:54
  SPEAKER_03: Yeah.
• 6:54
  SPEAKER_03: Um, and that can feel really exposing and vulnerable and scary and not okay for lots of folks.
• 6:59
  SPEAKER_03: They really need more attention and care and time to really feel seen, heard, understood.
• 7:05
  SPEAKER_03: So I I didn't realize that.
• 7:06
  SPEAKER_03: And that's actually that's cool.
• 7:08
  SPEAKER_03: I knew that psychiatric nurse practitioners could prescribe medications, and I've seen them, and some of my patients have seen them, but I didn't recognize the distinction there.
• 7:17
  SPEAKER_03: Yeah.
• 7:18
  SPEAKER_00: I think especially if they're resistant to medication, I found that that's a um a less intrusive route uh to go is to refer to a psychiatric nurse practitioner.
• 7:29
  SPEAKER_00: It kind of feels like more of an ease-in for people.
• 7:32
  SPEAKER_00: Interesting.
• 7:32
  SPEAKER_00: Um, because I get a lot of medication resistant clients.
• 7:36
  SPEAKER_03: Oh, yes, me too.
• 7:37
  SPEAKER_03: For sure.
• 7:38
  SPEAKER_00: And, you know, I think that y'all were asking me um earlier if if I get calls, you know, asking if I prescribe, and I don't, I think that's probably because I'm a master's level.
• 7:49
  SPEAKER_00: Um, and so I don't get that the same.
• 7:52
  SPEAKER_03: There's not as much confusion around that.
• 7:54
  SPEAKER_03: And and maybe because psychologists and psychiatrists, they just sound very similar.
• 7:59
  SPEAKER_01: I think that's a good very logical point.
• 8:00
  SPEAKER_03: I mean, you know, that's just even simpler.
• 8:02
  SPEAKER_03: It's just like they sound like the same thing.
• 8:05
  SPEAKER_01: Um okay, interesting.
• 8:07
  SPEAKER_01: I also wonder if the background in nursing coming from that lens, which is more patient focused, yes, might be a big part of that.
• 8:13
  SPEAKER_01: I think it is.
• 8:13
  SPEAKER_03: Yeah, I the training, right?
• 8:15
  SPEAKER_01: And the focus nursing versus just typical like doctor psychiatrists definitely are trained in a medical model of mental health.
• 8:22
  SPEAKER_01: Yeah.
• 8:22
  SPEAKER_03: Yep.
• 8:23
  SPEAKER_03: Yeah.
• 8:23
  SPEAKER_03: And so, okay, you want to explain what medical model is?
• 8:27
  SPEAKER_03: No, just no, I just probably really loud.
• 8:30
  SPEAKER_03: Sorry.
• 8:31
  SPEAKER_01: No, I think the medical model of mental health is um, it can be depending on the school.
• 8:37
  SPEAKER_01: I think there's a lot of nuance with this too.
• 8:39
  SPEAKER_01: Caveat, caveat, caveat, guys.
• 8:41
  SPEAKER_01: Um, I think it depends on school.
• 8:43
  SPEAKER_01: I think there's like there we could get into the weeds with this a little bit with DO versus.
• 8:47
  SPEAKER_03: There's a little bit more of a hierarchy, usually, I think, in the medical model, where the the doctor, the psych, you know, or psychiatrist is a little bit more the professional.
• 8:55
  SPEAKER_03: Um and there's a little, again, like the hierarchy in nursing and some other fields, they're not really trained in that same model, or that there's not that hierarchical kind of difference.
• 9:04
  SPEAKER_01: So that's the power difference.
• 9:05
  SPEAKER_01: It's the power differential.
• 9:07
  SPEAKER_01: Sure.
• 9:07
  SPEAKER_03: Some people feel a lot more safe with an actual doctor with that hierarchy, actually.
• 9:12
  SPEAKER_02: Uh-huh.
• 9:12
  SPEAKER_03: Um, and others do not feel as safe with that hierarchy, and they really do better with someone who's on the same, the same kind of power differential.
• 9:20
  SPEAKER_03: And I think it's a vibe, and I think it's a personality style, and I think it's training, and it's kind of I think it's all probably combined.
• 9:27
  SPEAKER_03: And so there's this is it's nuanced too.
• 9:31
  SPEAKER_03: And in what you really feel safe with and need and and want when you're when you're thinking about your medication provider.
• 9:37
  SPEAKER_01: So that's psychiatry and psychiatrists.
• 9:39
  SPEAKER_01: Yeah.
• 9:40
  SPEAKER_01: What do psychologists do?
• 9:42
  SPEAKER_01: What do we do?
• 9:42
  SPEAKER_03: What do we do?
• 9:43
  SPEAKER_03: What do we do?
• 9:44
  SPEAKER_03: What do we do?
• 9:45
  SPEAKER_03: We do a lot of things.
• 9:47
  SPEAKER_03: A lot of things.
• 9:49
  SPEAKER_03: We are generally trained in a variety of different kinds of things.
• 9:54
  SPEAKER_03: For when my program, you know, I it was a generalist program.
