Latest / The Trauma Therapist / Episode 781: Taking Care of Our Clinicians with Doreen Hills

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Episode 781: Taking Care of Our Clinicians with Doreen Hills · The Trauma Therapist

• 0:10
  Right. Welcome back to the Trauma Therapist Podcast. My name is Gamiferson.
• 0:14
  My mission is to help trauma therapist be their incredible selves, to be human,
• 0:19
  to be real, not just a clinician. I'm a big believer in
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  who we are is more important than what we know, and this requires cultivating
• 0:27
  authenticity, genuineness, and vulnerability, and that requires intention. Can learn more
• 0:33
  about my courses and workshops by going to the Trauma Therapist project dot com.
• 0:37
  That's the Trauma Therapist Project dot com. Let's get started. So here we
• 0:42
  go. So five four, three, two and one, our folks,
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  welcome back to the podcast. Very excited to have back. Doreen Hills,
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  Doreen, welcome, thank you. I'm happy to be back, all right.
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  So, Dorean is a founder director at the Center for Trauma, Healing
• 1:00
  and Attachment. Their mission is to provide cutting EDGs treatment approaches in healing traumatic
• 1:06
  distress and they're committed to finding ways to provide quality and affordable therapy and to
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  be the pioneer in healing trauma in the North East region. During has been
• 1:15
  a mental health provider for over twenty years and has worked in various mental health
• 1:19
  settings in New York Philippines and Colorado. Her background includes intense and immersed experiences
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  working with povery stricten fishermen in the Philippines, orphans that were severely neglected and
• 1:30
  abandoned, as well as Muslims and Manila. These experiences gave her immense insight
• 1:36
  to trauma, resiliency and healing. She's conducted and facilitated trainings, workshops,
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  and presentations in Morgan County and neighboring Northeast counties in Colorado on topics such as
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  attachment, trauma, and neuroscience during Welcome back here. So before we go
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  in here, and for those listeners who maybe haven't listen to the previous times
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  you're on the podcast, give us a brief, kind of a brief overview
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  of how you got into this field in the first place. I think it's
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  been ingrained in me growing up. I've I really have so much experience and
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  exposure working with people that experienced trauma in the Philippines, and I look at
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  this more of a calling, and that's where I came came about, and
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  I think this is that's purpose, It's you know, I meant, I'm
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  meant to do this kind of work, and I love it. That's the
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  thing I think. I think part of why I'm able to expand what I'm
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  doing is because I love doing it. I love I love the direct care
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  services, I love the direct client service. I know that I have to
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  be wearing many hats A is a executive director and founder. But I go
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  back to the roots of you know, sitting with my clients, being on
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  the floor with kids and doing activities and trauma processing. That's what, you
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  know, that's what I loved the most. So you said, it's a
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  it's a calling this this. You have experience witnessing trauma, being immersed in
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  it from a very early age. Yes, yes, And I think if
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  people listen to the previous podcasts, you know I've I've witnessed and you know,
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  exposed to what I what I call the general Well it's not generation,
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  the ancestral trauma. You know, We've I've experienced and witnessed the you know,
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  the fear in during the martial law and also the it's a revolution in
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  nineteen eighty six. So I've experienced that, We've we we've felt it as
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  a nation, and you know, I was very fortunate to have a good
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  family that you know, consider I considered them as a buffer, their protective
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  factors for me to you know, to continue and to build resiliency. But
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  as a nation, yeah, Philippines, this third world, and you just
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  I don't trust I did not, don't and would never trust the government there.
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  You know, they're not for the people, you know, And that's
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  how I feel about it. And so I've experienced that ancestral trauma growing up.
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  One of the things that inspires me about you and talking to you is
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  you know, you've taken this experience and like you said, it's kind of
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  blossomed as this calling, but it doesn't stop there for you. I mean,
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  you founded this whole organization. You're so it's like you have all this
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  energy you I mean, it is right, it's like this, this this
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  almost a need this. You're on a mission. Yes, And I think
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  I am persistent. I'm one of the trainers that did the training would be
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  yesterday on complex trauma one oh one. He you know, he shared you
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  know, I am persistent, and I think I am because I do believe
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  that it's not it does not stop, you know, Okay, I'm settled
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  here. No, I think as a human being, I think we are
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  capable. We have the gift of actually expanding what gifts we have as an
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  individual. It does not end, you know, as just being a clinician.
