7 Ways To Practice Confidence With Your First Clients - Even When You Don't Feel It Yourself

The first time that you meet with a client is a heady mix of thrill and terror. It will probably seem both like it came too quickly and you've been waiting way too long for it. 

And one of the biggest things on your mind during those first few meetings? 

"How can I inspire trust in my clients so that they can open up and get the help they need?" 

One of the most effective ways of inspiring trust is displaying confidence in your own ability to help your clients. When you trust yourself, your clients will trust you. But how can you display confidence in your abilities when you're struggling to feel it yourself? 

Though I dislike the connotation of the maxim, "fake it till you make it," I have to admit the principle applies here! The more you practice self-confidence, the more you will feel it - and conversely, the less you practice self-confidence the more likely you are to get stuck in a cycle of feeling like a failure. You practice self-confidence by identifying the anxieties in your mind that are attacking your faith in yourself, and creating a new framework of understanding to operate from going forward. 

7 Ways To Practice Confidence With Your First Clients - Even When You Don't Feel It Yourself

1. Instead of worrying over what you don't know, take stock of what you DO know. What do you do well? What did your professors praise you for in class exercises? Try to come up with at least 5 things that you can pull out in situations in which confidence is hard to to find.
2. Check their expectations - which are probably not what YOU think they think. We can pretty easily work ourselves up wondering if this client is thinking we're messing things up, or that we're no good at what we do. But really, how likely is it that that condemning US is what's most on their mind right now? Practice telling yourself that they have other things to worry about then our abilities, such as the reasons they are coming in to get help from a counselor. 
3. Get a yay-sayer in your life. Everybody needs someone encouraging around them on a regular basis! For many of you that will be your clinical supervisor, but if not, connect with a fellow counseling student or layperson friend who can tell you that the small things you are agonizing over really aren't that big of a deal.
4. Pre-settle the "experience" question. A lot of us in the student stage get ensnared by the experience question, i.e. "How can you know what I'm going through? Do you have (fill in the blank) kids/husband/wife/traumatic experience/death of a loved one. You're never going to "win" by a direct yes or no answer to this question, because there will always be some experience you have not shared. Plan on how to deal with it using a version of these two responses: 1) Getting at the real question: "Why does it matter to you if I've been through that? Your experience is what matters." And 2) Getting clear on the fundamentals: "I may or may not have been through _______ but I've felt pain before, and pain is pain no matter where it comes from." 
5. Don't be afraid to say that you don't know. You might think the worst possible thing you can say for inspiring trust is "I don't know." But you can't possibly know everything! It's all in the attitude. If you calmly and evenly say, "You know what? I don't know the answer to that right now, but it's important to me and I will look into it before our next session" it will both inspire trust and provide excellent client care.
6. Remember the "get-to-know-you" gap. When you first meet a new client, it honestly takes a minimum of 1 1/2 sessions to start to get a handle on the person...at least it does for me! Before then, we may have some idea, but we don't have enough information to move forward. So don't pressure yourself to know everything right away. No one does!
7. LISTEN. Sometimes, you don't have to have the answers to inspire trust. Sometimes, you just have to be willing to listen. 

When you struggle with self-confidence in beginning counselor training, what do you do or say to yourself to remind yourself of what you have to offer? 

Are YOU Going To The ACA Conference This Year?

I've booked my airline tickets & my hotel. I'm going to the ACA Conference this year for the very first time March 12-15.

What I want to know is: are YOU? 

In the past, we've had some fun Beginning Counselor groups meeting up there!  

Check it out - ACA 2011!

Tony & Earl (who was the awesome photographer of the trip...)

Only one problem... (big pout)....I didn't get to be there with you!!

Okay, I know it's not all about me (despite what you may think that I think) but I'm seriously excited about meeting some of you that I've known virtually for MANY years in person for the very first time. We HAVE to make a big deal of this.

Not only is this my first year attending, I'm also honored to be speaking at the Waiting List Only series (find my talk on page 19 of the brochure, with full credit to the conference resource page.) I'll be speaking at 4:oo PM on Friday the 13th. Good thing I'm not superstitious....

I think it would be fabulous for us to take this opportunity to get to meet each other as a community. 