• 9:58
  SPEAKER_03: I went to UNT, um, but I specialized in child and family therapy.
• 10:03
  SPEAKER_03: So some of the things that an LCSW would do, for instance, I did have actually quite a lot of training in family systems and relationships and couples and marriages and that and that kind of thing.
• 10:14
  SPEAKER_03: But we're trained, you know, a lot of programs are generalists.
• 10:17
  SPEAKER_03: So we get a lot of training in psychopathology, assessment, um, doing therapy.
• 10:23
  SPEAKER_03: Right.
• 10:23
  SPEAKER_03: You know, many of us can and do see couples and families, um, conduct assessment, um, what else?
• 10:32
  SPEAKER_03: Research.
• 10:32
  SPEAKER_03: Some PhDs are just research focused.
• 10:35
  SPEAKER_03: Some just teach.
• 10:35
  SPEAKER_03: They teach and do research.
• 10:37
  SPEAKER_03: Um, some are industrial organizational psychologists, so they study business systems, I guess.
• 10:42
  SPEAKER_03: It was personality factors related to hiring.
• 10:44
  SPEAKER_01: Yep.
• 10:44
  SPEAKER_03: Yeah, yeah, yeah.
• 10:45
  SPEAKER_03: Organization.
• 10:46
  SPEAKER_01: Um, how to improve like employee employee performance.
• 10:49
  SPEAKER_01: Fun fact, I wanted to go into that.
• 10:51
  SPEAKER_01: Really?
• 10:51
  SPEAKER_03: Did you?
• 10:52
  SPEAKER_03: I did.
• 10:53
  SPEAKER_00: I did prior to finding my fun fact.
• 10:55
  SPEAKER_03: When I went to my undergrad, we had someone on the faculty in the psychology department was an IO psychologist.
• 11:00
  SPEAKER_03: And so I had considered that briefly too.
• 11:02
  SPEAKER_00: It's less common here in Texas.
• 11:04
  SPEAKER_00: So at the time, I didn't find as much as many options.
• 11:07
  SPEAKER_00: But yeah, that was definitely.
• 11:09
  SPEAKER_03: You could have been an industrial organizational psychologist.
• 11:12
  SPEAKER_00: Interestingly.
• 11:13
  SPEAKER_00: Yeah.
• 11:14
  SPEAKER_00: Interesting.
• 11:14
  SPEAKER_00: It's a very I'm pretty happy wearing it.
• 11:16
  SPEAKER_01: Yeah, yeah, yeah.
• 11:17
  SPEAKER_01: It's a very different field of psych psychology.
• 11:20
  SPEAKER_01: Um, and it's not, and it's see, that's the thing.
• 11:22
  SPEAKER_01: We're kind of getting in the weeds a little bit here, too, guys.
• 11:24
  SPEAKER_01: Just for you guys watching and listening at home.
• 11:26
  SPEAKER_01: Even within these niches, there is a lot of variety.
• 11:29
  SPEAKER_01: It is a great deal.
• 11:29
  SPEAKER_01: For example, an IO psychologist, industrial organizational, does not, to my understanding, in Texas, need a license.
• 11:35
  SPEAKER_01: They're hired by a company.
• 11:37
  SPEAKER_01: They don't go through the boards.
• 11:38
  SPEAKER_01: Oh, I didn't know that.
• 11:39
  SPEAKER_01: They don't have a licensing process.
• 11:40
  SPEAKER_01: No, they don't, because they work for a company and they're an employee for a company or they're like a contractor or a consultant.
• 11:47
  SPEAKER_01: Oh, okay.
• 11:48
  SPEAKER_01: Interesting.
• 11:48
  SPEAKER_00: Which is why I probably couldn't find a whole lot of information on it.
• 11:53
  SPEAKER_01: To my understanding, my understanding, because there's if you think about clinically, they don't the person they're treating is they're working for the company.
• 12:00
  SPEAKER_01: They're working for the company.
• 12:01
  SPEAKER_01: So if they're looking at improving employee performance or improving systems related to like human performance in a company organization, or which human factors go into an agency.
• 12:11
  SPEAKER_03: I mean, maybe there is an agency of checking value.
• 12:13
  SPEAKER_01: I'm happy to be called out in the comments.
• 12:15
  SPEAKER_01: I I to my knowledge on this day.
• 12:18
  SPEAKER_01: We will probably be called out.
• 12:19
  SPEAKER_01: I'm sure.
• 12:20
  SPEAKER_01: And maybe it's different.
• 12:21
  SPEAKER_01: We're based in Texas, so maybe there's a difference in different states.
• 12:24
  SPEAKER_01: That's a everything varies by state.
• 12:26
  SPEAKER_01: Every license varies by state.
• 12:27
  SPEAKER_03: Right.
• 12:28
  SPEAKER_03: Yes.
• 12:28
  SPEAKER_03: So when you're thinking about these, you know, even many of us psychologists do therapy.
• 12:34
  SPEAKER_03: Not all of us, but if you are looking for a therapist who is also a psychologist, then you just want to be intentional about their training and their background and what kind they are.
