When The Counseling Field Sucks

There are times when I'm just so disappointed in our profession.

Like when an intern tells me that his group steals clients he pays to attract.

Or when supervisors tell student counselors gossip about clients.

Or the fact that we have tons of training and yet might be subject to lawsuits if we practice life coaching over state lines, while untrained, unlicensed life coaches can do the same with much less liability.

I can think of a half-a-dozen more things to complain about in the field of counseling. Legitimate things. The invasion of privacy by insurance companies. The questionable choices made in the DSM-V. The lack of business training in counselor education. The poor compensation offered most counseling interns, after exiting a prohibitively expensive educational path.

You can probably add your own. There's a lot to be frustrated with about this field. I'm sure there are similar frustrations with every field  - but in some ways the injustices and complications are harder to accept within the world of counseling.

Has it ever felt that way to you?

It has to me, because I tend to feel that since we're doing a good thing - helping people heal emotional wounds - we should be supported in that effort.

Even as I write that, I think how entitled that sounds! We should get a break, why, because we're "good people?"

The truth is what we all know but struggle to accept when it applies to us. Life's not fair and sometimes good is not rewarded in the way we expect.

Yep, there's a lot of things that aren't fair about the counseling profession - or counselor training - right now. 

So what are we going to do about it? 

If you agree that this situation isn't where it should be, you have three options (at least the way I see it).

1. Leave the profession. Sadly, that's what some counselors do. I sympathize - but I hate it!
2. Stay in the profession and grow bitter. Unfortunately, that's what a lot of you guys tell me in confidence that the older counselors around you have done!
3. Claim your internal locus of control, and refuse to let the circumstances dictate your ability to do your job as you were called to do it.
• Lobby for change. 
• Leave managed care if you can't come to a satisfactory agreement. 
• Charge no-show rates or private pay alongside more inexpensive options, or instead of those options if that's what you must do to be in business.
• Hold clients to accountability if that's what's best for them. 
• And so forth!

Think that's impossible? Honestly, if you lead with your values and your calling it is absolutely possible. Let me give you some examples:

• Your state suggests a law that potentially reduces access to counseling care in rural or underserved areas. Spread the word and change the law like we as a beginning counselor community did in August 2013.
• Your managed care company demands that you justify your client's treatment in more detail than you know is ethical to share with the representative. (It happened to me.) Explain to your client the situation and have them reach out to the insurance company to share the info, if they so choose, or offer a reduced rate to forgo managed care altogether. 
• Your client calls 15 minutes late to cancel for the second time in a row. Add the no-show rate to your bill, explaining, "I understand, but as we discussed that means that the time is still billed to you because we have to have 24 hours notice." Your agency won't let you charge? Wait a few days or a week before you reschedule, so that they client learns to value this time as much as you do. 

I'd guess those last two examples might cause indignation or fear. It seems like we're being mean when we put up boundaries with clients, but unless we're only doing it to be mean, we're not. Ultimately, it's healthier for clients if we have strong boundaries driven by concern for their best. It's not good for a client's secrets to be at the mercy of a managed care corporation. And the client gets nothing out of therapy if they don't show or they don't respect it. And so on...

In my experience, you the interns are the most generous and ethical of all of us. The only thing that you don't realize is that it's okay to ask for what is right on behalf of you, and on behalf of your clients. You don't think you know enough or have enough experience to justify it. 

Maybe you don't. But what would it hurt to ask yourself (the next time you come across a situation that feels odd or unfair, even unethical) "What can I do to make this better for myself and my clients?" 

"What might it help?" 

Have you ever been in a situation where you knew the right thing to do, but lacked confidence in yourself to do it? How did you deal with it? Share with us below!

Why are you qualified?

How do you know what you're doing?

"Are you married?"

"Are you a parent?"

"How old are you?"

"How long have you been doing this?"

When you're a student counselor or a counselor newbie, these questions just come at you. Most of the time, the harshest questions come from yourself.

