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How to Be Accessible Beyond the Sliding Scale An interview with Lindsay Bryan-Podvin, LMSW, about how therapy can be accessible (and not just financially). Curt and Katie chat with Lindsay about capitalism versus money exchange, the social enterprise model, and how therapists can make a good living without feeling like greedy capitalists. We also explore the many different types of accessibility and the importance of setting your fees based on your needs and values rather than as a mechanism to single-handedly fix the broken system or to meet an artificial money goal.     It's time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age. Interview with Lindsay Bryan-Podvin, LMSW, Mind Money Balance Lindsay Bryan-Podvin (she/her) is a biracial financial therapist, speaker, and author of the book "The Financial Anxiety Solution." In her therapy practice, Mind Money Balance, she uses shame-free financial therapy to help people get their minds and money in balance. She's expanded her services to help private practice therapists with their money mindset, sustainable pricing, and authentic marketing so they can include financial self-care in their work. She lives with her partner and their dog on the traditional land of the Fox, Peoria, Potawatomi, and Anishinabewaki peoples also known as Michigan. In this episode we talk about: How therapy can be more accessible (and not just monetarily) The money “shit” that gets in the way of us thinking about other options for accessibility Decreasing stigma and the notion that therapy is by and for white folks Are we making our practices accessible for all sorts of folks? ADA compliance, supporting neurodivergent and disabled folks Cultural competence, the ability to apply that in sessions with clients who are different than us Being embedded in our communities Taking therapy out of the shadows The challenges in getting out and having a larger voice How accessibility is intertwined with therapist visibility How to become part of your community in effective and impactful ways Financial ways to make your practice more accessible beyond sliding scale Social Enterprise Model: intersection of what you do well, what values you stand for, and what can you get paid well to do Feeling like a greedy capitalist What it means to be paid well How to think about setting your fees Fee-setting based on what you need to survive and thrive (not capitalist principles) The problem with “know your worth” The big cognitive shift required to move from community mental health pricing and work-life balance, fees Tying money to quality of life, not specific monetary goals Getting to “enough” not more and more Capitalism versus money exchange The wealth of knowledge we have as therapists (and how therapists take it for granted and/or devalue it) Sharing your knowledge as a mechanism of accessibility to your whole community To practice self-care, you have to be able to afford it Our Generous Sponsor: Trauma Therapist Network Trauma is highly prevalent in mental health client populations and people are looking for therapists with specialized training and experience in trauma, but they often don't know where to start. If you've ever looked for a trauma therapist, you know it can be hard to discern who knows what and whether or not they're the right fit for you. There are so many types of trauma and so many different ways to heal. That's why Laura Reagan, LCSW-C created Trauma Therapist Network.  Trauma Therapist Network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work and what they specialize in, so potential clients can find them. Trauma Therapist Network therapist profiles include the types of trauma specialized in, populations served and therapy methods used, making it easier for potential clients to find the right therapist who can help them.  The Network is more than a directory, though. It's a community. All members are invited to attend community meetings to connect, consult and network with colleagues around the country. Join our growing community of trauma therapists and get 20% off your first month using the promo code:  MTSG20 at www.traumatherapistnetwork.com.   Resources mentioned: We've pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! www.mindmoneybalance.com https://www.instagram.com/mindmoneybalance/ Lindsay's podcast: Mind Money Balance   Relevant Episodes: Lindsay's previous podcast episode: Financial Therapy Katie Read: Therapists Shaming Therapists Negotiating Sliding Scale Making Access More Affordable Asking for Money Reimagining Therapy Reimagined   Connect with us! Our Facebook Group – The Modern Therapists Group  Our consultation services: The Fifty-Minute Hour Who we are: Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making "dad jokes" and usually has a half-empty cup of coffee somewhere nearby. Learn more at: www.curtwidhalm.com Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt's youthful energy, so that she can take over the world. Learn more at: www.katievernoy.com A Quick Note: Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We're working on it. Our guests are also only speaking for themselves and have their own opinions. We aren't trying to take their voice, and no one speaks for us either. Mostly because they don't want to, but hey.   Stay in Touch: www.mtsgpodcast.com www.therapyreimagined.com Our Facebook Group – The Modern Therapist's Group https://www.facebook.com/therapyreimagined/ https://twitter.com/therapymovement https://www.instagram.com/therapyreimagined/   Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano http://www.crystalmangano.com/   Transcript (Autogenerated)   Curt Widhalm  00:00 This episode is sponsored by trauma therapist network.   Katie Vernoy  00:04 Trauma therapist network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work, and what they specialize in so potential clients can find them. Visit traumatherapistnetwork.com to learn more,   Curt Widhalm  00:27 listen at the end of the episode for more about the trauma therapist network.   Announcer  00:31 You're listening to the Modern Therapist's Survival Guide, where therapists live, breed and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Curt Widhalm and Katie Vernoy.   Curt Widhalm  00:47 Welcome back modern therapists. This is the modern therapist Survival Guide. I'm Curt Widhalm, with Katie Vernoy. And this is the podcast for therapists about things that we do things that we don't do things that maybe we should do. And both Katie and our guests today are looking at me like, where is this going? And honestly, this is just one of those rambling intros that we have. So rather than making this more awkward, we're joined once again by Lindsey Bryan Podvin. She's been a guest to the show before spoken at therapy reimagined with us, talking to us about money and ways that we could be looking at it for our practice. So thank you for joining us again.   Lindsay Bryan-Podvin  01:35 Oh, yeah, I'm really happy to be here. This is my favorite thing to chat about, and to be in community with you guys. Again, it's fun.   Katie Vernoy  01:43 Oh, we're so glad to have you back. And we'll definitely link to your previous episode in our show notes. But for folks who haven't heard from you for a while, or for our new listeners, tell us who you are and what you're putting out into the world.   Lindsay Bryan-Podvin  01:57 Yeah, so as Curt mentioned, my name is Lindsay Bryan-Podvin. I'm a social worker, and financial therapist, and I have kind of two arms of what I'm putting out there into the world, I have my clinical arm, and then I have my consulting arm. So in my clinical world, I'm doing financial therapy, which is helping clients with the emotional and psychological side of money, which spoiler alert is all of it, I think. And then, on the consulting side, I know you all know that therapists have money, shit, and we have a lot of hang ups about it. And so in my consulting arm, I help mostly other therapists, though, over the past year, I'll say that other kind of helping professionals have woven their way in, whether it's dietitians, acupuncturist, Reiki healers, because I think a lot of us get similar messaging about what money is and what it isn't. And so I help them work on their emotional and psychological relationship with money so they can have sustainable and profitable businesses. And I do, like outside of the the hands on work, or the zoom work, I suppose I have a podcast and Instagram, a pretty active blog and an email list that keeps me using my creative side of my brain.   Katie Vernoy  03:13 Nice. I love it.   Curt Widhalm  03:15 One of the big discussions that's been in the social justice aspects of our field, especially for private practitioners, and admittedly also here on our show, is talking about things like accessibility and being able to make our services go beyond just those top paying cash pay clients. Can you walk us through kind of what you hear in these discussions about accessibility for practices, and especially as it relates to some of these monetary issues?   Lindsay Bryan-Podvin  03:50 Yeah, I think as therapists we get really stuck on accessibility being only a monetary issue. So we think about solving for that problem by sliding our scale or by offering pro bono spaces. But we forget about all the other ways in which we can and should be accessible if that works in alignment with us. So as I think you guys were talking with Katie read about like the the the money talk that comes up on therapists forums and how there's so much guilt and shame and, and judgment about what people do or don't do, whether they do or don't take insurance, whether they do or don't slide their scale, but that's where most of us get stuck. And there are so many things beyond sliding our scale and the fee that we charge that can bring about accessibility for our practices and in our communities.   Katie Vernoy  04:45 What are some of the things that we can think about beyond sliding scale because I think I get stuck there as well with and maybe this is just our focus is that we're so focused on the monetary aspects and our own money shit as you described it, and We aren't thinking about what else isn't making us accessible.   Lindsay Bryan-Podvin  05:03 Yeah, I think taking a few steps back before a client even finds our website or finds us on a therapist directory, really thinking about how can we make our field more accessible by talking about what is therapy, I think in a lot of communities, we still have these stigmas that therapy is buy in for white people. And it's done on a couch with, you know, a person who's got reinforced elbows and they're smoking a pipe, right? You know, like, we have that imagery. And if we are not talking to our communities about what therapy is and who it is for, and how it can be helpful by not just talking about what it is, but also the stigma reduction, we don't even get people landing on our websites or knocking on our, you know, figurative door, right. So being in our communities and talking about what it is and who it's for, and how it can be helpful. And also talking about just the ins and outs of therapy, that it is confidential. I think in a lot of communities, there's a fear that if I go to a therapist, then you know, my mom's cousins going to find out about it, or that my employer will be told about it, or that my partner will be told about it. So I think there's some education that has to happen on the backend before people even get to our doors. And then in terms of other measures of accessibility outside of this scale. Let's get really granular on on what is accessibility? Do our clients see themselves reflected in the way that we practice therapy? Can clients who have disabilities, either neurodiversity or physical limitations, do they have actual access to our offices? Are they ADA compliant? Do we offer you know, nowadays, so many of us offer basically zoom therapy? Which makes it so much more accessible? Are we operating on bus routes and public transportation? Is there easy parking, like the literal accessibility piece? And then the cultural competency piece? Can they speak my language? If I don't speak English? Do I have somebody sitting across from me in the therapy room? Who gets what I'm talking about? When we talk about cultural competence? Not just thinking about, you know, whether or not you took a class on Southeast Asian Studies. But what does that mean? And how does that show up in our spaces, and being embedded in our community beyond just like, hiding in this little bubble, where we're kind of shrouded in mystery, I think, taking therapy out of the shadows and making it more commonplace in our communities, like we are healers in our communities. And we shouldn't be hiding behind the walls of like mystery what when there are community events, I would love to see more therapists out and they're out and about, as sponsors, as networkers and things like that, like, we also have to take ourselves out of the shadow. So there's, there's a lot of different ways we can talk about accessibility.   Curt Widhalm  07:59 So I love what you're saying, I completely agree with getting out there. There's some some stumbling steps that can happen in putting ourselves out there, because so much of our history is in being shrouded to the, you know, the shadows. And sometimes the responses that I hear from clinicians is, oh, that person went out and was talking about this, but didn't represent themselves. Well, it isn't representing the field. Well, do you have any advice as far as taking some of these steps? You know, look at you, and all of the things that you post in your newsletters and social media and this kind of stuff, money seems to be kind of like a fairly neutral ground as far as being able to talk about relationships with money. For those who are looking to maybe take some other steps as far as making this accessibility happen, that might be around more unique issues to communities. Do you have any suggestions on how people might find the confidence to be able to make those steps?   Lindsay Bryan-Podvin  09:03 Yeah, I really like this question. Because I think that accessibility and visibility are are intertwined. And visibility isn't just social media. So let's say you do want to be more accessible in your community and you do want to be more visible in your community, but you're talking about something that is more sensitive, like you know, sexual trauma, then yeah, maybe going on in doing an Instagram live about it isn't probably the most appropriate way because you don't know who's on the other side of it, you really can't create a container of people to make sure that it's safer or at least safer. So maybe in that instance, it's going to, you know, a high school and pulling a you know, having a group of 30 kids that you are talking to about this in like a speaking engagement setting or maybe it is going to the healthcare system and sitting down and talking to the medical social workers about what you know, or to the nurse midwives about what you know, right there. Different ways to get out and become a part of the community that don't involve these kind of one way one sided communication methods. Does that make sense?   Katie Vernoy  10:11 It does, I think this idea of making the whole profession more accessible to folks and all folks, and not just the kind of historical white people and the, the, the patches and the pipes. I think that to me is, it's really, really important. And I think it also is only a first step. Because when they get to our door is there still is I think, you know, financial accessibility concerns for a lot of folks. And so are there financial ways to be accessible that don't involve involves sliding your scale?   Lindsay Bryan-Podvin  10:48 Yeah, of course. So, undoubtedly, money is a real accessibility issue. I'm not just saying like, Oh, you know, just get out there. That's it sounds it? All. Right, exactly. Exactly. An email newsletter is not going to fix accessibility. But as you guys have also talked about on this podcast, it's not the responsibility of an individual therapist, to fix the broken medical system salute here. And at the same time, there are more creative ways to provide services to people in your community that are might be easier on their pocketbooks. So group therapy is also a really great option, because you as the clinician are still generating the revenue that you need to, and the people on the other side are usually paying you less dollars per session. Insurance, I know there's a big again, it's not your job to accept insurance if they don't reimburse you well, but accepting insurance is a measure of accessibility. And even if you aren't accepting insurance, helping your clients out, walking them through what a super bill is, you know, spending a little bit of time in session, making sure that they know what that means and how to actually get it done. That, to me is incredibly helpful. So providing a bit of space in the in the session to talk through how you can do that, particularly if they have anxiety, or they've got some ADHD, you know, they might need a little extra hand holding to get those things done. There are depending on your licensing board, I've seen some people do sponsored therapy spot. So it's a little bit different than a pro bono. It's Think of it like a scholarship for therapy. So the way that I've seen this work is for clients who pay a full fee, you essentially tell them look by you paying a full fee, a portion of your fee goes towards sponsoring somebody who would not be able to afford therapy with me. So you're still getting income, but you're also having the clients who are able to pay your fee, kind of some buy in that they are also kind of helping out other people in the community. So those are some different ways to be accessible, that don't involve sliding your scale doesn't mean you have to do all or any of them. It's just different ways to think about it.   Curt Widhalm  13:04 On of the things that you talked about in your presentation at the therapy reimagined conference, this social enterprise.   Lindsay Bryan-Podvin  13:12 Yes.   Curt Widhalm  13:14 Can you tell us more about that, what it means for people who maybe didn't attend the conference and what the social enterprise model is and how this might fit in for therapists?   Lindsay Bryan-Podvin  13:24 Yeah, I think so many therapists struggle with this idea of charging for services because we've internalized so many things about what money is or what it isn't. And the social enterprise model essentially says, look, there are three things to provide something that you can feel good about doing. And also know that you are being compensated fairly for it. And it exists at the intersection of these three things. One, what do you do well, what values do you stand for? And what can you be paid? Well to do, and as therapists I think, if we can think about ourselves at the intersection of that, of existing, and I do this really well, these are in alignment with my values, this type of therapeutic intervention is in alignment with my values, and I can be paid well to do that. You know, that you are contributing to the greater good of the community by making sure that you're not just wringing out your clients for the most dollars you can get right? I think so many of us think that if I charge money, then I'm a greedy capitalist, but it's also about am I being compensated for the skills that I offer and the transformations that I'm able to help facilitate in a meaningful way?   Katie Vernoy  14:41 I know that there are a lot of different perspectives on how you decide how much money to wring out of your client. And, and and you mentioned the episode with Katie Read and we've had other conversations as well, just about the shoulds. And you know, how I should set my fees and those types of things. Yeah, and to me, it feels like there's so much nuance. It's it's a wide open space, there's a lot of shit. So people feel like it's not wide open, but I feel like it really is. What advice do you have on on setting those fees? Because when we're in that space where I can be paid well for it, it's aligned with my values, and I can do it well, like, it can be hard to figure out like, and what does being paid? Well mean, that I can feel good about?   Lindsay Bryan-Podvin  15:30 Yeah. And I think that's such a good question. Because this idea of what does it mean to be paid? Well, is so skewed in our field, my first job, I was making $32,000, you know, with a master's degree, and I don't think that's an unfamiliar number or salary for people to hear. And so when a lot of people go into private practice, they hold themselves to that standard, oh, well, I was making 40k or 50k. I think that's a reasonable salary. I think that's what I'll try to make. So we haven't thought beyond what do we actually need to survive and thrive. And that's where doing things in alignment with your values can be really beneficial. So when it comes to fi setting, you're not just thinking about what are you charging your clients? You're also thinking about? Does that fee sustain me and allow me to practice financial self care? Which means Can I take care of my financial needs? Yes, but do Am I also able to support my mental, my emotional and my spiritual self. With that? I know, I was, I was loving your episode on burnout. And I love the modeling that the two of you did by saying, Look, we're going to hit pause on the therapy reimagine conference, we also have to build in time off and time for restoration, there is a study that says we need, I think, oh, shoot, I'm going to botch it. Now. I think it's eight or 10 consecutive days off in a row to actually unplug from work. So making sure that you have that built in to your time off. So making sure it covers your time off making sure it covers your health insurance. Unfortunately, we live in a society where your healthcare is tied with your employment. So when you're self employed, you have to make sure that you can cover your health insurance, you have to also make sure that you're thinking about your future self in traditional employment, we often have access to retirement plans or programs. And when we move into entrepreneurship, we are our own 401k or four, three B plan. So we have to make sure that all of those things are taken into account. And we don't want to be overworking ourselves. When we show up exhausted and burnt out and watching the clock, we are not being good clinicians we just aren't. And just taking stock of our own energy, my full pre pandemic was 18, I could comfortably see 18 clients a week that felt like a good fit for me, I wasn't burnt out, I wasn't presenting my clients, I had downtime to get the things done, I needed to do and I charged accordingly. Now, my max is 12. I have found that doing zoom therapy. While there are so many advantages of it, like I genuinely really like it, I find that literally the physicality of sitting still and staring at my screen and just what really watching so much harder for nuances through the screen takes so much more energy out of me and I can no longer comfortably and competently feel like I'm a good practitioner when I'm seeing 18 clients when I've had to scale that back to 12. And then what do I have to do to make up for that income? So that was a long answer of saying it depends. You have to figure out what money you need to be bringing in and you need to make sure that you're not just thinking about comparing it to what you use to earn an agency job because you were likely being underpaid there.   Katie Vernoy  18:47 It's hard not to feel like a greedy capitalist. With that it means you have to charge a premium fee mostly   Lindsay Bryan-Podvin  18:56 Yeah, yeah.   Curt Widhalm  18:59 Give me advice for people making that jump to those premium price because I'm sure that there's a lot of our listeners who might be considering leaving an agency job and being like, you know, I know you know my session value in this agency and this aligns maybe with my values but in going out and charging somebody three four or five times that fee in order to meet my money goals seems like it has a lot of opportunity to bring up some that imposter syndrome and really being able to balance that for those individuals you have any guidance on what to really look at hopefully beyond just kind of know your worth.   Lindsay Bryan-Podvin  19:43 Yeah. Oh my god. Thank you for saying that because also the Know your worth thing. That's a trope I used to find myself repeating. And then a friend of mine who's a behavioral economist, she shared with me Jaquette Timmons and she's goes Lindsay You have to stop saying that because we as humans We don't have a worth. So instead, she invited me to reframe it as charged the value of what your services are worth to give yourself a little bit of psychic distance there between like, I'm worth $300. Now it's like no, the value of my services are worth $300 an hour. So anyway, tangent aside, how can you come into charging fees for your services, I think there is a pendulum swing that I see happen when people try to get out of the mentality of sliding their scale as low as possible to charging premium fees. And so they go from being in spaces where being a good therapist means charging very little into spaces that are like, You need to be a six, seven figure business owner, and you need to be charging premium fees, which can be as we know, a big jump cognitively. And so I always invite people to come back to your values, your lifestyle needs, your unique financial goals. And I'm not about bashing the people who are saying, Oh, you need to make six figures or seven figures. My practice does generate six figures. But I don't think that is a magical goalposts where all your problems are suddenly solved. I think this chase this money charge, the premium fees, you have to work more can backfire. In that it forces us to work more meaning when you have that mentality of I have to work harder, I have to chase this x figure goal or this premium fee number. What happens often is you get into this space where I'll just use myself for an example that that 12 clients Oh, I saw 12 clients a week, I made enough money to hit my goals. I started to cultivate work life balance. But now what if I saw twice as many people, I could make twice as much money? What could I do it twice as much money. And then all of a sudden you forget about why you did it in the first place. So coming back to how much do I need? How much do I desire and is the money that I'm charging, allowing me to do things in alignment with my values, let's say family is like the most important value to me. And I want my 10 consecutive days off in a row with my family. And I want to go somewhere where I don't have to worry about you know, finding activities for us to do or cooking a bunch of food, I want to make sure that I have enough money to pay for that Airbnb to pay for takeout and that Airbnb is conveniently located to a lot of like outdoor activities. That's a goal that I can kind of reverse engineer my way. And to me, it's also modeling for your clients, you don't necessarily have to say to your client, like, Oh, my financial goal was this, this and this, and I was able to achieve it. But you're also modeling for your clients the importance of taking time off of adhering to your boundaries and practicing self care. So again, that's a tangent of an answer. But I guess the long and short of it is as you move towards charging premium fees come back to like, what your WHY IS, and when you feel that anxiety to work more and charge more and go harder, you actually may already have enough.   Katie Vernoy  23:02 I like that I think the piece that resonates for me is this, the letting go of I must get to this number, I must make more money. And I think for me, there's also this big push of like we must leverage we must, we must continue to grow and expand. And I think there's a point at which we have enough I mean, there, there may still be challenges that we need to do. But there's this, this freedom and not having to constantly grow and, and make my business bigger and make my business more successful. Like there's each person has to decide where they land or where they land for a time and you know, different seasons of what I need and what I want and what's most important to me, but it feels like it and this is kind of circling back to the the social enterprise model and kind of this idea of capitalism versus money exchange and, you know, clarifying all of that, but but it seems like when it's completely tied to values, what you're positing is that feels better than just making money for money's sake. And so, so tell us a little bit more about this. Because to me, I feel like I'm just starting to grasp the idea I was I was too caught up in the greedy capitalism, to understand kind of what what we were what we were starting to talk about with a social enterprise model.   Lindsay Bryan-Podvin  24:24 Yeah. So to bounce off of this idea of what is the difference between capitalism and money exchange? I think it's important to note that capitalism is a is a political economic system that we we know the dangers of right it is propped up by the unpaid and underpaid labor. So the person or people who are in charge, get the greatest amount of profit available. And as such, as we kind of touched on earlier, it's a system where we give all the praise to the people who Make a lot of money because they must have worked hard and simultaneously shamed the people who didn't make a lot of money because they must have not been hard workers. And we've we bought into that idea as a society so much so that you know, at the time that we're recording this, if you're on Twitter right now, you can see people rallying around Elon Musk saying like, yeah, he shouldn't have to pay taxes, he worked really hard. So we've got all these people saying, like, yeah, we save the billionaires instead of let's make sure we have a safety net that people can't fall through for the greater good of our society. So that's capitalism. And there's a lot of problems with it. And even if you disagree with it, unfortunately, we live in that society. Yeah. And money exchange, on the other hand has been around since the dawn of time, whether it was literal dollars or coins, there has always been an exchange of things for other things, or things or other services. And when we think about small business owners, which is most private practice owners, if we can think about ourselves as kind of the community farmstand, it helps to shift that mentality. So for example, if I go down to the farmers market, and I purchased a half a dozen eggs, I'm helping to support sustainable agriculture in my community, I get to know the person who grew my crew, my eggs, I don't think we're growing eggs, but you don't I mean, maybe if you're vegan, actually, you're growing your eggs. So you're growing your eggs substitutes? Got it? So we want to think about as therapists, how can we kind of fit into that model, where what we do in charging for services, and helping people in our community is a win win. Because when we have a healthier person in our community, because we are helping them with their mental health, what is that ripple effect on the community? And how can that be beneficial?   Curt Widhalm  26:57 It sounds like, you know, this is what a lot of practitioners do by going out into the community and sharing even some of the things that you were talking about at the top of the episode of just going and talking about mental health and about their practices and doing some, I guess, pro bono work and in the way of psychoeducation, or community education that helps to make that Win Win happen.   Lindsay Bryan-Podvin  27:25 Yeah. Yeah, absolutely. I think it's so so powerful. I think when we are in our spaces where we're surrounded by other mental health, folks, we forget what the baseline is of mental health knowledge. Oh, yeah, forget, just like what a wealth of information we have, like the other day, I did a presentation for non mental health care providers about what financial anxiety is, and tips to cope with it right. And for anybody in the therapy field, they'd be like, that's like, entry level CBT, maybe if you're lucky. But for this group of people, it wasn't that they don't, it's just we forget how much knowledge we have, and how valuable explaining some basics of how our minds and bodies and thoughts are connected, can be a huge value for other people in our community. So just don't take what your knowledge is for granted. Get out of your academic kind of echo chambers and go talk to people who aren't in the mental health care field. And that is really where you can offer a lot of wisdom and value in your community.   Curt Widhalm  28:33 So once again, echoing stop hanging out with therapists.   Lindsay Bryan-Podvin  28:41 That might be a theme. Yeah.   Katie Vernoy  28:44 Maybe it's stopped just hanging out with therapists   Lindsay Bryan-Podvin  28:47 That's a good reframe  Katie   Katie Vernoy  28:49 I know, I just it's really hard. I know, for me, and we've all spoken for therapists, we've all kind of done that thing. And I'm sure, just from the way you described it, Lindsay, you've got the thing. Like, that was a really nice reminder. And like, it is so dismissive. When a therapist comes up and says that to you, you're like, Yeah, but why did you need that reminder? You know, so I think it's that piece of when you start talking to folks who are not therapists, you recognize this is really important information. And it's not going to be discarded as Oh, I already knew that because it is this new piece that's coming in, that then allows, and this is, I guess, going to do accessibility thing. It allows this information to be disseminated more widely widely. It's something where they then are able to implement it, and maybe some people wouldn't need therapy if this information are readily available and was there first and so I think I'm putting the pieces together, Lindsay, I'm starting to see but it's it's really sharing the knowledge. It's making sure that you're available and that you've set up a fee system that makes sense for the folks that you're Working with but it's, it's this additional piece of you know, maybe you get creative and you do sponsorships or I mean there's people that have whole mechanisms for nonprofits to donate for, for scholarships for therapy. So I, there's, there's so much creativity that doesn't require an individual to slide their scale to an unsustainable fee. But this notion of just be accessible for all with all of these other pieces, I think is is hard to do. If you're not making enough money to survive, and you're seeing 40 clients a week,   Lindsay Bryan-Podvin  30:33 Ding ding ding that is exactly it. We cannot care for other people in our community when we don't take care of ourselves. And it's, you know, we hammer on this message as therapists but we forget that in order to practice self care, we need to be able to fucking afford it. Like we just do.   Katie Vernoy  30:48 Yeah, exactly.   Curt Widhalm  30:52 And it's not just kind of the big luxurious, affording things like yeah, you know, that eight to 10 days, go and do a vacation if that's your jam, but it's also being able to afford the consistent little things of and you know, it's going home at a decent time of night. It's being you know, not spending your your off hours catching up on notes, or it's having all of the other systems and everything else that we've talked about on this podcast of being able to have the convenience of being able to afford shutting off at each and every day.   Lindsay Bryan-Podvin  31:30 Yeah, absolutely in in those are the things that we know, make. The biggest difference is that consistency and that predictability, that predictability that you can power down the predictability that you can pay your bills that helps to give us that mental space to rest and to be safe.   Katie Vernoy  31:51 Where can people find you?   Lindsay Bryan-Podvin  31:53 My website is called Mind money balance. It's the same name as my practice. My podcast is of the same name. My Instagram handle is of the same name so people can find me on any of those places.   Curt Widhalm  32:08 And we'll include links to Lindsay's stuff in our show notes. You can find those over at MCSG podcast calm and also follow us on our social media and join our Facebook group, the modern therapist group. And until next time, I'm Curt Widhalm with Katie Vernoy And Lindsey Bryan-Podvin.   Katie Vernoy  32:26 Thanks again to our sponsor, trauma therapist network.   Curt Widhalm  32:30 If you've ever looked for a trauma therapist, you can know it can be hard to discern who knows what and whether or not they're the right fit for you. There's so many types of trauma and so many different ways to heal. That's why Laura Reagan LCSW WC created trauma therapist network. Trauma therapist network therapist profiles include the types of traumas specialized in population served therapy methods used, making it easier for potential clients to find the right therapist who can help them. Network is more than a directory though it's a community. All members are invited to attend community meetings to connect, consults, and network with colleagues around the country.   Katie Vernoy  33:07 Join the growing community of trauma therapists and get 20% off your first month using the promo code MTSG 20 at traumatherapistnetwork.com Once again that's capital MTS G the number 20 at Trauma therapist network.com   Announcer  33:23 Thank you for listening to the modern therapist Survival Guide. Learn more about who we are and what we do at mtsgpodcast.com. You can also join us on Facebook and Twitter. And please don't forget to subscribe so you don't miss any of our episodes.