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  I wanted to do more because I do believe again looking at it and
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  brain science, you know, we are capable of doing more than what we
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  are thinking. We you know, we are at right now. No one
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  can limit us. The only one that limits us is us. And so
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  I still am you know, every time, there's always there's always something in
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  my brain, you know, just things that we can do to expand the
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  trauma center, things that we can do to help the people we're serving and
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  also the staff you know, under my care. So today you had mentioned
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  you'd like to talk about kind of protecting therapists and talk more about what does
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  that mean. What are we talking about here? Yeah, I don't think
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  I've ever shared this with you and you know the other previous podcasts. But
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  for four years, I think between four to five years, and I ended
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  my term during COVID. I served as a device chair at the it's called
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  Dora Department of Regulatory Agency, that's the licensure board for LPC in Colorado.
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  I served as a vice chair there for four years and it is a very
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  I've learned so much. I've learned so much from that experience. We the
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  purpose of the board is to to make sure that we hold you know,
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  that all clinicians in North in Colorado follow the statues, the Mental Health law
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  and also following the Code of Ethics of ACA. And you know, some
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  of them has something to do with educating licensed clinicians, provisional clinicians on you
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  know, what they need to do, you know, the updates, the
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  continuing ed But the biggest piece that we've done there is unfortunately, sanctioning,
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  you know, clinicians that violate the mental health statues and the ethics. And
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  that is the that in itself is very draining for me because here you are,
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  we have clinicians that, you know, when they violate something that can
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  be marked in there, you know, in their license and it's it's something
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  that we don't want to see happening, but it happens. So what are
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  we talking about specifically? What kind of violations? Oh so, when I
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  was when I was with Dora the Department of Regulatory Agency, the biggest,
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  the three biggest things that we that we run into first is the substandard level
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  of care, and that means poor documentation, very poor documentation, not knowing
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  let's say, in divorce cases or child custody cases, not paying attention to
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  who needs to sign and co sign forms for children. People can get thing
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  there and it can be you know, considered a substandard level of care,
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  not you know, not getting their continuing ads, poor boundaries, and then
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  it goes into more much deeper, which would be sexual relationship with you know,
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  with their clients. So for I mean, aside from the sexual relationship
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  with the how is this brought to your attention? For example, if someone
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  is not assigning documents properly or even if boundaries are broken, how does would
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  that your agency learn about these issues? So we get the complaints, because
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  Dora has a public website, we get complaints from. It can be another
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  clinician, another or an agency or other you know agencies out you know,
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  agencies referring to this clinician, let's say the ones that they're gonna they're gonna
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  complain about, and even parents and families. Sometimes it's you know, from
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  from attorneys and so it really you know, there's a website that would that
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  focus on if you have any complaints. Let us know, and then it
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  gets you know, it gets brought up to us during our meetings and they
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  are very I mean these are intense meetings to where the public is you know,
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  the public can actually hear what's going on. The complaints are intent in
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  what way? How how so we bring I mean with you know, the
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  the identity of the person. You know, all the identities are therey are
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  highly confidential. But the cases we bring up the cases and sometimes you know,
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  we we put it on executive you know, executive executive session or we
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  can actually let the person know or let the public know that this is what's
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  going to happen. So there are depending on how severe the cases are,
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  you know, it can go to executive meeting or we can let you know,
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  we can let the public know that this is the violation and this is
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  what's you know, this is the sanctions. And once you have the sanction
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  in your you know, in your license, it's difficult. I think the
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  rate of insurance increase. You know, when you you have to notify NBCC,
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  you have to notify insurance and commercial insurances you know that you have these
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  sanctions, and it can be really really exhausting for clinicians. Now, are
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  there certain violations that some clinicians aren't even aware they're making or have made?