• 12:43
  SPEAKER_03: Clinical psychologists for sure can usually, you know, they'll do therapy, counseling psychologists.
• 12:48
  SPEAKER_03: Yeah, my background is counseling psychology.
• 12:50
  SPEAKER_03: Technically, mine is two, but I work with a lot of clinical psychologists and got a lot of training.
• 12:55
  SPEAKER_03: So I I kind of use the terms interchangeably.
• 12:58
  SPEAKER_03: Yeah, sure.
• 12:58
  SPEAKER_03: But technically speaking, I'm a counseling psychologist.
• 13:02
  SPEAKER_03: So I got all the training and like vocational training.
• 13:04
  SPEAKER_03: Like counseling psychologists got their start after World War II.
• 13:09
  SPEAKER_03: So like doing vocational and uh IQ testing.
• 13:11
  SPEAKER_03: Vocational and IQ testing and placement because there was a huge, a huge need for you know the veterans to be able to find jobs and be placed.
• 13:20
  SPEAKER_01: It was also in during the war to figure out who would be good at what job.
• 13:23
  SPEAKER_03: Yes.
• 13:24
  SPEAKER_03: Yeah.
• 13:24
  SPEAKER_03: So so we learned all the assessments for you know career and vocational.
• 13:28
  SPEAKER_03: I still use that.
• 13:28
  SPEAKER_03: I have it in my battery of tests.
• 13:30
  SPEAKER_03: If people want career counseling or vocational counseling, I will definitely do it as part of the battery.
• 13:36
  SPEAKER_03: Yeah.
• 13:36
  SPEAKER_03: Um, I still I I value that that training.
• 13:40
  SPEAKER_01: So well, now that we've kind of given like a very brief overview about psychiatry and psychology, Aaron, tell us what an LPC is, at least in Texas, and kind of like your pathway to get to there to that license.
• 13:52
  SPEAKER_03: Yeah, and also a little bit about your practice because I'm curious to hear what it looks like these days and who you're treating and what you're into.
• 14:00
  SPEAKER_00: Okay.
• 14:00
  SPEAKER_00: Um, so a licensed professional counselor, so an LPC.
• 14:04
  SPEAKER_00: Um, I just re-looked up the requirements because it's been a minute.
• 14:08
  SPEAKER_00: Um I've been fully licensed for 13 years.
• 14:12
  SPEAKER_00: Um, so in the field for 15 and been in private practice for five now.
• 14:18
  SPEAKER_00: It'll be five in December.
• 14:19
  SPEAKER_00: So and the path to getting there, I did my undergrad in psychology at TCU.
• 14:27
  SPEAKER_00: Um the purple.
• 14:28
  SPEAKER_00: Clearly, the purple.
• 14:30
  SPEAKER_03: Um TCU, all the way down to her toes.
• 14:33
  SPEAKER_00: I love it.
• 14:34
  SPEAKER_00: Um uh with a minor in English, and I I took some time in between and used the minor um and till I was ready to go to grad school because I knew eventually um that's what I really wanted to do is be a counselor.
• 14:48
  SPEAKER_02: Okay.
• 14:49
  SPEAKER_00: Um, but I took some time off in between um to figure out to kind of you know, see the world a little bit and figure out if that's what I really wanted to do.
• 14:57
  SPEAKER_00: Um, and then in 2008, I went back to school to Texas Wesleyan.
• 15:02
  SPEAKER_00: Um Texas Wesleyan.
• 15:04
  SPEAKER_00: Here in Fort Worth as well.
• 15:06
  SPEAKER_00: Um, and uh and got my master's in um master of science.
• 15:11
  SPEAKER_00: So in our program, you could do a master of arts, which was the primary counseling or school counseling route, and the master of science was the marriage and family therapy route.
• 15:22
  SPEAKER_03: So my that's a good distinction because that's often the case for PhDs in the doctoral level, you know, you can you can do a you can do a PhD or you can do a Psy D.
• 15:32
  SPEAKER_03: One is like much more science-based, one's more research and clinical, and then one's much more clinical.
• 15:38
  SPEAKER_03: So there's like different even tracks in the master's and PhD.
• 15:42
  SPEAKER_03: So much nuance.
• 15:43
  SPEAKER_03: Yeah, there's so much nuance.
• 15:44
  SPEAKER_00: Yeah, we had three tracks.
• 15:46
  SPEAKER_00: Um, the school counseling, which is a a different animal, um uh LPC, and then LMFT, which is marriage and family therapist.
• 15:56
  SPEAKER_00: I initially started out on both paths.
• 15:58
  SPEAKER_00: I wanted to be licensed in both.
• 16:01
  SPEAKER_03: In LPC and LMFT?
• 16:03
  SPEAKER_03: Yes.
• 16:03
  SPEAKER_03: Oh, in the same time.
• 16:04
  SPEAKER_00: Um so my master of masters of science is in marriage and family therapy.
• 16:09
  SPEAKER_00: Um, but my license is in professional counseling.
• 16:13
  SPEAKER_00: It's very confusing.