The Lucky Mojo Hoodoo Rootwork Hour is a real, live call-in show where the general public gets a chance to ask about actual problems with love, career, and spiritual protection, and we recommend and fully describe hoodoo rootwork spells to address, ameliorate, and remediate their issues. We begin this show with a Discussion Panel focussed on the topic of Southern Hoodoo in Northern Climes. You will learn a lot just by listening -- but if you sign up at the Lucky Mojo Forum and call in and your call is selected, you will get a free consultation from three of the finest workers in the field, cat yronwode, ConjureMan, and a special guest, Doc Murphy. Sign up before the show to appear as a client! Post at the Lucky Mojo Forum at: https://forum.luckymojo.com/lmhrhour-free-readings-november-28-2021-southern-hoodoo-in-northern-climes-t95688.html Then call in at 818-394-8535 and dial '1' to flag our Studio Board Operator that you want to be on the air! We select new client sign-ups first and then call-back sign-ups. Call in right when the show begins and listen via your phone. Message the Announcer or the Studio Board Operator ("Lucky Mojo Curio Company") in chat to let them know you're available. The link above will also be the location of the show's CHAT LOG once it is posted, so you can follow along as you listen.

Think announcers have it easy? Think again. Adam Wilbourn presents 10 Times Wrestling Announcers Really F*cked Up...ENJOY!Follow us on Twitter:@AdamWilbourn@WhatCultureWWEFor more awesome content, check out: whatculture.com/wwe See acast.com/privacy for privacy and opt-out information.

A.J. began his career as a pro wrestler competing in the ring. His career has included such highs as working with Dwayne "The Rock" Johnson and getting back in the ring as an announcer for wrestling, boxing and MMA matches. Listen to AJ's unique path to success which brings together announcing, broadcasting and being in the ring. --- Send in a voice message: https://anchor.fm/james-herlihy/message

Dr. Jay Calvert & Dr. Jason Berkley chat with Former NHL'er & current Florida Panthers Play-by-Play Announcer Randy Moller! Randy shares how he became the first former player to transition to the announcing booth, identifies the key factors in the success of the NHL leading Florida Panthers, gives his thoughts on how the aftermath of Coach Q, tells us about his recent battle with COVID-19, & more! Randy also shares stories from his playing days with the Quebec Nordiques & New York Rangers(amongst others) - the days of fewer helmets, Moose DuPont, ash trays in locker rooms, & concrete boards! Plus, Randy shares his thoughts on the Stanley Cup race.

Peer Support Specialists An interview with Kemisha Fields, MSW, Amparo Ostojic, MPA, and Jeff Kashou, LMFT on what peer support specialists are and the value they bring to treatment teams, as well as the challenges and best practices in implementing these roles into clinical programs. Curt and Katie talk with Kemisha and Amparo about their experiences in these positions, exploring how their lived experiences created the successful integration of a more holistic approach to support clients. We also talked with Jeff about his journey in implementing one of these programs from scratch.   It's time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age. Interview with Kemisha Fields, MSW, Amparo Ostojic, MPA, and Jeff Kashou, LMFT Kemisha Fields, MSW: Kemisha Fields was born and raised in South Los Angeles, CA. As a former foster youth, she has taken a professional interest in the commitment to serving the needs of children and families as a Children's Social Worker working in Dependency Investigations. She has studied many modalities to bring healing to those in need. Kemisha is a life, long learner inspired by the abundance of opportunities available to enrich the lives of the people she serves. She earned her Bachelor of Science Degree in Psychology from the University of Phoenix. She received her Master of Social Work degree from the University of Southern California. Currently, Kemisha is a Doctoral Student of Business Administration with an emphasis in organizational leadership. She has extensive experience working with children, families, and individuals as an agent of support and guidance. Kemisha has a strong background in case management for an array of populations inclusive to at-risk youth, individuals with intellectual disabilities, commercially sexual exploited children, victims of trauma, and families within the dependency system. As a lead Dependency Investigator with Los Angeles County Child and Family Services, she has direct practice with assessing for child abuse and neglect in hostile environments. Kemisha works directly with County Counsel to investigate and sustain infractions of the Child Welfare and Institutions Codes. Jeff Kashou, LMFT: Jeff Kashou, LMFT is a manager of clinical product and service design for a mental health tech company that provides telemedicine to those with serious mental illness. Previously, he ran a county mental health program where he helped develop the role fo peers for adolescent programs county-wide and collaborated with peers to create management practices to support their professional development. In this position, Jeff developed a practice guideline for the utilization of peers in behavioral health settings for the County of Orange. Jeff has also served on the Board of Directors for the California Association of Marriage and Family Therapists, where he helped lead the association to support the field of Marriage and Family Therapy and those with mental health issues. He consults as experts in mental health for television productions, to ensure the accurate and helpful portrayal of mental illness and treatment in the media. Most recently, Jeff and his wife Sheila wrote a children's book, The Proudest Color, that helps children of color cope with racism that will be on shelves this Fall. Amparo Ostojic, MPA: Amparo Ostojic is a mental health advocate with personal lived experience. After working for the federal government for ten years, she decided to pursue her passion in working as an advocate to help promote recovery in mental health.  She has worked as a peer specialist for a mental health clinic as well as volunteered leading peer support groups. Amparo has a close connection with the Latino Community and feels it is her duty to do everything possible to prevent and reduce the suffering of individuals living with a mental health condition. Amparo created a Spanish speaking support group in East Los Angeles to offer free peer support to members of her community. Amparo has a bachelor's in business administration and a Master of Public administration. Amparo is a certified personal medicine coach and is working on becoming a National Certified Peer Specialist (NCPS). In this episode we talk about: What a peer support specialist is, how they work What peers can uniquely bring The hiring process, qualifications, and what that means for individuals seeking these jobs The difference in perspective that peer and parent partners can bring to treatment teams The importance of lived experience Comparing holistic versus medical model treatment The medical model and the recovery model complement each other The importance of advocacy for individuals (with the support of the peer support specialist) How peer support specialists are best integrated into treatment teams and programs The potential problems when the peer support specialist role is not understood How someone can become a Peer Support Specialist Certification and standardization of the peer support specialist role SB803 – CA certification for Peer Support Specialists Legislation Ideal training for these professionals How best to collaborate with a peer support specialist What it is like to implement one of these programs The challenges of hiring a peer support specialist Exploring whether there are systems in place to support peer support specialists with their unique needs The recommendation for a tool kit and a consultant to support programs in implementing best practices The Recovery Model and peer support specialists in practice Multidisciplinary teams may have pre-existing bias and prejudice against folks with lived experience, the role of stigma in the interactions The shift that happens when peers become part of the team (specifically related to gallows humor and the separation of “patients” and “providers”) Demonstrating the value of this role and the use of the recovery model Prevention and Early Intervention How to be successful with peer support programs and the benefits at many different levels Our Generous Sponsor: Trauma Therapist Network Trauma is highly prevalent in mental health client populations and people are looking for therapists with specialized training and experience in trauma, but they often don't know where to start. If you've ever looked for a trauma therapist, you know it can be hard to discern who knows what and whether or not they're the right fit for you. There are so many types of trauma and so many different ways to heal. That's why Laura Reagan, LCSW-C created Trauma Therapist Network.  Trauma Therapist Network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work and what they specialize in, so potential clients can find them. Trauma Therapist Network therapist profiles include the types of trauma specialized in, populations served and therapy methods used, making it easier for potential clients to find the right therapist who can help them.  The Network is more than a directory, though. It's a community. All members are invited to attend community meetings to connect, consult and network with colleagues around the country. Join our growing community of trauma therapists and get 20% off your first month using the promo code:  MTSG20 at www.traumatherapistnetwork.com.   Resources mentioned: We've pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! RAND Report: How to Transform the US Mental Health System Los Angeles Times Op-Ed: Our mental health laws are failing Wise U Training for Peers Advocacy through Cal Voices ACCESS Program SB-803 National Certified Peer Specialist NCPS Excellent guides and toolkits on how to integrate peers in clinics: Association of Home Social Rehabilitation Agencies Meaningful Roles for Peer Providers in Integrated Healthcare Toolkit Philadelphia Peer Support Tool Kit   Relevant Episodes: Fixing Mental Healthcare in America Serious Mental Illness and Homelessness Psychiatric Crises in the Emergency Room Advocacy in the Wake of Looming Mental Healthcare Work Force Shortages   Connect with us! Our Facebook Group – The Modern Therapists Group  Our consultation services: The Fifty-Minute Hour Who we are: Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making "dad jokes" and usually has a half-empty cup of coffee somewhere nearby. Learn more at: www.curtwidhalm.com Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt's youthful energy, so that she can take over the world. Learn more at: www.katievernoy.com A Quick Note: Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We're working on it. Our guests are also only speaking for themselves and have their own opinions. We aren't trying to take their voice, and no one speaks for us either. Mostly because they don't want to, but hey.   Stay in Touch: www.mtsgpodcast.com www.therapyreimagined.com Our Facebook Group – The Modern Therapist's Group https://www.facebook.com/therapyreimagined/ https://twitter.com/therapymovement https://www.instagram.com/therapyreimagined/   Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano http://www.crystalmangano.com/   Transcript (Autogenerated)   Curt Widhalm  00:00 This episode is sponsored by Trauma Therapist Network.   Katie Vernoy  00:04 Trauma therapist network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work, and what they specialize in so potential clients can find them. Visit traumatherapistnetwork.com To learn more,   Curt Widhalm  00:27 listen at the end of the episode for more about the trauma therapist network.   Announcer  00:31 You're listening to the Modern Therapist Survival Guide, where therapists live, breathe and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Curt Widhalm and Katie Vernoy.   Curt Widhalm  00:47 Welcome back modern therapists. This is the modern therapist Survival Guide. I'm Curt Widhalm with Katie Vernoy. And this is part four of our special series of fixing mental health care in America. And today, we are shining a spotlight on peer support specialists and the role that they have in our behavioral health care system. And a lot of the advantages that these kinds of roles bring in, as well as some of the difficulties of getting peer support implemented despite a lot of very positive evidence in their role in treating mental and emotional disorders that happen in our world.   Katie Vernoy  01:27 I'm really excited about this particular episode, we've got two sections. The first one is we're joined by two folks who've worked in the peer support specialist role who are both still in social work and in advocacy. First off, we've got Kemisha Fields, who's a Master of Social Work who is was actually somebody I worked with, and she did a great job in one of the programs I was running. And then also person I was introduced to by one of our amazing friends of the show on Amparo Ostojic, who is an MPA and also someone who works in advocacy specifically about peer support specialists. So I'm really, really looking forward for all of you to listen to that and learn about what that role is. And we recognized also and I, I had a little bit of this, but Jeff Kashou LMFT is someone who has in the past actually implemented one of these programs, and he was able to talk with us about what it was like as a director, putting those things together. So take a listen.   Kemisha Fields  02:30 So my name is Kemisha Fields. I enter social services call for like 17 years ago, I took a entry level position at a homeless shelter. So that was my entry into social services. And from there, I've just kind of progress and work my way up. And I've worked with different populations. So I've worked with the homeless population. I've worked with individuals who are struggling with substance abuse. I worked in recidivism. I've worked in community mental health, and now I'm working in the child welfare system.   Amparo Ostojic  03:10 So my name is Amparo Ostojic. And I've been in mental health advocacy and peer support. For the last four years, I have worked to increase awareness about mental health, especially in the Latino community. And I worked as a peer support specialist for a mental health clinic for about seven months, I currently still do advocacy in the mental health space. And I work with individuals that want to know more about how to live, a quote unquote, normal life, even with my severe mental health condition.   Curt Widhalm  03:50 A lot of mental health clinicians, they may have heard of a peer specialist. I have found that a lot of my travels and talks in therapist communities that many people don't know what a peer specialist does, can you help us understand what a peer specialist does what their role is in the bigger part of the treatment systems.   Amparo Ostojic  04:13 So a peer specialist is basically a role model of positive recovery behaviors. So it's meant to give hope to someone living with a mental health condition and help them not feel as alone in this recovery process. So, in essence, a pure specialist will share their personal lived experience of mental health and oftentimes offer examples of what it's like to deal with a condition. And you know, what they've done to get better, such as tips or a really useful tool is, for example, the living successfully plan or the wrap plans, where you go over with a client what it is like to be in a healthy space, what it's like to see warning signs, and when it's time to call your psychiatrist or go to the hospital. So kind of teach them about themselves and guide them in their self determination of managing their their health condition.   Katie Vernoy  05:17 So you're really talking about from a place of your own experience and knowledge helping someone to plan for themselves,   Amparo Ostojic  05:26 right. And a lot of it is teaching them to self advocate for themselves, and put themselves in the driver's seat of their health condition. So for example, a lot of times, it's kind of directed from the top as if the psychiatrist or therapist is telling them what to do, or kind of teaching them what they should do. Whereas if your specialist is on the same level, and there's no sort of hierarchy of who knows more, there's a relationship of learning from each other, and really sharing what it's like to live through this. I was given the example where it's like, Is it someone that you want to work with, like someone that's like a biologist that knows about like the forest or something or someone that lives in the forest, because that personal lived experience is really key to understanding things that someone else that hasn't experienced them wouldn't really know, or perhaps hasn't dealt with.   Curt Widhalm  06:26 When you started in this, you started as a parent partner, how was that process of getting hired?   Kemisha Fields  06:34 So the qualification for a peer partner or parent partner would be a life experience in one of the systems of DCFS, Department of Children and Family Services, probation, and I believe education, like do individual education plan. And so my entry into being a parent partner was through my son's IEP, Individual Education Plan. And, you know, it just kind of happened by chance, a friend of mine recommended me for the position and I follow through with it, the interview process, or the application process, they I was asked what my qualification to being a parent partner, so I did have to disclose some important information regarding my own experiences with my son. And we just, I remember asking, like, anybody could have kind of said, like, oh, yeah, I have this child that has a special needs, like, how did they confirm that information? So I was looking for them to kind of want some sort of documentation from me, and they didn't. And so, at the time, the executive director says, usually confirmed based on the series of questions they asked me during the interview about different programs that may have been introduced to, to my son, which I found quite interesting, like, Okay,   Katie Vernoy  08:07 how was it for you to disclose personal things to get a job, because that seems like that would be a pretty vulnerable way to enter into a position.   Kemisha Fields  08:19 Very much so and because it's the opposite of what we've always been told, typically, in interviewing process, you don't share too much personal information, just your professional history. So it was a little different. But I always been transparent with my struggles with my son. So it was it was just a little different in I didn't know this person, but it was okay. I you know, I feel comfortable through the process. And I didn't, it was okay for me to, you know, share my experiences. Being a parent of a special needs child.   Curt Widhalm  09:01 I have to imagine, and this is prior to being hired in this position. Did you have somebody serving in that kind of a role for you, somebody that you relied on while you were going through your child's IEP process and all of the struggles that that usually entails?   Kemisha Fields  09:19 That is... I love that question. I absolutely love that question and Yes, but very informal. So I did not have a formal being like, Whoa, this is your parent partner, and she or he's going to help you through this process. What I have was professionals who kind of just stepped up I had one of the very first school psychologists who helped me through the process of my son's assessment, what to look for what questions that I should ask and she helped me not on a professional level but a personal level. She kind of walked me through that process. So I was grateful for that. So I've had a lot of support with my son, just from individuals who cared enough to show me what this looks like and what questions I should be asking. So I appreciate that.   Curt Widhalm  10:20 I have to imagine that working with the mental health systems, the people in those roles, there has to be some difficulties in getting integrated into the more professional sides of the organizations, what kinds of challenges to peer specialists end up having, trying to help clients be able to advocate for themselves and fit into this professional system as well.   Amparo Ostojic  10:45 The professionals, such a psychiatrist, therapist, they usually operate from the medical model, which is very top down, like I mentioned, and it kind of has this perspective that I no more in teaching the patient how to, you know, work with medications, or live with this condition, where as peer specialists work from the recovery model, that look at everything, the main four points are home, community health, and purpose, that's really important, like your reason to get up in the morning, right? That sometimes the recovery model is not taking us seriously, it's a more kind of holistic approach, looking at the person. And in the medical model, you're looking at the condition like it's a problem to be solved. And I'm looking at the person as the whole and how their whole life could be better. So my focus may be different than a psychiatrist, their focus may be to reduce the symptoms, and let's say get rid of hearing voices, things like that, or as my role is really to make that person as a whole better. So for example, I usually medications is a big thing must take medications, or as my role may not necessarily say that I typically never tell the client, you know, don't take medications, but I really allow the client to the side that and some other parts of the medical team may not like that. But also, my role may not be taken as seriously because, for example, in my experience working with a mental health clinic, they worked with people that were homeless, and I would say extreme cases. So as someone with bipolar disorder, they kind of put me in this category that, you know, I probably couldn't offer as much. And my perspective wasn't as valuable. So it was really hard. Working with therapists or psychiatrist that saw me as someone that was in the space of like, part of the problem. I don't know how to describe it. But it was really hard, because at the beginning, I definitely felt like I wasn't taking seriously. And it took a while to gain trust, and get there super for me clients. And those were one of the challenges,   Curt Widhalm  13:01 I have to imagine some of the providers are like, you're just completely undermining all of the treatment by using trust, none of this professional experience that we've learned. How did those conversations go? Because it seems like so much of a treatment plan would be developed from, you know, the scientific and medical model sorts of approaches. And then for somebody to come in with lived experience to be able to be like, maybe the medication thing is something that you want to talk to your doctor about.   Amparo Ostojic  13:33 Well, I take medication, and there was five years that I didn't from when I was 20 to 26. And I was fine. I think, you know, I used to run marathons, I was super fit. And there was a time that I didn't think I needed medication. But then having more episodes, I realized that it does benefit me. So I never really tell a client, don't take medication. But I'm not as I guess pushy into that they may need I needed something to happen for me to sort of learn my lesson and realize, you know, it's it's easier, my life is a little easier with medication. And that may not be the case for everybody. So I definitely don't think they see it as me undermining them. But the recovery model and the medical model are supposed to complement each other. And I think that's the hesitation at the beginning. There's no better treatment or a they say they're supposed to complement each other and offer a level of understanding and acceptance and validation that sometimes the professionals can't offer because they haven't lived through that. So for the most part, I'm never, you know, moving them away from medication or therapy and validating their experience but perhaps they may tell me, you know, I didn't like my psychiatrist. And this is what happened. And I will be honest and say I've had psychiatrist that didn't work with me and didn't work for me. And I had to find a different one. Or I had to advocate for myself and say, you know, this side effect is, is not working for me, you know, maybe this is working, like, the symptoms are, you know, improving. But, you know, it's, it's making me sleepy, and then I can't get to work on time, things that are important that sometimes I think clients are afraid to say, because, you know, like, the main symptom that they're after is maybe under control. But other aspects of your life have completely lost balance now.   Katie Vernoy  15:42 Yeah, I think for me, and I was that person at one point. So   Kemisha Fields  15:46 You were!   Katie Vernoy  15:48 But I think the thing that felt very powerful when I entered into that program, and saw how it was set up was that the team had set up this structure to make sure that each member at the table was heard that each person was allowed to share ideas. I had been in other programs where folks were subjected to that hierarchy, where the therapist or the psychiatrist got the most air time, they're the ones that were making the decisions. And to me, I think, whether it was making sure that the parent partners were supervised by the director, and or really having a culture of, we are all here supporting the family. And we all equally bring important things to the table, I think it was really effective. I think we just get worried because I did see even with programs that were and maybe it was because it was intense now that I'm thinking about it, because like less intense programs, sometimes folks were using either parent partners or bachelor level providers to do like, copying and filing. And it's like, no, no, these are mental health providers, these are people who are at the table. And so to me, I think when when people are able to integrate into the team, it can be really good.   Kemisha Fields  17:05 My personality type wouldn't have allow for that, if I'm honest. Like no. And I think when you come in and you kind of demand a level of respect, you get that level of respect. So I've never had a problem, I think, in my whole career of value, my experience as a parent partner, it laid the foundation for so much of the work that I do now. So I'm still connected to a lot of those colleagues, who at the time were clinicians and I, at that time, I wasn't even I had not completed my undergrad studies yet. And we're like the best of friends. So my experience as a parent partner is one that is really great. And had you know, a lot of good things have come out of that for me,   Curt Widhalm  17:59 I want to change the conversation here a little bit to talking about how people can become peer specialists and what the certification process is like. And I understand that that's quite different in many different parts of the country.   Amparo Ostojic  18:15 Yeah, and even within California, each county has different guidelines. So first of all, California just passed SB 803, which is going to allow pure support specialists to have a certification, which will hopefully increase the use of peer specialists in mental health clinics. So 48 states now have peer certification, including California. And the, the principles are pretty much the same. But how a peer support is used in different parts of a state or country is going to vary. So it's difficult if someone moves to another state or another county, and they try to use the same principles. It may not work as effectively. And it's basically it's not standardized right now. So it's hard for someone working in that field to have many options of going to different places, and even like a client that's moving from another county and experiencing pure services in a different way.   Katie Vernoy  19:26 So if someone were to want to jump into this, where it sounds like it's starting to become more regulated, there's certification in 48 states, that's great. What does it look like? How does someone become a peer support specialist?   Amparo Ostojic  19:39 There's a few organizations that are considered certified to train for peer support. And, for example, the training that I took was an 11 day course, where, you know, like 40 hours a week, and you learn the principles of peer support. And then To become a certified peer specialist, you need 3000 hours of supervised work or volunteer experience providing direct peer support. And you need a letter of recommendation from a professional and from supervisor that has overseen your peer support. And then there's an exam that you would take and pass. And that's how you would become national certified peer specialist. And on top of that, like I said, California is still in the process of creating their peer support guidelines. So in addition to that, you know, whatever guidelines that they'll come up with will be the California guidelines for certification in California,   Curt Widhalm  20:45 a lot of research gives you more credit than being a middleman, that when we look at outcomes for treatments, when we look at treatment, we see that peer counselors, we see that parent partners are more effective towards client outcomes than even just working directly with licensed professionals. And a lot of it is due to a lot of the problems that therapists just kind of face and being approachable themselves for the mental health system themselves that there is a down to earth Ness that having that lived experience really does embody that, yes, you can get through this. And I've got some experience to be able to say that not only do I actually demonstrate that I know what you're going through, but that you can get through it, there's a way through this, that there is a light at the end of the tunnel. How do you think that peer partners, peer counselors can be trained should be trained to best exemplify that part of treatment,   Kemisha Fields  21:51 I would say they should be trained the same way that any other team members trained in I know, from a clinical perspective, there's a different type of training that comes into play. But for our child and family team specialists that you know, we have trainings, usually agencies are sending you out to different trainings, and I I believe that parent partners should be a part of those trainings, if they are not already a part of those trainings. And that should and will help them in their role as a parent partner with the life experience on top of that,   Katie Vernoy  22:32 how can therapists psychiatrists, other people in mental health clinics, support peer specialists?   Amparo Ostojic  22:38 one of the most important parts is understanding and learning to see how we can be used. I think, once you collaborate with a peer specialist, and notice the different perspective that they offer, I think both psychiatrists and peers, and mental health professionals, other mental health professionals can learn from each other. And I really appreciated that with one of the psychiatrist that he like, I could see that he really learned from me, and that gave me a lot of confidence. And I learned a lot from him. And it didn't feel like a top down relationship. And it really felt like he valued my perspective as a professional. And that helped a lot because basically just have faith in in something even if you don't understand how it works. You want to try and see how you can work with this person and encourage them to do actual peer support. If at first you don't know what to do as far as how to work with them. There's really good guides. There's one that I really recommend, that is put out by Castro. And they are basically recovery organization. And they have it's called the meaningful roles for providers in an integrative healthcare. And they really break down the different positions that peer specialists could do the different roles so like a peer navigator peer advocate, wellbeing coach is sometimes what they call it. And it really spells out things that a peer specialists can do. And it helps both the pure and the professional because they will say, you know, they could serve as a bridge between the community based organization, they could help clients in enrolling with health insurance programs, they it really spells out things that a client can do with a pure specialist, and that helps both the pier and the clinic.   Katie Vernoy  24:53 How about letting us know a little bit about if someone's interested in this I think from many different angles I wanting to advocate for better utilization of peer support specialists within mental health programs advocating for swift implementation of SB 803. For California, you know, or even this advocacy for individuals who are navigating mental health concerns themselves or with their family members, and how they can advocate like, it seems like there's a lot of lot of potential calls to action for our listeners here. What resources would you recommend that they look into, and we'll put all of those in our show notes.   Amparo Ostojic  25:33 So definitely the I would guess, I guess, I would say, one of my favorite organizations that I worked with for the past two and a half years is Cal voices. And they have different programs, the advocacy space, is access. So access stands for advancing client and community empowerment through sustainable solutions. So they're kind of a systems change perspective. And they have really great e learning toolkits that give you tools on how you would advocate for yourself and for systems change within your community. One of the great resources that Cal voices has is their Ys program, which stands for workforce integration, support and education. And they have what they call the YZ University. And it's created by peers, it's taught by peers. And this is where I got my training for becoming a peer support specialist. And they basically provide a lot of support in what a peer does. And like they have wise Wednesdays, where they provide information about something related to peer support and learning about how to, you know, either be a peer specialist or work with a peer specialist. And that's everyone's they. And so, it's a great program, because like I said, it's peers that are teaching and creating the curriculum. And I think that's just wonderful because receiving that information for someone with the lived experience is very powerful.   Curt Widhalm  27:21 Switching gears here and talking about the implementation of peer support specialists, here's our interview with Jeff Kashou. We are joined by Jeff Kashou, a licensed Marriage and Family Therapist. He's a former Service chief who oversaw collaborative behavioral health program in Orange County, and had opportunities to oversee the implementations of peer counselors into some of the programs.   Jeff Kashou  27:51 Yeah, well, first off, thank you for having me on. And I'm very much appreciated that you guys have this podcast and give the opportunity for topics like this to be covered.   Katie Vernoy  27:59 The thing that I find very interesting about these roles that I know you and I both have hired these roles, but people have to claim lived experience in order to get these roles. And so it's it's a very interesting line to walk. There's there's very interesting things there. But what do you see as the difficulties that are associated with hiring peer counselors?   Jeff Kashou  28:20 Yeah, so I think, very specifically, what makes the role unique and special also makes it kind of a unique challenge in the interviewing process? How do you ask about one's lived experience as a direct, you know, in theory qualification to have that job is what makes it a unique role to a to an organization or an agency. So I would, you know, really encourage anybody who is looking to start a peer program to bring on a consultant who can really help you think the process all the way through and how to have those conversations without inadvertently walking into equal opportunity ramifications or accidently discriminating against someone while also being very mindful that you're bringing into the room into the interview room and process someone's vulnerabilities. And so being able to manage that very tactfully and professionally, while also ensuring that this person, you know, feels comfortable to share that as well. That's your first introduction to somebody and they're interviewing you in that, that process and they want to ensure that your program has really thought through how they're going to be not just added to their system of care, but how your entire system of care embraces and is made better by having peers on board. Oftentimes peers are looked at as very client facing but really in the best situations for them are those for the entire service model is made better by their presence.   Curt Widhalm  29:48 A lot of the talk that we've had on this show about how programs barely take care of their mental health professionals within the work systems. Is there any management that is actually being put towards looking after peer counselors in this way without infantilizing them. I mean, if we're not doing this with the brunt of the behavioral health health workforce, are there other implementation problems when it comes to ensuring this kind of stuff or incorporating them into treatment teams,   Jeff Kashou  30:19 when I created a practice guidelines of like best practices for the entire Orange County systems, and not just County, but the entire behavioral health system for how to conduct supervision with peers, I leaned very heavily on a toolkit that I found from the city of Philadelphia, that there Department of Behavioral Health and intellectual disability services put together on how to create a peer support system, from the first moment you decide you want to all the way through to supervising them to managing disciplinary things to supporting their growth. And looking at it even from you know, how is the entire system set up to support them, even the interactions that they have within the multidisciplinary team, you know, they face an additional layer of potentially of scrutiny or challenges by constantly having to explain who they are, why they have any authority to work with patients or clients. So there's, there's added stress to the question or the systems in place to actually take care of them. You know, I would really look at that toolkit that the city of Philadelphia put together as sort of a way to evaluate if your system is there, I'd say, it's certainly lacking just to be completely blunt, the county that I worked for, from the children's behavioral health side was not equipped at the time to take them on effectively. And it required a lot of having to build the plane while you fly it, which I think for some roles, it's okay. I think for peers, it can add additional stress. And it means, you know, workplace ambiguity is stressful enough. But when it comes to all the other challenges of integrating them and supporting them and explaining their role, and giving them the right training, and so on, and so on. There's just another level that needs to be thought all the way through.   Curt Widhalm  32:11 How are pure counselors implemented into treatment teams, and how are their voices in actual practice, kind of placed into the role where there's a bunch of other potential licensed professionals across a wide variety of interdisciplinary systems?   Jeff Kashou  32:30 Yeah, so I can speak to my experience, and then also kind of broadly to and the research that I've done on the topic. So it's often implemented as a top down approach, it's, you know, people in leadership, saying, we're gonna add this program to our larger organization, without ever really embracing maybe the full scope of what it means to engage in a recovery service model, which is really antithetical to the principles of the peer program, you know, which is meeting people where they're at. So a system of care, really understanding from the bottom up what's happening on the ground level, that's really where the entire program began with. But the ways that they're being implemented, we have that additive approach that systems of care will take. And from a very top down perspective, oftentimes, systems need a way to recoup revenue by bringing on this workforce and, you know, supporting the work that they do. And so when it comes to Medicaid, for example, it's involving them in the billing system. So it requires choosing a diagnosis for the person from the list that the other providers have diagnosed the individual with, which is sometimes very new and a bit challenging. I think, sometimes for peers who don't want to necessarily see someone as a diagnosis. But you know, our current system of billing practices and documentation practices requires that also, multidisciplinary teams really don't know about peers, and can have a lot of prejudice as they go in. So systems need to really be thoughtful and do a self assessment before they decide to bring on this very important role, you know, on are this system set up? Or what are the prejudices or preconceived notions that other providers on the team have of people that come in with lived experience? Right, you know, oftentimes, we have that sort of gallows humor as providers when we talk about our patients or whatever. But, you know, now you have to be very mindful of that, not just because you don't want to upset somebody, but due to having that internal shift of like, you know, I actually really maybe need to check myself when it comes to that, and why I engaged in something like that in the first place. So really thinking about decreasing the stigma and helping the rest of the team even before peers come on, understand what it is that they do, the value that they add, and how they're going to be just as important of a member of a treatment team. So really leading with the why through this process. They're often brought a board you know without much structure I Which, you know, leads to them being assigned a lot of admin tasks as well. One of the things that I learned a lot when working with pure forums was that peers are often assigned, you know, a lot of filing tasks or, you know, paperwork kind of tasks, because the program wasn't really trained or made to be aware of what appear is going to do. And so managers will get, you know, assigned X amount of peers and hire them on but not really know what to do or may not have the bandwidth to train them and think through that whole job requirement. Similarly, what I experienced was, sadly, even partway through the interview process, we found out that we were actually interviewing for peers, but the program was set up, they had to find a job title or job classification that they could fit these folks within, so that we can hire them in a timely manner. And so when we were hiring mental health workers were actually supposed to be hiring peers. And so we found out midway, that we were hiring peers, which meant as managers, then we had to shift and reevaluate what we were doing which we put a lot of emphasis and fervor and figuring out and making it a smooth process as much as we could. But it was by no means ideal. And the cohort that we hired, certainly struggled with a lot of the ambiguity and sometimes just having to sit around and wait while we figured things out for them.   Katie Vernoy  36:16 You've mentioned a couple of times the the money element of it, that oftentimes these are folks who are hired to do an important service that isn't always reimbursable. And it makes me think about the value. And this speaks to the prejudice as well. But it makes me think of the value that people hold for this role. You know, they're not generating revenue, typically, or not generating a lot of revenue. They're not seen as experts, although they're oftentimes more expert than the folks in the room that are doing the treatment planning. And so what are the ways that you have found whether it's best practices or what you were able to accomplish in your program, of integrating these folks more successfully into, you know, kind of explaining the role? Like, why is it so important? What is the value of this? Because I feel like, and maybe you've already said this, and maybe this isn't needed, but it does feel like there's a case for this role. There's an importance to this role. And I just feel like maybe we need to be more direct and saying it, I don't know.   Jeff Kashou  37:25 So yeah, so there's really two directions to think of when it comes to how do you demonstrate the value, there's two those who would be, you know, deciding to bring on this role, which would be those key stakeholders. And then you also have the provider teams as well. And then I guess, there might even be a third group, which are the patients or clientele that you would be serving. So when it comes to demonstrating the value, I think the message needs to be pretty clear all the way through, which is when you're working with, you know, with individuals with serious mental illness, or those with CO occurring disorders, some of these more serious conditions, we know we preach about prevention and early intervention. And this is the rule that really helps with that. And this is the rule that allows us to make that big shift towards a recovery model, and not just pay lip service to saying that, you know, we meet our patients where they're at, and, you know, we want to, you know, improve the quality of their lives and help them reach their full potential. Now, that's, you know, a bit more idealistic and trying to sell it maybe to those that population level into the stakeholder level, but to the provider team, it's also a matter of, you know, recognizing that they will complement the services that, say, a therapist or psychologist or psychiatrist provides as well. And so it's more of like a meshing of gears versus like, people running off into separate directions, you know, where we know that metod here, it's a very important thing. Medications is a very important aspect of treatment. And if individuals, you know, go to their psychiatrist and they prescribe them an antidepressant, we oftentimes know that adherence drops off very quickly, either because the person has some sort of side effects, or because they start to feel better, and they decide they don't want to take the medication anymore. What you know, for multitude of reasons, here, the peer can actually meet with that person, you know, right after they meet with a psychiatrist, or maybe even be in the room with them when they meet with a psychiatrist. And help them ask the questions that are there might be uncomfortable asking, or ensure that they're asking the questions they didn't think to ask, creating that plan afterwards with them for how they're going to fill the prescription, how they're going to, you know, lay out their medications for the week, how they're going to make sure they maintain their motivation to take it or communicate changes that they need with their medications. When it comes to treatment adherence, you know, we assign individuals journaling to do for example, but I don't know about you guys and how often we assign tasks to to patients to do in between sessions, it's extremely hit or miss. And then you end up spending your next session processing, why they didn't do it when you'd rather be processing what they did. And so it's not to say it's 100%. But a specialist can really help with complementing services in those ways. I think ideally, we know that there's attrition, oftentimes with this population. So here's how we keep people engaged in care. I think the other thing is we think about completing goals or completing treatment plans. But that's not really the case. Again, it's not like that broken leg where your leg gets mended, and you don't have to really do anything afterwards, you have to maintain those gains for the long term to allow you then to get to those next levels of functioning, or satisfaction or fulfillment, whatever they might be. And that's where the period specialists can help somebody in the sort of aftercare discharge planning or even long, long term support through their maintenance of their goals.   Katie Vernoy  40:56 I think another element for the treatment team, and this is something where, you know, we had the conversation with Kemisha about this, but they're also an expert on the lived experience. I mean, obviously, each person's experience is different. But there's so much that I think my treatment teams anyway, we're learning from our peers, because they just hadn't been in the situation themselves. And so I think there's, there's also incorporating in that way, like here is another member of the team who has really valuable and valid feedback that you need provider. Because I think it's I think it's hard, I think it's hard to understand this. And I think that we've hidden behind a hierarchy that clearly doesn't work, we need to have, we need to have a whole bunch of human beings working on this on a level playing field.   Jeff Kashou  41:47 Yeah, I'm really glad you brought that point up, Katie, I remember, and you guys probably had to do this in your grad programs as well, where we were assigned the task of attending a 12 step meeting to understand what the recovery community is like. And we can see what these you know, non therapeutic support systems are like, and it's a way to get that experience. But we were only assigned that at one point in time, and there is so much value that appear can add in terms of to use your your point expertise in these areas, you know, the approach, I think a lot of us take in the recovery systems, you know, I will get asked oftentimes, you know, well, are you in recovery yourself? And I think as a therapist, you make your own call in terms of self disclosure. And I would say the while I can tell you yes or no, it's more important for you to tell me what your experience is like, rather than me telling you all about what your experience is like. But I think there's a way we can sort of fast track that by having peer specialists add that level of detail to us upfront so that we're not always taxing individuals to have to educate us each and every time if that's not something that supports their care in the short term.   Katie Vernoy  42:52 Exactly.   Curt Widhalm  42:54 There seems to be a lot of mixed evidence on the effectiveness of pure counselor type programs, with the United States in particular lagging behind a lot of other countries when it comes to the implementation of this, some of which is highlighted by some of the funding stuff that you're talking about within things like Medicaid, and we even see some of this going on and private insurance type programs where this stuff can't be implemented. What do you see is the difference between a successful incorporation of pure counsellors versus the ones that kind of fizzle out,   Jeff Kashou  43:32 it's going about it with a systematic approach. And that's I'd really emphasize either, you know, utilizing one of those toolkits, like I mentioned, the city of Philadelphia created, which is extremely comprehensive, and very much focused on the existing org and not necessarily on what peers need to be doing. But I think in the absence of that, it's really identifying just like with any big change that you want to make for a business, it's identifying, you know, what, you know, doing your SWOT analysis, and then looking at what is your measure? What's your success metric going to be? And how will you know you got there and then be flexible, to iterate and improve upon things as you move forward? Again, to that authenticity point, it's just like how we work with our, you know, our clientele, it's, you know, we don't expect perfect, but, you know, let's talk about what didn't go well, and let's improve upon it, we need to be able to do that authentically, as well. I think, unfortunately, in healthcare, and especially behavioral health care systems, where we're kind of the afterthought in terms of funding and attention and resources, you know, we just have always learned to make do and stay the course. And then on top of it, you have folks in power, who don't necessarily understand what we do, and they just kind of keep adding more and more stipulations and regulations and so on. And so it's also a matter of like, can you cut through some of that maybe sometimes even through the side door, like in California, we have our mhsaa funding that peer programs are oftentimes Funded there, which is very nice, and that they don't have to be capturing revenue through Medi Cal. This is through funding that has less requirements to it. But it's also pushing back and saying, do they really need to do this level of documentation? You know, so I do think it's a matter of like, thinking things through from bottom to top, like doing that assessment and really assessing yourself like, can we take this on, and being very brutally honest with yourself as a system of care, it's an exciting program, it's an exciting idea. It's one that can bring a lot of benefit. But you have to really understand what it is that you're bringing on. There's other companies that I've worked for that have said, you know, hey, we're, you know, one day down the line, we'll have peers and that way our current clientele can engage and give back, it'll be kind of a lower level service line. I think if you're thinking about it from that perspective, only, and really seeing the dollar signs as part of that image. It's not to say that, you know, money isn't the driver here, but it can't be that upfront. Otherwise, what you're doing is you're commoditizing, a service provider who is designed really to add value simply by them being there and engaging with clientele in that way, without necessarily generating dollars by increasing retention by increasing engagement in services. We know outcomes improve, when systems can demonstrate improve outcomes. Oftentimes, they're the ones that get the next grant are the ones that get the renewed contract, sometimes even a larger contract. So it's really, you know, credenza question in a short way. It's, it's all about approaching it systematically. And not just Yeah, that sounds really exciting. Let's do this.   Katie Vernoy  46:43 I think it has to be baked in, it can't be like, let's add this on to the program. It's almost like you have to build it from the ground up, to have these truly integrated into whatever the treatment program is.   Jeff Kashou  46:56 Yeah, there's kind of three different approaches that that Philadelphia tool toolbox outlines, just like that additive approach that I discussed, there's that selective approach. And then it's really taking on the one that has the greatest level of success is what's called a transformative approach, which a lot of systems are understandably nervous to take on. But to make a program successful, you have to be willing to transform things, sometimes top to bottom to make it work.   Katie Vernoy  47:21 Yeah, it's interesting, because the the program that I had, it was, it was baked in, it was like, my agency decided to do a wraparound program. And at the time, it was called an FSP. Program. And so as, you know, maybe you move clinicians into it, but it was like, here is how you do it. And it was baked in. So it wasn't like, Oh, you're already doing services, let's add this on. Functionally, maybe it looked that way. Because we had clients who then you know, like, followed their therapist, and then got these other services added on. But the program itself was well defined by LA County. And so there was discrete roles, there was training that was required. And like, especially with wraparound, there was like, a week long training where you, everybody went, and there were people from all different roles, and you went when you just first started and all the managers had to go to, so I had to go to it as well. And we would sit there for a full week and interact with other people in our same roles or in the in the peer or the you know, the all the different specialists roles. And so to me, it was, it didn't feel as chaotic because it was like it was completely structured. And it was baked in.   Jeff Kashou  48:31 Yeah, and a wraparound program is oftentimes very much set up for that, you know, they traditionally will have either bachelor's level providers as PSCs, or personal service coordinators, which truthfully appear would be phenomenal at which it sounds like that was the role that you had at your program. And because   Katie Vernoy  48:47 No we had we had bachelor's level folks, we had peers, we had a facilitator, and we had a therapist, so there was four or five people on the team.   Jeff Kashou  48:56 That's a tremendous program. You know, and we're the approach, you know, you've probably experienced this as well, the approach of a wraparound program is like whatever it takes, you know, this is a child, an individual, a family in such a challenging situation that we have to throw everything at this person that they need, and and some to get them to the, you know, to a better place.   Katie Vernoy  49:17 Yeah, yeah. I think it just is a good way to think about it as if you actually create a program from the ground up that includes these roles. I think that is stronger. I'm really glad that we're that we did this episode that we're talking about this related to our fixing mental health care in America. I know that it was mentioned in the RAND report, but I also recognize that one of the elements of this is it has been viewed. I think we did this in one of our more recent advocacy and workforce episodes as a way that we take away work from licensed credentialed mental health professionals and I really see this as an important adjunct a positive step forward. And I think we were able to really see that in the conversations that we had with our three guests today.   Curt Widhalm  50:08 And I mentioned a couple of times in the show, both this episode and recently about how little using supporting roles, like peer support specialists is actually taught as part of therapists education.   Katie Vernoy  50:22 Yeah.   Curt Widhalm  50:23 And there's a lot of emphasis on therapists education that's on what we as individuals can do to help with clients, but don't help us to look at the overall workforce system. And I'm echoing your happiness of this episode. And being able to amplify that really good. Mental, behavioral, emotional health treatments, takes a village. And it does take people from a lot of different viewpoints to really help create healing. And especially those people who have that lived experience and have a really great way of helping to help our clients interact with the system to be able to navigate it in ways that makes sense for them. So continuing to emphasize this will be part of our ongoing role in bringing mental health advocacy to the world. And we encourage you to do so as well.   Katie Vernoy  51:24 And for folks who were really interested in this, there are a lot of links in the shownotes that will help you with some of the some of these concepts, we've got the the guides and those things both onpattro and Jeff sent stuff over that are very helpful for folks who either want to be a peer support specialist or who want to implement those programs. So definitely feel free to reach out to us if can't find it on our show notes. But those things are just the really amazing resources that we were able to put down there.   Curt Widhalm  51:55 You can find those show notes over at MCSG podcast.com. And check out our social media out give us a like or a follow and schrinner Facebook group modern therapist group to further these discussions. And until next time, I'm Kurt Wilhelm with Katie Vernoy.   Katie Vernoy  52:11 Thanks again to our sponsor, trauma therapist network.   Curt Widhalm  52:15 If you've ever looked for a trauma therapist, you know it can be hard to discern who knows what and whether or not they're the right fit for you. There's so many types of trauma and so many different ways to heal. That's why Laura Reagan LCSW WC created trauma therapist network. Trauma therapist network therapist profiles include the types of traumas specialized in population served therapy methods used, making it easier for potential clients to find the right therapist who can help them. Network is more than a directory though its community. All members are invited to attend community meetings to connect consults, and network with colleagues around the country.   Katie Vernoy  52:52 Join the growing community of trauma therapists and get 20% off your first month using the promo code Mt. SG 20 at Trauma therapist network.com Once again that's capital MTS G the number 20 at Trauma therapist network.com   Announcer  53:09 Thank you for listening to the Modern Therapist Survival Guide. Learn more about who we are and what we do at MTSGpodcast.com. You can also join us on Facebook and Twitter. And please don't forget to subscribe so you don't miss any of our episodes.