"Are you really good enough to help them?"

"What if you hurt them?"

"Do you really know what you're doing?"

The good news is, it gets better. I was inspired to write this today because it's been so long since I struggled with those kinds of thoughts. And trust me, it's not because I don't have bouts of crazy insecurity.

It's because I know what makes me qualified. It's what makes you qualified, too.

It's because I care.

It's because I give my clients a different perspective.

Because I listen when most people would talk.

Because...all that stuff.

It's just what we do. 

 What makes YOU qualified to be a counselor? Share below! 

Do Counselor Regulations Promote Client Abandonment?

Does this sound familiar to you? Your practicum is complete. You graduate and take the NCE/NCMHCE or take the NCE/NCMHCE and then graduate. But then everything stops when you've graduated until your paperwork is approved by the state board to obtain your temporary license to practice. A period of time which can take 2-4 months, depending on when you are allowed to take your exam. (In my case, I graduated May 15, took my exam first week in July, then got my LPC-I in late August.) 

2-4 months at a time in which most experts agree you cannot legally be allowed to see clients.

So if you're continuing at your practicum site into your internship, that means you're in essence abandoning clients for that period of time - no matter their situation - and then may or may not be able to work with them again in the future. 

That means they have to be shuffled to someone else or simply wait on that work until you come back. If (as is true for many practicum sites) they are clients who have suffered trauma and abandonment many times over, they may assume that this is a "sign" that they don't deserve help and should sign off from seeking it ever again. 

Think I'm exaggerating? I can't count the number of people I've heard that from when something goes wrong with a counseling appointment. That might be a situation in which insurance coverage is denied, appointment times are miscommunicated, the counselor or client moves, or the student counselor enters the dead zone between graduation and temporary licensure. These are clients hanging on by a thread to the idea that they can get help, and it doesn't take much to let it snap.

*****

Legally, all that is required to avoid "client abandonment" is that you help make arrangements for the client to see another competent counselor when you are unable to provide those services. So it isn't that you are legally abandoning a client when you take off after graduation. 

It also isn't as if we can never promise a client there won't be circumstances in which we can't see them - we will have to relocate sometimes, or we need to take a vacation or take maternity leave, or we face an illness - but these are life interruptions, not institutional interruptions.

This is an interruption in care that can be avoided. 

How? Well, what if, instead of creating an unnecessary gap in care, as a profession we created a legal solution that is safe for both clients and more consistent with the needs of graduating therapists? I'm not claiming by any means to have all the answers, but I do have a few ideas...

• Allow for a provisional application to temporary licensing status, i.e. the student counselor approaching graduation can apply based on plans to graduate, and plans to pass the state exam. A time period could be set within which the counselor MUST meet these requirements or have their provisional license revoked along with any accompanying hours. A supervisor agreement would be required so that under no circumstances would a student counselor be practicing without proper guidance. In order to qualify, student counselors would have to have satisfactory performance in practicum classes and obtain the recommendation of leadership in their graduate programs. 
• In keeping with the current system, students could continue to apply for assessment and/or temporary licensing after graduation. But state counseling boards could implement an automatic extension of 3-4 months after graduation in which counselors can count hours and more importantly be allowed to continue relationships with existing clients. Again, a supervisor agreement would be required, and if the exam wasn't passed or graduation could not be substantiated, the counselor would be subject to having licensure revoked, along with hours. 
• Improvements could be made to the licensing application process, allowing electronic submission of applications and application components to the state board, along with automatic reporting of passing test scores to the state board. (They report GRE scores to graduate schools...why not this?)

I am all for accountability. In fact, it would be good to enact strong penalties in a situation like this for noncompliance, so as to discourage the abuse of such a provision. But if we are truly committed to client welfare, as an organization of professionals, I would argue that we need to seriously consider changing situations like this one. 