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  How does I could imagine that? I mean again, sexual abuse sexual relationship
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  seems at the far end of the continuum, right, I mean, obviously
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  a clinician knows they're not supposed to be doing that. But in terms of
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  other uh violations, are there some instances where clinicians like I don't know.
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  Oh yeah, we we run into cases like that, Like clinicians, I
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  did not know that I violated this or I did not know that there is
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  a complaint against me. And that is why I think it is important to
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  be aware of the mental health statutes for you know, for each state wherever
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  you're practicing, you need to be well informed, you know of the statutes
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  there, and also be aware of fully aware of you know, ACA Code
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  of Ethics, because if you're not, you can, you know, you
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  can put yourself in harm and also your client. So to to avoid those
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  pitfalls, I mean, here's the thing. If if someone is licensed,
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  we assume we fully well, we fully believe that you are aware of the
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  statutes, that you are aware of the Code of Ethics. That's why you
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  pass the test, but it does not stop there. Guy, it doesn't
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  stop there. You have to file, You have to check your licensure boards
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  and make sure that there are any if there are any updates that that's going
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  on, if there are any rules that's you know, that's added. I
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  think it's important to be up to date to that and also checking with American
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  Counseling Association and the Code of Ethics. Now, this discussion is interesting to
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  me because we we would think that peopleople who go into this field, who
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  want to be therapists or counselors have the best interests right in heart. No
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  one gets into this field because they want to do any harm or you know,
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  create any kind of infractions. But at the same time, with boundaries,
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  that seems to be a very interesting issue. Can you talk a little
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  bit more about that, because it could seem to me like you could make
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  a boundary violation but yet have the best interest, have the client's best interest
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  in your mind. Well, I was just they called me, and I
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  was, you know, I wanted to give them most access to me.
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  I wanted to help them talk a little bit about that. Yeah, and
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  I do believe we have the best in the kindest and pure intention and we
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  run into appropriate you know, the boundary violation, which oftentimes you know it
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  is a substandard level of care, it's still violation. I think when we
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  you know, when when there isn't enmeshed or we get so confused with what
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  is our role as a clinician. You know, like an example would be
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  would be texting, right, and sometimes there are grey areas there. Okay,
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  so what is the limit of the texting. Is the texting you know,
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  only specific for you know, appointments or schedule or is this something that
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  you know your client texts you because you know they wanted to know more,
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  you know, like, hey, I'm having trouble those kinds of stuff.
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  We have to be we have to be aware, like, okay, when
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  you're texting, is it just specifically focusing on you know, just appointments and
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  you are still guarding their you know, their their their identity, or the
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  texting is deeper than that, You're actually like doing texting or counseling through texting,
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  which is in a way like a hip that can be a hip of
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  concern. Right, So those things they may feel or they may seem insignificant
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  or small, but We've got to pay attention to that because that that again
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  can be an appropriate you know, that can be a boundary you know,
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  concern the other one personal. It does. But I was thinking, like,
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  is there a situation where people get more personal in the text? That's
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  yeah, that does that happen? That happened, you know, the personal
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  and you know it gets they get personal in text, and so okay,
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  when that when when that happens to you, you got to pay attention.
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  Okay, it's do we need to pull away? I need to, you
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  know, to put it on my informed consent that I will own. They
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  use texting as appointments, not for any type of conversation. If we have
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  to have conversation, let's have let's meet in person or you know, teletherapy.
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  So you were on this board for you said four years. Yes,
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  you learned a lot. What were some of you okay, what were what
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  were some of your your take home? Uh issue? What are some of
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  the things you learned from this? From this experience, I learned I learned
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  so much about self care. I think those boundary issues happen when and we
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  get so conflicted or confused or enmeshed with our clients when we start to experience
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  burnout, when we start to have those vicarious trauma, that means for me,
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  you become more emotional, you become more reactive now versus actually, okay,
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  I am your helper, I'm not your fixer. So self care is
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  so important when it comes to, you know, when it comes to maintaining
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  healthy boundary, and we do have When when I was doing the when I
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  was with the board, we actually would, you know, would recommend the
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  clinicians to seek some type of training on vicarious trauma or even receive therapy on
• 18:37
  their you know, for themselves. We do that. So self care is
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  definitely very important. Another piece I wanted to share with the listeners is receiving
• 18:51
  receiving professional consultation. If you in your gut, if your instinct is telling
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  you I don't know what to do or I am confused, you need to
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  have a capable and credible supervisor to help you through this. Very very important.