On how to conduct the perfect interview; on why Dennis Quaid was such a nightmarish pain in the ass; on Reggie Jackson and Joe Torre and having people open up when they'd rather not open up; on beginning as a New York beat writer.

The Lucky Mojo Hoodoo Rootwork Hour is a real, live call-in show where the general public gets a chance to ask about actual problems with love, career, and spiritual protection, and we recommend and fully describe hoodoo rootwork spells to address, ameliorate, and remediate their issues. We begin this show with a Discussion Panel focussed on the topic of Rootwork to Aid Mental Health. You will learn a lot just by listening -- but if you sign up at the Lucky Mojo Forum and call in and your call is selected, you will get a free consultation from three of the finest workers in the field, cat yronwode, ConjureMan, and a special guest from AIRR, Papa Newt. Sign up before the show to appear as a client! Post at the Lucky Mojo Forum at: https://forum.luckymojo.com/lmhrhour-free-readings-november-21-2021-rootwork-to-aid-mental-health-t95675.html Then call in at 818-394-8535 and dial '1' to flag our Studio Board Operator that you want to be on the air! We select new client sign-ups first and then call-back sign-ups. Call in right when the show begins and listen via your phone. Message the Announcer or the Studio Board Operator ("Lucky Mojo Curio Company") in chat to let them know you're available. The link above will also be the location of the show's CHAT LOG once it is posted, so you can follow along as you listen.

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Tech Announcers Suspended, Campbell Comments Go National, and More - Thursday Hour 1

Justin Verlander Resigns With Astros, Texas Tech Announcers Suspended For Referee Comments, Taylor McHargue

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Home Announcers Add to College Sports, A Hawk in Husker Territory, and More - Tuesday Hour 1