Why? Because:

• Although we've talked online, many of us have never met in person.
• We're already going to be there (many of us) and how often will we have that kind of opportunity?
• You may not already know anyone you're going with, and regardless, even if you DO know someone you're going with, you likely won't attend every session with the same person or group. It's a lot more fun at these big events to have people you know already to sit with at sessions or talk with at the social events....and engaging as a community gives us those connections. 

Do you think that's a good reason to want to connect at the 2015 ACA Conference? I do!

I have a few ideas for a plan for us to connect, but it's not all up to me! I want to know what YOU would like to do re: spending time with the Beginning Counselor community. 

Here's some options:

1. Have a dedicated social event unofficially in one of the local restaurants/shops. Big challenges with that plan are times and reserving a spot of the right size. We'd have to all RSVP, and we'd miss an official ACA event most likely if we were to do that. I'm open to that, but I'm thinking a simpler solution would be:

2. Create a connection system where we can find one another at all the major events (and even some of the minor ones.) We designate a certain area to sit together and connect, and/or find each other throughout the conference by all adding a special signifier to our ID badge, tote bag, etc.

By signifier, I mean: 

• I can create a printable image to put on our person.
• We can all tie a green piece of yarn or ribbon on our badges so we know we're fellow Beginning Counselors. (This might be my favorite...)
• Or, there's always a red rose tucked inside a copy of "Pride & Prejudice." (Not a real option...)

 

Or was she too prejudiced and Mr. DARCY was too proud? 

A third option is to do nothing at all, and just see if we run into one another, period. I have to say that's not my preference, because I would really like the chance to shake your hand and say thanks for reading the blog and being a member of the community for all these years - whether you've just joined recently OR you've been a member since the very beginning.

However, I'll judge if you feel the same way by your response below.

If you do NOT want to have any kind of meetup organized, or identify yourself or others as a Beginning Counselor at ACA, then don't respond at all. I'll be bummed, but I will totally understand. 

But if you ARE going to the ACA conference and would like to connect with other Beginning Counselors, I'd ask you to share your preference with me by commenting below:

Just copy this phrase & paste: "I'm going the ACA Conference and I'd like option [insert 1 or 2]." If you have any other ideas for our meetup plans, feel free to write them in the comment section as well. 

All you need to do is select option 1 or option 2 and comment about it in the comment section below. Please take just a minute here to let me know what you think! I'd really appreciate it.

Hope to get a chance to see you in March!

[Guest Post] The Big WHY Behind the Power of Sandtray Therapy

So you’ve heard about sandtray therapy but aren’t sure if it REALLY works. I mean, it’s just playing in the sand right? Also, it’s not REALLY therapy- you don’t even know what’s going on during the session? And isn’t it just for kids?

I know, I’ve heard all of those (and even said them myself at one point). 

Rest easy though. I’m here to tell you WHY all of these beliefs are just a big ol’ pile of crap.

Know why? Because SCIENCE.

Science helps us understand ourselves and our brains better. I always like it when science helps explain something we already knew to be true. 

Like sandtray therapy. For years, we knew it worked but were not REALLY sure why it did. Kind of like gravity. Or weather systems. Or [insert natural phenomenon here]. 

We now can peek inside the brain with fMRI’s and understand how our brain processes information.  Information is processed first with pictures and THEN words and linguistics are attached to it. This makes sense if you think about it- we can process images WAY before we can words developmentally. 

I bet if you think about, this still happens. Ever seen a picture that affected you a certain way in your body and mind but struggled to put it into words?

That’s because information is processed first with pictures and images in the right part of our brain and this information may never get moved to the left part of the brain (where words happen).  The right side of the brain is where all of our early trauma lies as well as our feelings and emotions. 

Seems like the right side of the brain is where the big meat of the therapy stuff lies doesn’t it?

But yet, think about how we normally work in session. We talk left brain to left brain.  We try to get at those inner feelings and trauma that are hampering our client’s growth only through words. More often than not, we feel like we just can’t get what is really going on with just words and feel that there’s more we just can’t access.

It’s not you, it’s not your fault. You are just trying to get at information that isn’t stored with words. It’s like trying to dig a hole with half of a shovel. You may make progress and get there but it’s going to be tough going. 

I’m here to give you the entire shovel. Sandtray therapy is your shovel. It will make your life easier and it will allow you feel more confident in your ability to dig in and get at all of that feeling stuff buried in the right brain.

