What Therapists Need to Know About Menopause and Perimenopause: An interview with Dr. Sharon Malone, MD

Curt and Katie interview Dr. Sharon Malone, MD, author of Grown Woman Talk, about menopause and perimenopause. We explore the mental health impacts as well as the differential diagnosis when assessing a woman over 40 who might be experiencing this phase of life. We also talk about what good treatment can look like, including discussing the debate about hormone therapies.

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode, we talk about mental health impacts of (peri)menopause

After Katie was diagnosed with perimenopause, she began looking for sources of information on this seldom-talked-about phase of women’s lives. She found Dr. Sharon Malone’s work and was so excited that she agreed to come on to talk about menopause and perimenopause as well as her new book, Grown Woman Talk!

What is perimenopause and menopause?

·      Life stages for women in midlife and beyond

·      Hormonal shifts (not just dropping, but inconsistent through

·      Remodeling of the brain

·      Perimenopause is not short, it can be up to a decade

·      Too often women think they can power through, but it can and should be treated

What are the psychological impacts of perimenopause and menopause?

·      Feeling different or more emotional due to hormonal shifts during up to a decade prior to menopause (when hormones drop)

·      During perimenopause there is an uptick in depression, anxiety, sleeplessness, late onset ADHD, rage, brain fog

·      Perimenopausal mood and psychological changes may be better treated by hormones than by typical psychotropics

·      The differential diagnosis should start with ruling out perimenopause for any woman 40+

What does good perimenopause treatment look like?

·      The most effective treatment of perimenopausal symptoms is estrogen or menopause hormone treatment

·      Too often, women get individual symptoms treated by individual specialists rather than a more global impact of hormone imbalances

·      Hormone treatments can potentiate antidepressant (synergistic effect) for mood concerns

·      We also address the concerns related to hormone treatment (the study was misrepresented)

·      Women should be armed with the questions to ask and collaborate and agree on treatment with their doctors

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Conscious and Trauma-Informed Leadership: An interview with Kelly L. Campbell

Curt and Katie interview Kelly Campbell about her work with leaders. We explore the ways in which trauma can impact leaders, their teams, and their organizations. We also look at what trauma-informed leadership coaching can look like, including overarching goals for trauma-informed and high conscious leadership.     

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode, we explore trauma-informed leadership

While writing her book, Kelly Campbell reached out to Curt and Katie to connect with a previous interviewee, Dr. Sidney Stone -Brown. We loved that she is talking about trauma-informed leadership, so we invited her to come on the podcast to talk with us about it.   

 What is trauma-informed leadership coaching?

·      Recognizing that past traumas can impact how someone leads a group

·      Identifying impacts of trauma on a client’s ability to perform the tasks of leadership

·      Working to shift dynamics within leaders (and their teams) based on impacts of past trauma

What are the common impacts of trauma on leaders and their leadership skills?

·      People-controlling behaviors (like micromanagement)

·      People-pleasing behaviors (like not holding people accountable)

·      Lack of trust

·      Impostor Syndrome

·      Attrition of employees

·      Lower profitability (as a lagging indicator)

What is the goal for trauma-informed leadership?

·      High conscious leaders

·      Vulnerability and trust

·      Healing the impacts of trauma on the workplace

·      Refraining from people-controlling or people-pleasing behaviors

·      Modeling a new way of being to shift the company culture

·      Self-advocacy, clear boundaries, and improved communication

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Is It Worth It? Analyzing return on investment for your therapy practice

Curt and Katie chat about different types of return on investment (ROI) for a therapist in private practice. We look at what therapists often get wrong when deciding how to invest their time, money, or energy. We also give some ideas of what can be more effective in getting the highest ROI (of all types) for your therapy business and career.

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode we talk return on investment

In response to last week’s episode on managing your money, we had additional ideas on the concept of a return on investment.

What are the different types of return on investment that therapists have in their practice?

·      The financial ROI of money in versus money out

·      How much time spent versus the benefit to your practice and yourself

·      The amount of energy spent (or saved) or the type of energy you have available at different types of day

·      Connections made while networking and how they can be valuable to a therapist (e.g., referral sources, friends, support system, business collaboration)

·      Learning and expertise, continuing education

·      Enjoyment and fun

·      Supporting mission, vision, and/or values, legacy

What do therapists typically invest time, money, or energy in, that don’t have a good ROI?

·      Saying yes to everyone and every opportunity

·      Going to networking with only financial ROI (getting referrals for your therapy practice) as a goal

·      Insufficient marketing (i.e., not staying consistent through enough touch points before someone refers or signs up as a client)

·      Not assessing return on investment for the different types of activities you perform for your practice

·      Getting additional certifications without a clear ROI for your practice

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Don’t Forget to Pay Yourself and Other Money Planning Strategies: An interview with Carla Titus

Curt and Katie interview Carla Titus, Fractional CFO about what therapists get wrong when budgeting for their private practice. We explore financial strategies to maintain a viable business as well as how you can grow your business responsibly. We talk about making sure to pay yourself first, then set up a rainy-day fund, and follow that with saving additional extra funds for hiring or new services before you scale.    