In this case, and in others, current regulation is out of touch with the needs of the average client. An example of this was the recent proposed revision to the Texas LPC rules requiring that online counseling clients first be required to meet in person with a client, a proposition that would have created unnecessary roadblocks to some client groups. Thankfully, the LPC board graciously listened to the state counselors when we rose together to vote against what we felt was an issue of mental health parity. 

What else could we accomplish if we simply let more people in authority know what we see as important in the practice of our profession?

One definition of abandonment is to leave and never return to someone who needs help. If our leaving the client is due to a situation that could be avoided, like this one, isn't that a kind of systematic sanction of abandonment? Please understand, I do not think this is the way anyone intends it to be. But if we let it go unrecognized, it seems we are sanctioning it by default.

I am not strong on the process it would take to reform a rule like this one. I do not know if it would need to be addressed state by individual state or at a level such as the American Counseling Association or American Mental Health Counselor Association. It is also my understanding that the same rules affect marriage and family therapists, who follow a different but similar path to licensure. Regulation changes made only at the state mental health counselor level would not help LMFTs, as it's a separate licensing track. 

Though I do not know any of this, I do think I know the next step. And that is simply to see if I am the only one who is bothered by this state of affairs. Because if so, than I can deal. It actually no longer affects me personally, since I have my LPC license. 

But it does bother me on your behalf. And on behalf of the clients you see. 

If you feel the same way, then we can find together a way to start getting the issue noticed. The ACA offers an action center at which to contact our officials regarding important issues. We could draft a letter to our state licensure boards. We could also seek advice from social and nonprofit organizations who have successfully petitioned for changes before. 

We could do it.

I can't. 

So what do you want to happen next? 

Who are you? Part three.

If you've been following along in this series so far, you know that many counselors, especially new counselors, struggle with SELF-CONFIDENCE. You've also found out that the secret to developing new counselor confidence is marketing. Not advertising, though that can go with it, but marketing. That's because marketing forces you to:

Identify your specific strengths.


Perfect the art of talking about your strengths.


Regularly share your strengths.

Today, let's talk about what that looks like and how you can make it happen in your life. 

First, identify your specific strengths. Remember in the last post when I shared a list of counseling skills I believed I had? This is your turn to do that. In a Facebook comment, one counselor asked if these were the kinds of characteristics one would put in an "about me" page on your website. Absolutely yes! These are the kinds of things people look for when they come to a counselor. And it leads right into my first suggestion when listing your specific strengths, which is:

• Think about explaining your talents to someone who hasn't ever heard of a counselor before. This makes you look at your strengths a whole new way, and it helps you to explain your skills in layman's terms.

When listing your skills, it's helpful to plan on taking at least 15 minutes of uninterrupted time, and writing freestyle and editing later. If you get stuck, think about:

• "What am I proud to offer in counseling that maybe other counselors don't have?" Think in terms of personal experiences, counseling skills (confrontation, listening, reflection) and communication styles. 

The second step of this journey is perfecting the art of talking about your strengths. And there is an art to it! The beginning of developing this artistic strength is identifying the skills, which most of us don't do ahead of time. After you do that, you want to practice sharing why they matter:

• Practice with a loved one or colleague. Pretend they're asking you, "Why would I send a client to you as opposed to this other counselor or no counselor at all?"

Get used to the idea of unashamedly sharing what you have to offer. You're not saying you're good at everything, you're saying what you are good at. Wouldn't you expect your clients to be as proud of their own talents? So lead by example:

• Watch out for minimizing body posture and words, like saying "sort of," hunching or shrugging your shoulders, or otherwise non-verbally counteracting your words.

Third, regularly share your strengths. Practice makes perfect! Get out there. Here's a phrase I used recently, "I can offer killer talks and articles about preparing emotionally for the transition to college." That was a big step for me! What might be a way you can step out there and share?

• Offering a "brown-bag" lunch presentation at your local school for parents or teachers.
• Writing a professional perspective article on a local or current issue. (Why Justin Beiber and every other child star seems to inevitably implode...)
• Starting a small group at your church, local civic center or community college and enlisting the staff of these places to help spread the word. 