With sandtray therapy, you can access all of that therapy meat in the right part of the brain and heal it with using images AND words.  When we work in the sandtray, we are using both sides of our brain.  When we get both sides of the brain to come online together, the more our client’s brain integrates. More integration means faster, more powerful progress.

This integration is why adults working in the sandtray get better so much faster and get at insights they normally wouldn’t be able to access during just talk therapy.  It’s because the images in the sandtray naturally tap into the feelings part of the brain, allowing to go straight to the source, right brain to right brain. 

Healing happens right brain to right brain.

Kids naturally use their right hemisphere more during play so you may not get the stark difference you see with adults in the sandtray.  Sandtray therapy goes in the backdoor in the brain to get it ALL to come online so we as therapists can help heal ALL of the wounds, even the deep ones that are too scary to put into words.

Now, you can see that sandtray therapy isn’t just playing in the sand, for adults, or some kind of hocus-pocus.

It’s science. Sandtray therapy is a brain-informed method that works where our client’s hurt lies - in the right brain. 

To learn more about what sandtray therapy is and is not click here for a FREE webinar. It will answer all of those nagging questions, if you’re still not convinced. If you are, then you still need to watch it, it will only reinforce the truth of sandtray therapy’s awesomeness.

Comment below with any questions or observations you have about sandtray therapy. 

How have you experienced progress in therapy through experiential methods, such as sandtray?

Amy Flaherty, LPE-I, RPT has been working with in the outpatient setting for over 10 years and has been in private practice since 2007.  Since learning about sandtray therapy, it has become her passion.  She now has a training institute, Southern Sandtray Institute, where she trains other therapists in this powerful method.  To find out more about the program and if sandtray therapy is right for you click HERE to grab your free webinar about the 5 most common sandtray therapy myths.

[Guest Post] Acing The NCMHCE Examination

[[Please Note: This post was originally written 1/8/2015. Check with your state licensing board to make sure all information is still accurate, as rules change!]]

Graduate school is over - but you still have a lot on your mind! 

You’re wondering where to start first and where to go next. Well, while that is usually an individual decision (because there are a lot of directions you can take) many of you will be interested in getting your licensure as a professional counselor. If so, then you have probably already started to think about the licensure exam! Most of us would like to tackle the exam as soon as possible (though others may decide to wait and take it at a later point!)

Either way, when it’s time to sit down and register for the exam, you probably have forgotten where exactly it is you have to go and which exam it is you need to take. That can be quite stressful! But don't worry. Today, I will be sharing with you everything you need to know to ace the National Clinical Mental Health Counselor Exam.

What exactly is the NCMHCE? 
It’s the National Clinical Mental Health Counselor Examination, and many states require this examination before granting licensure.

What states require the NCMHCE for State licensure? 
As of right now some states require one (the NCMHCE) OR the other (the NCE), in order to obtain a state licensure. Below is a list that shows which states ONLY accept one or the other, right now:

Some states will accept either (NCMHCE) OR (NCE) exam for their licensure. So, essentially, if you are moving from any of the above states to any of the below states, you wouldn’t necessarily have to take another whole exam, you would still be able to use your scores from the NCMHCE. 

Here are the states that will accept either exam:

Now that we have established some of the basics, you may want to note the differences between the words “accept” and “require.” This criterion will be your main determination of which exam you need to take and where to put your focus, if you want to get licensed in any of those states. For example, if you live in Florida (like myself) and decide you want to move to Texas, I would have to take the NCMHCE to be state-licensed in Florida and then also take the NCE to become state-licensed in Texas. However, If I moved to Georgia instead, I would be able to use my scores from the NCMHCE that I used for my Florida licensure. (Yes, very confusing I know! I am right there with you! But you can do it!)

As you’re reading this, you’re probably wondering, what about the National Certification? (NCC) "Can’t I just take one test and be Nationally Certified?" Well...you can... BUT, it’s a certification and not a licensure so, each state will still have individual requirements they need from you to become licensed in their state. Simply put, the NCC alone is not enough to practice legally in your state. That issue is a whole separate topic in itself so, for clarity’s sake, we will just keep our focus on the NCMHCE for now!

When you have decided you want or need to take the NCMHCE, here are a few basics that you need to know:

What is the NCHMHCE like?