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  So this is interesting. So, if I'm hearing you correctly, you're
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  saying that some of these violations result from lack of self care. Yes.
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  Interesting, Okay, let me just pause here for a moment. I want
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  to thank our sponsors. We're talking with Dorian Hills, founder director at the
• 19:32
  Center for Healing Trauma and Attachment. We'll be right back. Okay, So
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  vicarious trauma. So people are therapists are going through or experiencing vicarious trauma.
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  They might not even realize that, and yet they start to make these infractions.
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  Yes, And I think when and we don't realize it? Right because
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  again, our job, or we tell ourselves, our focus is to take
• 20:00
  care of people. But we got to take care of ourselves. And when
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  we are doing this on our own, we're not going to notice it.
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  And I think this is why we have we need to access and utilize the
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  power of consultation and supervision. You know what, I don't really care if
• 20:17
  your license, if you already got your licensure you still have. I mean,
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  I've been doing this for over twenty years, guy. I am receiving
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  two supervision consultation with other you know, with another with two other providers,
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  because I want to make sure that I am in check, I'm emotionally and
• 20:38
  mentally in check, and I'm making sound and wise decision when I'm working with
• 20:44
  the clients we serve. I have two supervisors and I already got my you
• 20:48
  know, my license in New York and Colorado, right right, So it
• 20:55
  seems like you're saying it can be very easy for clinicians to feel I'm licensed,
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  I'm knowledgeable, I've got experience, and yet forget to get get the
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  importance of having those other set of eyes. Yes, yeah, that's a
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  really good point. We've got to have, you know, and it doesn't
• 21:14
  have to be weekly. You can check in maybe once a month with you
• 21:18
  know, with your supervisor or you know or consultant. The other piece of
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  consultation or supervision is receiving legal consult at the trauma center. And what I
• 21:30
  mean by that is at the trauma center we actually have. I think it's
• 21:36
  a very good investment for clinicians. I have a malpractice attorney that actually check
• 21:45
  with us, and if I have any questions regarding a case that may put
• 21:51
  us in hot water or at risk, we check with an attorney and make
• 21:56
  sure I can you check you know, our consents and make sure it's up
• 22:00
  to date. Can we can you check if this is following the mental Health
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  Statute of the Colorado you know the Colorado rule, So we check with that.
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  So I do have again two consul consultants that I that's so important for
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  clinicians. One is someone who works for mental you know, the mental health
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  consultation, and also legal consultant, super super important. What would such a
• 22:30
  case, Uh, when would you can need a consultant, a legal console,
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  a legal consult Yeah, I would, you know, just checking your
• 22:42
  documentations yearly, once a year, I connect with connect with our legal consult
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  and I check with him. Hey, can you make sure that all our
• 22:55
  informed consents, our disclosure statements, all that stuff follow the Colorado rule and
• 23:02
  then all the you know, let's say releases, release of forms and also
• 23:07
  if sometimes the case of divorce or custody can be really really sticky, and
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  so prior to taking cases like that, it is important to have a legal
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  consult very important to have a legal consult and make sure that, okay,
• 23:26
  is the you know, do we only require one parent to sign the consent
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  or do we need to have two parents signing the consent? Because about let's
• 23:38
  say, about thirty five percent of people that get that we you know that
• 23:45
  we have in our in the complaints section, in the complaint part of DORA,
• 23:51
  are people that are clinicians that did not get the right consents. So
• 23:56
  the other parent is upset that Okay, well you're not including me in the
• 24:02
  therapy part of our you know. So maybe so maybe that that particular parent
• 24:07
  didn't get a certain monies that were allotted to them and they were like,
• 24:12
  wait a minute, so they formed they have a reason to complain. Interesting,
• 24:18
  Yes, so we got to be very careful before you open a case.