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode, we explore what therapists need to know about financial planning for their business

Curt and Katie talk with Carla Titus about financially planning for your business. We look at common mistakes as well as how you can grow while still paying yourself.  

 What does financial planning look like for a therapy practice?

·      Managing cash flow

·      Understanding the Return on Investment for new ventures

·      Running the numbers on costs and revenue, the gross margin

·      Calculating the profitability of adding clinicians or trying new programs

·      Working to get a total profit margin of 10-20%

·      Creating a reserve fund and saving profit to reinvest, when needed

Common Mistakes therapists make when financially planning for their practice

·      Not paying attention to their expenses

·      Not tracking cash flow (i.e., not getting billables timely and having expenses that are due before you have the money on hand)

·      Therapists often avoid looking at numbers

·      Scaling before you have another reserve of money to fund it (2-3 payroll runs for a new employee for example)

What should therapists do before hiring a clinician into their private practice?

·      Save money from profit to reinvest into the business

·      Making sure you have your rainy-day fund prior to adding additional funds to float a new person as they get up to speed

·      Make sure you’re able to pay yourself while bringing on the new hire

·      Order of priority: pay yourself, save for a rainy-day, then save for scaling

How can a therapist manage their “money,” even when they are just starting out?

·      If you’re taking out a business loan or grant, have a plan for how you’re going to use that money

·      Focus on revenue generating ideas to be able to get money and/or pay back loans

·      Expenses should also have a high return on investment for the business longevity and the bottom line

·      Try to avoid shiny object syndrome

·      Know the expectation of the outcome for the money you are spending (for example on marketing)

·      Evaluate outcomes and course correct when needed

·      Beware the sunk cost fallacy

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

An Expert Witness Weighs in on Therapist Malpractice: An interview with Dr. Frederic Reamer

Curt and Katie interview Dr. Frederic Reamer about his perspective as an expert witness opining on therapist conduct. We talk about the three types of cases he sees (mistakes, challenging decisions, and misconduct) as well as what therapists can do to protect and set themselves up for success.   

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode, we share an expert witness perspective on therapist mistakes

Curt and Katie talk with Dr. Frederic Reamer about how therapists can get in trouble as well as what an expert witness does when evaluating these therapist mistakes. 

 What do Expert Witness do for cases involving therapists?

·      Evaluate malpractice and standard of care

·      Opine on whether therapists have acted appropriately in their role as professionals

·      Reviewing records, reports, depositions, and testifying on trial

What are the different types of cases that are brought against therapists?

·      Good people making mistakes

·      Challenging ethical dilemmas (i.e., making a decision that is not wrong, but leads to a bad outcome)

·      Misconduct (e.g., having sex with clients, inappropriate dual relationships, impaired therapists)

How can therapists set themselves up to avoid getting sued or licensing board complaints?

·      Appropriate documentation

·      Consultation with colleagues or supervisors (and document this consultation)

·      Have sufficient malpractice insurance

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Are You Burned Out or Are You Bored?

Curt and Katie chat about another type of burnout, “bore out.” We explore the difference between burnout and boredom. We talk about what might be unique to therapists’ jobs that would lead to boredom. We also dig into how dissociation can show up as either burnout or boredom. Finally, we share ideas on how modern therapists can mitigate some of the impacts of burnout, boredom, and vicarious trauma.

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode we talk about both burnout and “bore out”

Katie has been feeling a little bit bored lately, so she decided to do some research on what might be happening. She uncovered a concept “bore out” which seems to be the opposite of burnout, but with similar consequences. We decided to dig into this topic to see what therapists can do to try to avoid (or address) burnout.

What are the differences between burnout and boredom?

·       Burnout is overstimulation to the point of running out of energy

·       Boredom is under-stimulation to the point of lack of creativity and stagnation

·       Burnout is a pretty common topic, but “bore out” never really took off

·       People more likely to leave a job due to boredom

What are the types of boredom that therapists face?

·       Clinical boredom (repeated stories, lack of progress)

·       Repetitive clinical work (due to niche, evidence-based practice)

·       Notes and documentation are frequently described as boring

·       Trauma therapists may become cynical

·       Vicarious trauma, compassion fatigue and moral injury

·       Desensitization and disengagement of vicarious trauma can feel like boredom

·       Dissociation may also be part of this disengagement

What can therapists do to address boredom?