• Stimulations that cover a broad area of competencies, rather than simple facts to remember. 
• You will be given 10 clinical cases.
• Each case is divided into 5-8 sections that will be classified as either:
• Information Gathering (IG), or:
• Decision Making (DM)

What does the exam cover?
The exam will assess 3 main areas of your clinical competency:

1. Assessment and Diagnosis:
• Your ability to integrate client assessments, observations, and identification of precipitating problems, and individual/family/relationship problems.
2. Counseling & Psychotherapy:
• Your ability to inform the client about ethical standards, practices, counselor/client roles, treatment plans and evaluation of referrals. 
3. Administration, Consultation & Supervision:
• Will determine how well you maintain case notes, records, and files as well as how you determine if services meet client's needs. Also, will examine how you orally communicate with other professionals as well as your ability to assist clients with obtaining social services. 

What can I expect the exam to look and feel like?

• The exam will assess your clinical problem-solving abilities, which will include your ability to identify, analyze, diagnose and treat clinical problems.
• It will be presented in "real-life scenario" type format such as a paragraph with key information about a client, including information such as age, gender, presenting problem, etc. 
• You will be expected to gather appropriate information (IG from above) which might include missing information that is not provided, but necessary for a true diagnosis. For example: family background, physical health, previous experience in counseling, etc. 
• You will also be expected to make clinical judgments and/or decisions (DM from above) such as what to do with the information you have gathered, know, or have been provided such as making a diagnosis, a referral elsewhere, other social services, etc. 

Is there a right or wrong answer? How will my exam be scored?

• Yes and no. You should know that this is not a fact-based examination and that some questions will have multiple correct solutions. You should select all options that are appropriate for that question. There will also be some questions that are "single best answer" which will provide more than one acceptable option but, only one option is "generally" more acceptable than the other. I know! I know! Trust me, they are really testing your clinical abilities with the NCMHCE and as we all know, real-life scenarios are not black-and-white, and we have to assess each situation individually. That is exactly what this test is designed for. 

So, how can I prepare?

• I, personally, would prepare by allowing yourself to develop professionally first, and gain experience in real-life situations, during your first year of post-graduation licensure. Coming straight out of grad school we have been tested over and over again on factual, black-and-white, right-or-wrong answers! However, that's just not what the NCMHCE is looking for. So, allow yourself some time to adjust to the "grey" area of real-life diagnosing, analyzing and decision-making first. 
• Then, prepare to study! There are numerous resources available but, here are a few that have worked well for others and have been suggested as resources that can help!
• The NBCC website. They supply a good list of study guides that others have found to be useful. Here's the link.
• Dr. Linton's DSM-5 Online Study Prep for the NCMHCE, 6th Edition, which includes online simulations & prep, prior to the actual exam. Many therapists have used this and suggest it as a great way to pass the exam! 
• Click here for access to the main website & other study resources, such as the online subscription service mentioned above. 
• Click here to purchase the Study Guide for the DSM-5 on Amazon.com (Paperback).
• Click here to purchase paperback, Nook, Kindle, or pdf versions from Dr. Linton's website. 
• Dr. Howard Rosenthal's Encyclopedia of Counseling, a.k.a. "the purple book," is a great resource to use complementary to the resources mentioned above, and as a refresher on areas that you need help with. However, this format is primarily designed for passing the NCE. 
• Click here to purchase the Encyclopedia of Counseling package (2009) on Amazon.com.

Whew! Now that we’ve established everything you need to know about the NCMHCE and what to expect, you’ve probably got a lot MORE on your mind than you did before you read this. The most important thing to remember is to take the test at your own pace, when YOU feel most ready for it.

For more information about cost, the DSM-5, how to register and where to go for the exam, visit the National Board of Certified Counselors (www.nbcc.org) and always check with your state to find out which exam they require. Some states will also require “pre-approval” to sit for the NCMHCE through the NBCC first.

If you have any additional resources for studying, or experience you with taking the NCMHCE that you would like to share please feel free to post in the comments below! We always love to hear what has worked and hasn’t for others! 

Jessica Richards is a Registered Mental Health Counselor Intern for the State of Florida. As a graduate of NOVA Southeastern University, she holds a master's degree in Mental Health Counseling. With the help of Stephanie Adams, Jessica established Beginning Counselors of Florida, a support group for beginning counselors leaving grad school and seeking licensure. She is currently serving as Registered Intern Representative for FMHCA. She currently contracts with several community agencies while working on establishing her private practice.