This series, as you can probably tell, has been very personal for me, and it's something near and dear to my heart. So I wanted to do something very unique to close it out. I want to hear from YOU, what questions do you have about marketing your way to self-confidence after reading this series? Post on the blog comments, or email me if you want your name kept private (stephanie AT stephanieadamslpc.com). I will answer as many questions as I can in the next blog post. 

Once again, the question is, "What other questions do you have about marketing yourself to new counselor confidence?" In other words: "Where do you get stuck on this issue?"

Cannot WAIT to hear from you. Comment below or email me! 

Names and identities of counselors responding will be obscured unless otherwise requested. 

7 Ways To Start The Search For The Perfect Clinical Supervisor

After graduation, there's one thing standing between you and your dream career - your clinical internship. This internship is made up of two essential ingredients: several thousand hours, and a clinical supervisor. This is a person you will spend 2-5 years with, who will sign off on your license application, and shape your perspective on counseling as a profession. Kind of a big deal. 

Ironically enough, such a big decision often is made for you, as many supervisors "come with" an internship site. Your supervisor is so important to you, it seems crazy that most people get them as a package deal like fries and a Coke. Not that it doesn't make sense - internship sites are hard to come by, and it seems excessive to pay outside fees for a supervisor if you already have one set up. 

But I've found that some people aren't happy with the clinical supervisors they get with their site - sometimes they find out later that the supervisor doesn't have the experience in what they want to learn about, or even in some cases, that the supervisor is unethical. So they have to find a new one.

Some sites, especially nonprofits, don't come with a supervisor at all. They just don't have the means to keep one on staff. 

Any of these situations mean that an intern would have to do their own legwork in finding an independent clinical supervisor. As I discovered when recently asked to help refer an intern to a clinical supervisor, that is not as easy a task as one might think.

To be successful in finding the perfect clinical supervisor, you need several things. 

You need to do your homework and find out what a supervisor wants from you.

You need to know what YOU want in a supervisor and prioritize. 

You need to know how you are going to pay the fees an outside supervisor requires and what you get for those fees. 

But before all that, you need to know where to start. 

That's what I'm here to help you with today. We're going to talk about seven ways you can get started in your search for the perfect clinical supervisor.

1. Your University. My school, like many others, keeps a roster of local LPC-S supervisors that have worked with their students before. Usually this includes both outside and site-based supervisors. School bulletin boards in your department might also include advertisements for private clinical supervisors. 
2. State Rosters. My completely unscientific sampling of several state licensing board showed that each provides a listing of supervisors in their state. There is no further descriptive data on individual supervisors, but it's a place to start. (Examples: Washington, New York) Tip: If your roster is not searchable, download the excel file and sort by city, selecting the column and then "sort." 
3. Networking. Just as one of you interns asked me, ask another counselor or fellow intern if they know someone who does clinical supervision. Right now, I don't have a huge referral list, but I have a few names I'm happy to share. Someday, I might even be able to refer you to myself! I've been considering getting my supervisor credentials lately...
4. Supervisor Listing Websites. SupervisorDirectory.com allows supervisors to list their availability for a low rate, so you're likely to get supervisors of different fee rates if that's important to you. Supervision Today is free for you to search and easy to navigate, for LPCs, LCSWs, and LMFTs.
5. LinkedIn. Linked in is a surprisingly good and often overlooked resource for finding supervisors, though it won't be as effective if you don't already have some counselor connections. Just type in LPC-S, LMFT-S, etc. into your search box and you'll start coming up with people you are already connected with and people who are connected to potential supervisors.
6. Psychology Today. This is lower on the list because it's more time-intensive to search. But it's still possible to pull up local listings and scan the credentials of each counselor listed. Some, not all, will list their supervisor credentials here! This is a neat option because you get more information about potential supervisors before you call them. 
7. Search Engines. This is certainly something that's easy to try, but it's last on the list because it is hard to find the right search term. You're just as likely to get a listing of LPC-S jobs as you are to find LPC-S-es that you can call. But it's worth a shot.