• 16:14
  SPEAKER_00: It is confusing.
• 16:16
  SPEAKER_00: Um uh now it's it's um there's less of a full distinction now just because we're all under the same umbrella.
• 16:22
  SPEAKER_03: Um governing agency.
• 16:25
  SPEAKER_03: Yes.
• 16:26
  SPEAKER_03: Yeah.
• 16:26
  SPEAKER_00: Um and so, but at the time, LPC was the stricter license, meaning if I had both, I would be bound to the the licensing rules of interesting of the LPC.
• 16:39
  SPEAKER_03: Okay.
• 16:39
  SPEAKER_03: Yes.
• 16:40
  SPEAKER_00: So I ended up ultimately um training is an LMFT and then extra, yes, kind of extra education in in LMFT.
• 16:49
  SPEAKER_00: So I I'm able to do both.
• 16:52
  SPEAKER_00: Um and I have some additional trainings in in that regard.
• 16:56
  SPEAKER_00: I thought I was gonna be a straight marriage therapist, and spoiler alert, I'm not.
• 17:01
  SPEAKER_03: It is hard, it's hard work hard couple or two.
• 17:05
  SPEAKER_03: Yes, same.
• 17:06
  SPEAKER_03: But I'm I yeah, and the same for family work because the more bodies you have in the room, the more energy.
• 17:12
  SPEAKER_03: Yes, yeah, that's a great way to put it.
• 17:14
  SPEAKER_03: I feel like energetically I can't do much of it.
• 17:17
  SPEAKER_02: Yes.
• 17:18
  SPEAKER_03: All of you know, so I same because child and family.
• 17:21
  SPEAKER_03: It's like all the family training, uh-huh, uh-huh, and I was all about family therapy.
• 17:26
  SPEAKER_03: Yes, that's what I wanted to do, and child work, and it has evolved and morphed.
• 17:31
  SPEAKER_03: And I see I love working with kids, but I my caseload is certainly less children, yes, and less couples and no families right now.
• 17:39
  SPEAKER_00: Yes, I started working almost primarily with teenagers, which was a population I never thought I would work with.
• 17:46
  SPEAKER_00: Uh because my husband so much.
• 17:48
  SPEAKER_00: I do love them so much.
• 17:49
  SPEAKER_00: But my husband is a high school uh teacher and coach.
• 17:53
  SPEAKER_00: And so I thought he's got that population covered.
• 17:56
  SPEAKER_00: I'm good.
• 17:57
  SPEAKER_00: Um, but the second I had a teenager come into my practicum, um, my thoughts on that changed.
• 18:04
  SPEAKER_00: And I found that I really uh relate well um to teenagers.
• 18:09
  SPEAKER_00: Of course, now that I've been doing this a while, um, they've kind of they've morphed into uh young adults, and I primarily work with young adults now.
• 18:18
  SPEAKER_00: I'll see 17 and up, um, but mostly, mostly young adults, and then I really enjoy my mature uh uh adults as well.
• 18:28
  SPEAKER_00: So all the way up, I think um the oldest I've seen is like 70, 75.
• 18:34
  SPEAKER_00: Um, so I really enjoy, I have a lot of clients in their 50s and 60s, and um and then uh the the uh complex PTSD is something that I work um in.
• 18:48
  SPEAKER_00: And I have a lot of clients that um I've been seeing for for a long time on their journey.
• 18:53
  SPEAKER_03: Yeah.
• 18:54
  SPEAKER_00: Um and I do a lot of grief work.
• 18:56
  SPEAKER_00: Um I work with the LGBTQ IA plus community um really closely.
• 19:01
  SPEAKER_00: I started in Burleson and um I became kind of a safe, safe space for those in Burleson um and the surrounding areas.
• 19:10
  SPEAKER_00: Um and so a lot of them followed me to to my practice um in Arlington.
• 19:15
  SPEAKER_02: Okay.
• 19:16
  SPEAKER_00: And so um I take a lot of pride in and my work with that community as well.
• 19:20
  SPEAKER_03: Okay.
• 19:21
  SPEAKER_03: And you when you were in Burleson, it was more of a community mental health or like a other-led private practice.
• 19:26
  SPEAKER_03: I can't remember.
• 19:27
  SPEAKER_00: It was a group practice.
• 19:28
  SPEAKER_00: A group practice.
• 19:29
  SPEAKER_00: Yeah, okay.
• 19:29
  SPEAKER_00: It was a group practice.
• 19:30
  SPEAKER_03: Um you've done some group practice, you've done some community mental health too.
• 19:34
  SPEAKER_00: Yes, so I was I um worked at a behavioral health hospital um when I was earning my hours, and then um uh for a couple years after I I was fully licensed.
• 19:45
  SPEAKER_00: Um, I did I dabbled in inpatient, but mostly it was it was uh IEP and PHP.
• 19:52
  SPEAKER_00: So the um intensive outpatient and uh partial hospitalization.
• 19:57
  SPEAKER_00: Um and so that's really how I earned the bulk of my hours and gained that experience and learned that group therapy is not my jam.
• 20:06
  SPEAKER_00: It's not your thing.