What You're Afraid Of Right Now

The results are starting to come in.

The most common Beginning Counselor fear is fear of lack of personal ability. Running right behind that (less than five percentage points behind) is fear of failure.

Do you identify with that as well?

I certainly did. Last week, I sent Beginning Counselor members an email talking about how fear of screwing up a client reduced me to a nervous mess before my first session. I invited Beginning Counselor members to take an anonymous survey on what fears they struggle with on a regular basis. (If you haven’t yet, you can take the survey right now, it’s still open.) 

Over 60% of those polled described their professional anxiety as ‘moderate’ – meaning regular (although not constant) worries about their future or professional abilities. The most common result of those worries, so far, is the “genuine worry that [they] will be unable to make this career work.”

While this is not a scientific survey – I cannot guarantee a random sample or eliminate other factors as influential in the results – I think it calls for further research at the very least. And a frank discussion of what this means for us, even with the caveat of it not being a fully scientific research study.

Respondents to the study shared comments about their concerns that their fears would impact their work with clients. They said things like:

• I'm “freezing up mentally with clients due to my negative thoughts like, ‘I don’t know what the hell I’m doing.’”
• I’m worried I will begin “overstepping boundaries with clients that I begin to care a lot for.”

They shared worries about their future career options, saying things like: 

• “I fear I will not be able to get enough hours to pass, and then if I do graduate can I afford to live on being an intern and will I have to pay for supervision, too”?
• I know “if counseling was my only profession I would have to get another job to survive financially for awhile, based on other beginning counselors I know.”
• I’m concerned about, “not being able to repay my student loans…not being able to start and sustain a private practice.”
• I’m afraid that, “my goal is unrealistic.”

As for me? Here’s what I worry will happen if we don’t address this within our community.

Due to fear or lack of support, I fear we will lose good counselors.

• If you’re afraid you can’t make a living…
• If you’re afraid you won’t be able to help…or may even hurt your clients…
• If the pressure gets overwhelming…

It would seem a logical concern that you might consider leaving the field somewhere down the line.

That, to me, is unacceptable. 

So what can we do about it?

There’s really only three options:

1. Do nothing.
2. Wait and see.
3. Do something.

Here’s a hint: the first two options are the same.

Can I guarantee that doing something is going to be doing the right something? Heck no. But I prefer the option of trying something to the other two.

So here’s what I suggest as far as “doing something.”

1. If you haven’t already, click on this link and help us get more accurate data to work with by taking the survey on professional anxiety. (Paying special attention to question #8 which tells me what I can do to help you in the future.)
2. Share your fears with another beginning counselor you trust, to normalize the anxiety and offer support to someone else.
3. Attend “Beat Private Practice Anxiety! How To Get Rid of Your Business Fears Once & For All,” October’s FREE MYOB webinar. Even if you’re still in training, if your private practice is way down the line, or if you’re not sure whether you’ll start a private practice at all, you still need to come. 

For one thing, the earlier you prepare for practice success, the more likely you are to have it. For another, I’m going to be talking about how to have confidence in yourself as a professional as part of how you can have success in private practice. So either way, you need to make sure you will be there!

 

5 Ways To Broaden Your Training Experience (Even If You’re In A Single-Focus Internship)

Thrilled with your current position as an intern at a domestic violence shelter, a hospital ER, or a faith-based counseling center, but wishing you had the chance to explore more of the variety that is out there in the counseling field?

Here’s your guide to getting the most out of the time you have in training – no matter what your internship focus is!

1. Multitask. Whatever you’re doing for hours now, think

about how you can get the most possible experience for your time there. Can you spin your work with preschool play therapy into some parent coaching sessions? Can you develop and use different sets of skills with the same group of clients, like trying cognitive-behavioral & EMDR-based methods on your trauma clients?

2. Observe. Other interns in different specialties. Your supervisor. Any other counselor that will allow you to watch them in practice. 