So there you have it. Seven ways to start the search for the perfect clinical supervisor. Try them out and let me know which was most successful for you! But before you do so, will you do one more quick favor for me? 

I've really liked getting to know all of you better, and I think the real strength of Beginning Counselor is in our community. So, in the interest of knowing each other more as well as giving me insight into the kind of referrals you need from me, will you share your experience with me?

If you'll do this quick thing for me, you'll help me jump start a new project I'm working on for all of you. For now, let's just call it the Community Snapshot project...but it can't happen without your help.

Click if I've succeeded in my guilt trip and you'll fill out this quick 4-question form. 

I know I have some licensed counselors reading my posts, but this one's just for the students & interns. So you're off the hook.

How did you find your supervisor? What did you learn was important in the search? Share in the comments below!

[Video Post] Ways For Counselors To Reduce No-Shows (Even With Clients Who Come See You For Free)

I Can't Find A Site! [Classic Beginning Counselor]

To celebrate the new blog location for Beginning Counselor, I've collected and updated some classic blog posts for you. Enjoy!

Ever lost any sleep over the possibility that, despite your best efforts, you won't be able to find a practicum site to earn your hours? If so, you're not alone. 

We all went through worry about finding our prac site. Or, we all will. Finding a site is just so fundamental, it kind of takes over everything else.  

Don't be discouraged, though. Most people will find a place to begin their training. But it will be because they work hard at it.  Here’s some tips to make sure you get the best situation possible.

(1) You cannot start too early. Seriously. Many sites have to make decisions by committee, which for busy agencies or groups could meet only once a month. Many also only “hire” at certain stages of the business cycle, or in certain months. Also, the good sites are going to be on the top of everybody’s lists.

(2) Compile a list. A master list, which will allow you to be the master of your future. Write down names and numbers, as well as names of facilities. Make notes as you go along, to make sure you’re not calling the same people twice and that you’re not missing up on a chance to follow-up on a call that hasn’t been returned.

For help creating a master list, check out The Beginning Counselor's Survival Guide Workbook. 

(3) Get the names on the list from three major sources. The internet is a great resource: try searching “counseling” and your zip code. Psychologytoday.com has a specialized search engine for therapists in group or private practice, as well as selected counseling facilities. For the third option, use your own brain to get creative about what other places might offer therapy: a hospital? A parenting center? Your church?

(4) Have an “elevator pitch” ready. I’ve called to ask to speak to the counseling director and ended up giving a preliminary phone interview with the receptionist, who happened to be the director’s wife. You have to be prepared that whenever you make that call, you might be asked who you are and why you want to be there.

(5) Know your terminology. If you’re looking for a practicum site, you’re a “practicum student”. This tells whoever you’re speaking with that you need less hours and less supervision, as you are still being monitored by your school. If you’re looking for an internship, you say you are an intern.* Then the place knows you will want significant hours and likely be there a long period of time.

(6) Interview the site while you’re allowing them to interview you. It won’t do any good to get a place that cannot provide you the right number of hours, or if you think you’re getting a supervisor on-site and later find out that person is not qualified to do the job.

(7) Network! Who do you know that is a counselor, or social worker, or nonprofit center director? Have you worked previously at a place that would be willing to recommend you? Do you know a person you could name-drop while you’re placing those calls?

This part of the process can be discouraging. Some areas are glutted with counseling students, and some places aren’t willing to nurture a new counselor. Don’t give up. It only takes one place to say yes. I firmly believe there are clients that need something that only you can bring. You have a purpose in this field. Go for it! 

*Some states and some graduate programs do also have a separate PRE-graduation internship in addition to a practicum. If this is the case for you, just specify "internship for licensure" or "supervised post-graduate internship" and that will hopefully clear up any lingering confusion.

Originally Published 12/10/10