• 20:07
  SPEAKER_00: Talk about bodies in the room.
• 20:08
  SPEAKER_00: Yeah.
• 20:08
  SPEAKER_00: Oh my god.
• 20:09
  SPEAKER_03: There's a lot of energy there.
• 20:11
  SPEAKER_00: Yes.
• 20:11
  SPEAKER_00: I preferred my teenage groups uh uh to my adult groups.
• 20:16
  SPEAKER_00: Um, but I I gained some invaluable experience and um that I wouldn't trade, but also showed me, showed me what I did and didn't want to do.
• 20:25
  SPEAKER_03: So when you when you were getting your master's, did you have to have a practicum experience like during your master's?
• 20:33
  SPEAKER_03: Yes.
• 20:34
  SPEAKER_03: Okay.
• 20:34
  SPEAKER_03: Yes, we did.
• 20:35
  SPEAKER_03: Most of them most of the master's level clinicians require correct and the and the usually the PhD programs, society programs, probably most of them.
• 20:43
  SPEAKER_03: That's required clinical programs.
• 20:45
  SPEAKER_03: At least a practicum LCS, not multiple.
• 20:47
  SPEAKER_03: L C sure.
• 20:48
  SPEAKER_03: So then that kind of further when you're thinking about providers, you know, and their experience, like what fits yours and your needs.
• 20:55
  SPEAKER_03: Like everyone has kind of chosen different off-site options for training.
• 21:00
  SPEAKER_03: Yeah.
• 21:01
  SPEAKER_03: You have your inpatient experience.
• 21:02
  SPEAKER_03: I never worked, I worked at the eating disorder hospital, but and there was an inpatient component, but I didn't get a lot of inpatient treatment.
• 21:10
  SPEAKER_03: Um, whereas a lot of the folks I work with got a lot of inpatient treatment.
• 21:14
  SPEAKER_03: And so they tend to work with people who have more severe presentations of just, you know, more um severe mental illness.
• 21:22
  SPEAKER_00: Well, and so practicum, which is um, which is like when you're still in school, um, being being heavily supervised, you're still a student.
• 21:32
  SPEAKER_00: And um, I did, we had an on-campus.
• 21:35
  SPEAKER_00: We had the privilege of having an on-campus counseling school.
• 21:38
  SPEAKER_00: We did two of them.
• 21:39
  SPEAKER_00: Yeah, yeah, yeah.
• 21:39
  SPEAKER_00: I guess we did two.
• 21:40
  SPEAKER_00: Not as many do, which is unfortunate.
• 21:42
  SPEAKER_00: Um we did, and um, and so I did that, and then I also got to work with one of my professors in private practice.
• 21:50
  SPEAKER_00: Oh, yeah.
• 21:50
  SPEAKER_00: So I was kind of able to.
• 21:51
  SPEAKER_03: So you did lots of different things then while you were also in school.
• 21:55
  SPEAKER_00: I did, and then when I graduated, is when I got um the job with uh technology.
• 22:00
  SPEAKER_00: Texas Health actually and um and then did a lot of their outpatient ran a lot of their outpatient groups um and would then substitute for the inpatient groups at times.
• 22:12
  SPEAKER_00: Um okay, okay.
• 22:13
  SPEAKER_00: Yeah, so that's how I really earned my hours towards full licensure.
• 22:18
  SPEAKER_00: So I got to I had the benefit of seeing kind of different different types of of therapy.
• 22:23
  SPEAKER_00: Um that to let you know what you like and don't like.
• 22:25
  SPEAKER_00: Yeah, absolutely.
• 22:26
  SPEAKER_00: I got to um observe uh uh oncology counseling, which is another field I thought I was going into.
• 22:33
  SPEAKER_00: Um and and my time interesting, my time observing that was really invaluable, but it also taught me it's really heavy.
• 22:40
  SPEAKER_00: And so sure um, you know, that was something that uh I I certainly don't specialize in, but I do see a lot of clients with a chronic illness.
• 22:50
  SPEAKER_00: Um I think helped me prepare, absolutely prepare me for that.
• 22:54
  SPEAKER_00: I also see a lot of clients that are struggling with infertility, okay.
• 22:59
  SPEAKER_00: Um, or that are on an adoption journey as well.
• 23:02
  SPEAKER_03: So Okay, cool.
• 23:04
  SPEAKER_00: Yeah.
• 23:04
  SPEAKER_03: I have you told me what did you do for practicum wise?
• 23:08
  SPEAKER_03: I did a lot of things.
• 23:09
  SPEAKER_03: Did you?
• 23:09
  SPEAKER_03: Oh, we don't have time for that.
• 23:10
  SPEAKER_01: We don't have time for all the things.
• 23:12
  SPEAKER_01: No, we don't.
• 23:13
  SPEAKER_01: But I do want to hear about like, I think that's an important distinction, like that all of these degrees and licenses, they are as practical experience before we're like released on the road.
• 23:23
  SPEAKER_01: You know what I mean?
• 23:23
  SPEAKER_03: Yeah, we're not just in a classroom learning theory.