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With Thanksgiving almost here and the winter holidays around the corner, we know that diabetes stress is about to ratchet way up. The D-Moms are here to help! Moira McCarthy joins Stacey to talk about everything from holiday travel, long car rides, well meaning relatives and holiday gifts centered on T1D. And of course, FOOD! Get advice to keep your children with T1D safe and happy so you can make terrific memories without freaking out about "perfect" blood sugars. Previous D-Mom Holiday advice here Adults with T1D give their take on the holidays:  This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode Transcription below:  Stacey Simms  0:00 Diabetes Connections is brought to you by Dario health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first pre mixed auto injector for very low blood sugar, and by Dexcom, take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:20 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:26 This week, Thanksgiving is almost here and many holidays just around the corner. Ask the D moms is here to help more McCarthy and I answer your questions and share our own stories to help you make more wonderful memories with less stress, even if that means doing things differently for a special occasion.   Moira McCarthy  0:44 And the reality is in this long, long, long, long, long lifetime marathon diabetes, you need to just chill a mile here and there. And by doing this and saying to your children, we're going to turn this off. This is okay. Don't worry about it. You're fine. You're modeling that for them and you're giving them the confidence and the courage to know that they can be okay. Yeah,   Stacey Simms  1:06 she said turn this off. She's talking about something I dare to say and do about Benny's CGM. We also talk about long car rides well-meaning relatives and holiday gifts centered on diabetes. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show. I'm your host Stacey Simms always so glad to have you here. You know, we aim to educate and inspire about diabetes with a focus on people who use insulin. And yes, this time of year. I mean, it's the holidays are stressful without diabetes, right. But I'm already seeing in my local group, the stress ratcheting up, somebody said to me the other day that they feel like even though they're not necessarily doing more than they did before the pandemic as more people are venturing out and traveling. They feel like they're really busy. And I think a lot of it has to do with the fact that we haven't been very busy for the last year and a half, really. So there's gonna be more pressure on this holiday season. There's going to be more travel, there's going to be I don't know, it'll feel like higher stakes and especially if you are new to type one, that first year those first holidays, those first milestones are incredibly stressful. So Moira and I are here to help you out you probably already know. But just in case Moira McCarthy is a dear friend of mine. She is the author of many books about raising kids with diabetes, including the amazing raising teens with diabetes, which has that fabulous photo of a teen rolling her eyes right on the cover. I love that cover. You'll hear how long her daughter Lauren has lived with type one. She's a very successful adult now living on her own. And if you are brand new, my son Ben, he was diagnosed almost 15 years ago. He is almost 17, which is really hard to believe so most of my stories have to do with the early years. We're not out of the teens yet, and Moira will help kind of pick it up from there. And I always look to her for guidance as well. One funny thing about Thanksgiving this year, we have a set menu, right? We have our traditions. My husband is the cook in the family and we've always hosted Thanksgiving. He does something a little different every year, but it's really up to him. But Benny has been working in a grocery store for the past six or seven months now. And he is really jonesing for a sweet potato casserole with marshmallows, which we don't usually do nothing do with diabetes. It's just not our style. We generally save the marshmallows for dessert. But my mom who makes our sweet potato casserole every year has valiantly stepped up and says she will make one for him. Because at the grocery store. He has been seeing the display and he's like Mom, it's just sweet potatoes, brown sugar, sweet potatoes, marshmallows, sweet potatoes, brown sugar, like they have this. And he took a picture that I saw the last time I was there. I mean, it's one whole side of a produce display. So this poor kid, he is really dying for that that marketing worked on him. He wants those marshmallows. My daughter is the canned cranberry sauce person, right. You know you make that beautiful, homemade cranberry sauce with the whole cranberries. Are you you boil it down? No, we have to have it in the can with the jelly lines on it. I prefer that as well. I have to admit. Alright, Moira and I talking about real stuff just a moment. But first Diabetes Connections is brought to you by Gvoke Hypopen. Our endo always told us that if you use insulin, you need to have emergency glucagon on hand as well. Low blood sugars are one thing – we're usually able to treat those with fact acting glucose tabs or juice. But a very low blood sugar can be very frightening – which is why I'm so glad there's a different option for emergency glucagon. It's Gvoke Hypopen. Gvoke HypoPen is premixed and ready to go, with no visible needle. You pull off the red cap and push the yellow end onto bare skin – and hold it for 5 seconds. That's it. Find out more – go to diabetes dash connections dot com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma – visit gvoke glucagon dot com slash risk.   Moira, welcome back. I am so excited to talk to you What a week. I didn't even think about this when we planned. This is a big week for you and Lauren,   Moira McCarthy  5:04 it is yesterday, October 28. At 2:35pm was exactly her 24th diaversary. My daughter has had type 1 diabetes for 24 years. I can't even believe it. It's crazy.   Stacey Simms  5:22 But I have to ask you the time had you know the time.   Moira McCarthy  5:25 So I don't know why I know the time. We were at a doctor's appointment, and I know what time the appointment was. And I know what happened when I got there. So I don't know. It's just drilled into my head. And then there's people I meet that are like, I can't even tell you what day my kid was diagnosed. But for some reason, it just stuck with me. And as a little kid Lauren, like celebrating every year, so I sent her flowers yesterday. No, I don't care. 24 hours or so give us Do you   Stacey Simms  5:51 mind, maybe just a little bit of how she's doing maybe a little update. If this is someone's first time joining us for Deimos.   Moira McCarthy  5:57 I'd be happy to so my daughter Lauren was diagnosed. Well, I just said the date. So basically the beginning of kindergarten when she was six years old, right after her sixth birthday. I can remember feeling like the world was gonna end. But we had a really great medical team from the beginning who were saying to us, you are going to live the life you lived before. We're just going to add steps to it. And Lauren at six years old was saying I'm gonna lead you're not gonna, you know, let this hold me down. Now has it been all rainbows and butterflies? Absolutely not. We have had challenging days. We've had challenging weeks, we've had challenging years in her teen years. But right now, I think, well, first of all, what everybody cares about most is her physical health. She is 100% healthy. She has the labs that a person without diabetes would have if you checked, you know, her kidney and her eyes and everything else. Emotionally, she's really doing great. She has a long struggle with burnout. But I think she really has figured out a way to deal with that when she recognizes it coming up. And the most important lab of all I always say is she's incredibly happy. She has an amazing career and lives in the middle of Washington, DC all by herself, and I don't follow her on share. And I never worry about her. She has 8 million friends and I couldn't be prouder of her and the life that she is building as a young adult. So that's where she's at pretty good. Right? Despite diabetes, that's fine.   Stacey Simms  7:28 I love hearing that, as you know. And as you listen, you may know, I have followed Moira and Lauren story for many, many, many years since before more and I knew each other. So I always kind of look ahead. It's like my time machine of what could happen with us. Where could he go? And of course, he's never leaving our hometown, going to a scary place far away like DC he's gonna He's going to live here. And   Moira McCarthy  7:51 Sunday dinner every week   Stacey Simms  7:53 is nice. That's so nice. So I'm glad she's doing so well. Like you're doing so well. And you know, gosh, I heard something recently about diversity that made me smile. Instead of the diversity you're you're on the new level. So Lauren has reached level 24.   Moira McCarthy  8:08 I like that. That's really funny. And her boyfriend is a big video gamer so he'll like that.   Stacey Simms  8:13 Oh, that's good. Yeah, Benny's approaching level 15. And I am one of those people who I always have to look up the date. I just know it's the first weekend of December, but I never. Yeah. Alright, so we are in that time of year where it's not just our kids diver series. It is holiday time. And after I rewound the Halloween episode that we did a couple of years ago and I got a lot of questions and people asked us to do a follow up for Thanksgiving and looking ahead to the winter holidays. And I got some great questions. So I was wondering more if you wouldn't mind sharing though, you know, the first holiday season that you and Laura and your whole family had to address this you guys want a very different routine? Yeah, we can be a little more difficult but would you mind sharing what that was like that first year?   Moira McCarthy  8:59 I will and and I think it's good to hear because it can help people see how far we have come daily care for this disease. We may not have a cure yet, but what it looks like on a day to day basis is completely different. So Lauren was diagnosed in October so Thanksgiving was our first big holiday and I remember we were going to my in laws and back then you took a moderate acting or we called it long acting, but it was really middle acting insulin called NPH that peaked a bunch of times during the day and then you took regular which you had to take it wait 30 minutes and then eat exactly what you had dose for it exactly 30 minutes which was super fun with a six year old child I will tell you and no waiting in between. So I had reached out to my in laws ahead of time and asked them if they could work the meal around the time that it would work best for her to eat and they said yes and I I move some things around with A doctor to kind of compromise with them, you know, so we changed what time we gave everything starting, like two days before to be ready for Thanksgiving. And then we showed up and they were like, oh, yeah, we decided on a different time. Oh my gosh, the world is ending. But the world didn't end. You know, we figured it out. We got through it. What I will say for these holidays, for people who are new to it, it's not always going to feel this scary and confusing and daunting. I think the first 12 months, you go through every holiday, every special event, every family tradition for first time. And then the second year, you're like, Oh, I remember this from last year, and it gets a little better. And then the third year, you're, you're sailing. That's my theory, and I'm sticking to it.   Stacey Simms  10:43 I would absolutely agree with that. I also kind of suffered and I'll say suffered from this feeling out of the box, that it had to be perfect. Because I remember one just show everybody that we were okay. Especially my mom, I wanted her to not worry. And know that we were we were just fine. And for some reason that got tangled up in my brain by thinking this has to go perfectly and I can't make a mistake. And of course that lasted about three   Moira McCarthy  11:06 seconds. Yeah, we're really with a toddler with type one, and you want to put together a perfect Thanksgiving. Why don't we do that to ourselves, though, you know, but feelings of control at a time when you feel like you've lost control?   Stacey Simms  11:21 Night? Exactly. Alright, so let's get to some of the questions that came in. I got one in my local group. And this was about travel. And the question was, we're driving along distance. And I guess we could talk a little bit about flying or other modes of transportation. But this particular case, we're driving along distance, you know, six or seven hours to a relative's house. Any ideas or tips for helping me and the question here was about stable blood sugars. But I'm also going to kind of throw in there. How do I make this trip? easier on the whole family? Yeah, I'm I have a lot of ideas that maybe you do too.   Moira McCarthy  11:56 Well. So I guess my first idea would be for special occasions and events, stable blood sugars aren't the most important thing ever. I don't think there's anything wrong with trying, of course, we want to try but the first thing I'd say is if it doesn't go perfectly, that's perfectly fine. I am quite sure if you ask your medical team to help you with the plan. That is one of the things they will say to you. That's the first thing. So I mean, what did you do on long car rides? For us it I don't remember it impacting her blood sugar that much, you definitely have to have snacks in the car and like more than you ever think you're going to need in your life, because you never know when you're going to get stuck in a traffic jam from a car accident or something like that. You know what it is be prepared, and then you don't need it. We tend as a family, not just for the person with diabetes, but for everyone to try to stop every 60 minutes and get out of the car and stretch and move around and breathe fresh air and then get back in. I think that helps   Stacey Simms  12:56 us How about depressive we don't my husband would have fit? No. So in my   Moira McCarthy  13:01 father, he would never do that. That's probably why I do it. I grew up driving from Minnesota to Massachusetts and like never being allowed to get out of the car. So   Stacey Simms  13:10 I would say for us we actually did struggle a lot with long car rides, because we did a lot of trips, especially to my parents in Florida, which is like a nine or 10 hour road trip. And we found that Benny's blood sugar would go very high. Just you know, an hour or two in the car and looking back, it's probably because toddlers never stopped moving. So his insulin dosage was all based on constant activity. So when he was sitting still, just looking back that's my assumption. Also, as you mentioned, you know everybody's eating in the car   Right back to our conversation, but first Diabetes Connections is brought to you by Dario health. And, you know, we first noticed Dario, a couple of years ago, we were at a diabetes conference, and many thought being able to turn your smartphone into a meter. It's pretty amazing. I'm excited to tell you that Dario offers even more now, the Dario diabetes success plan gets you all the supplies and support you need to succeed, you'll get a glucometer that fits in your pocket unlimited test strips and lancets delivered to your door and a mobile app with a complete view of your data. The plan is tailored for you with coaching when and how you need it. And personalized reports based on your activity. Find out more go to my dario.com forward slash diabetes dash connections. Now back to the D mom's and I'm talking about what we did when we realized Benny's blood sugar would always go pretty high in the car. What we did was talk to our endocrinologist about adjusting doses giving more insulin when he was in the car, giving more insulin for food when he was in the car. And that was a real trial and error for us because, you know we have to be really conservative about that you're not going to be changing basal rates by enormous amounts and so it may not quote unquote work the first time you do it, but I think you know we're doing Talking about stable blood sugars, I hope that this person means is like maybe kind of sort of in range. You know, when I see somebody talking about stable blood sugars, I usually think like, it's not going to be a steady line at 95, right? We're just trying to keep them from skyrocketing and staying there. And even if that happens, which happened to us a ton, it's fine, and you fix it. When the baby was younger, and the kids were younger, I was much more mindful about healthy eating. You know, they're 19 and 16. And it's like, they buy half their own food. Now anyway, I don't know what they're eating. But we used to get coolers the big cooler, and fill it with, you know, healthy fruits and veggies and hard boiled eggs and carrot sticks. And you know, and then of course, everybody would want to stop for fast food and ruin everything. Right?   Moira McCarthy  15:39 So I made the assumption, and perhaps I shouldn't have that by stable, she meant within that range. If this mom is suggesting that her child should have a straight line across my answers quite different. I have no idea going on the assumption that what she means is within their range. And my answer was based on that what I meant was, if you go above your range, or below your range, I think it's okay. I don't think that if you're going to celebrate with a family, the most important thing is, is staying in your blood sugar range, I think the most important thing is enjoying the time and loving your cousin's and running around and having fun and staying within a an area that is safe. And by safe. I mean, you're not you don't need to get in an ambulance, I guess. And maybe my advice would be talk to your medical team, take some ideas that we have on your idea, I think that's a great idea. My only caveat would be the doctors probably going to want you to err on the side of your child being hired. The first time you do this, as you mentioned, you did it after some trial and error, I'm not sure a new parent to diabetes should just, you know dial way up on their kids insulin because they're going to be in the car for nine hours, I think you should take it slowly and go a time or two or three and see what happens. And then make decisions like that after that. But for now talk to your team. They're they're going to say what I said, and they're going to support you and say, Don't worry about going out of range. You know how to do corrections, here's when and here's why to do a correction and then take it from there.   Stacey Simms  17:12 And like you said, some kids sit in the car and nothing happens. Right? They don't go super high. That's why can't do   Moira McCarthy  17:17 assumption, right. That's why you have to wait and see what happens. One quick   Stacey Simms  17:22 thing about the car that I learned the hard way you mentioned about you know, be prepared for traffic be prepared for you know, delays, if you have and we all do I think have a you know a diabetes kit. Make sure it's where you can reach it, especially if your child is very young, right? I mean, there's a lot of kids, they're older, they can have it the backseat with them. I'll never forget packing everything we needed and leaving it in the trunk or like the way back of the minivan. And then we were delayed. And I'm like I need a new inset like says it was leaking, or we'd like crawl through the car.   Moira McCarthy  17:54 That's a really good tip. So put it   Stacey Simms  17:57 up to the front seat with your pack, even if you just pack a couple of things. And we had so many car adventures. Okay, the next question, I loved this one, because this just I could picture this one I know you can do more. So Deborah said we are in the first year of diagnosis, I just realized I don't know what to do about our Christmas cookie tradition. We make a bunch and give them to relatives we usually eat as we go. Can we still do this with diabetes child is eight and is on multiple daily injections, so no insulin pump yet.   Moira McCarthy  18:26 So my answer is eat all the cookies, bake all the cookies, visit all the friends have all the fun, click your fingers if you want to. But then wash your hands, have all the fun and check in with your child's doctor. And what they're going to say is go do all that check at the end of all the fun. If you need a correction, here's what we'd like you to correct. And here's what we'd like you not to correct for they may not want you to correct because sometimes these things involve a little adrenaline high. And again, first times you have to see what's going on. But just have all the fun. Fix it later. If your child gets high during it, it's no big deal. If they get low, you've got cookies. There's an old saying it started with Kelly crewneck, who's a very well known person on the diabetes world on the internet. And she said people with diabetes can't have cookies, dot dot dot with poison in them. Right? The only cookies you can't have.   Stacey Simms  19:26 I think that's fantastic. And it took me back listening to that about we know we don't have a Christmas cookie tradition. But we certainly you know, I think most people with little kids love to bake. And it's just such a fun activity to do with them. And in the first couple of weeks with shots, it was so difficult. You know, Binney ran away from us. He didn't want anything to do with it. But after a little while, he didn't really care as long as we didn't make a big deal and make him stop what he was doing. So and we bought after, which I know is like bananas that people admit to bolusing after these days, but I think it's so much less   Moira McCarthy  20:00 Streisand gets really super smart, particularly with a small child.   Stacey Simms  20:04 And so for something like this, like we would bake, and then I would kind of try to estimate like, what did he licked the spoon? Did he eat the crumbs? You know, when you do a guess? And in my case, I would always get a little less because he was teeny tiny. And then we would eat the cookie, and a couple hours later, we would correct and move on. Now. I don't know, I feel like the fun as you said, the memories of that time, you know, outweighed the quote, unquote, out of range blood sugar, I'm sure his blood sugar went out of range. And he might have been low, because they sometimes they just get really excited. And you know, he might have been high, but he's, they're healthy.   Moira McCarthy  20:39 You know what, I think this, this mom, and anyone who's considering these kind of questions over the holidays should think about too, when I look back on Lauren's life, these 24 years with type one included, I don't remember that her blood sugar went higher low. I don't remember what her diabetes did one day, I remember that the cookie swap was fun. And so that's why I think it's important to focus on the fun, within reason with a kid with diabetes, you know,   Stacey Simms  21:12 oh, yeah, that's a great way to put it. And I'm realizing as he gets older, I have a lot of those same feelings. I'm so glad it didn't stop us. I'm sure at the time. My heart was pounding, right, especially at first, I'm sure I was worried. I'm sure I was thinking, Am I doing this the right way. But look, you know, you have those fabulous pictures and those great memories. So that's a great way to put it. Alright, so let's talk about well meaning relatives. More Hi, Moira. And Stacy. My aunt thinks she knows everything about diabetes. She has type two and is always lecturing me about not letting my second grader eat, quote, bad foods. Holidays are the worst. I'm sorry to laugh, because she wants us to have sugar free desserts. There's so much going on. In that question.   Moira McCarthy  21:59 Bless her heart, right. You know, I mean, what do you do? It would depend on what kind of person she is. And if they have, if they have a relationship that she could, I would call her ahead of time and say, Look, we're working on adjusting Stevie's life, whatever the child is, and, and there's a lot of things he's dealing with right now. So I'm just asking you, if you have anything you want to say about it? Could you say it to me now over the phone before we go, and let's just avoid talking about diabetes other than Hey, how you feeling? I'm really glad you're doing well at the holiday because I don't want him to feel sad when he has all this on his mind. That's a great way to put it. Who knows what she'll do. Right, right.   Stacey Simms  22:45 I mean, you have you have well meaning relatives who want to help you have nosy relatives who think they're helping, it all depends on my mother for the first year or two she wants to make she makes one of those sweet potato casseroles, not always with marshmallows, but it's got a ton of sugar in it. And so she made it sugar free. And I didn't really notice but it's not something Vinnie was going to eat much of anyway. Yeah, when he was he was three at his first Thanksgiving with diabetes. But she meant well, but what I found worked over the years, and I still use this, even though he's his own advocate. Now, I really found that saying, Our doctor says, which I made up, but our doctor says helped everything. So I would say to somebody like this. Oh, you know, thank you so much for thinking about my son. I really appreciate it. I gotta tell you things with diabetes have changed so much now. And our doctor says that he can eat these foods and as long as we can dose with insulin, you know, we know what we're doing. He's helping us or our doctor says that Thanksgiving should be a date, like every other day or whatever it is. But people would never listen to me. Listen to what my doctor   Moira McCarthy  23:46 says my my words for that was always her medical team. Yeah. sound very official, our medical team is me. But they don't need to know that. The one thing I'll say, though, is it's also okay, if it's not super aggressive, and really out of line. I think it's also okay to teach our children to show some people a little grace. And sometimes and all this even when people are wrong, maybe at the family thanksgiving, or Hanukkah, or whatever party isn't the time to say, Do you know what I mean? Great. And so if someone makes a sugar free thing, and your kid hates sugar free, you say to your kid, please just put a tiny slice of that on your plate and then push a couple pieces around under something. And it'll be fine. They met Well, yeah, you know, yeah, say and then afterwards, you can say hey, he really liked that. But FYI, next time, you don't even need to do that make the same delicious pie, but you don't need to make it sugar free. Right   Stacey Simms  24:41 on everything. And that's a good point. Because we're so in our society today, we're so ready to fight. We're so ready to be on the defensive. And so I think that that's a great point just to be able to say we really appreciate it. We know how you meant it, you know, just thanks and then have the discussion later on. Yeah,   Moira McCarthy  24:57 but if they're over the top aggressive about about telling your child what they do wrong with their diabetes, then you need to have a conversation ahead of time. That's right.   Stacey Simms  25:04 Or you know, even in the moment if this sometimes you see, you know, I made this for these kids who don't have diabetes and look at this wonderful vegetable plate I made for your child like they're having cupcakes, but you could have the carrot that it's okay.   Moira McCarthy  25:17 It just jello Jaguars. My daughter was locked up. I always have to bring a tray of jello jugglers This is before acting. And   Stacey Simms  25:25 that is so funny. I'm so sorry for sugary jello. jigglers Woohoo. Oh, my gosh. Okay, another question. How do I dose for all of the grazing that goes on during Thanksgiving and holiday gatherings? This is kind of similar to the Christmas cookies, or I would think our answer is going to be but in some homes, right? It's not just one set meal. It's we showed up and we're starting to eat and we don't stop for seven hours. Oh, yeah.   Moira McCarthy  25:51 My house isn't that yours?   Stacey Simms  25:53 Isn't? No, no, no.   Moira McCarthy  25:57 Not every house was like that on a holiday. Seriously, this is interesting. All right, well, I guess I'll answer this first, then talk to your medical team. Ask them about planning different times during the day for check ins. And then just let your child have what they're going to have. And at the check in times that you agree with your doctor, it may be every two hours, it may be every three hours, it may be twice I don't know. They'll they'll help you decide. You see where they're at. You look at what's going on what they're going to be doing next. And then you do a correction of corrections needed. That's it.   Stacey Simms  26:31 Go, I'm going to add a layer to that. Yes, please do. For those who are addicted. I don't know anyone like this. I certainly have never been like this anyone who's addicted to their Dexcom. So if you're listening to more thinking, how am I supposed to check every two hours when the Dexcom or wherever three hours, whatever the most no more thinking how am I gonna check at those intervals, when my Dexcom is blaring every five minutes, okay, stay with me, people consider turning your Dexcom high alarm off, and then look at your child's Dexcom High Alert off, and then only looking at it as recommended by your care team. It will take away an enormous amount of stress. Even if your child goes high. And you bolus it's not going to happen right away. You know this, it takes a long time for insulin to work, right. So you're not really doing yourself any favors by checking it every five minutes. I know it's hard. Ask your doctor. But that has helped me more than the years when I was glued to it listening for this a lot.   Moira McCarthy  27:34 And you know, I think that's really wonderful advice. Because there's nothing wrong with freeing up the family to enjoy a good time. If it's so important to you that you keep them in a certain range and you want to watch it all day, then go ahead. But I think what you suggested and what you just said you do is such a good model for your child, because as you care for your child, you're modeling how they should care for themselves later. And the reality is in this long, long, long, long, long lifetime marathon diabetes, you need to just chill a mile here and there. And by doing this and saying to your children, we're going to turn this off, this is okay. Don't worry about it, you're fine. You're modeling that for them. And you're giving them the confidence and the courage to know that they can be okay. If they're not doing, you know, 150%. So I love that answer. Stacy, you get a gold star. Yeah,   Stacey Simms  28:34 it's funny to think about, but that's actually how we use Dexcom. And how everyone use Dexcom intil. Gosh, I'll probably get the year wrong. But until, let's say 2015 Because Dexcom share did not exist, right? So at school, our child would like many others basically used his Dexcom receiver as a no finger stick monitor. Right. So at the time of day were Benny would normally have done a finger stick, he just looked at the receiver showed it to his teacher. And that was it. We started using it like that. So I think it makes it a little easier if you come home from the hospital, like a lot of families do attuned to every alarm. These things may seem like an astronomical ask, but you really can do it. And I would also add with the grazing, we you know, we were grazing experts, because I had a two year old with type one who was diagnosed. I mean, a few years after Lauren, so you know, was not on that very regimented timing. So Benny could pretty much eat all day, like a normal two year old. I mean, obviously not all day, but you know what I mean? Several times a day, and we just had to give them fast acting. So it makes it it does make it a little more difficult, right? It's not but it's not something you do every single day, either. So I think that you know, you've got to kind of let go a little bit, but it's not harmful and it can make these ladies have these wonderful memories. Alright, and finally, this question, I'm a little stymied by this one. What's the Christmas present for a child with die? beedis   Moira McCarthy  30:01 Okay, a good Christmas present for a child with diabetes is what they put on their Christmas list. If you want to give diabetes related gifts for Christmas, that's all good and fine. I knew someone who gave their child quote unquote, their insulin pump for Christmas and like, their heart was in the right place, and the child felt great, but it just made me a little sad. I guess if your child puts insulin pump on their Christmas list, though, that's different. But even then I think I'd say no, Santa doesn't need to bring you medical stuff, we can just get that went whenever you need it. There are toys and animals and things like that. If someone's interested in actually, diabetesMine is having me do a list of them that's going to run in late November, early December. We can link that on this after Oh, that would be great. Like   Stacey Simms  30:54 the American Girl doll stuff and road kid kits. Fabulous.   Moira McCarthy  30:59 And then I don't mean that there's anything wrong with that stuff. I just think that you should give your child gifts that they want as a child, not as a child with diabetes. Yeah,   Stacey Simms  31:09 I think a lot of that depends on how your family celebrates and what gifts you're giving. We are We joked in our family for Hanukkah, when I was growing up, you would get everything from the toy that you really, really wanted to the dictionary that you did not ask for to the socks that you need it right so if your gift giving is like that mixed up, and it's you know, if your family expectation is that kids will get super useful stuff in all the kids not just the kid with diabetes, then I guess I could see it. But I'm with you, I think unless it's something really fun like one of those add on what your list is going to be made up but like, what are those stuffed pancreas like? silly things like that. And yeah, accessories for dolls and fun stuff. It's just like a useful medical thing. I think you've got to be very careful and know, the child like especially a parent to a kid is one thing but if you're like the fun and or you're the family friend thinking this will be a big hit. I just be a little careful. One of the things I saw in another group was you know, there's a newly diagnosed child which they get the family and the most popular response was don't get them anything quote diabetes related, get them fuzzy slippers, and a gift certificate for babysitting or you know a trip to the movies and get them something fun and engaging.   Moira McCarthy  32:22 Get them something normal and and pushing back on what you said I still even if my family did that stuff, I still wouldn't give my child like a box of syringes. So core. I like if you're giving your kids toothpaste for Christmas, because that's what you do, then give your kid with diabetes toothpaste for Christmas treats the same way you treat your other kids when it comes to gifts.   Stacey Simms  32:42 That's a good point. I think if anybody ever gave Benny any diabetes related gifts, and no one would ever mind my family would have ever done that. But   Moira McCarthy  32:49 one time in our family Yankee swap, I used a syringe box, like for the gift and whoever opened it thought it was syringes and we're like, I don't get it. And I'm like, Oh, for goodness sake. It's just a box.   Stacey Simms  33:03 Open it up. Is a Yankee swap like a Secret Santa.   Moira McCarthy  33:07 Yeah, kind of but you you could take gifts away from like a one white elephant. I don't know. I'm sorry. That's a white Jewish lady. It's like we're from different worlds, Stacy.   Stacey Simms  33:21 Oh, you New Englanders.   Moira McCarthy  33:24 Bless my heart.   Stacey Simms  33:26 We do have one funny story. So on Christmas day in Gosh, I'm looking back already. This was this is eight years ago. So on Christmas Day, we started the Dexcom. The very first time we ever used the G four platinum. Vinnie was nine. Oh no, the g4 Platinum pediatric. So Vinnie was nine years old. And we were sitting around a Christmas day at my mom's house like you do. And we said, let's start the Dexcom. Why don't we will put it on we had been instructed on how to do it. Of course, again, I don't know if I can emphasize this enough. We do not celebrate Christmas. I don't think I would do this. Christmas. So but we put it on and I will never forget because that was you know, Christmas Day. Gosh, so yeah. Merry Christmas kid. That was the big horrible insert or two.   Moira McCarthy  34:14 But then it could have Chinese food before the movie, right?   Stacey Simms  34:18 Really my house.   Moira McCarthy  34:21 I know you.   Stacey Simms  34:23 That's great. So normally at the end here, we talk about where we're going in the diabetes community. Of course, you know, there's no diabetes events going on now. And I'm really, really hoping they come back next year. But I mean, I'm doing some virtual events. I'm reaching out, but I cannot wait to be in person again more.   Moira McCarthy  34:39 I feel you. I can't believe I was just thinking about this the other day because my Facebook memory was, I guess right before the pandemic I was in Buffalo, New York speaking at a big diabetes event at this time and they were all these pictures and people posting about interesting things they learned and how happy they were going to be and I was like, oh, I want to go back somewhere. I think we're We're gonna see things start bubbling up I do believe friends for life is going on this summer I'm hoping I'll be there I haven't heard yet but um I know that's probably happening and I think JDRF is going to start doing some smaller half day programs in the near future knock on wood so I hope we're in the same place to Stacey that's what I hope not only we get out and speak but you and I are in the same place.   Stacey Simms  35:22 Yeah. Oh my god,   Moira McCarthy  35:23 it's all about us.   Stacey Simms  35:26 Why not? I was kind of pausing because I don't remember when we saw each other live to look that up. At the end of the show.   Moira McCarthy  35:33 I think it's been at least two years Stacy that's really weird.   Stacey Simms  35:37 It has to be it has to ah, I miss you.   Moira McCarthy  35:40 Me too. We talk every day practically. I miss you as a as a human life form.   Stacey Simms  35:50 Well, the next time we get together we can we can do a Yankee swap.   Moira McCarthy  35:52 Yeah. And and a white elephant, white elephant.   Stacey Simms  35:57 Well, if I don't speak to you have a wonderful Thanksgiving, enjoy your family and your adorable grandchildren. And give Lauren my best and tell everybody we said hi. Same here   Moira McCarthy  36:07 and make sure those kids yours know that I still think they're awesome.   Announcer  36:16 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  36:21 I will link up some information, including to an episode we did with adults with type one and their take on Thanksgiving. I'll put that in the show notes along with the transcription for this episode, you can always go to diabetes connections.com. Every episode starting in January of 2020 has a transcription. And there's lots more information there. I got to tell you more. And I make it sound pretty easy now, right? But those first couple of years, it's so stressful because you're trying to have a nice holiday. You're trying to project confidence, you know, we're doing great. Diabetes won't stop us. And then you're freaking out, you know, what did you eat? Should we pre bolus what's gonna happen now? Am I gonna be up all night? You know, it's, well, you know, who's got the carb count? Is it accurate? Spoiler, the carb count is never accurate. It's never accurate. I hope you know that. We're estimating everything, even packaged foods. Even somebody who weighs in measures, everything is a total guess, on carbohydrates. So just do the best you can. And it's you got to get through that I think you've just got to get through that experience. There is no other teacher like experience and diabetes, you've got to make mistakes, you've got to kind of be upset, you gotta be worried you got to get through it. But if you let yourself I think as a parent, you really can get to a place where you're like sure marshmallows on sweet potatoes, we can figure that out and go from there. And if you hated my advice to turn the Dexcom off, let me know I would love to hear from you. You can yell at me all you want. Let me know if you try it though. And if it works for you, I don't want to cause more stress. I promise. Diabetes Connections is brought to you by Dexcom. And hey, listen, I'm all about using the technology in a way that helps you thrive with diabetes. So when I say turn it off, it's not a knock on Dexcom. It's sharing how we use it to help us make great choices. Live well and be happy. I stand by that you know we have been using the Dexcom system since he was nine years old. We started back in December of 2013. And the system just keeps getting better. The Dexcom G six is FDA permitted for no finger sticks for calibration and diabetes treatment decisions, you can share with up to 10 people from your smart device. The G six has 10 Day sensor where the applicator is so easy. I have not done one insertion since we got it but he does them all himself, which is a huge change from the previous iteration. He's a busy kid, knowing that he can just take a quick glance at his blood glucose to make better treatment decisions is reassuring. Of course we still love the alerts and alarms and that we can set them and turn them off how we want. If your glucose alerts and readings for the G six do not match symptoms or expectations use a blood glucose meter to make diabetes treatment decisions. To learn more, go to diabetes connections.com and click on the Dexcom logo. A couple of quick housekeeping notes we will have a regular episode next week. Our regular episodes are on Tuesdays. So we will have one for you next week. We will not have an in the news edition of Diabetes Connections. Thanksgiving week though. I will not be doing that live on Wednesday and there will not be an episode Friday the 26th I will say if anything really big happens if we get an FDA approval, you know something like that. I'll probably pop on and give you an update. I you know, I know we're all waiting for something so I can't promise I won't do it. It's not it's like the news person in me I was in you know, I've been doing this since I was 19. So if something breaks, I'm gonna have to jump on. Even if Slade is like, you know, making turkey behind me. We'll figure it out. But right now again this week, the week of the 16th. We will have the regular in the news on Wednesday, which will become an audio only podcast on Friday. The following week. We will have a regular episode, but there will be no in the News episode Thanksgiving week. All right. With that thank you to my editor John Bukenas from audio editing solutions. Thank you so much for listening I'm Stacey Simms I will see you back here for in the news this week until then be kind to yourself Diabetes. Benny  40:10 Connections is a production of Stacey Simms media All rights reserved. All wrongs avenged