·       Clinical consultation and your own therapy

·       Professional development and continuing education

·       Refreshing your knowledge and bringing new techniques into session

·       Adequate stimulation to get work done

·       Doing things in small doses

·       Reframing things to make them more positive (not “onerous” or “boring”)

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Seeking Purpose Beyond Accomplishment: An interview with Kasey Compton

Curt and Katie interview Kasey Compton, LPCC, on her new book, In Search of You. We explore her journey of healing and what it was like to put that healing into a public space. We also talk about Kasey’s challenges with being bullied in her home town due to the choices she has made (getting divorced and then choosing a same-sex relationship) and how her “hard head” has helped her to get through it all. She also shares some ideas for therapists in their own healing journeys.  

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode, we talk about how even successful therapists may need their own healing journey

Curt and Katie talk with Kasey Compton about her new book, In Search of You: When Doing More Isn’t Doing It Anymore.

 What is “In Search of You” about?

·       Kasey wrote a book while going through therapy about her healing process

·       Looking at moving away from accomplishment and toward making meaning

·       Getting to a place of self-love

·       Using Kasey’s stories she wrote during therapy, in real time

How can a high achiever, people pleaser, or “seeker” move toward self-love?

·       Understanding the relationship between love and accomplishment (or lack of relationship between these two)

·       Understanding the difference between authenticity and vulnerability

·       Shifting one’s relationship with shame

What is it like to heal in public?

·       Coming to terms with vulnerability

·       For Kasey, her hometown is religiously conservative who were very judgmental about her stages of healing (including her divorce, a new relationship with a woman, and now writing this book)

·       Putting on emotional armor in unsafe places

·       Finding community support

·       Moving forward with boldness and self-acceptance

·       Detaching from outcomes

How do these lessons apply for therapists?

·       Taking a holistic, full person look at who you are professionally

·       Using a timeline to understand ourselves and how our lives have impacted us

·       Doing our own work with a therapist or through journaling and doing a timeline

·       Finding balance

·       Moving away from self-sacrifice as a mechanism toward accomplishment

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

When Your Clients are Wealthy and Well Known: An interview with Dr. Holly Daniels, LMFT

Curt and Katie interview Dr. Holly Daniels about working with high profile clients. We talk about the lifestyle factors (like isolation and dehumanization) that come with celebrity as well as the differences when working with famous and powerful people who bring in more common concerns like relationship challenges. We also explore the skills and trustworthiness required to be able to succeed with these clients.

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode, we talk about what it’s like to work with the rich and famous

Curt and Katie asked Dr. Holly Daniels to talk about her work as a therapist, relationship coach, and consultant for the wealthy and well-known.

 What is it like working as a therapist or a coach with the wealthy and well-known?

·      Seeing the isolation and the reality of their lives

·      Making sure to avoid being swept up in the fame

·      Understanding the countertransference tendencies (to agree, to be critical)

·      Don’t get sucked into aligning with them if it isn’t in their best interest (everyone around them agrees with them)

·      Don’t join the power struggle when clients become very dismissive

·      Therapists must be emotionally very boundaried and logistically very flexible

·      When people are this wealthy or well-known, they have to be very cautious and they have a very high bar related to trust – therapists need to know how the difficulty with trust impacts the relationship

·      Allow the client to bring the public information into the session, don’t assume their response to what is in the news

How can therapists support clients who have an influential public persona?

·      Separating your personal self from your public persona

·      Looking at these two selves as related, but not the same

·      Helping clients to let go of public approval or hate as related to who you are

·      The commodity is the public persona, not you

What are the family systems and relationship concerns that come with fame?

·      There is a closed, isolated bubble where there can be a lot of enmeshment

·      There are different challenges and dynamics unique to being part of a famous person’s life

·      Looking at the full family system, including the kids

·      Feeling guilty for having mental health concerns because they have so much

·      It is important for therapists not to bring in their own political or social agenda

·      People dehumanize famous people

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

When Your Client is a Little Bit Famous: The unique needs and perspectives for working with content creators in therapy

Curt and Katie chat about the unique needs that content creators (youtubers, podcasters, onlyfans performers) bring to session. We look at the development stages of being a creator, what exactly a “content creator” is, pros and cons (for mental health) of being a content creator, and how therapists can work more effectively with these folks. We also talk about the safety concerns and ways that therapist scan support content creators in protecting themselves. This is a continuing education podcourse.

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode we talk about therapy with content creators

Content creators and influencers have their own sets of mental health challenges. Therapists working with content creators have many factors to consider when it comes to the particularly unique influences that this occupation has on a person’s mental health. This workshop explores how content creation, streaming, and parasocial relationships affect the mental health and worldview of creators in ways that are both similar and different to other types of performers.

Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide

You can find this full course (including handouts and resources) here: https://moderntherapistcommunity.com/podcourse/

Continuing Education Approvals:

Continuing Education Information including grievance and refund policies.

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

The Power and the Peril of Pop Psychology

Curt and Katie chat about pop psychology. We look at what it is, how it influences society, the dangers of leaving it unchecked, and how therapists can support their clients in navigating through all the different self-help content. We also challenge the use of Enneagram and Myers Briggs as “identity” and talk about using pop psychology as a starting point for conversation rather than taking it all at face value.

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode we talk about the dangers of pop psychology

Curt has had a bee in his bonnet about pop psychology and the potential harms of watering down psychology for the public. We decided we’d take a critical look at what’s out there, including self-help, business, and news content that may be harming the public.

What is pop psychology?

·      Researchers sharing their findings through popular media using lay language

·      Applied psychology – practical self-help created by psychology practitioners geared toward improving your life

·      Targeting people with mental health concerns to decrease suffering – may be created by people with lived experience and is self-help in the place of therapy

·      Applying psychology to other realms (like business or sales, spirituality)

What are concerns with pop psychology?

·      Overemphasizing the importance of specific pop psychology principles and claiming these things as identity

·      Not going back to the evidence base or looking at who the authors are (is it their research or is it a good storyteller who is extrapolating)

·      The impact of the audience on which stories or psychological findings are shared

How does Malcolm Gladwell fit into this conversation about the dangers of pop psychology?

·      He was enamored with the “Broken Windows” theory of policing and his writings influenced the use type of policing in New York (including Stop and Frisk)

·      He ignored the criticism of these policies, like the racial bias that was seen

·      He chose not to write about policies that were working to decrease the over prescribing opioids

·      He has not recognized the influence on those who read his work

What role can therapists play in supporting our clients around pop psychology?

·      Talk with our clients about what they are reading and use it as a starting point

·      Bring the evidence-based science into the conversation

·      Help them to create a unique, tailored plan for your client to use what works for them

·      Correcting misinformation (e.g., the stages of grief)

·      Putting out content that is accurate

·      Staying current on what is being talked about in popular media

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/

Is AI Really Ready for Therapists? An interview with Dr. Maelisa McCaffrey

Curt and Katie interview Dr. Maelisa McCaffrey of QA Prep about her assessment of the AI tools available for therapists. We chat about the high expectations many clinicians have for note writing tools (and whether these expectations are really reasonable right now). We also look at what therapists are getting wrong when starting to use these tools, exploring some concerns related to HIPAA compliance and who is actually putting together these tech tools.

Transcripts for this episode will be available at mtsgpodcast.com!

In this podcast episode, we talk about the development of AI tools for therapists

Curt and Katie asked Dr. Maelisa McCaffrey to come on and talk about what she thinks about AI for documentation.

What are therapists getting wrong about AI?

·      Therapists believe that AI can do their notes, but it is often a lot of work and/or is an expensive application is required

·      There is a choice when using a free platform and/or an untrusted platform is that you are either writing an insufficient note or adding PHI, which causes you to break HIPAA

·      AI for notes takes a very long time due to how slowly they process the information as well as your need to review and edit each note

·       Some platforms are claiming to be HIPAA compliant and are not

What are the different ways that AI works to provide documentation?

·      AI listens to the session and/or you upload the recording or a transcript

·      You enter the information on what happened in the session and AI writes the formal notes

What do therapists need to know about an AI platform before using it?

·      Checking for actual HIPAA compliance versus a false statement about HIPAA compliance

·      Understand how it is telling you to use the software

·      Do they give you a BAA?

·      The pricing is relatively similar to an EHR - $10-$40 per month

·      This is not an electronic health record or practice management system

·      Some of the AI applications do not have access to the diagnosis, assessment, treatment plans, so you will have to insure that you prove medical necessity and demonstrate the clinical loop

Are these AI platforms really ready for therapists?

·      The tech experts are taking care of data security

·      Many companies are still figuring these things out

·      All of the platforms Maelisa tested created fake elements of sessions (i.e., put things in the notes that did not happen)

What else can therapists use AI for?

·      Creating templates for progress notes (i.e., not for a specific client, no PHI)

·      Creating resources for clients

What do therapists need to do for their clients if they are using AI?

·      You must inform your client that you are using AI (informed consent)

·      AI is experimental, so it must be optional for your clients to opt in

·      You must insure that the platform is actually secure and HIPAA compliant

·      Ethics codes aren’t really saying anything, but some statements could be coming out soon on the ethics of how to use AI with or for clients

What do therapists need to know about AI?

·      It is very new and changing constantly

·      This is going to happen, so we need to understand and participate in this transition

·      New resources will be created through AI

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

Our Linktree: https://linktr.ee/therapyreimagined

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano https://groomsymusic.com/