• 23:26
  SPEAKER_03: No.
• 23:26
  SPEAKER_03: We are also doing on-site and off-site practicum trains where we are actually seeing patients in a variety of settings with supervision so that we feel more prepared to see patients when we're out of school.
• 23:38
  SPEAKER_01: Yeah, and I think like kind of like you talked about, in a in a sense, when you from my understanding, when you're a student in mental health, no matter which program you're in, master's or PhD, you kind of pick the practicum for the most part.
• 23:48
  SPEAKER_01: Yes.
• 23:49
  SPEAKER_01: That you go to.
• 23:49
  SPEAKER_01: So you kind of self-select to a degree and then you learn what's for you and what's not, which I think is super important when you're in that journey as a mental health student training to become a provider.
• 23:59
  SPEAKER_01: Yes.
• 23:59
  SPEAKER_01: Um, I do want to make sure we have time to talk about LCSW.
• 24:02
  SPEAKER_01: Yeah.
• 24:03
  SPEAKER_01: And I know we don't have an LCSW to talk today, but I work with a lot of LCSWs, and they the training I think that is there's parallels with a lot of these, and there's divergence and very like specific.
• 24:14
  SPEAKER_01: So I don't want to speak out of term, but in Texas, LCSW training is the social work attract, and that training generally involves you can have a lot of social workers that um are really not doing a clinical or counseling focus, like in-the-room treatment, but they do a lot of um referrals to resources, um support, and things like that.
• 24:35
  SPEAKER_01: But you do also have working with LCSWs that are that would consider themselves therapists.
• 24:40
  SPEAKER_01: Uh-huh.
• 24:40
  SPEAKER_01: That's the interesting thing, I think, and important that it can be confusing to people is all three of us, I think, at some point we'll call ourselves a therapist.
• 24:46
  SPEAKER_03: Yeah, because therapists means that you conduct therapy.
• 24:50
  SPEAKER_03: Right.
• 24:50
  SPEAKER_03: Yes.
• 24:50
  SPEAKER_03: Um, and so psychologists, LPCs, L C L CSWs will all things like that.
• 24:55
  SPEAKER_01: And I want to be also mindful that there's a lot of other labels and terms, and Larry's Larry's Larry's Labels.
• 25:01
  SPEAKER_01: Oh, I would like who's like Larry.
• 25:04
  SPEAKER_01: I don't know.
• 25:04
  SPEAKER_01: It's probably our next guest.
• 25:05
  SPEAKER_01: We'll figure it out.
• 25:08
  SPEAKER_01: I don't even know any Larry's either.
• 25:09
  SPEAKER_01: Do you know a Larry?
• 25:10
  SPEAKER_01: You'll find a Larry.
• 25:11
  SPEAKER_01: So funny.
• 25:11
  SPEAKER_01: You'll find a Larry.
• 25:12
  SPEAKER_01: I mean, I've known Larry's like patients have been Larry's.
• 25:15
  SPEAKER_03: I don't even know if I've had a patient, Larry.
• 25:17
  SPEAKER_01: I haven't.
• 25:17
  SPEAKER_03: I have a family member, Larry, but uh that's okay.
• 25:20
  SPEAKER_03: Anyway, continue.
• 25:21
  SPEAKER_01: Anywho's, but licensures vary highly by state.
• 25:24
  SPEAKER_01: There are licensures that exist in other states that we don't have, they just have different words and terms in different states.
• 25:30
  SPEAKER_01: And that's important to note.
• 25:31
  SPEAKER_01: That's all very confusing, super confusing, which is why I kind of wanted to spend some time talking about that today.
• 25:37
  SPEAKER_01: Um, but I think the biggest thing is important, I think, is and I think Aaron, you and I've talked about this a while ago, but the licensure doesn't determine the quality of a therapist.
• 25:47
  SPEAKER_01: And I I myself go to a therapist that is a master's level clinician.
• 25:52
  SPEAKER_01: Oh, me too.
• 25:53
  SPEAKER_03: Yeah, me too.
• 25:54
  SPEAKER_03: And I think that's really Yeah.
• 25:55
  SPEAKER_03: I've been I've been seeing my therapist for the plus years.
• 25:59
  SPEAKER_03: I mean, she she's really great.
• 26:01
  SPEAKER_03: Um yeah, mine is a mass, I think she's an LPC.
• 26:05
  SPEAKER_03: She's trauma informed, like her specialty is trauma.
• 26:07
  SPEAKER_03: Um, but I purposefully chose someone who would be able to treat my particular concerns.
• 26:15
  SPEAKER_03: Um, and that was more important to me than a license than the title or the degree.
• 26:21
  SPEAKER_03: Yeah.
• 26:22
  SPEAKER_03: Um so yeah, I think there, you know, most of who we're talking about here can do therapy.
• 26:28
  SPEAKER_03: Not all do.
• 26:30
  SPEAKER_03: Right.
• 26:30
  SPEAKER_03: And it in general, their training and experience in school on, you know, at school and off-site is just kind of um a little bit more specific.