This episode of Dish With Pepper features my friend and fellow broadcaster from the L.A. Clippers KidsCast, Noah Eagle! I had so much fun with him and hope you'll take a listen! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Is Your Practice Ready for Paid Digital Marketing? An interview with John Sanders, owner of RevKey, about Google and Social Media Ads. Curt and Katie talk with John about the importance of a solid website, effective sales process, and metrics when considering paid digital advertising. We also explore what to expect when you create Google or Facebook Ads. We also talk about why you may want to outsource this and the financial risks for getting this marketing wrong.    It's time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age. Interview with John Sanders, RevKey John is an expert in paid search, specifically, Google Ads (which used to be called Google AdWords). He holds a BBA and MBA, and he has put this education to work in a variety of positions in the marketing field, including inside sales, purchasing, E-Commerce, and marketing management. Once he found Google Ads, John was hooked. He enjoys helping businesses generate leads through Google Ads that will help their companies grow, and he has partnered with businesses in a range of professions, including medical offices, B2B companies, and national product brands. John can help your business achieve its full potential. In this episode we talk about: Google Ads and other digital advertising (social media for example) The mistakes folks make in purchasing digital ads, typical pitfalls Specific to Google Search Ads: why not to use smart or dynamic ads Keywords and negative keywords The importance of tracking your results and what results you're looking for The difference between social media and Google ads What a good ad looks like and what page it goes to What's needed on a website before starting Google Ads (sufficient, relevant content and pages) Service pages and the specificity of the search How social media ads work (e.g., Facebook and Instagram) Building an audience within social media to target with your ads The value of an ideal client or niche when using social media ads Social media is more of a branding exercise than Google Ads Facebook has a lot of specific rules for advertising What return on investment you should expect, the goal of placing ads How to assess what is not working Looking through the full sales cycle to determine where to improve efforts (including answering your phone) The technical savvy that is needed to run and assess these ads The usefulness of Google analytics Determining DIY versus hiring out advertising How to outsource paid digital advertising How to determine the average value of a client Advantage of paid digital advertising versus Search Engine Optimization (SEO) The potential to lose money if this is done wrong The benefit if it is set up properly Setting up a multitier marketing plan including Google Ads and SEO Our Generous Sponsor: Trauma Therapist Network Trauma is highly prevalent in mental health client populations and people are looking for therapists with specialized training and experience in trauma, but they often don't know where to start. If you've ever looked for a trauma therapist, you know it can be hard to discern who knows what and whether or not they're the right fit for you. There are so many types of trauma and so many different ways to heal. That's why Laura Reagan, LCSW-C created Trauma Therapist Network.  Trauma Therapist Network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work and what they specialize in, so potential clients can find them. Trauma Therapist Network therapist profiles include the types of trauma specialized in, populations served and therapy methods used, making it easier for potential clients to find the right therapist who can help them.  The Network is more than a directory, though. It's a community. All members are invited to attend community meetings to connect, consult and network with colleagues around the country. Join our growing community of trauma therapists and get 20% off your first month using the promo code:  MTSG20 at www.traumatherapistnetwork.com.   Resources mentioned: We've pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! RevKey.com   Relevant Episodes: Bad Marketing Decisions The Brand Called You Creating Relevant Ads Hostage Marketing SEO Guide for Therapists Marketing with Empathy Clinical Marketing Branding for Your Ideal Client Connect with us! Our Facebook Group – The Modern Therapists Group  Our consultation services: The Fifty-Minute Hour Who we are: Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making "dad jokes" and usually has a half-empty cup of coffee somewhere nearby. Learn more at: www.curtwidhalm.com Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt's youthful energy, so that she can take over the world. Learn more at: www.katievernoy.com A Quick Note: Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We're working on it. Our guests are also only speaking for themselves and have their own opinions. We aren't trying to take their voice, and no one speaks for us either. Mostly because they don't want to, but hey.   Stay in Touch: www.mtsgpodcast.com www.therapyreimagined.com Our Facebook Group – The Modern Therapist's Group https://www.facebook.com/therapyreimagined/ https://twitter.com/therapymovement https://www.instagram.com/therapyreimagined/   Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano http://www.crystalmangano.com/   Transcript (Autogenerated)   Curt Widhalm  00:00 This episode is sponsored by Trauma Therapist Network.   Katie Vernoy  00:04 Trauma therapist network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work, and what they specialize in so potential clients can find them. Visit trauma therapist network.com To learn more, listen at the end of the episode for more about the trauma therapist network.   Announcer  00:31 You're listening to the Modern Therapist's Survival Guide, where therapists live, breed and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Curt Widhalm and Katie Vernoy.   Katie Vernoy  00:47 Welcome back modern therapists This is the modern therapist Survival Guide. I'm Curt Widhalm with Katie Vernoy. And this is the podcast about all things that therapists face. Sometimes their business stuff, and today's episode is diving into the world of online digital advertising. Any of us who are working through the pandemic have our small businesses, needing to find ways to potentially reach new clients that we haven't had to in the past. I know for people like me, I've built my practice largely on in person networking and some of those relationships. But it's as I get asked by some of the listeners of like, I'm ready to start a practice now. How do I develop a practice like yours? And I say, I don't know, because we're not allowed to beat people during the pandemic. I don't know, maybe like find some Google ads or some Facebook ads. They're like, Well, what works for you. And I'm like, talk to our guest today. John Sanders from RevKey, this is something that he's going to be able to speak on way better than I am. John, thank you for joining us today.   John Sanders  01:54 Thanks for having me.   Katie Vernoy  01:56 We're excited to have you here I was so I don't know what the right word pleased. I'll just say pleased, I was so pleased when you reached out to connect related to the conference, actually, and I'm so excited that you're one of our conference sponsors. Thank you so much for your support. But just in talking with you and about RevKey and what your mission is, I am really excited to have you to talk with our audience about this area that I think a lot of folks just don't know anything about and can be a real great way for people to market their practices. So we'll dive right in with the question we ask all of our guests, which is who are you and what are you putting out to the world.   John Sanders  02:34 So I'm John Sanders. I'm the owner of RevKey. And I focus on Google ads for mental health professionals, probably 90% of my revenue is generated by therapists and counselors who are looking to increase the size their practice, and get new clients either for themselves or for therapists who are working for them. I started doing this I, I kind of got into this a little bit of a natural way, my wife opened her testing psychology practice. And so I started running Google ads for her while I was also running Google ads during the day doing a day job at a marketing agency. And over time, helping her started helping a couple of her friends. And then 2018, it just became my entire job. And I quit my marketing agency job. And I opened rev key and I haven't looked back since.   Katie Vernoy  03:28 Nice, I like it. There's a lot of mistakes to be made in buying digital ads, rather than going networking to a small community where people might be able to get to your physical office or that kind of stuff. Now you're potentially advertising to the whole world. What kind of mistakes do you see people making when they're first moving into some of these online ads that if we can save them a few dollars here and there to be able to be more effective with them? What kind of mistakes do you see that people could avoid?   John Sanders  04:02 Sure. So with Google ads, some of the most common mistakes are setting up what's called a smart advertising campaign where Google really does most of the work for you. But it really doesn't have a lot of options in terms of customizing different ads, and trying to avoid clicks that you don't necessarily want. So if you're going to use Google ads, and when we're talking about Google ads, we're talking very specifically about Google search ads. And those are the advertisements that appear on Google after somebody searches something, make sure you're using the full version of Google ads and not not a smart ad. I'm not a big fan of their dynamic ads that just scan your website, you can end up with all sorts of weird traffic based off of that. We want to be able to go and specifically say these are the keywords that we want to target and then we want to be able to look at the search terms what people are actually searching to come to your website, a couple of other things that that I commonly see when people come to me who are running their own Google ads is not having any what are called negative keywords. And those are words that you put into Google and say, if this word appears in the search, do not show my ad. And probably the most common one that I see is massage. So I'll see a bunch of people will say therapy near me, and they'll get a bunch of searches for massage therapy near me, which is what we absolutely don't want. And then probably the final thing is not really having a good way of tracking your results, not really knowing how many people are calling you, because your ads not knowing how many people are filling out forms. And so you don't really know if Google ads is working for you if you don't do those things. So all of a sudden, Google ads just becomes you know, a charge on your credit card every month that you're just not sure if you're getting anything out of it. So that measurement piece is super important.   Katie Vernoy  06:00 So there's different types of ads that I know that you work on. I know you do Google ads, but you also do social media ads. And to me, it seems like most of these platforms are cost per click or cost for per view, or the more people are responding to clicking into seeing your ad, the more you're going to pay. And so it seems like there's some nuance there that would be important for people to understand what they should use, which one is better for their practice that kind of stuff. So talk to us a little bit about. And maybe this is way too big of a question. But as far as like, what does a good Google Ad look like? Why should someone think about Google ads? And then also looking at the the social media ads, and when that is potentially the right choice, the better choice a good addition? You know, it's kind of like, what are we talking about here, when we're saying digital marketing, online, paid ads?   John Sanders  06:54 Well, let's start with social media ads. In this case, they are a very different animal from Google search ads in that if somebody searches you on Google, they are at least somewhat through their buying journey already to use a little marketing speak, they have already decided that they need a therapist, and so they type in something like therapist near me or counseling near me. And then you know, we want to show them an ad that really deals with what they're looking at. So for example, if somebody types in anxiety treatment near me, or anxiety treatment in their city, I want to show them an ad that talks very specifically about anxiety, I don't want a generalist ad, I don't want something that includes something about couples counseling, or anything that's not related to anxiety, I want then them to click onto my ad. And I want to take them to a page on a website that talks very specifically about anxiety treatment, I don't want to take them to a page that is a bullet point of services, or a homepage that has a whole bunch of other things that they're not looking for, I want to take them to a page specifically about anxiety. And ultimately, the goal is for them to either call you fill out a form or go to, you know, some sort of scheduling link. And that's really the process when you advertise on Google that you should think about as every time you're putting in a keyword thinking, What page is this going to? And how is this going to be successful. And that's really kind of how you should write your ads. And also be thinking about your website. You know, one of the things that we had talked about previously is that before you start Google ads, really getting a good website going is very key and having what we would call service pages, where you have a page very specifically for all of the specialties that that you do, instead of having that page of just bullet points, because that's not going to engage customers. Also, Google's constantly judging our ads. And they're not going to really see that as a high quality landing page. And so your ads are going to get judged by Google for that. So it's really good to have those pages in place before you start advertising both from a Google standpoint, and also from a potential user standpoint as well.   Katie Vernoy  09:12 Yeach you don't want to pay for something and send them to a website that then talks them out of working with you.   John Sanders  09:18 Right, or just doesn't have any information. And yeah, and I know that it's really easy to fall into that trap is, you know, if you're just starting out, you go on WordPress, and you put together your first website, to not include enough content out there. But really the it's it is very key to make sure that you have that content before you start trying to advertise,   Katie Vernoy  09:41 you know, you talked about kind of being a certain way through the the buying process or the or whatever when they're searching on Google for a therapist, but when we're looking at Facebook ads or Instagram ads or any of the social ads, like how do those work and what are those best use for   John Sanders  09:59 So Facebook and Instagram ads are both run out of the same platform. And the way that you target customers is by creating what's called an audience. And this is a combination of behaviors and demographics and interest that people have. So you can say, show my ads to people who have job titles similar to therapist or something along those lines. And you can put in several different ones. You can also do it based off of behavior have they come to your website before that is what's called remarketing, although that's going to get a little more difficult in the next year as kind of that cookie based remarketing that a lot of people have heard about is going to start to go away. So you can target people based off of their age based off of their location based off of particular interest they might have. And so it's really good to use social media ads, when you have a very specific idea of who your audience is, in terms of those demographics. If you're more of a general therapy practice, you're you're going on a little bit of a fishing expedition, because you're going to write kind of a general ad towards a general audience. And that's not necessarily a bad thing. But we can't measure it in a lot of the same ways as a Google search ad where they're already so far through the buying process, you could end up showing ads to people who don't think they need a therapist, or I've never even thought about getting a therapist. And so then it's much more of a multistage situation where you're trying to get them to come to your website, and then maybe you serve them some remarketing ads, or you send them an email or something along those lines. And so I really kind of warn people that when you're doing social media ads to not necessarily hold them to a the same standard as Google, but also to think about a little more as an exercise in branding than what I would call direct conversion.   Katie Vernoy  11:57 You're saying that direct conversion be more likely if they have a product or a book or or some sort of like an event like something that's very specific, that's going to be a better social media ad than, hey, do you happen to be ready for therapy right in this moment, and I've targeted you appropriately.   John Sanders  12:17 Right, exactly. And also, with social media ads, you have to be very careful about the wording you use. For instance, you know, if you try to use the word, you in a Facebook ad, your ad could get disapproved, because you're trying to talk directly to the customer, which Facebook does not like, and Facebook has a number of rules around, you know, the wording and usage it within within your ads, and probably more rules than Google has on that front.   Katie Vernoy  12:48 What makes a successful campaign, you're talking about getting better results here. How do you interpret whether or not what you're doing is successful?   John Sanders  12:55 You know, when we talk about it within Google ads, if we are getting 100 clicks for a customer, I want to see how many of those actually turned into phone calls, leads scheduled clicks. And look at that in terms of our percentage, generally, I want that percentage to be at least 5%. So if 100 people click on your ads, I want at least five of them to do something. And then we also have to look at how much you're spending for each of those leads. And then ultimately, the most important thing is, are those leads turning into customers and revenue for you. If you get into a situation where you're spending $500 a month on Google ads, you want to make sure that you are getting a good return for for that $500 ad spend. And that's where kind of tracking get with you know, your assistant to make sure that those people that are clicking on your ads are actually turning into clients is super important.   Katie Vernoy  13:54 When you're finding that people are not hitting like that 5% What do you see as often kind of contributing to that? Or what kinds of steps do you look at to evaluate where things aren't converting?   John Sanders  14:06 Sure. I think it depends on the, you know, where people are kind of dropping off in the process. You know, for instance, if you know, somebody comes to me, and shows me their Google Ads account, and they're saying, I'm not really getting anything off of this. And I find that you know, less than 1% of people are actually clicking on their ads, that's usually an indication that you have an ad problem, or your ads are being served on search terms that we don't want to go back to the massage therapy example. If you're advertising anxiety therapy and somebody types in massage therapy near me, your ads never kind of get clicked on. So that's that's one of the first things to to look at. If people are then you know if people are actually clicking on your ads that are relatively recent, right, which I would define as about at least two to 3% of the time. I know they're getting to your website. Are they spending enough time on your website? If you find find that your average time on your website is from people from your ads is 30 seconds, they're not spending very long on your website, and they're not seeing a particular bit of content that that they are looking for, kind of the measure that I have for that is I want to make sure people are spending at least 60 seconds on your website. And to go back to the previous example of the service page that just has bullet points. If you're running ads to that, typically people are going to look at that and go, and then they're going to click off under 30 seconds, and you're not going to end up converting that client.   Katie Vernoy  15:37 There's a lot of stuff you're talking about that sounds pretty technical, which is, you know, kind of monitoring the click rate monitoring, you know, and kind of what percentage are people clicking and what percentage of people are actually getting to the website, and how long they're spending on the website? That seems like a lot to first figure out how you can actually get that information. And then also a lot to try to sort through like for DIY errs Is it obvious if you're able to get a little bit technically savvy, how to get that data, so you can even look at it.   John Sanders  16:14 Google Ads has a lot of different menus in it. And so that can, especially if you don't know what you're looking for, can be a little difficult. In a lot of cases, you're having to pull information from another program called Google Analytics, which even if you're not running Google ads, you should definitely have Google Analytics installed on your website. So you can see how many clicks overall, you're getting, how long people are spending on your website, getting information about about those individual pages,   Katie Vernoy  16:42 it seems like people need to have at least some some knowledge and have installed at least Google Analytics to be able to see some of this data.   John Sanders  16:51 Right. And that's one of the first things that as a common mistake that when people will come to me and they're they've maybe they've been running their own Google ads, that they haven't installed Google Analytics, or they haven't put on those negative keywords that we've talked about. Or you don't really have any of that measurement, which is not necessarily obvious in Google ads. And in a lot of cases, you have to involve things like Google Analytics, or even third party programs, if you're looking to track some calls,   Katie Vernoy  17:18 as far as some of the time investment to figure this kind of stuff out. And I'm guessing the monetary mistakes to try some of these things out, see what's effective or not, is this worth a clinicians time to invest this kind of stuff? Or is this kind of one of those things where the best advice is, have people who are good at this pay for their services and let them do their thing, we don't want them treating suicidal clients, we want them to refer to us therapists is this honestly, just something where it's a better use of clinicians time to hire out these kinds of services,   John Sanders  17:58 I would say for the most part, this is something you want to hire out. Much like I hire out graphics design or accounting, I don't like to do accounting. That's why I have an accountant. And I could spend my time and try to figure all of this out. But I probably wouldn't end up doing that good of a job on it. As somebody who professionally does it day in and day out. That's not to say you can't I've had some very technically minded therapist, especially a couple of them that, you know, maybe used to work in it. And this is their their second job, those guys have been able to understand it fairly well. But for the most part, I would say most of the people who try this themselves, they fall into some of these traps that we've talked about. And they potentially end up wasting a lot of money on Google, that doesn't really lead to any clients.   Katie Vernoy  18:47 Yeah, I think to me, the financial downside of doing this wrong can be pretty high, especially if you set it and forget it. And to me, I feel like this is something that I cannot emphasize enough that if you can get it right. I mean, this is a way to have marketing just happening in the background all the time. And this is kind of what therapists desire, like I don't have to do anything and I get clients. And so it's interesting because I think a lot of people are worried to invest. How would somebody identify a good return on investment for outsourcing Google ads, outsourcing potentially other paid online marketing? And and kind of what that would look like? Like, let's just say a solo practitioner who's wanting to start or grow their caseload like, what should they expect as far as being able to get something like this set up? And then what would that return look like?   John Sanders  19:46 I think to answer that question, you have to start with, what the average value of your client is, what you're charging, how many sessions you're keeping them. And if you can, look at that. data you can figure out, well, I charge, let's say, $100 an hour, people tend to stay with me 20 to 30 sessions. So we have each customer being approximately worth two to $3,000. And then you have to think about how much would you be willing to pay for one of those customers. And so, you know, we go back to what we talked about earlier, where let's say you're spending $500 on Google a month, if you can get one client out of that, who's two to $3,000. In revenue, that's a pretty good when and if you get any more than that, it's enormous. If you can be getting four to $6,000, of revenue off of $500, in advertising spent. And you also do have to kind of keep in mind, especially if you're, if you're doing therapy, you have to kind of think about that long term return on investment of what that client is worth, you know, over their lifetime to you, as opposed to on a month to month basis. I think that that's a mistake that that some people make, they'll say, Well, you know, in month X, I'm only gonna make x on this. But you have to not necessarily think about month one, you have to be thinking about months 2345 and six,   Katie Vernoy  21:11 how long does it take to reasonably expect a return on is that it I hear clinicians who are like, Oh, I'm hitting a slowdown portion of my schedule, you know, summertime slowdown or something like that, now's the time that I should be investing in Google ads, are they going to see the kind of quick turnaround to fill up their practice with this kind of an investment? Or is this something that needs to be planned out even more ahead of time on something like this,   John Sanders  21:37 the advantage that Google ads and digital advertising in general has over I would say search engine optimization is that it is something that you can do, and get on the first page. Like if you're a solo practitioner, who's just gotten started, if you try to organically grow on Google, that can take six months to a year, for you to really start getting some clicks off of that the advantage Google Ads has is you go tell Google can show these ads for these particular keywords. And you can get on to that first page, really, really quickly. And really kind of that first 30 days for me is is the period of where I'm figuring out in a specific market, you know how much I'm going to pay for each of those clicks. And that's gonna vary greatly, depending on the market, and what you are trying to advertise. If you're trying to do couples therapy in New York, be prepared to pay eight to $10 per click. If you're trying to do general therapy out in a suburb, you might, you know, only pay three to $5 that click. And that is very much based off of who else is there who is trying to advertise? To get an idea of that what you need to be bidding on those keywords? And then also looking at those results. Are you are you seeing the results? Are people staying on your pages long enough? Are they calling YOU ARE THEY filling out your forms, and that's where you start to to make adjustments, and then over time, you will figure out, you know, I need to change the content on this page, or I need to not advertise in a specific neighborhood that maybe is too far from your practice. And that's kind of the optimization process. And then also looking at, and I would say that this is probably the most important thing for the DIY audience out there is to look at the search terms that are causing your ads to appear. And if most of them are good, you're probably going to do really well. But if you see a bunch of nonsensical therapies, and I see all sorts of different types of therapies that come up that we want to add to the negative keyword list, if you're spending a lot of money on things that aren't relevant to your business, it's going to be very hard for you to succeed with Google ads.   Katie Vernoy  23:53 One of the things that I'm hearing and correct me if I'm wrong is that there's the initial optimization process of making sure that your ad was reading properly, has the right keywords, has good negative keywords. And then it's driving traffic to a page that actually closes the business, so to speak, and gets people to sign up for consults or call the practice or whatever, and to become clients. So there's, there's a part that truly needs to be the therapist or the therapist with a marketing specialist on making sure the webpage that you're driving traffic to is going to convert and going to be targeting the right people. And then also potentially really looking at what is your intake process look like? What is your call look like? You know, do you have? Like, can you get all the way through the sales cycle, so to speak, but once you get that set up, once you have an optimized ad, you have your page is on fire. You you close the call, and you're getting clients, it almost feels like it could be a spigot that your turn off and on with Google ads, because you'll you know, I assume that there's going to be a job So with algorithms and that kind of stuff, so there's still a little bit of tweaking after that. But to me, it seems like once it's set up, then that process of the summer slowdown that Kurt's talking about would be like, Okay, well, we just need to in about two weeks before we want to get some more clients, we just turn on the Google ads. Am I Am I oversimplifying that too much.   John Sanders  25:19 I think it depends on the practice. I think if you're a solo practitioner, I think that that can definitely be the case, I have larger clients who, if they've got 10 therapists, and all of them get full, they go out and hire two more. And then so those Google Ads kind of continue on going. Or for more of your midsize practice that, you know, is four or five people and they hire a new therapist who is specialized in couples, then it's okay. For these couple of months, let's go ahead and run ads for couples and marriage and relationships and really focus on those pieces. So I think that that really depends on the size of the practice. But I think that you are right, in that for smaller practices, you can do that it's probably the number one reason I lose customers is because they get fault, which is a it's a high class problem to have. But it's still a problem.   Katie Vernoy  26:12 So you need more clients   John Sanders  26:14 Well and one of the things I'm also working on right now is is doing a search engine optimization product, because that is the sort of long term planning, and is also another complicated subject of being able to help build practices over the over the long term, like I said, that can take six to nine months for Google to really start recognizing your website with when they crawl it and saying that this is a high quality website and should appear higher up in the search results.   Katie Vernoy  26:42 I think that ends up being a good plan where you start with Google ads, and in the background, you're building the SEO. So it seems like it's a natural partnership, for sure.   John Sanders  26:50 Right   Katie Vernoy  26:51 What kind of tips do you have, you know, spending the last moments here of the podcast here of how those two things fit together? I mean, you're talking about outsourcing this, but for clinicians who are trying to picture okay, I've got the ads, what needs to go on to the website in order to keep people there who are engaged, do I just like, put a video that takes 45 seconds to load so that way, they're going to stay for a minute,   John Sanders  27:18 Google won't like that at all.   Katie Vernoy  27:21 And if the video doesn't load, I'm off that page in 10 seconds.   John Sanders  27:25 Absolutely. Google. And Google knows that. I mean, one of the things that when Google's judging a landing pages, not only is it judging, you know, the content, but it also like if you have images or videos that roll out really slow, Google is not going to show your ads as high up in terms of you know, some of the other things a writer I regularly work with, you know, recommends that you have, you know, four to 500 words on that page. Not only does that give Google enough keywords to grab a hold of and say okay, that this is high quality for an anxiety search. But also, it allows people who are actually looking at it to go yes, this is this is what I'm feeling this is, you know, this is what's happening with me, and to kind of get them nodding their head, and then you know, hopefully, getting them to take that next step of contacting you somehow.   Katie Vernoy  28:16 I think it's something where the hard truth for folks that want to get clients quickly, because I think I've definitely had consulting clients that are like, should I do Google ads, and I was like, let's look at your website first. And I think the hard truth is, sometimes there is quite a bit of work that needs to happen before you really can take this into, into your marketing strategy. Because if you're spending money to send them to a website, that does not reflect who your ideal clients are, does not connect with your ideal clients, and does not show you in the best light. It's it's just throwing money in a hole, and it's not actually getting you results. And it can be very discouraging. And so there may be some work to do ahead of time to get prepared for the calls to get prepared for the web traffic. But once you actually have that in place, it sounds like Google Ads can be a way that you can really, pretty quickly start building a caseload and the return on investment can be very high, especially if you if you have a fee and a length of treatment, typical length of treatment that makes each client worth 1000s of dollars. And you know, even if you're only getting one client a month, you know, that still ends up being a nice return on investment. And usually I'm hearing people get more than that. Do you have a sense of like, if you've got a really good, optimized ad, like you know, and a reasonable spend, you know, how many people are typically getting, how many clients people are typically getting?   John Sanders  29:48 Well, let's you know, take that 100 Click example. And you know, we talked about 5% Earlier, let's double that. Let's say let's say you're doing really well and you get you get 10 people who contact you, then it gets down to that, that that close process that that we talked about earlier, are you are you answering your phone is a common thing that I'll end up talking to clients about who I'll notice off of my call tracking software, they're not answering their phone, and they're getting a bunch of voicemail messages. But if you can take those 10 leads, and you know, you can turn six of those into clients, you know, all of a sudden, your your return on investment, if you're spending $500, you know, you could be looking at several $1,000, and potential long term revenue. That's huge. And, um, it is very hard to find a way to do that anywhere else. You had mentioned the work that goes up front, very often, when people contact me, they'll say, Hey, I'd like to run Google ads. And you know, I really have to tell them, Okay, go work with a content writer, go work with, you know, web designer, let's let's get your website in a good place before we try to run those ads. Because otherwise, I'm going to start running ads, you're not going to get the results and you're just going to get mad at me. And that's just no fun. I, I'd much rather do all of that upfront and delay working with a client for three months. And this happens on a fairly regular basis where I'll refer people out and then they come back three months later and say, okay, my website's ready. Let's go ahead and run those ads.   Katie Vernoy  31:14 Yeah. And I would add, make sure that you have a conversation with someone if your close rate isn't what you'd like it to be if you get a lot of calls, and nobody becomes clients. There's other folks to talk to about that as well.   John Sanders  31:26 And I think Google ads, especially once you put some of those tracking metrics on there, that makes it very obvious very quickly. For instance, I have some larger practices who will go through those call logs, and they will, you know, really scrutinize those and you know, potentially say, you know, why aren't these these people closing? If you're seeing a closed rate of only 30%? You know, you have to start asking those questions about what's going on with the intake process that's causing that drop off?   Katie Vernoy  31:54 Where can people find out more about you and your services.   John Sanders  31:57 Sure, if you want to know more about me and what I'm about, go to redsky.com, that's revkey.com. And feel free to fill out that form on the website. And I will get back with you really quickly because because this is what I preach to people all day. So you've you've got to follow up on those leads. So and then, you know, typically what I do is, you know, start with a conversation where we talk about their practice and how many people they have and you know what specialties they they want to run for. And then put together a proposal and send it over to him and hopefully start working with them.   Curt Widhalm  32:35 And we'll include links to that in our show notes. You can find those at MTSG podcast.com. And until next time I'm Curt Widhalm with Katie Vernoy and John Sanders.   Katie Vernoy  32:46 Thanks again to our sponsor, trauma therapist network.   Curt Widhalm  32:49   If you've ever looked for a trauma therapist, you can know it can be hard to discern who knows what and whether or not they're the right fit for you. There's so many types of trauma and so many different ways to heal. That's why Laura Reagan LCSW WC created trauma therapist network. Trauma therapist network therapist profiles include the types of traumas specialized in population served therapy methods used, making it easier for potential clients to find the right therapist who can help them. Network is more than a directory though its community. All members are invited to attend community meetings to connect consults, and network with colleagues around the country.   Katie Vernoy  33:26 Join the growing community of trauma therapists and get 20% off your first month using the promo code MTSG20 at Trauma therapist network.com Once again that's capital MTSG the number 20 at Trauma therapist network.com   Announcer  33:43 Thank you for listening to the Modern Therapist Survival Guide. Learn more about who we are and what we do at MTSGpodcast.com. You can also join us on Facebook and Twitter. And please don't forget to subscribe so you don't miss any of our episodes.  

The Lucky Mojo Hoodoo Rootwork Hour is a real, live call-in show where the general public gets a chance to ask about actual problems with love, career, and spiritual protection, and we recommend and fully describe hoodoo rootwork spells to address, ameliorate, and remediate their issues. We begin this show with a Discussion Panel focussed on the topic of Emotional and Spiritual Transformation. You will learn a lot just by listening -- but if you sign up at the Lucky Mojo Forum and call in and your call is selected, you will get a free consultation from three of the finest workers in the field, cat yronwode, ConjureMan, and a special guest from AIRR, Jon Saint Germain. Sign up before the show to appear as a client! Post at the Lucky Mojo Forum at: https://forum.luckymojo.com/lmhrhour-free-readings-november-14-2021-emotional-and-spiritual-transformation-t95656.html Then call in at 818-394-8535 and dial '1' to flag our Studio Board Operator that you want to be on the air! We select new client sign-ups first and then call-back sign-ups. Call in right when the show begins and listen via your phone. Message the Announcer or the Studio Board Operator ("Lucky Mojo Curio Company") in chat to let them know you're available. The link above will also be the location of the show's CHAT LOG once it is posted, so you can follow along as you listen.

On this episode of FRM Freland and Ritt welcome in ROH Star Eli Isom and Former NXT Announcer Alyssa Marino!