• 24:26
  Find out who who is you know, do we need do you need
• 24:30
  to have to you know, two parents signing the consent for treatment for a
• 24:36
  child, and so those kinds of stuff to where you feel like you're okay,
• 24:40
  legally I'm feeling you know, I'm not comfortable. Don't wait, you
• 24:44
  know, seek a legal alpractice attorney that focus on working with you know,
• 24:49
  mental health clinicians. Yeah, as a general rule, do you feel like
• 24:55
  a lot of clinicians don't really think about this stuff? No, they don't.
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  They don't until it's too late, right, until it's too late,
• 25:03
  until you you know, until you get something in the mail from you know,
• 25:07
  from from the from the licensure or the licensure department, you know,
• 25:14
  making complaints or you have a complaint letter, and then boom, okay,
• 25:18
  what what did I do? And you sleep? You know, you you
• 25:21
  lost sleep, and then it can also be very traumatic for clinicians. So
• 25:26
  don't wait, don't wait. Let's kind of bring this back again. We're
• 25:30
  speaking with Dorian Hills. He's the founder director at the Center for Healing,
• 25:34
  Trauma and Attachment. Now, as we talked about recently on our last couple
• 25:41
  of interviews, you guys offer trainings. Let's talk a little bit about the
• 25:48
  trainings that you offer for the therapists and clinicians and so forth. Yes,
• 25:56
  I we've offered many and I can still offer for that something related to self
• 26:03
  care, self care, vicarious trauma burnout in how to you know, how
• 26:08
  to take care of yourselves. You know, sometimes we give that to our
• 26:12
  people, but you know, to the people we serve, but we don't
• 26:15
  give it to us. And so we identify different strategies. And also besides
• 26:22
  that type of training, I also we also provide complex trauma training treatment strategies
• 26:29
  for you know, working with complex trauma individuals. And I think the more
• 26:34
  information you have as a clinician, the better you will develop sound treatment you
• 26:41
  know, treatment plans and treatment goals, which is part of ACA Code of
• 26:47
  ethics. You have to be aware. You have to be fully knowledgeable and
• 26:52
  aware of you know, the right treatment, effective treatment strategies for your clients.
• 26:57
  You know, are you Let's I'll give you an example. So let's
• 27:02
  say you know you're working with a complex trauma individual and you have basic information
• 27:08
  about trauma. Are you operating beyond your scope of practice? Or you know
• 27:18
  or you think that this person is you know, going to be helped by
• 27:23
  how much you know? So I think continuing it is very important for you
• 27:30
  know, for for all of us. And sometimes we have cases to where
• 27:34
  we recommend, we recommend respondents to get more. You need to get continuing
• 27:42
  it for these specific courses because you went above and beyond your scope of practice.
• 27:51
  And are these courses that you're offering these are in person, online both
• 27:56
  or what? So? Yes, the day December fourth, we we did
• 28:03
  the in person. We also have online as well. It really depends on
• 28:10
  what the community needs, but we can offer online classes, okay, and
• 28:15
  just remind our listeners, how can they learn more about what you're doing?
• 28:19
  How can they reach out to you? Yeah, so they can connect with
• 28:25
  us through our website. It's kartainc dot org and if they have feedback or
• 28:32
  any questions, they can There is that comment section there and that's pretty much
• 28:37
  it. Okay, and KATA Inc. Is that c h TA Inc Dot
• 28:44
  org. We'll have that link up here at the show notes page at the
• 28:47
  Trauma Theapers podcast dot com. During so inspiring as always, I mean you
• 28:52
  can feel, well seriously, I mean you can feel that this is what
• 28:56
  you do, this is a calling for you. You and you're on a
• 29:00
  mission, and it's inspiring. It's really inspiring. Well, thank you,
• 29:07
  it's really you know, not only for the people we serve, but also
• 29:11
  if I can be of help to clinicians, because I know you and I
• 29:15
  both know that they come to this, to this work to help others.
• 29:21
  And if I can share some of my some of my experience and knowledge from
• 29:26
  from the regulatory agency, I want them to be protected too. Awesome,
• 29:32
  awesome, Our dooring will be in touch. Thank you so much, Thank
• 29:36
  you, all right bye bye yeah