• 26:41
  SPEAKER_03: Right.
• 26:41
  SPEAKER_03: Right.
• 26:42
  SPEAKER_03: So license licen uh LMFTs, they're really going to get more training and experience with couples and families and family systems.
• 26:49
  SPEAKER_03: LCSWs are gonna learn a lot about the communities and the systems.
• 26:53
  SPEAKER_03: Exactly.
• 26:54
  SPEAKER_03: They're gonna advocate and they're gonna link patients up with resources while also being able to do therapy potentially.
• 27:00
  SPEAKER_03: Exactly.
• 27:01
  SPEAKER_03: Um, psychologists tend to be more generalized and get training in a lot of these areas, but then specialize, right?
• 27:08
  SPEAKER_03: And so you might a psychologist who does way more couples therapy and that's what they enjoy in their specialty.
• 27:15
  SPEAKER_01: So I think that's the important thing that that I really appreciate about you, Aaron, so much is you're someone, and Terry, you've done this as well, after school and after the degree, after the license, you both have really pursued very specific trainings very intentionally to treat the population in the most effective way.
• 27:31
  SPEAKER_01: And so I really appreciate that so much of that.
• 27:33
  SPEAKER_01: That's the point is after the degree, so many of us go on to specialize and continue our schools, our unofficial school.
• 27:40
  SPEAKER_03: We have to continuing education credits too to keep up with our license.
• 27:44
  SPEAKER_03: So there's always ethical um, you know, CEUs, and there's always diversity CEUs, and then you get to pick based on what your want to learn about your interests are, what you want to learn about.
• 27:56
  SPEAKER_03: So I'm you know doing EMDR training and internal family systems training, and I'm learning about assessment.
• 28:01
  SPEAKER_03: These are things I care about, and I'm I will pick training in that vein.
• 28:06
  SPEAKER_01: Yeah, and Aaron, you've done a lot of those similar things as well, especially I think with your work on trauma.
• 28:11
  SPEAKER_01: Um I think the main takeaway is I think people always kind of know, want to know what who do I go to.
• 28:17
  SPEAKER_01: Um and generally a rule of thumb, and this is not inclusive, caveat, caveat, caveat.
• 28:23
  SPEAKER_01: Sorry guys.
• 28:24
  SPEAKER_01: Generally a prescriber is gonna be able to do the medication side of mental health, and some do therapy, but not as common.
• 28:31
  SPEAKER_01: And a therapist, whether it's um an LCSW, an LPC, an LP, which is a licensed psychologist, those are potentially consider themselves therapists.
• 28:41
  SPEAKER_01: And so that's the first thing, and that's one of the bigger distinctions.
• 28:44
  SPEAKER_01: But I think I've just Aaron, what have you taken away from our conversation today?
• 28:48
  SPEAKER_01: What do you think is important for folks that maybe don't have like we're in it, so the sanctions are really clear for us.
• 28:53
  SPEAKER_01: Yes.
• 28:54
  SPEAKER_01: But what are you thinking like from this conversation?
• 28:57
  SPEAKER_01: What are you taking away from today, I guess?
• 28:59
  SPEAKER_00: So I think that above all, the fit is the most important thing.
• 29:04
  SPEAKER_00: It doesn't really matter what licensing we all have.
• 29:08
  SPEAKER_00: Um, I mean, in terms of of schooling and and um, you know, background and and um credentials, I think that's important to know, you know, um that the person you're seeing is is legitimate, right?
• 29:21
  SPEAKER_00: Experienced and what you're wanting to be treated.
• 29:24
  SPEAKER_03: You know, you kind of, yeah, you're looking for that.
• 29:26
  SPEAKER_00: But I think just like and and it it's interesting how this has happened, but I tend to be the therapist that people find after they've had a bad experience.
• 29:35
  SPEAKER_00: Interesting.
• 29:36
  SPEAKER_00: Unfortunately.
• 29:37
  SPEAKER_00: Um and and at first I found it really curious, and now I embrace it because I take that job very seriously um to make sure that people feel safe, um, that feel seen, and uh because therapy can be very intimidating.
• 29:54
  SPEAKER_00: Um you know, and I always I always tell my clients the first session, I tell them how brave they are for coming in and and that they're doing this for themselves.
• 30:05
  SPEAKER_00: And um, and I always encourage them, um, you know, if if they don't feel that I'm the right fit, that they need to keep looking.
• 30:14
  SPEAKER_00: Um, you know, just like you would do with a doctor of a second or third opinion.
• 30:18
  SPEAKER_00: You know, if the first fit does not feel right, um, you don't owe that therapist anything.
• 30:24
  SPEAKER_00: Right.
• 30:25
  SPEAKER_00: Um, and my fellow therapist might disagree, but I agree.
• 30:28
  SPEAKER_00: Um you don't owe them anything.
• 30:30
  SPEAKER_00: And so I think it's so important to feel safe, um, to feel seen, to feel heard, to not feel like you're an identified patient.
• 30:39
  SPEAKER_00: Um, I know we use different terminology.
• 30:42
  SPEAKER_00: I I tend to prefer client um because I do not have a doctorate.