Written by: Rich Masters, Paul Turner, and David Spyve Art: Rich Masters and twitter.com/Axe_Wizard Music: twitter.com/_VidaZen_ Editing: twitter.com/major_third Announcer: twitter.com/LanceMcSteel Cathy/Computer/Future Cathy/Computer 2.0: twitter.com/poisonClanCats Crash/Tivan/Lord Spacedanger/Brother Tivan: twitter.com/spivzy Drak/Drakbot Prime: twitter.com/major_third Dross/Badmiral Dross: twitter.com/palmturner Hoteen/Low'Teen: twitter.com/MastersRich T'Pon/Two'Pon: Jeff Rawisch With Special Guests: Barkeep: Jason Whitcomb Bar's PA System/Commodore Sweetberry: Aaron Damrau Ship's Emergency Computer: Ross twitter.com/strtrk1701 Bugsy: Linda Butler twitter.com/HenInAHat1 Rocko/DMV Employee: Jason Whitcomb Starfleet Officer: Rich Masters Admiral Friendly: Jenn Tifft Crew Member: James O'Fallon twitter.com/LanceMcSteel Other Crew Member: Vidazen twitter.com/_VidaZen_ and Shuttlebus Captain: AxeWizard twitter.com/Axe_Wizard

Jon and Jim ad Oakland A's announcer Ken Korach on to talk about Bob Melvin and just what the Padres are getting and what fans should expect!

Conspiracy Theories in Your Office Curt and Katie chat about clients who bring conspiracy theories into therapy. We talk about differentiating between psychosis and believing in conspiracy theories, the characteristics of folks who may be likely to subscribe to these theories, and the importance of the relationship in working with these folks. We also look at steps we would like professional organizations to take to support clinicians. It's time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age. In this episode we talk about: How to handle when clients bring conspiracy theories into your office Distinguishing between delusions, shared psychosis, and conspiracy theories Reality testing, obsessive research, and other factors that may distinguish between psychosis and conspiracy theory The impact of internet research and social media algorithms The characteristics of folks who are more likely to believe in conspiracy theories How fear of uncertainty, lack of trust can play into this dynamic Societal impacts like advertising certainty The different responsibility that therapists have when someone brings in a conspiracy theory Hesitation in addressing these theories both in the room and at the professional org level The continuum of engagement with conspiracy theories (from “entertainment” to going down the rabbit hole) The level of investment in the theory, groups forming around these theories, and cults The risk factors and legal/ethical responsibilities related to harm Allen Lipscomb's BRUH modality (Bonding Recognition Understanding and Healing) The problem with direct challenging The importance of identifying is it a conspiracy theory or is someone actually out to get you, especially with clients who are in traditionally marginalized communities Building trust within the relationship through deep understanding of the client's experiences Societal measures that can help (like deplatforming leaders of the theories) Starting from compassion and curiosity; managing reactions Exploring the nuance of challenging irrational fears versus conspiracy theories Seeking common ground and identifying impacts The call to action to professional organizations for guidance and taking a stance (and the understanding of why they balk at doing so) Our Generous Sponsor: Trauma Therapist Network Trauma is highly prevalent in mental health client populations and people are looking for therapists with specialized training and experience in trauma, but they often don't know where to start. If you've ever looked for a trauma therapist, you know it can be hard to discern who knows what and whether or not they're the right fit for you. There are so many types of trauma and so many different ways to heal. That's why Laura Reagan, LCSW-C created Trauma Therapist Network.  Trauma Therapist Network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work and what they specialize in, so potential clients can find them. Trauma Therapist Network therapist profiles include the types of trauma specialized in, populations served and therapy methods used, making it easier for potential clients to find the right therapist who can help them.  The Network is more than a directory, though. It's a community. All members are invited to attend community meetings to connect, consult and network with colleagues around the country. Join our growing community of trauma therapists and get 20% off your first month using the promo code:  MTSG20 at www.traumatherapistnetwork.com. Resources mentioned: We've pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! The Mind of a Conspiracy Theorist in Psych Today Mashable Article: What happens when people talk to their therapists about conspiracy theories? It's tricky   Relevant Episodes: Political Reactionism and the War on Science (interview with Dr. Tereza Capelos) White Terrorism and Therapy Mass Shooters and Mental Illness   Connect with us! Our Facebook Group – The Modern Therapists Group  Our consultation services: The Fifty-Minute Hour Who we are: Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making "dad jokes" and usually has a half-empty cup of coffee somewhere nearby. Learn more at: www.curtwidhalm.com Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt's youthful energy, so that she can take over the world. Learn more at: www.katievernoy.com A Quick Note: Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We're working on it. Our guests are also only speaking for themselves and have their own opinions. We aren't trying to take their voice, and no one speaks for us either. Mostly because they don't want to, but hey. Stay in Touch: www.mtsgpodcast.com www.therapyreimagined.com Our Facebook Group – The Modern Therapist's Group https://www.facebook.com/therapyreimagined/ https://twitter.com/therapymovement https://www.instagram.com/therapyreimagined/   Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano http://www.crystalmangano.com/   Transcript (Autogenerated) Curt Widhalm  00:00 This episode is sponsored by trauma therapist network.   Katie Vernoy  00:04 Trauma therapist network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work, and what they specialize in so potential clients can find them. Visit trauma therapist network.com To learn more,   Curt Widhalm  00:27 Listen at the end of the episode for more about the trauma therapist network.   Announcer  00:31 You're listening to the modern therapist Survival Guide, where therapists live, breathe and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Curt Widhalm and Katie Vernoy.   Curt Widhalm  00:47 Welcome back modern therapists, this is the modern therapist Survival Guide. I'm Curt Widhalm with Katie Vernoy. And this is the podcast about all things therapy related for therapists the things that we do the things that we face with clients, and literally everything else. Even the things that you don't know that are out there, we are today talking about conspiracy theories. And are we are we actually treading into a conspiracy theory podcast here, like, I'm just now realizing that, but what to do, how to handle when clients are bringing conspiracy theories into the office. Now, as we're looking at this episodes, we don't want to necessarily speak to any particular conspiracy theories that are out there. So we're just going to use a philan conspiracy theory as an example throughout this episode. So the theory that we're working with today is that the company is behind seeded grapes are all just a money laundering front because no one buys seated grapes on purpose.   Katie Vernoy  02:02 I think that's a great one. Okay.   Curt Widhalm  02:04 We're gonna work with that. So do you have clients who were talking conspiracy theories? Bringing in seeded grapes into your sessions?   Katie Vernoy  02:17 Not currently. Actually. I had some folks previously pretty recently, but I think the thing I want to distinguish first, because I think that there are conspiracy theories, and then there's also delusions, shared psychosis and and other types of psych psychotic symptoms. And so because I've had clients that have psychotic symptoms and believe that the world is out to get them, but how do we differentiate conspiracy theory believers from folks who have psychosis? Because for me, I feel like psychosis has other elements to it, that potentially lead to that diagnosis versus someone who doesn't have a mental health condition, but has beliefs that are along the lines of conspiracy theory, how do you make that distinction?   Curt Widhalm  03:08 The profession has not really defined clearly the difference between the two other than we know that they're different. So if you're asking me, there's   Katie Vernoy  03:20 I just did ask you. Yeah, and I was just doing.   Curt Widhalm  03:25 So if you're asking me, it's a focus on ideas, it's more of the approach to the ideas than it is necessarily about the ideas themselves. That when I've worked with clients who have presented with delusions or with psychosis, or something else, there's a certain level of reality testing that we go through that those clients response to, that does not show the obsessiveness into the research of whatever YouTube videos are out there or spending the amount of time going into them. They're not alienating themselves away from friends and family in the way that conspiracy theorists tend to do. And as I see with some of the clients and some of the people who who consults with me, it's more of the actions around what the beliefs are that pushes something into kind of that conspiracy theorist territory. This is evidenced by some of the clients who might be sending me several YouTube links from somebody who got their doctorates off of, you know, some website someplace who's posting 30 minute videos about seeded grape industry and several of them and talking about how their family members will stop talking to them because of their beliefs. So, to me, it's more of the qualitative actions around how they approach it as opposed to necessarily the content of what they're bringing in.   Katie Vernoy  05:10 I agree, I think there's, with the clients that I've had with psychotic symptoms, they seem to just believe and know it to be true. There isn't that research level. I agree with that. I think there's also an element of, in fact, they see proof to the contrary, and fold it in to the delusion or the hallucination that they're experiencing, and it stays in this realm, that's very different. I do think that folks with psychosis can alienate the people around them. And I think, in fact, do they, you know, I've had clients where they believe that you're part of the conspiracy against them, and, and then either decide to meet with you anyway or not, I've had, you know, different folks who argue with, you know, the voices in their head, you know, to try to not do therapy or whatever, or believe family members are part of these larger things and alienate themselves. So I think it's, it's kind of like we know it when we see it. Right. You know, whereas conspiracy theories, sometimes it's perfectly reasonable and rational folks that have kind of gone down this social media rabbit hole, where, you know, basically all of the the algorithms are, are designed to give them more and more information about the seeded grape industry that were as someone with more of a kind of a standalone psychosis or delusion, doesn't have that it's more that they are building things. And this means this, which means this, which means this and it's it's their own logic versus something that they're finding within more established means that that they believe they're doing the correct research, but they've actually gone down these these rabbit holes.   Curt Widhalm  06:53 There's Psychology Today article that is the mind of a conspiracy theorist. This was part of their November 2020. Magazine. We'll link to this in our show notes, you can find those over at MTS g podcast.com. But this article talks about particular personality traits that are more likely to lead to people believing in conspiracy theories. And those things include things like low levels of trust, increase needs for closure, feelings of powerlessness, low self esteem, paranoid thinking, and a need to feel unique. And that these are rather stable personality traits that conspiracy theorists hold across their lifetime. And guides us into probably the crux of this episode, which is, what do we do with this, when these kinds of clients come into our office, when they talk with us about the things going on the coded messages that they might be receiving or spending inordinate amounts of time on the internet with that, it does help to look at the combination of these personality traits as part of how you might want to look at guiding your response.   Katie Vernoy  08:19 And as you were talking about the types of folks I just want to touch on that first, is it when you were talking about the traits it just reminded me of the conversation that we had with Dr. Tereza Capelos on treating political reactionism. And I think that there's there may be some some ties between kind of political extremism and belief in conspiracy theories, if there's some overlap in those those things. So I just wanted to comment on that. I will link to that podcast episode in the show notes as well. But it seems like there could be a perfect storm around this.   Curt Widhalm  08:56 Sure. It makes sense when you've got a low level of trust and the need for closure. Yeah, that if you're not trusting the information that is being presented, and you have that drive for needing things to be in nice, neat little boxes, that that sets up that profile of people who are always going to want just that little bit more, not believing that everything has been quite stated yet. And that leads to the opportunity to start filling in boxes that may not actually be there or partial boxes that kind of exists and haven't. And we've really seen this play out in kind of real time over the last couple of years where people in response to the scientific methods of round the COVID 19 pandemic. Don't follow along the scientific paths. have real time science, which is, oh, we've got an idea. We've tested this, this idea doesn't work, or this idea only partially works. Yeah. And the belief that either that is not factual or that it's absolutely factual and why are they keep looking? They must not be telling us something that is widely prevalent at this point.   Katie Vernoy  10:25 Sure. And I think that there when when we look at a lack of trust, there's societal efforts towards us feeling very decided. Very sure. In what what steps we must take, I mean, the marketing does that this is the answer to your problem purchase this thing. And it's the answer to your problem. And you know, the quick fixes and all those things, the setting with uncertainty, or the setting with, you know, kind of partially conflicting messages or those types of things is not something that we are really encouraged to do by a lot of the content we consume. So it makes sense that there are going to be during times of uncertainty that we want the security of a conspiracy theory, because it feels so definite, and it feels like you know, more than someone else, and it feels like you have the true answers, and so that you're safe, even if all the people around you are not. I think for me, the the part that becomes really hard is that there are if someone brings it into a therapy session, there's this, though, there's a different responsibility that we have, as therapists, let me say it that way, like as a therapist, we have a different responsibility to our clients, then a family member or a family member can just be like, yeah, that's crazy, dude, like, stop it. Whereas with us, as a therapist, there's, there's a responsibility to take care of this client. And there's a responsibility to sustain the therapeutic relationship, there's a responsibility to do and work in service of the client. And so to me, I think the the difficulty becomes, at what point do you push hard back on a conspiracy theory that's very harmful to a client? And at what point do you enter the world of the client and, and help them to kind of process what they're experiencing? I mean, I know we're gonna go into a few different articles that talk about how therapists are managing it. But one of the things and a I think it was a Mashable article that you sent over to be heard that the first paragraph was like, APA doesn't want to actually come on record with how to address conspiracy theories,   Curt Widhalm  12:44 why not? What are they hiding?   Katie Vernoy  12:48 Because they don't want to piss off people that maybe support them, right? And potentially, they don't want to stand up against what a lot of people are saying as conservative rhetoric as conspiracy theory. And we're clearly not saying that we're talking about seeded grapes. But I think that there's that element of, there's some shying away of talking about how do we actually handle this.   Curt Widhalm  13:11 And I think a lot of our tendencies are, this is uncomfortable, we don't want to piss off people. And so therefore, we're just going to smile politely to our clients, and then just return back to whatever's already in their treatment plan. Yeah. But there probably is times to push back on this. Because going back to the Psychology Today article, they point to Timothy McVeigh, the person behind the 1995, Oklahoma City bombing, as having violent fantasies that started out in conspiracy thinking, and, well, those level of things are rare. You did bring up our episode with trees capitalist as far as Yeah, that extremism can form some of the roots in this and it might lead to lower levels of vandalism and harm people destroying seated grapes, because right within this, you probably have a responsibility as a therapist to not just brush things off is his centric sort of hobby thinking. I've seen some literature around that there's kind of three groups of people when it comes to conspiracy theory type stuff is there's those who don't believe in anything that's kind of not scientific at all. There's the people who look at conspiracy theory type stuff with no kind of an entertainment value sort of thing. And then there's the people with the other extreme end who are alienating friends and family. They're staying up late into the night They're missing work because they're not caring for themselves. And it's a continuum. And some of the people who start in some of that entertainment sort of area, start going down the rabbit hole, and potentially do slide into some of this more extreme ideology and rhetoric. And especially with things like the internet, you mentioned the algorithms earlier of ending up in echo chambers, where they're only hearing people from the same viewpoints that end up developing them even further down the rabbit hole.   Katie Vernoy  15:37 And I think when there is that investment, in a conspiracy theory, or a range a, a family of conspiracy theories, and there is a group that forms around it, I think what can happen is that the investment is so high in it being true because of whatever it provides to them. But I think there There can also be an element of others, helping each other to overcome any objections from family members. From other things. I did a little bit of reading around cults and different things like that. And I think once you get a group of conspiracy theorists, I don't know when it becomes a cult, but I think it's something where some of those mechanisms of really getting into someone's head whether it's these algorithms or people and and really creating a space that allows them to disregard everything else in their life and just continue to support this conspiracy theory. I think that becomes more obviously, a mental health issue and a primary mental health issue. I think when we're talking about when do we have to step forward, I think that that knowing how to work with colds and knowing how to help someone, you know, whether it's deprogramming or whatever you want to call it, I think that that's a that's another conversation. That's not what we're talking about today. But when someone is starting to do things that are harmful to themselves to others to property, I mean, at some at certain points, even just as a therapist, we're mandated to take action to make sure that people are not causing harm. But I think the the nuance that that I think you're looking for and I think what we want to talk about today are folks who have these low, low, low level conspiracy theories that they believe in, that could rise to the level of violence or destruction of property, and how we intervene, where we don't alienate our clients. So that they start they keep going down the rabbit hole, but we're not with them, and we can't then take some of those protective action for them and for the people around them.   Curt Widhalm  17:46 One of the biggest signs is people who believe in one conspiracy theory are susceptible to believing in more and part of this is just in social expansion that says you start diving into some ideas that people that you would be conversing with in those areas would also be bringing in other conspiracy ideas. You know, not only is it seeded grapes but now it's seeded watermelons like why did those exist still What didn't we get that figured out? Like   Katie Vernoy  18:23 yeah, I think we've started a whole new conspiracy theory around seeded seeded fruit I'm sure that we can you know if you have the the biological knowledge of why we still have these seated grapes and seeded watermelons, please send us an email at curt@therapyreimagined.com   Curt Widhalm  18:42 only if these are videos by doctors and poorly lit rooms. At least half an hour in length. But in working with these, going to this Mashable article they interviewed Dr. Alan Lipscomb, he is a social worker who has worked a lot with black men grappling with trauma and grief and noticed with many of his clients that conspiracy theories became a reoccurring theme in their sessions really related to things like race related microaggressions that even started with things like the clients talking about, like the Tuskegee experiments, where the government purposely infected black people with syphilis and seeing the effects of these kinds of treatments,   Katie Vernoy  19:43 which is not a conspiracy, which is not - it's true,   Curt Widhalm  19:46 which is true.   Katie Vernoy  19:48 Yes.   Curt Widhalm  19:49 But this helps to push some of the mistrust of the government things   Katie Vernoy  19:55 of course,   Curt Widhalm  19:56 Which not going to blame it Anybody coming from this community with stuff like this in the history of having a healthy mistrust of government? Sure. And even in the response here, I love the acronym for Dr. Lips comms approach to this. It's called the bra approach. Now, I'm cynical enough that this could also be just like, bra, honestly. But this actually is an acronym that stands for bonding, recognition, understanding and healing. And even in the way that we're introducing his work with his particular population, comes with a place of understanding, yeah, I see where these people are coming from I, I agree that some of these interpretations are going to be natural responses. And it takes building trust with these clients, to help them work through some of the mistrust issues. And that includes working on the trust in the therapeutic relationship. Some of my clients who are coming in and talking about the money laundering that goes with CDB grapes right now will continuously kind of still test me with some of the things that they're talking about, Oh, you must not believe in seeded grapes at all that, you know, I hear you, I've, I've seen some seeded grapes before, like, these are things that you're not going to get anywhere with these kinds of clients by directly challenging them with your own beliefs. Otherwise, you're going to be, you know, seen as in on the conspiracy yourself.   Katie Vernoy  21:45 Yeah. Yeah, I guess the thing that I want to point out because I think with the the example, in the Mashable article, I think, the the other element of the conspiracy theories were, you know, kind of based in the reality of the medical harm against the black community, folks were believing that there were other things happening during the COVID 19 pandemic and with vaccines. So, to me, I think, the difficulty in sorting out, is it a conspiracy theory? Or are people actually out to get you -  I think that part is really important, especially in marginalized communities. I think starting from a place of this as a conspiracy theory, can be very harmful. And so and you may not know that it's a conspiracy theory until you actually have a chance to sit with them and understand and so my thought process is, when you actually take the time to understand someone's perspective, understand the oppression that they're feeling, understand the fears that they have, and trying to sort out how is this impacting you? What evidence can you get for and against, and I think there's a there's an issue with going too much into the evidence with someone that's truly in the in thrall to a conspiracy theory, I think that there has to be a space that it may not be a conspiracy theory, it may be that they're actually being oppressed and marginalized and or people are out to get them. And so I guess I just wanted to comment on that. But I think that there's a need I agree a need for trust within the relationship so that you can truly understand the experience and understand where it's, it's going from my reality to a conspiracy theory.   Curt Widhalm  23:30 Part of what the COVID 19 pandemic has done is it's forced people away from being around people with differing viewpoints in their jobs in public. And therefore they are spending more time online with people who are sharing the same beliefs that you know that algorithm stuff that Katie was referring to earlier. Part of getting into the trusting relationship with your clients, also serves a very long term goal of helping to provide a space for them to think critically about different viewpoints and even potentially, opening up to not hearing from some of the heads of some of the theories that are being driven. We've seen this, we've seen evidence of this being successful with things like the D platforming of people like Alex Jones, that when their messages are no longer allowed on places like Twitter or Facebook or this kind of stuff. The people who have followed them, their rhetoric also becomes less extreme when it comes to some of these conspiracy theories. So keeping in mind that this is a slow and deliberate building of trust with clients means that you really have to watch your own reactions and sessions. You can't be rolling your eyes, you can't be necessarily avoiding conversations about these kinds of things. But having compassion for the starting place of where these clients are coming from, so that way, when they are ready or willing to take that next step with you, that you are seen as a trusted figure in their lives,   Katie Vernoy  25:24 how would you differentiate addressing a conspiracy theory with a client versus addressing a a fear that is gone to a slightly irrational place?   Curt Widhalm  25:38 I don't know that I would approach them much differently. That, at least as far as how I'm hearing, what you're saying, with some of the instances that have come up in my practice, is, in my general response, you know, I'll provide some curious space for Oh, I haven't heard about that, that does come from maybe a more neutral place that allows for me to be a curious thinker of Well, I wonder about, fill in the blank, you know, I wonder about, you know, seated oranges. So those things still exist. Or, you know, something that might be a curious challenge to it that does invite looking at things from from different viewpoints as team members that you would also do with clients who do present with irrational fears, irrational beliefs. Yeah. You know, Never have we ever, you know, just confronted a client in session, been, like, hey, that that irrational fear you have? How about just thinking about it differently? Like, if that was the way things worked, our grad school training would be a lot shorter, but it doesn't work that way. So it was   Katie Vernoy  26:57 it, there isn't Rational Emotive therapy? Isn't that kind of like, that's irrational? Like, isn't that isn't that actually a tried and true therapy.   Curt Widhalm  27:07 I love that Aaron Beck can just yell at clients that they're wrong and that, but it, but even even within REBT, there's the trust in this is somebody you know, you're not just yelling, that's your rational in the first session. You're not just there arguing with clients. And part of this is really understanding that you might get 45-50 minutes out of a week with a client, and they're spending eight hours a day online listening to Joe Rogan or   Katie Vernoy  27:43 the seeded grape industry.   Curt Widhalm  27:45 Yeah.   Katie Vernoy  27:47 I think the thing that I'm I'm sensing from the way that you work as well as this is the way that I work is that there is a connection with the client that then allows for some exploration of what's going on. I think this is another distinguisher, between conspiracy theory versus kind of an irrational fear within a normal kind of anxiety presentation is, is that folks who are anxious think that their anxiety is too high for what they're experiencing. And it seems like folks who with a conspiracy theory feel like they're not afraid enough that this is super dangerous. And so I think, really trying to sort through where someone sits there and being able to honor what is occurring, I think is really important. I think the that part that can get very confusing, I think, you know, and this has happened with me with some of my conspiracy focused psychosis that I've seen, but also I think, with folks who are just very intelligent people that believe things that have been put forward as conspiracy theories, I think what ends up happening is, is I try to connect with the pieces that feel like they are, I don't know what the right word is common ground maybe, and trying to understand the impact of of what they believe on how they behave on their relationships, trying to sort through it from that angle. I think it becomes challenging when there's just such an interweaving of reality and conspiracy theory where you can't just you can't yell at them. It's irrational because it's not completely irrational. There's it's so nuanced and there's so many little pieces that the conversation has to be very rich. And so it goes back to that element of it really has to come from a very strong relationship. And and we need to be able to stay in relationship and and the more we push back, the less light someone in our in our office is going to be able to hang with us if they've really invested in the conspiracy theory.   Curt Widhalm  29:55 This Mashable article has interviewed Dr. Ziv Cohen, the founder and medical director of principal psychiatry in New York City. And Dr. Cohen really calls out that the professional organizations do need to be more involved in providing some guidance in this area. And I can understand why the professional organizations are not. That's because many therapists probably also believe in some conspiracy theories.   Katie Vernoy  30:30 Okay, here we go, here's where we're gonna get all of the feedback on the episode.   Curt Widhalm  30:34 Well, and as a professional organization, we know that their first job duty is to make sure that the continuance of the professional organization exists. And if they are alienating their members, that is potentially a drop in membership, and therefore, they don't want to alienate members. So, even being able to wade into this, Dr. Cohen calls for the professional organizations to take more of a stance and guidance, you know, at least use something like, you know, seated grape industry, as an example, we don't need to necessarily go out and address things. But we do need to work on training clinicians on how to recognize when it does progress from seated grapes to harm and potentially identifying those who are most vulnerable to be acting out violently. And it is a continuum and a slippery slope. So call your professional organizations tell them your thoughts on seated grapes. Don't put any context into it, but make seated grapes happen.   Katie Vernoy  31:52 So I want to actually push back on one of the things that you said, as a profession. Is it not important for us to comment on conspiracy theories that are psychologically harmful to the populace?   Curt Widhalm  32:07 Absolutely, we should.   Katie Vernoy  32:09 Okay, so why would you then say that professional organizations shouldn't address that, but should address how therapists   Curt Widhalm  32:16 I'm saying, cuz I'm, I'm picturing the heads of these organizations and what their response is the pearl clutching that they will have in looking at their membership, and giving them an out to be able to walk the line in between what they should be saying and how they can package it nicely to actually start presenting this information.   Katie Vernoy  32:40 So you're trying to get to a place where they would actually do something versus actually commenting on what they really should be doing.   Curt Widhalm  32:47 Exactly, yes. So   Katie Vernoy  32:49 alright, that's fair. Yeah.   Curt Widhalm  32:51 Check out our show notes at MPs G podcast, join our Facebook group, the veteran therapist group, follow us on our social media and continue to drink the modern therapist Kool Aid. And until next time, I'm Curt Widhalm with Katie Vernoy.   Katie Vernoy  33:07 Thanks again to our sponsor, trauma therapist network.   Curt Widhalm  33:11 If you've ever looked for a trauma therapist, you can know it can be hard to discern who knows what and whether or not they're the right fit for you. There's so many types of trauma and so many different ways to heal. That's why Laura Reagan LCSW WC created trauma therapist network. Trauma therapist network therapist profiles include the types of traumas specialized in population served therapy methods used, making it easier for potential clients to find the right therapist who can help them. Network is more than a directory though it's community. All members are invited to attend community meetings to connect consults, and network with colleagues around the country.   Katie Vernoy  33:47 Join the growing community of trauma therapists and get 20% off your first month using the promo code Mt. SG 20 at Trauma therapist network.com Once again that's capital MTS G the number 20 at Trauma therapist network.com   Announcer  34:04 Thank you for listening to the modern therapist Survival Guide. Learn more about who we are and what we do at MTS g podcast.com. You can also join us on Facebook and Twitter. And please don't forget to subscribe so you don't miss any of our episodes.   Curt Widhalm  35:49 If you're still listening, the code is 62 160 1600  

The Lucky Mojo Hoodoo Rootwork Hour is a real, live call-in show where the general public gets a chance to ask about actual problems with love, career, and spiritual protection, and we recommend and fully describe hoodoo rootwork spells to address, ameliorate, and remediate their issues. We begin this special Oracle Hour show with a Discussion Panel focussed on the topic of Rune Divination. You will learn a lot just by listening -- but if you sign up at the Lucky Mojo Forum and call in and your call is selected, you will get a free consultation from three of the finest workers in the field, cat yronwode, ConjureMan, and a special guest from AIRR, Angela Marie Horner. Sign up before the show to appear as a client! Post at the Lucky Mojo Forum at: https://forum.luckymojo.com/lmhrhour-free-readings-november-7-2021-oracle-hour-rune-reading-t95647.html Then call in at 818-394-8535 and dial '1' to flag our Studio Board Operator that you want to be on the air! We select new client sign-ups first and then call-back sign-ups. Call in right when the show begins and listen via your phone. Message the Announcer or the Studio Board Operator ("Lucky Mojo Curio Company") in chat to let them know you're available. The link above will also be the location of the show's CHAT LOG once it is posted, so you can follow along as you listen.