3. Read. Case studies, journal research articles, autobiographies, memoirs, counselor-authored practice books. Here’s some possibilities to get you started:

Journeys To Professional Excellence: Lessons From Leading Counselor Educators And Practitioners 
Ariadne's Thread: Case Studies in the Therapeutic Relationship 
On Being A Therapist 
Inside the Session: What Really Happens in Psychotherapy 

4. Volunteer. Any kind of social services agency will work!

5. Man (or Woman) a Hotline. Sexual assault recovery, crisis pregnancy, suicide prevention, LGBT, domestic violence – there is a hotline for almost any specialty you might want to explore further. While you would likely be a volunteer in this position, it’s still worth your time to pursue if it’s of significant interest to you. 

Right now, you may be feeling stuck, or out of options. But you have more flexibility than you realize. This is literally the only time in your life when you are new to the field of counseling, AND you have the assistance of a trained supervisor to help you with any and all of your counseling-related questions.

And that’s the key that’s going to make the suggestions above work for you. Any of these suggestions on their own might do you some good. But if you consciously filter these new experiences that you’re having through that lens of new counselor experience you will have insights you’ve never gained before and some you’ll never have again. If you take notes back from these experiences to discuss with your supervisor, or practice with a fellow intern, you’ll find your intern experience to be both diverse and more rewarding than you ever thought it could be! 

How do you suggest finding diversity in a more narrow internship experience? Comment and share below!

Who Else Wants to Measure Client Success?

Ever wonder if your efforts with clients are getting anywhere? Are you making the difference you hope to with your interventions and techniques, or are they falling flat? 

How do you know if you’re being effective in your client work?

This time in your life (practicum & internship) is all about trying new things. You’re supposed to be experimenting and finding your own personal style. But in order to do that, you need to measure the results of the new things you’re trying.

You can test the effect of your interventions on client’s stated goals by looking for these key signals as a sign that something is happening. You might not know what it means yet, but you will be able to identify that there is a reaction that means something.

The client asks specific questions about your intervention. Example: “How long do we take a time-out? What should I say to my partner when I need a break, so that they don’t feel abandoned?” This means they are engaged with the logic of what you’re suggesting and seriously considering putting it into play. The real test, of course, is to see if they…

Come back and tell you about trying it. Example: “We did this and it really worked! We were able to communicate so much better afterwards.” This is one of the most straightforward and welcome ways for you to recognize the benefits of your work…it helps your confidence a great deal when a client can specifically tell you about what worked and didn’t work. If they do not do this on their own, I encourage you to come right out and ask! It will show them you care and help you monitor your progress as well as theirs.

The client is super-quiet, even still. Example: You suggest something they could try to alleviate a symptom of their problem. A normally chatty, even bubbly person, may become quiet and not move. He/She may look at the wall or their hands. This is a sign of contemplation, obviously, but at another level like a kind of shock, indicating you may have shared with them an idea that is new to them and needs to absorb. When the client does this, consider simply mirroring them until they speak again – if it is quiet for a long while, you might also reflect the situation back to them. “It seems like you got really quiet there. Did something about that hit a nerve?”

The client starts making jokes. Example: You say, “Have you thought about telling your family you’re taking medication now?” They say, “Oh, sure, I’ll can’t wait to tell them I’m on drugs!” While a little dark humor can actually be a healthy way to process (seriously, they’ve done research) it can also be a way to deflect from feelings of fear or confusion. The fact that they want to deflect is a sign you’ve hit on something that matters, so follow up on it with them.

The client gets angry or belligerent. Example: When you suggest something, they say, “That seems like a terrible idea. It doesn’t make any sense. Why would you waste my time?” etc. Like inappropriate humor or sarcasm, this is a way to push you away and get you to focus on something else rather than what you suggested. This aggressive behavior could be physical, verbal, manipulative (passive-aggression) or sexual (flirting or come-ons) but the point of it all is the same. You got to something they want to protect. If at all possible, it’s important to not react and stay focused on the problem they’re covering up. Stay safe, but if you can, try to connect with them before they lead you off the track. 

These are signs that you are making progress in counseling. The ultimate sign of progress, of course, is when you run out of things to talk about. You know they’re not holding back, they’re simply done with their goals. That’s when you can begin to ease them back into a more independent process of self-exploration. But until that point, these clues above can help you know you’re on the right track.

What signs do you look for to measure client successes? Comment below!  

And join me on Sept. 2 for a

Free Private Practice Webinar