• 30:46
  SPEAKER_00: I think that's important.
• 30:48
  SPEAKER_00: Um, but you know, I always say that I'm on the journey with them.
• 30:52
  SPEAKER_00: And so I think that fit is hugely important.
• 30:55
  SPEAKER_00: Absolutely.
• 30:56
  SPEAKER_03: Even that terminology is interesting because in my counseling program, we learned client.
• 31:01
  SPEAKER_03: And then when I went into private practice and I had people who were in a more medical model program, it switched to patient.
• 31:08
  SPEAKER_03: Yeah.
• 31:08
  SPEAKER_00: Right.
• 31:08
  SPEAKER_03: And so there is it's yeah, it's just even terminology is interesting.
• 31:12
  SPEAKER_00: Well, and then the behavioral health hospital, they're patients as well.
• 31:14
  SPEAKER_00: So I had to flip, you know, once I got into private practice too.
• 31:18
  SPEAKER_00: I mean, I've always related more to client versus and then the other, the other interesting takeaway I thought was that y'all both see master's level of clinicians, which I think is so interesting.
• 31:30
  SPEAKER_00: I sought out for my own therapy a licensed psychologist because I wanted a different perspective.
• 31:36
  SPEAKER_00: Interesting.
• 31:37
  SPEAKER_00: Um, I wanted to see someone with with a different uh level of expertise than myself.
• 31:43
  SPEAKER_00: Um, I wanted to be challenged in a different way.
• 31:45
  SPEAKER_00: And so I think that's interesting too.
• 31:47
  SPEAKER_03: Yeah.
• 31:47
  SPEAKER_00: That you know, we all sought out.
• 31:49
  SPEAKER_03: I've I don't know, I don't know if this is true at all, but in my experience as a as a person searching for a therapist, I have found that more master's level clinicians are trauma-informed or like do more trauma-specific treatments.
• 32:02
  SPEAKER_02: Yes.
• 32:02
  SPEAKER_03: Um, I was looking for someone who could do talk therapy, but who could also address some other issues I was have relating to trauma, who could do EMDR and somatic experiencing.
• 32:11
  SPEAKER_03: She does yoga therapy.
• 32:13
  SPEAKER_03: I love that.
• 32:13
  SPEAKER_03: Um, that was very important to me.
• 32:15
  SPEAKER_03: And I that's I don't think it's as typical.
• 32:18
  SPEAKER_03: It has not felt as typical in a for PhDs.
• 32:22
  SPEAKER_03: Am I taking away from change care?
• 32:24
  SPEAKER_03: Um, well, I thought the psychiatric nurse practitioner thing was really interesting.
• 32:29
  SPEAKER_03: And I don't know if I thought about that or really understood that distinction or what you're seeing in your own practice.
• 32:36
  SPEAKER_03: And I want to keep that in mind when I'm making referrals.
• 32:40
  SPEAKER_03: I think that's helpful.
• 32:42
  SPEAKER_01: I guess I'm taking away just a really appreciation how we're all kind of like shoulder to shoulder at this, and that it is really, really important.
• 32:50
  SPEAKER_01: I love Erin that you talked about fit.
• 32:51
  SPEAKER_01: I think that makes a total sense to me.
• 32:52
  SPEAKER_01: And that is one of the first things when I do any kind of introductory call with a client or patient, where I say, I'm okay, like not every shoe is gonna fit on every foot.
• 33:02
  SPEAKER_01: And I'm really okay with not being.
• 33:04
  SPEAKER_01: If I'm not your shoe, that's okay with me.
• 33:06
  SPEAKER_01: Um so I'm just taking away from like the similarities and the commonalities and how important it is to educate people that are coming into us without any kind of feeling of like I don't want anyone to feel bad about asking questions what the difference in this stuff is.
• 33:19
  SPEAKER_01: It's it's confusing.
• 33:20
  SPEAKER_00: Sure.
• 33:20
  SPEAKER_01: And it's important that people understand so they can advocate for themselves.
• 33:24
  SPEAKER_01: So I'm taking away just appreciation for you know the camaraderie.
• 33:27
  unknown: Yeah.
• 33:27
  SPEAKER_01: Let us know what you're taking away.
• 33:29
  SPEAKER_01: And if you have other questions about this, um, let us know in the comments.
• 33:45
  SPEAKER_01: This podcast is intended for informational and educational purposes only, and is not a substitute for therapy, diagnosis, or any kind of professional mental health treatment.
• 33:55
  SPEAKER_01: We hope that we can share with you our experience authentically and genuinely, and we hope that occasionally we'll make you laugh.
• 34:01
  SPEAKER_01: Maybe you can relate to our quest and how we're psyched for sanity.
• 34:05
  SPEAKER_01: The content we share is um our personal opinions and insights.
• 34:09
  SPEAKER_01: They are not clinical insights to anyone, and they don't represent or reflect any entity that we work in or have worked for in the past.
• 34:16
  SPEAKER_01: But if listening to this podcast has made you think, we really encourage you to seek out a mental health professional in your area.