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App Store pricing, device repairability, Beats Fit Pro Andy's Opera costume Apple releases Beats Fit Pro HomePod mini colors are now available 'Your system has run out of application memory' error caused on Macs by Mail and other apps Application memory error affecting many Mac apps; Intel as well as M1 Apple to Start Offering iPhone XR as Loaner Device During Lengthier Repairs iFixit reveals full MacBook Pro teardown showing improved repairability Notability goes Freemium Apple reportedly cuts iPad production to increase iPhone shipments Apple gains two big subscription podcast partners Picks of the Week Andy's pick: Adobe Lightroom Mobile Rene's pick: Peachy Merch Mikah's pick: Satechi USB-C Hybrid Multiport Adapter Alex's pick: Cinema 4D r25 & Studio Technologies, Inc. Model 205 Announcer's Console Hosts: Alex Lindsay, Rene Ritchie, Andy Ihnatko, and Mikah Sargent Download or subscribe to this show at https://twit.tv/shows/macbreak-weekly. Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Sponsors: wealthfront.com/macbreak UserWay.org/twit Coinbase.com/MACBREAK

App Store pricing, device repairability, Beats Fit Pro Andy's Opera costume Apple releases Beats Fit Pro HomePod mini colors are now available 'Your system has run out of application memory' error caused on Macs by Mail and other apps Application memory error affecting many Mac apps; Intel as well as M1 Apple to Start Offering iPhone XR as Loaner Device During Lengthier Repairs iFixit reveals full MacBook Pro teardown showing improved repairability Notability goes Freemium Apple reportedly cuts iPad production to increase iPhone shipments Apple gains two big subscription podcast partners Picks of the Week Andy's pick: Adobe Lightroom Mobile Rene's pick: Peachy Merch Mikah's pick: Satechi USB-C Hybrid Multiport Adapter Alex's pick: Cinema 4D r25 & Studio Technologies, Inc. Model 205 Announcer's Console Hosts: Alex Lindsay, Rene Ritchie, Andy Ihnatko, and Mikah Sargent Download or subscribe to this show at https://twit.tv/shows/macbreak-weekly. Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Sponsors: wealthfront.com/macbreak UserWay.org/twit Coinbase.com/MACBREAK

App Store pricing, device repairability, Beats Fit Pro Andy's Opera costume Apple releases Beats Fit Pro HomePod mini colors are now available 'Your system has run out of application memory' error caused on Macs by Mail and other apps Application memory error affecting many Mac apps; Intel as well as M1 Apple to Start Offering iPhone XR as Loaner Device During Lengthier Repairs iFixit reveals full MacBook Pro teardown showing improved repairability Notability goes Freemium Apple reportedly cuts iPad production to increase iPhone shipments Apple gains two big subscription podcast partners Picks of the Week Andy's pick: Adobe Lightroom Mobile Rene's pick: Peachy Merch Mikah's pick: Satechi USB-C Hybrid Multiport Adapter Alex's pick: Cinema 4D r25 & Studio Technologies, Inc. Model 205 Announcer's Console Hosts: Alex Lindsay, Rene Ritchie, Andy Ihnatko, and Mikah Sargent Download or subscribe to this show at https://twit.tv/shows/macbreak-weekly. Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Sponsors: wealthfront.com/macbreak UserWay.org/twit Coinbase.com/MACBREAK

App Store pricing, device repairability, Beats Fit Pro Andy's Opera costume Apple releases Beats Fit Pro HomePod mini colors are now available 'Your system has run out of application memory' error caused on Macs by Mail and other apps Application memory error affecting many Mac apps; Intel as well as M1 Apple to Start Offering iPhone XR as Loaner Device During Lengthier Repairs iFixit reveals full MacBook Pro teardown showing improved repairability Notability goes Freemium Apple reportedly cuts iPad production to increase iPhone shipments Apple gains two big subscription podcast partners Picks of the Week Andy's pick: Adobe Lightroom Mobile Rene's pick: Peachy Merch Mikah's pick: Satechi USB-C Hybrid Multiport Adapter Alex's pick: Cinema 4D r25 & Studio Technologies, Inc. Model 205 Announcer's Console Hosts: Alex Lindsay, Rene Ritchie, Andy Ihnatko, and Mikah Sargent Download or subscribe to this show at https://twit.tv/shows/macbreak-weekly. Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Sponsors: wealthfront.com/macbreak UserWay.org/twit Coinbase.com/MACBREAK

App Store pricing, device repairability, Beats Fit Pro Andy's Opera costume Apple releases Beats Fit Pro HomePod mini colors are now available 'Your system has run out of application memory' error caused on Macs by Mail and other apps Application memory error affecting many Mac apps; Intel as well as M1 Apple to Start Offering iPhone XR as Loaner Device During Lengthier Repairs iFixit reveals full MacBook Pro teardown showing improved repairability Notability goes Freemium Apple reportedly cuts iPad production to increase iPhone shipments Apple gains two big subscription podcast partners Picks of the Week Andy's pick: Adobe Lightroom Mobile Rene's pick: Peachy Merch Mikah's pick: Satechi USB-C Hybrid Multiport Adapter Alex's pick: Cinema 4D r25 & Studio Technologies, Inc. Model 205 Announcer's Console Hosts: Alex Lindsay, Rene Ritchie, Andy Ihnatko, and Mikah Sargent Download or subscribe to this show at https://twit.tv/shows/macbreak-weekly. Get episodes ad-free with Club TWiT at https://twit.tv/clubtwit Sponsors: wealthfront.com/macbreak UserWay.org/twit Coinbase.com/MACBREAK

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Therapists Shaming Therapists An interview with Katie Read about therapists shaming each other when they raise their fees or start playing bigger. Curt and Katie talk with Katie about the puritanical culture within the therapist community that leads to group think, public shaming, and milquetoast messaging to mitigate their fear that anything different will be attacked. We look at reasons behind this (jealousy, guilt, shame, and moralism) as well as what therapists can do to step outside of this culture to create more success.   It's time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age. Interview with Katie Read, LMFT, Six Figure Flagship Katie takes lessons from her nearly-20 successful years in the field to help clinicians grow...then OUTgrow...their practices. Immediately upon licensure, Katie was made Director of a large Transitional Aged Youth program in Oakland, CA. Later, she was recruited to Direct one of Sacramento's largest Wraparound Programs, and from there she moved into the role of Director of Clinical Supervision, personally supervising 40+ interns towards licensure. Concurrently, Katie had private practices in multiple cities, taught graduate psychology students, and wrote and created therapist training materials. Katie is also a special needs mom and loves helping other moms tune into their own intuition and lead their best-possible lives by taking the sometimes-scary leap into following what's best for them, deep down. She is the creator of: The Clinician to Coach® Academy, The Clini-Coach® Certification, and the Six-Figure Flagship™ Program. She's a little bit obsessed with helping therapists get profitable doing the creative, out-of-the-box, authentic work you're called to do! In this episode we talk about: How therapists are treating each other The concept of trolling, piling on, shame The Article in the Atlantic – New Puritans – and the concept of the illiberal left How identity plays a role and the group dynamics within therapist Facebook groups The shaming related to increasing your fees Katie Read's origin story as an on the street social work The value placed on sacrifice and avoiding guilt for the difference in privilege when working with clients who are impoverished Socially-prescribed perfectionism, self-imposed perfectionism The fine line about what is acceptable to charge or make as a therapist Cancel culture and the lack of allowance for errors Echo chambers, factions, and exclusion The fear of dissenting opinions The low context of the internet paired with the high context nature of a therapist's job Milquetoast messaging to avoid getting attacked Dialing down authenticity to fit into what is acceptable Challenging our financial mindset Cultural and societal factors that frame us as cheap labor The seeming requirement for therapists to suffer in order to understand our clients The reality of therapists as business owners Therapist guilt for “earning money” Feminized professions and the expectation of doing things out the goodness of our hearts Rapidly changing social rules versus entrenchment in what has been How this identity shift is spilling over into real life Jealousy, guilt, and shame, and moralism The best therapists have the worst impostor syndrome How to navigate when you're a therapist going against the grain The importance of every therapist doing their own money mindset work Our Generous Sponsor: Trauma Therapist Network Trauma is highly prevalent in mental health client populations and people are looking for therapists with specialized training and experience in trauma, but they often don't know where to start. If you've ever looked for a trauma therapist, you know it can be hard to discern who knows what and whether or not they're the right fit for you. There are so many types of trauma and so many different ways to heal. That's why Laura Reagan, LCSW-C created Trauma Therapist Network.  Trauma Therapist Network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work and what they specialize in, so potential clients can find them. Trauma Therapist Network therapist profiles include the types of trauma specialized in, populations served and therapy methods used, making it easier for potential clients to find the right therapist who can help them.  The Network is more than a directory, though. It's a community. All members are invited to attend community meetings to connect, consult and network with colleagues around the country. Join our growing community of trauma therapists and get 20% off your first month using the promo code:  MTSG20 at www.traumatherapistnetwork.com.   Resources mentioned: We've pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Katie Read's program: Six Figure Flagship Article in the Atlantic – The New Puritans by Anne Applebaum   Relevant Episodes: Therapist Haters and Trolls Advocacy in the Wake of Looming Mental Healthcare Workforce Shortages In it for the Money? Overcoming Your Poverty Mindset (with Tiffany McLain) Not Your Typical Psychotherapist (with Ernesto Segismundo) How to Overcome Impostor Syndrome to leave your Agency Job (with Patrick Casale)   Connect with us! Our Facebook Group – The Modern Therapists Group  Our consultation services: The Fifty-Minute Hour Who we are: Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making "dad jokes" and usually has a half-empty cup of coffee somewhere nearby. Learn more at: www.curtwidhalm.com Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt's youthful energy, so that she can take over the world. Learn more at: www.katievernoy.com A Quick Note: Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We're working on it. Our guests are also only speaking for themselves and have their own opinions. We aren't trying to take their voice, and no one speaks for us either. Mostly because they don't want to, but hey.   Stay in Touch: www.mtsgpodcast.com www.therapyreimagined.com Our Facebook Group – The Modern Therapist's Group https://www.facebook.com/therapyreimagined/ https://twitter.com/therapymovement https://www.instagram.com/therapyreimagined/   Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano http://www.crystalmangano.com/   Transcript (Autogenerated) Curt Widhalm  00:00 This episode is sponsored by Trauma Therapist Network.   Katie Vernoy  00:04 Trauma therapist network is a new resource for anyone who wants to learn about trauma and how it shows up in our lives. This new site has articles, resources and podcasts for learning about trauma and its effects, as well as a directory exclusively for trauma therapists to let people know how they work, and what they specialize in so potential clients can find them. Visit trauma therapist network.com To learn more,   Curt Widhalm  00:27 Listen at the end of the episode for more about the trauma therapist network.   Announcer  00:31 You're listening to the modern therapist Survival Guide, where therapists live, breed and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Kurt Wilhelm and Katie Vernoy.   Curt Widhalm  00:47 Welcome back modern therapists, this is modern therapist Survival Guide. I'm Curt Widhalm with Katie Vernoy. BLEEP you! This is the podcast where we talk about all things therapists, therapy related, therapist communities. And we are talking about the ways that we treat each other and a lot of this happens in the online groups. You know who you are. And   Katie Read  01:20 But do they?   Curt Widhalm  01:22 I think they do. Well, helping us here in this conversation today coming back to the show. Our good friend Katie Read. So before we before we start shaming the shamers.   Katie Vernoy  01:37 For shame!   Curt Widhalm  01:39 Tell us a little bit about yourself and what you're bringing into the world.   Katie Read  01:44 Hi, I'm Katie Read. Thank you for having me back. I missed you guys. We haven't been around here for a while.   Katie Vernoy  01:50 I know!   Katie Read  01:51 Good to be back. Although I did get to see you in person at the conference recently, which was amazing. So anyway, you can find me over at six figure flagship dot com. I do. One of the things that plenty of therapists like to shame, which is encouraging therapists who are creative who had that little spark that maybe someday they want to outgrow the therapist office, I... whispering under my hand here, I help them do that. Lest all the shamers jumped out at us. That's what I do. But I have like you been very active in therapists groups over the last couple years, and been often just shocked by the level of shaming that can happen in these groups. And it's so funny, I don't know about you guys. I've told this to other people, non therapists, like neighbors, friends just being like, Yeah, it's amazing. Those groups, people are astounded to hear that therapists would shame one another like it would never occur to them that therapists would be because they think of us all as being nice and wonderful and accepting and loving and caring and empathic, and all of these things. And I know we all three have had conversations in the background, like why does that fall apart on the internet, and I really do think it's just on the internet. It's not in person. It's just on the internet, but on the internet and therapists group. So not that I have any grand answers for this. But I'm super interested in this conversation today.   Katie Vernoy  03:18 We've talked about this in some ways before, and we'll link to those episodes in the show notes that we've got a therapist, haters and trolls. And there's a couple others, I'll look at them when I'm getting ready to put this together. But to me, I think the biggest thing that I see that that has always been shocking to me is the the piling on, that happens at someone put something out there, it becomes given that that is wrong and bad. And somebody has an opinion that this is wrong and bad. And then there's the defenders, but then there are the piler on-ers, is that is that a word? The people that then cosign on this negative information. And then all of a sudden, it's like the snowball effect. And there's like, hundreds of comments, and you are horrible and all of this stuff. And I think that there is an element of this that I think we do want to call people out when they're doing things that are harmful. I think the the criteria for what is harmful sometimes feels a little bit wiggly to me   Curt Widhalm  04:26 I kind of started looking at this more from just kind of a an academic approach. And what sparked this, for me was an article in The Atlantic called the new Puritans by Anne Applebaum. And it's an incredible article, we'll link to it in the show notes. But it starts to talk about the illiberal left, which many therapists politically identify in kind of this political compass of the left side. And what happens in echo chambers like there pice groups is that it becomes many people coming with a desire for positive social change and social mores are changing that. We've seen this happen not only in society, but in our field over the last 20 years. But what happens seemingly is, we're developing this this collective identity in these groups that becomes part of our own identities and seeing other people acting even slightly different than how we would act ends up becoming almost there's harm to our own self identity that needs to be processed and spoken out against when it comes to things like, hey, I want to raise my fees on my clients by $5 per session.   Katie Read  05:51 I find this one absolutely fascinating because I, I don't think I've ever seen a post go by in a group where a therapist has said, Hey, I'm thinking about raising my fees, and have not gotten at least some very heavy negativity thrown their way. Which is so fascinating to me. Because if you step back and you look at any career on Earth, we assume about every human being in the world, that you will always be on a quest to kind of step up to the next level in your career step up to the next level in your income. This is understood if anyone tells you they've gotten a raise, they've gotten a promotion, you say congrats, that's great. When therapists who are self employed, who have only themselves to answer to they are their own bosses, and when they say it's time for my yearly raise, and I have earned my yearly raise this year, and they attempt to give it to themselves, what do the therapist communities often do? Jump in with really crazy stuff really crazy? Oh, I don't know, I didn't get into this career to make money. I couldn't imagine putting my clients under that kind of strange, just really, really deeply shaming words coming at them. And I find it fascinating. You know, and I'm not exactly sure where it comes from. But it's interesting, because in prepping for this podcast, I was thinking about my early days as an intern and, and I do wonder, probably, at least for me, this was part of it. I spent many years even before I went to grad school, I was doing social work type roles in very, very, very impoverished areas. And then during grad school, I was working with foster kids. And then after grad school, I was an on the street social worker in inner city, Oakland, with teenagers and young adults, most of whom were homeless, or they were sex workers or drug addicts, gang members, like Oh, terrible, really difficult lives, right, like really terrible life situations. And I was dead broke, that job paid next to nothing, it was an internship job. And in a way, coming home to my crappy apartment, where people got mugged right outside in broad daylight and eating my ramen noodles, because that was all I could afford. I didn't have to feel so guilty going into work the next day, because my life was certainly better than my clients lives were at that time. But it was still rough, like things were still rough at my end. And I wonder if I remember at the time, I would say to people, I would say, this is the hardest work you can imagine doing. But if you can do it, you just have to do it. Because these people just need the help. And they need the support. And they need people on the street. And I had this very grand idea of what it was to be an on the street social worker doing that kind of work, and, and staying poor for it. And oh, it took me a long, long time to realize that I had to put the air mask on myself first, you know, like on the plane, like it took me a very long time to come to that change. But I wonder if some part of that for a lot of us does start because I think many of us do start in those types of jobs, those types of internships where you're seeing such poverty, you're seeing such difficult lives and you do feel a guilt around that.   Curt Widhalm  08:57 Even in your story here. Part of what I'm hearing is you lead that off with this is unique to therapists. So you're already framing this as part of therapist identity means that you have to do these certain things. Look at the shame that we put on people who go straight from grad school into private practice, like they are bypassing part of that identity. And, you know, the echoes of the criticisms is, well, that's such a privileged place to come from that you didn't have to go through this with all of these other clients. And a big part of that is in this identity becomes this thing called socially prescribed perfectionism that you must do this because what you're doing reflects on me and in combination with socially prescribed perfectionism comes this self imposed perfectionism that I must act this way. Yeah. And if other people whose identities reflects on the same way as mine And that's not how I see myself doing, I have to deal with that internal conflict, and it's much easier to tear you down than it is for me to wrestle with. All right, you do you and I'll do me and we'll both potentially help out the people that we're best suited to help out with.   Katie Read  10:19 That's so interesting. And it's so true. And I wonder. So like, I'm thinking about the people who I did know from grad school who came from different backgrounds who did go straight into private practice and whatnot. And you do wonder, do they feel any of that guilt? Do they carry any of that with them? Does that bounce off of them that they're like, what I was doing exactly what you just said, Curt, like what I was meant to do, I was helping the people I was meant to help. This is where I'm well suited. It's just interesting.   Katie Vernoy  10:45 And it's, it's something where this idea of perfectionism what what resonated for me was this, it's very thinly defined. And not only have I heard the, the negative backlash around charging a high fee, and and I don't know, necessarily that I've seen a lot of the negative feedback with I'm raising my fee by $5 Next year, but it's anybody that has a premium fee gets roasted. And anyone that talks about charging very little or being on insurance panels, also gets roasted, because you're undervaluing the profession, you're, you're making it harder for me to make money. And so there's this really fine line of what's acceptable,   Katie Read  11:27 Acceptable, huh.   Katie Vernoy  11:28 And so this this perfectionism around, I can't, I can't make too much, but I also can't charge too little. It just it feels very crazy making. And I think this, this notion of we're trying to validate our own identity through making everyone else be like us, or like, what the collective has decided is okay, feels kind of scary.   Curt Widhalm  11:57 And the extension of this goes beyond just, you know, the parent comments in some of these, these groups, that there becomes almost this effort to cancel people across multiple posts, that there seems to be so little room for error, and especially in late, like I said, social mores changing of, you know, a lot of the things that I see is, you know, not doing the emotional work or not doing the education work for other therapists who are potentially asking questions around things like critical race theory and involving, you know, wonderment about communities that they might not have experience with that. While there is validity on both sides is I've seen some of this extension go across, you know, bringing up these kinds of arguments across separate posts across separate days, weeks, even months, that his efforts towards this cancel culture esque type thing that serves to only make this problem even worse, by creating even stronger echo chambers of we're only going to listen to people who think exactly like us. And what ends up happening is we get these factions of, you know, well, here's the group of like minded people who sit over here. And here's the group of like minded people who sit over here, and here's the people who are okay with microwaving fish in the office, and they're okay in their own corner. But then it just makes it to where it's uninviting for anybody to have any kind of a dissenting opinion. Because and this is particular to the internet groups that you brought up. Here at the beginning, Katie, internet culture is very, very low context. And therapists are very, very high context people. This is a sociological phenomenon, that high context is understanding people where they're coming from, you know, we spend years studying how to get the high context of our clients. And we're used to communicating with people in this very, very high context sort of way. And then you get like one paragraph on a Facebook post to be able to try and explain something to somebody else. And it's just this very, really low context like fast moving group of people who kind of opt in and opt out but aren't consistently there. That makes it really enticing to pick on well, you're missing all of these high context things that just it's critical, and it's something that because of internet culture, therapists aren't used to having to receive information in that low context sort of way in embracing how we communicate online. Mind. In other words, we think that we're really smart in some areas of our life, and therefore all areas of our life should be really smart. But the internet is not that place.   Katie Read  15:11 And the internet dumbs us down. Well, it's interesting. And a moment ago, I just lost my train of thought you had said something a moment ago that   Curt Widhalm  15:18 I do that to people.   Katie Vernoy  15:20 Just keep talking, it's   Katie Read  15:22 10 minutes back. There was something I just lost it   Katie Vernoy  15:27 Well, keep thinking because I had something you know, a few minutes back when you were talking about your, your experience as kind of an on the on the streets, social worker and having to overcome that self imposed identity around if I am not so privileged, I don't feel guilty going to work. How did you work to overcome that? Because I think we're looking at being shamed for it. And and you did it within that culture, like I know, that I would imagine you have probably been shamed for for what you do, as you know, a six figure flagship even having that is so money title. So right, having the right so and so actually, how do you how have you gotten through it, I guess.   Katie Read  16:12 Yeah. And I can tell my story, but it's interesting, because you just reminded me of what Curt had said that I had wanted to comment on. Because it's all related. You had to Curt the end. And even Katie had said previously, there's this very narrow band of what kind of therapists are willing to accept as appropriate. And because the echo chambers are loud, and because the pile on culture is intense, within therapists groups, what happens is people are terrified to speak. And so we end up with very very milquetoast messaging. That doesn't challenge that doesn't potentially disagree, we end up with people who only want a message in ways that they will not be attacked for because as we all know, it's very painful and scary. If someone's coming at you online, some stranger online and other people are piling on and everyone would love to avoid ever having that situation. So we dial down what is true, what is authentic, what is important, we dial it down into what we hope will fit this narrow little brass band of appropriateness. And it's interesting like us, for me, it took me years and years. I mean, I eventually went from we eventually moved my husband and I to a different town, I opened up a small private practice. And it's funny, I was one of those therapists, and I was in California, where therapy rates are high. But I was the person where I was charging $90 an hour. And I was the person who set it like this, when a new client came in or called me and said, What's your fee? I went? Well, it's 90. But I can slide I can slide. What do you need, I mean, I can do whatever you need, I can really I get whatever you need, whatever you need, like that was me all the time. Because again, I was still carrying this guilt, about even charging that much and feeling like well, I couldn't even afford to go see me for therapy. So how can I think somebody else's, I was very much in my clients pockets. And what was really interesting was, I had been in this office for a while, you know, I rented my time other people came in and out. And there were several interns in the office, all supervised by this one supervisor. And I was speaking with one of the interns when we were crossing paths one day, and at this point, I had been a licensed therapist. For years, I had worked my way through community mental health up to being a program director, I had taught grad school, I had done all these things. And I was still charging this low rate because of my own internal money issues. And this intern, I don't know how we got on the subject. But she said, Oh, yeah, our supervisor now she was still in grad school. There's a person in her first year of grad school, an intern seeing clients. And she said, Well, our supervisor won't let us start any lower than 125 as our hourly rate, we're not allowed to slide under that they were private pay 125 for the interns. And my mind was blown. That here I was with years of experience behind me years of training behind me. And I it really in that moment hit me I was like I am doing this wrong. I am absolutely doing this wrong. And I need to start working on this. And some of it was working on my money mindset, honestly, for me, doing what I eventually did and wanting to outgrow the office that was motivated by different things like we moved states and then I wasn't licensed for a year while I went through the licensure process in a new state. So my path out of the office and outgrowing the office was sort of organic. It wasn't a pre plan type of thing. It just happened that I moved into coaching and ended up loving it. But within the coaching world, you really really get challenged very quickly on your financial mindset. And you really actually learn very quickly that the norm in the rest of the world is if you bring great value into someone's life, you are well paid for it. And we therapists continually underestimate the great, great, transformative, wildly important value that we bring into people lives. And whether you choose to continue to do it in the context of therapy or to write a book, or to go on a speaking tour to do any of the number of things that therapists can go out in the world, and do, we do by virtue of our passion, our education, all of these things, we bring great value we bring about great transformation in people's lives, and in most of the rest of the world, that would be naturally richly rewarded. But because of sort of the culture, and I honestly think part of it is just the culture of how government even is set up that we need to be able to have cheap labor to go out and work with the people who need help the most. And so many of us, like we said, started off in community mental health in some form, or in schools, which are very underfunded just, we start off as sort of cheap labor. And it's hard to get out of that mindset that we should always remain just cheap labor, or that what we do is not that highly valued in society where, of course, I don't know about you, I remember, every therapist I've had, and I remember them dearly. And they were hugely impactful at those times in my life, and every one of your clients and everybody out there listening. It's the exact same way, you're hugely impactful.   Curt Widhalm  21:14 You know, as I'm listening to this, and going back to that piece by Anne Applebaum, she makes mention of The Scarlet Letter as kind of this this parallel of what's going on with the liberal left. And the thing about this is one of that one of the major themes from the scarlet letter is the the priest who impregnates Hester, I'm forgetting his name right offhand. But he is seen as more virtuous because his sermons have so much empathy, from his own sins that there's almost this parallel what's going on with the groups here that we're seeing of like, we have suffered this injustice. And therefore we're better at what we do in relating to our clients, because we've done this. And especially when it comes to things like privilege and fees in this kind of stuff. It's like, you're, you're not able to relate to your clients as well. Because you haven't done this suffering, and you haven't done this, and therefore, you must suffer in order to be able to be a better therapist.   Katie Read  22:21 Yeah, yeah. Yeah, that's so interesting, isn't it. And so as some of that just coming down, is that just back to that therapist skills, we were talking just today, I had my meeting with my folks in my clinic coach, six figure flagship, and we were talking, there's one therapist, she's putting an unbelievable amount of work into an event that she's producing just probably hundreds of hours of her labor is going into this work. It's a passion project. She's so excited about it. And she came to the group and she said, I'm donating all the proceeds to charity. And I was like,   Katie Vernoy  22:56 Oh, wow.   Katie Read  22:59 And so we really, we took it apart a lot, like we coach through it a lot in the group. And today in our meeting, and I was, like, you know, like part of this here is that we are also business owners. And when you put in hundreds of hours of unpaid labor on something, you actually need to retain at least the majority of your profits, so that you can reinvest them into your own business, so that you can stay afloat, have savings of money for like all the things that we need to do. But really, to me, what I was hearing was therapist skill was I don't want it to look to anyone, like I'm trying to actually make any money. I want it to look like out of the goodness of my heart, I'm putting on this big event for all my fellow therapists to learn and grow. But God forbid someone think I might earn money from doing this. Yeah. And so it's just it was fascinating, because I don't think there's any other profession, where they would even consider for a minute giving every single bit of all this labor, all this unpaid labor straight to charity, without a second thought, maybe with many second thoughts, but feeling like this is what I should do.   Katie Vernoy  24:05 Yeah, yeah, I just I think about teachers, I think about oftentimes nurses, part of it is kind of feminized professions do have this this impact where the majority of the folks in those professions are non male. And so there is an expectation, this is something we should be doing out of the goodness of our hearts. And it seems very mercenary if we would ask for money for it. You know, there are, you know, during the pandemic, these poor teachers, were finally getting recognition for what they actually do for folks' kids. But as soon as you know, even even well into the pandemic I started to get because I work with some teachers. I was started hearing that people were complaining that the teachers weren't doing enough and we're paying their salaries and why aren't they doing enough? And it's like, whoa, you know, or if they go on strike that is just heartless. So it's heartless. And it's kind of like would you work for the salary that they work for? And then we've seen the same with the Kaiser therapists. That was one of the things that happened. We see the same with nurses.   Curt Widhalm  25:11 I mean, our episode, recently where we talked about, you know, let's just throw more Subway sandwiches at therapists,   Katie Vernoy  25:19 workforce shortage at episode that we just put up.   Curt Widhalm  25:21 Yeah, it's just it's throwing more Subway sandwiches at therapists because, you know, how dare you ask for money. And part of this is as a field that our median age is higher than many other fields. And that anytime that we have a field that has rapidly changing social rules to it, it makes it to where, especially with fields that are older, like ours, the entrenchment becomes a lot more rigid. And so I think that that's contributing to part of this, too, is that there's, there's this almost cultural battle that we're facing within our field that is leading to a new identity. And if we're honest about it, we contribute to that a lot here in the podcast, we do call out things that we don't like, including calling out other therapists calling out other therapists. So we do encourage you to let us know your thoughts and feelings on this publicly in any of the therapist groups. But this happens, systemically it happens individually as well. And, you know, I do see this happening outside of the therapist groups, and actually it is spilling over into in real life as well. To hearing this, you know, from some of the practices, hiring people, where I think rightfully, employees entering into the workforce are asking for living wages. And it is a power balance shifts that is leading to things like some of the workforce shortages that we talked about in the other episode.   Katie Read  27:14 Let me ask you, Curt, because as you were talking about sort of the field being a little bit older, in terms of median age and whatnot, I wonder, and I'm curious, just either of your thoughts on this. Do you feel like so let's say you are out there, whatever age you are, really, but you're a therapist, you've kind of become acclimated to the 50k a year therapist average median income, you've kind of surrendered yourself to the fact that you have a very hard job that you can't talk to anyone about, that you are bound by ethics and confidentiality, that you don't get to come home and vent about your day, you have to keep a lot of things bottled up. And at the same time, you know, you're probably worried every month, if you have a $400 car bill this month, it's gonna throw you over the edge, you're not going to have a cushion for that. And then you go into a therapist group, and you see somebody who says, I charge 200 an hour in my area, and I'm doing great and everything's fine. Do you think part of this backlash is just that feeling of threat, that you can't do that or that you haven't chosen that or that you haven't gone to do whatever it is you need to do internally, whatever that sort of money work is that you need to do to actually start charging closer to your worth as an experienced person in the field?   Curt Widhalm  28:30 Absolutely. 100% think that a lot of where we socially prescribe other therapists to be comes from our own anecdotal histories. And our inability is to deal with our own crap when it comes to our relationships to money, our relationships to our professional identities, that and, you know, this even happens in things that I see like in law ethics workshops, that I teach that it's not even just about money thing, but just how much we distance ourselves from other people who make mistakes. You know, if somebody's name shows up in the spider pages, the disciplinary actions, how quickly are to just like, unfriend them or take them off of our LinkedIn connections? Even if it's something that might points closer to us, you know, you see this and things like people who admit to not being caught up on their notes and just kind of the furthering away, you know, these are ethical and legal responsibilities that we have in our profession. And as compassionate people we tend to have very little compassion for the other people in our profession. When they don't do the same kinds of steps that we think that we should be doing or have been doing all along ourselves.   Katie Vernoy  29:52 You're really saying jealousy, guilt and shame.   Curt Widhalm  29:54 Yes!   Katie Vernoy  29:56 Because I think of like the especially I think with the environment around you, Katie, which is like the six figure flagship, it's people outgrowing the office, it's that kind of notion of very successful, you know, I'm going to make a lot of money, I'm going to, I'm going to live a life. And and you don't argue that that comes easily. I saw your post on kind of hustle seasons. And so I appreciate that. But I think that there's this notion that you can work really hard, create something that's more sustainable and make a lot of money. And I think there's a jealousy there, either of the energy that you personally have. I know I'm jealous of your energy. And then there's also the success that people have, I think there's a jealousy there. And so then it's that kind of like, well, I didn't want it anyway, like that. That's wrong, because I don't think I can get it. I'm jealous that you have it. And so I don't really want it. And this, there's all of these moral reasons and moralizing around why I don't want it. I think what you're talking about Curt is kind of this guilt and shame over, I've been doing things wrong. I can't do that, because it goes against these self imposed values and morals that I've put around being a hard worker, that is one of the people and I am not going to I'm not in this for the money. And I'm doing this because it's so valuable. And even thinking about money is so mercenary and wrong. And so there's that guilt and shame of wanting more, but feeling like it goes against either the collective morals or the personal morals. And so to me, it's like if we think about guilt, shame, and jealousy, I mean, the fact that there is so many of those emotions that come out in these public shreddings, in these social media groups or on pages or whatever, like it just it seems strange to me, that therapist would would have those in such huge, huge, impactful ways.   Katie Read  31:54 It's interesting, too, because I was just putting together a workshop where we talked about how typically the best therapists tend to have the worst imposter syndrome. And I think imposter syndrome falls into what you're talking about, and the fact that because we all tend to be pretty intellectual, pretty academic, you know, even those of us who are super heart led, we all still have like our little academic streak. And I think that we all walk around with this belief that if I am not the top researcher in a particular field, I have nothing to say it's very black and white. If I am not the absolute most published person in this particular theory, I should just sit down and shut up, I know nothing, as opposed to being able to see all the gradients, being able to see all of the expertise that everyone has and that you can bring in that could benefit so many more people. If you were brave enough to kind of fight your own imposter syndrome. Stand up, talk about what you know, help even more people that way.   Katie Vernoy  32:55 Yeah.   Katie Read  32:56 But we get very caught in that. Because this will not win a Pulitzer, I might as well not even write it. I might as well not even try it. And I just want what's the point? What's   Katie Vernoy  33:06 and and how dare you, other person that is doing this? How dare you do that? Because I've decided, even though I may have more knowledge than you   Katie Read  33:17 Yes,   Katie Vernoy  33:17 that I'm not good enough to speak on it. So how dare you!   Katie Read  33:20 How dare you? Exactly. Oh, isn't that so true. And I do think this is what we see play out in therapists groups. And I do think it's terribly sad, because at the end of the day, to me, I always think the lay public are the only losers here. Because when you choose to not speak out, when you choose to not share what you know, when you choose to not be open and vulnerable, and who you are, and say, I know I might not be the world renowned expert on XYZ. But let me tell you a little bit about what I do know, because you might think it's interesting. And I think the thing a lot of therapists don't realize because we're sort of taught to write dissertation style for everything is that the average person doesn't want that. They do want the little tidbit. They do want the little micro snippet that you pulled from an interesting article you read that you couldn't get out of your mind yesterday, share that that's what they want to because it'll get into their head too and it'll help them in their life just like it helps you they don't need your full scope dissertation on anything.   Katie Vernoy  34:19 Yeah.   Curt Widhalm  34:20 So is the answer and stop hanging out with other therapists?   Katie Read  34:29 I don't know let's vote should we go around and vote? I you know it's interesting though, you I definitely think it's something that we talk about in our group is that we talked about how when you even when I when I first started doing the most basic stuff, offering like copywriting for therapists offering basic marketing for therapists in this tiny little way like putting a post on Facebook Hey, need help with your copywriting? You know, these tiny little ways? I had rude people I had predicted people I know going well that's never gonna go anywhere. What are you even doing? Why are you doing that? And so I just want all my students like any time, you are going against the grain a little bit breaking the mold a little bit of what it means to be a helping professional, because what I believe at the end of the day is what you call it doesn't matter as much as what you're actually doing. Are you out there helping people in some form? Is your internal calling to be out there helping people in some form? Great, are you doing it? If you are, and if you feel good and authentic, and you know that you are living out your calling that you are truly helping people in some form? Does it matter if you call it therapy today, and maybe tomorrow, it's consulting, and you have consulting clients, and maybe the next day you build an online course where you help people and maybe you go speak at a school the next day, doesn't matter what form it's in, that you're helping people as long as you are authentically helping people what you were called to do, does the name matter? So you can hang out with a therapist like that. Kurt,   Katie Vernoy  36:00 I hear you saying that hanging out with therapists who have that broader perspective that aren't so tied into the Puritan culture is probably helpful for folks that are really coming, that are pushing against the grain in some way. And and I really resonate with that, because I think that's, that's why we found each other and   Katie Read  36:18 That's what you've done   Katie Vernoy  36:22 We've been trying, you know, we don't we don't avoid the purity culture, we just try to push back against it. But I think it's, it's something where when you're really trying to step out and help people in a bigger way, it is, it is important that you find the right people to spend time with because you can get tamped down by purity culture,   Katie Read  36:40 You can. Well, and I should say this, like for a lot of us, I know for me, when I was I think it is important for therapists to do money work on ourselves, go read the self help books, go, you know, sign up with Tiffany...   Curt Widhalm  36:53 GO DO YOUR OWN RESEARCH!   Katie Read  36:58 I think it's important to do that. And I think it's important to hang out with people who get it and have done it. And I think for all of us to, there is a way that you can feel good about what you charge and feel good about what you give back. And that that is going to be different for everyone, whether it's that you do a couple free or cheap sessions every single week, or you give a certain amount to charity every year, like whatever that looks like for you. You can still set this up in a way where you're not going to feel like a greedy bastard, for earning a good living where you still know that you are I mean, for me, when I started outgrowing the office, honestly, my entire motivation was security. My husband worked at a large multinational corporation that was doing layoffs, rolling layoffs every single month. And every single month, it felt like we were going to be any minute we were going to be homeless because he was going to get laid off. And that was the bread and butter of the family. And what then and all I really wanted was some security. And so that drove me and I was like I said we had moved states. And so I didn't have a license in my new state. I couldn't just go open a therapy office, it drove me to get creative and do something else. But I think when your motivation comes from that, like there's, I don't know, a lot of therapists who are like, I'm gonna go get rich so that I can have seven maaser body it's like, it's just not who we are, you know, like, that's just not what we're doing here.   Katie Vernoy  38:16 Well, we do have to end here, but but I think we also if there is a therapist that wants to get ready to get seven Montserrado for months, seven months. Go for it do. So before we close up, where can people find you?   Katie Read  38:30 Six Figure flagship.com is the main program that we run right now it's an application only program for mental health therapists who do want to outgrow the office, that is the best place to find me. And otherwise, I'll just be kind of hanging out with you guys.   Katie Vernoy  38:44 I love it. Always again, it   Curt Widhalm  38:47 We will include a link to Katie's websites in our show notes. You can find those over at MTS g podcast.com. And follow us on our social media join our Facebook groups modern therapists group and   Katie Read  39:01 Or we will shame you.    Curt Widhalm  39:03 we actually have a really good group that seems to   Katie Read  39:08 No I said we will shame them for not joining it, we find them.   Curt Widhalm  39:14 Some we will post those links and until next time, I'm Curt Widhalm with Katie Vernoy And Katie Read.   Katie Vernoy  39:20 Thanks again to our sponsor, Trauma Therapist Network.   Curt Widhalm  39:24 If you've ever looked for a trauma therapist, you can know it can be hard to discern who knows what and whether or not they're the right fit for you. There's so many types of trauma and so many different ways to heal. That's why Laura Reagan LCSW WC created trauma therapist network. Trauma therapist network therapist profiles include the types of trauma specialized in population served therapy methods used, making it easier for potential clients to find the right therapist who can help them. Network is more than a directory though it's a community. All members are invited to attend community meetings to connect consults and network with colleagues around the country.   Katie Vernoy  40:01 Join the growing community of trauma therapists and get 20% off your first month using the promo code MTSG20. At trauma therapist network.com Once again that's capital MTSG, the number 20 at Trauma therapist network.com   Announcer  40:17 Thank you for listening to the modern therapist Survival Guide. Learn more about who we are and what we do at MTS g podcast.com. You can also join us on Facebook and Twitter. And please don't forget to subscribe so you don't miss any of our episodes.

RARE & SCRATCHY ROCK 'N ROLL_146 – “THE TOP 20 ROCK & ROLL COMPOSING TEAMS DURING THE GOLDEN AGE OF 45 RPM RECORDS” – This episode spotlights “The Top 20 Rock & Roll Composing Teams During The Golden Age Of 45 RPM Records.” We've based our survey on the research of acclaimed popular music statistician, Bill Carroll, Ph.D. He's our featured guest. Our resident “Rare & Scratchy Rock ‘N Roll” Rockologist, Ken Deutsch, and Radio Dave will count down the most successful composing teams, which also include individual songwriters who penned charted 45 RPM platters. Our time period for this tabulation is the golden age of that format for rock & roll singles. And we'll sample the two strongest-charted hit singles for each entry on our ranking. These include the only husband-wife team on our roll-call, plus the only family of record labels with four of the top 20 entries on our list. And just for fun, we've asked a valued member of our staff, Mr. Announcer, to reveal some of the famed rock and roll songwriters who were among the tops in their profession – but not among our top 20. It's all by the numbers, and you'll hear it all here.

The Lucky Mojo Hoodoo Rootwork Hour is a real, live call-in show where the general public gets a chance to ask about actual problems with love, career, and spiritual protection, and we recommend and fully describe hoodoo rootwork spells to address, ameliorate, and remediate their issues. We begin this show with a Discussion Panel focussed on the topic Halloween -- Peeking through the Veil. You will learn a lot just by listening -- but if you sign up at the Lucky Mojo Forum and call in and your call is selected, you will get a free consultation from three of the finest workers in the field, cat yronwode, ConjureMan, and a special guest from AIRR, Mama E. Sign up before the show to appear as a client! Post at the Lucky Mojo Forum at: https://forum.luckymojo.com/lmhrhour-free-readings-october-31-2021-halloween-peeking-through-the-veil-t95646.html Then call in at 818-394-8535 and dial '1' to flag our Studio Board Operator that you want to be on the air! We select new client sign-ups first and then call-back sign-ups. Call in right when the show begins and listen via your phone. Message the Announcer or the Studio Board Operator ("Lucky Mojo Curio Company") in chat to let them know you're available. The link above will also be the location of the show's CHAT LOG once it is posted, so you can follow along as you listen.

Today on the Marni on The Move  podcast I am joined by world-renowned IRONMAN race announcer, Mike Reilly, also known as the Voice of IRONMAN. Mike is the author of Finding My Voice, and host of the Find Your Finish Line Podcast. If you are just tuning in, this is episode three of our six episode triathlon series here on the pod. Mike has announced over 200 IRONMAN Races, so the odds are, if you finished one of these incredible events, Mike has announced your name as your crossed the finish line. If you are like me on the 70.3 circuit, be prepared to start looking for your first IRONMAN On this episode of Marni on the Move, I sync up with Mike to about his legendary announcing career and where it all began, We talk about his foray into triathlon aand what the scene was like when he startedvs wgere it is now. Mike shares favorite memories from his decades-long career being the voice that motivates and excites racers as they conquer the course. (Including the famous Iron War race with triathlon icons Mark Allen and Dave Scott) Mike also  talks about his own exercise and wellness routines, how his family is passionate about sports and how he loves what he does. Mike was every bit as energetic and enthusiastic in person as he is over the microphone. I think he might even have motivated me to take on the full IRONMAN sooner than I planned! CONNECT IRONMAN on Instagram, Facebook Watch, YouTube Mike Reilly on Instagram Marni On The Move Instagram, Facebook, TikTok, LinkedIn, or YouTube Marni Salup on Instagram and Spotify SUBSCRIBE Sign up for our weekly newsletter, The Download for Marni on the Move updates, exclusive offers, invites to events, and exciting news! RIDE WITH ME  Meet me on Zwift, Strava, or Peloton OFFERS Take control of your health and wellness journey with InsideTracker, the ultra-personalized nutrition platform that analyzes your blood, DNA, and lifestyle to help you optimize your body from the inside out. Transform your body's data into meaningful insights and a customized action plan of the science-backed nutrition recommendations you need to optimize your health!  Get 25% percent off today at InsideTracker with our code CHEERSMARNI Head over to our SHOP page for additional offers from Marni on the Move partners, sponsors, and guests SUPPORT THE PODCAST Leave us a review on Apple. It's easy, scroll through the episode list on your podcast app, click on five stars, click on leave a review, and share what you love about the conversations you're listening to. Tell your friends to what you love on social. Screenshot or share directly from our stories the episode you're listening to, tag us and the guests, and use our new Marni on the Move Giphy! SPECIAL THANKS Emma Steiner for help with show notes, guest research, and social media. Skye Menna for help with guest research and outreach, social media, and public relations    

Sports announcer Joe Buck was peeing in a bottle when called a touchdown thrown by Brett Favre! See omnystudio.com/listener for privacy information.

For the first time, Amanda Gynn brings you the latest news in the pro-wrestling industry including the latest on ROH, Greg Hamilton's departure from WWE and much more!

NOTE: This episode was recorded before Game 1 of the World Series. Dodgers vs Red Sox, the Battle for Mookie's Soul! What's that, they didn't make it? Screw this World Series. Who to cheer for when there's no morally good team to cheer for? Well at least Freddie Freeman is in the World Series! The Toronto Blue Jays might be in deep trouble trying to re-sign premium players this offseason after their ownership shenanigans spilled out into public. Watch West Wing. Just do it. Simpsonrama Episodes of the Week: Treehouse of Horror I (Jacob), Treehouse of Horror VIII (Ben)

The NHL on TNT's Kenny Albert is a broadcasting rarity, calling play-by-play in the NHL, NFL, NBA and Major League Baseball. In a 30-minute interview, Kenny tells us about his start as a substitute Islanders announcer and making $18,000 a year with the AHL's Baltimore Skipjacks, how he prepares for each broadcast, and how he embraces the challenges of calling national games “down the middle” even though he knows fans miss their local announcers. At the end of the show, Chris and Pat respond to a fan's question about the “blandness” of NHL players. Host: Chris BottaExecutive Producer: Dani Rylan KearneyProducer: Pat Boyle

Episode 184 - W/Hannah Uveges, Top 5 - Announcers, Hannah's Football Weekend, Browns/Steelers by Living Off The Land

With Dexcom announcing a big new agreement with Garmin this month, it seemed like a good time to check in on a few issues. Stacey talks with Dexcom's Chief Technology Officer Jake Leach about Garmin, the upcoming Dexcom G7 and Dexcom One. She asks your questions on everything from G7 features to watch compatibility to the future and possible non invasive monitoring. Just a reminder - the Dexcom G7 has not yet been submitted to the US FDA and is not available for use as of this episode's release. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Previous episodes with Jake Leach: https://diabetes-connections.com/?s=leach Previous episodes with CEO Kevin Sayer: https://diabetes-connections.com/?s=sayer Check out Stacey's book: The World's Worst Diabetes Mom! Join the Diabetes Connections Facebook Group! Sign up for our newsletter here ----- Use this link to get one free download and one free month of Audible, available to Diabetes Connections listeners! ----- Get the App and listen to Diabetes Connections wherever you go! Click here for iPhone      Click here for Android Episode transcription below:   Stacey Simms  0:00 Diabetes Connections is brought to you by Dario Health. Manage your blood glucose levels increase your possibilities by Gvoke Hypopen the first premixed auto injector for very low blood sugar, and by Dexcom take control of your diabetes and live life to the fullest with Dexcom.   Announcer  0:20 This is Diabetes Connections with Stacey Simms.   Stacey Simms  0:26 This week Dexcom announced a big new agreement with Garmin this month seemed like a good time to check in on a few issues, including what happens to the watches and insulin pump systems that work with G6, when Dexcom G7 it's the market.   Jake Leach  0:41 We're already working with Tandem and Insulet. On integrating G7 with their products have already seen prototypes up and running, they're moving as quickly as possible.   Stacey Simms  0:49 That's Chief Technology Officer Jake leach who reminds us that the G7 has not yet been submitted to the US FDA. He answers lots of questions on everything from G7 features to watch compatibility to the future and possible non invasive monitoring. This podcast is not intended as medical advice. If you have those kinds of questions, please contact your health care provider. Welcome to another week of the show are we so glad to have you here I am the host Stacey Simms, and we aim to educate and inspire about diabetes with a focus on people who use insulin. You know, my son Benny was diagnosed with type one right before he turned to my husband lives with type two diabetes. I don't have diabetes, I have a background in broadcasting. And that is how you get the podcast. And when I saw the news about Garmin, and Dexcom. I knew you'd have some questions. And I thought this would be a good chance to talk about some of the more technical issues that we're all thinking about around Dexcom. These days. I should note that since I did this interview with CTO Jake Leach on October 19. And that's exactly one week before this episode is being released that Dexcom released some new features for its follow app. I did cover that in my in the news segment. That was this past week, you'd find the link in the show notes. And as I see it for that news that release in the update, the big news there is that now there is a widget or quick glance on the followers home screen, it depends on your device, you know, Apple or Android, there's no tech support, right from the follow up, and a way to check the status of the servers as well. And I think that last one should really be an opt in push notification. If the servers are down, you should tell me right, I shouldn't have to wonder are the servers down and then go look, but that is the update for now. And again that came out after this interview. So I will have to ask those questions next time. And the usual disclaimer Dexcom, as you've already heard, is a sponsor of the show, but they only pay for the commercial you will hear later on not for any of the content you hear outside of the ad. I love having them as a sponsor, because I love that Vinnie uses the product. I mean, we've used Dexcom since he was nine years old. But that doesn't mean I don't have questions for them. And I do give them credit for coming on and answering them. Not everybody does that. I should also add that this interview is a video interview, we recorded the zoom on screen stuff. You can see that at our YouTube channel. I'll link that up in the show notes if you would rather watch and there always will be a transcript these days in the show notes so lots of options for however it suits you best. I'm here to serve let me know if there's a better way for me to get this show to you. But right now we've got video audio and transcript. Alright Jake leach in just a moment. But first Diabetes Connections is brought to you by Dario health and you know one of the things that makes diabetes management difficult for us that really annoys me and Benny, it's not really the big picture stuff. It's all the little tasks that add up. Are you sick of running out of strips do you need some direction or encouragement going forward with your diabetes management? Would visibility into your trends help you on your wellness journey? The Dario diabetes success plan offers all of that in more you don't the wavelength the pharmacy you're not searching online for answers. You don't have to wonder about how you're doing with your blood sugar levels, find out more, go to my dario.com forward slash diabetes dash connections. Jake leach Chief Technology Officer for Dexcom thanks so much for joining me. How are you doing?   Jake Leach  4:22 I'm doing great, Stacey. It's a pleasure to be here.   Stacey Simms  4:24 We really appreciate it. And we are doing this on video as well as audio recording as well. So if we refer to seeing things, I don't think we're sharing screens or showing product. But of course we'll let everybody know if there's anything that you need to watch or share photos of. But let me just jump in and start with the latest news which was all about Garmin. Can you share a little bit about the partnership with Garmin? What this means what people can see what's different?   Jake Leach  4:49 Yeah, certainly so I'm really excited to launch the partnership with Garmin. So last week we released functionality on the Dexcom side and Garmin released their products, the ability to have real time CGM readings displayed on a whole multitude of Garmin devices by computers, and a whole host of their watches. So they've got a lot of different types of watches for, you know, athletics and different things. And so you can now get real time CGM displayed on that on that watch. So they're the first partner to take advantage of some new technology that we got FDA approved earlier in the year, which is our real time cloud API. So that's a a way for companies like Garmin to develop a product that can connect up to users data through the Dexcom, secure cloud and have real time data, we've had the capability to do that with retrospective data that three hour delayed, many partners are taking advantage of that. But we just got the real time system approved. And so Garmins, the first launch with it.   Stacey Simms  5:50 Let me back up for just a second for those who may use these devices, but aren't as technologically focused. What is an API? When you got approval for that earlier in the summer for real time API? What does that what does that mean? Yeah, so   Jake Leach  6:03 it's a API is an application programming interface. And so what it really means is, it's a way for software applications, like a mobile app on your phone, to connect via the Internet to our cloud with very secure authentication, and pull your CGM data in real time from from our cloud. And so it's basically a toolkit that we provide to developers of software to be able to link their application to the Dexcom application, and really on the user side, to take advantage of that feature, you basically enter in your Dexcom credentials, your Dexcom username and password. And that is how we securely authenticate. And that's how you're basically giving access to say, for example, Garmin, to pull the data and put it down onto your devices. What other   Stacey Simms  6:51 apps or companies are in the pipeline for this. Can you share in addition to Garmin? I think I had seen Livongo Are there others?   Jake Leach  6:58 Yeah, so Livongo so Tela doc would purchase the Lubanga technology, they've got a system. They're also in the pipeline for pulling in real time CGM data into their application. And so they're all about remote care. And so trying to connect people with physicians through, you know, technology, and so having real time CGM readings in that type of environment is a really nice use case for them. And so and for the for the customers. And so that's, that's where they're headed with it. And we've got kind of a bunch more partners that are in discussions in development that we haven't announced yet. But we're really see this, the cloud API's are interfaces as a way to expand the ecosystem around a Dexcom CGM. So we really like to provide our users with choice. So how do you want your data displayed? Where do you want it? And so if you want to right place, right time for myself, have a Garmin bike computer so I can see CGM readings right on my handlebars, I don't have to, you know, look down on a watch or even thought phones, it's really convenient. That's what we're about is providing an opportunity for others to amplify the value of CGM.   Stacey Simms  8:06 This was a question that I got from the listener. What happens to the data? Is that a decision up to a company like Garmin, or is that part of your agreement, you know, where everybody's always worried about data privacy? And with good reason?   Jake Leach  8:19 Yeah, data privacy is super important area when when you're handling customer information. And so the way that it works is, when you're using our applications at the beginning, when you sign up, there's some consents, you're basically saying this is what can be done with my data. And the way we design our systems is, for example, with the connection to the Garmin devices, the only way they can access your data is if you type in your credentials into there, it's like it's almost like typing your username and password into the web to be able to access your bank account. It's the same thing, you're granting access to your data. And each company has their own consents around data. And so we all are required by regulatory agencies to stay compliant with all the different rules to Dexcom. We take it very seriously, and are very transparent about what happens with the data that's in we keep it in all of our consent forms that you click into as you as you work through the app.   Stacey Simms  9:13 But to be clear to use the API or to get the Dexcom numbers on your garmin, you said earlier, you have to enter your credentials,   Jake Leach  9:19 you have to you have to enter your Dexcom username and password. And that's how we know that it's okay for us to share that information with Garmins system because you are the one who authorized it.   Stacey Simms  9:30 Right. But that's also how you were going to use it. You just said you have to enter your name and password for them to use the information. So they just have to read individually like okay, Garmin or Livongo or whomever. Yes. Your individual terms of services.   Jake Leach  9:42 Yeah, for each each application that that you want to use you it's important to read the what they do with the data and how to use it.   Stacey Simms  9:49 That's really interesting. And Has anything changed with Dexcom? It's been a long time since we've talked about how you all use the data. My understanding is that it was blinded, you know, you're not turning around over to health insurers and saying yeah, done on this day this or are you?   Jake Leach  10:03 No, no, not at all, we basically use the information to track our product performance. So we look at products there. So it's de identified, we don't know whose product it was, we just can tell how products are performing in the field. That's a really important aspect. But we also use it to improve our products. So we when we see the issues that are occurring with the use of the product, we use it to improve it. So that's, that's our main focus. And the most important thing we do with it is provided to users where, where and when they need it. So you know, follow remote monitoring that the reason we built our data infrastructure was to provide users with features like follow and the clarity app and so forth.   Stacey Simms  10:36 Do those features work on other systems? Can I use Garmin to share or follow?   Jake Leach  10:41 Not today? So right now, it's, it's basically intended for the the person who's wearing the CGM. It's your personal CGM credentials that you type in to link the Carmen account. And so for today, it's specific around the user.   Stacey Simms  10:57 I assume that means you're working on for tomorrow.   Jake Leach  10:59 There's lots of Yeah, lots.   Stacey Simms  11:02 Which leads us of course to Well, I don't have to worry about that right now. Because you can't use any of this without the phone and the Phone is how we could share it follow. So it's not really an issue yet. Jake, talk to me about direct to watch to any of these watches. Yeah, where do we stand? I know G6. It's not going to happen. Where are we with G7? Right back to Jake answering my question, you knew I was gonna bring that up. But first Diabetes Connections is brought to you by Gvoke Hypopen. And when you have diabetes and use insulin, low blood sugar can happen when you don't expect it. That's why most of us carry fast acting sugar and in the case of very low blood sugar, why we carry emergency glucagon, there's a new option called Gvoke Hypopen the first auto injector to treat very low blood sugar Gvoke Hypopen is pre mixed and ready to go with no visible needle. In usability studies. 99% of people were able to give Gvoke correctly find out more go to diabetes connections.com and click on the Gvoke logo. Gvoke shouldn't be used in patients with pheochromocytoma or insulinoma. Visit Gvoke glucagon.com/risk now back to Dexcom's jake leach answering my question about direct to watch   Jake Leach  12:19 That's a great question and a really exciting technology. So direct to watch is where through Bluetooth, the CGM wearable communicates directly to a display device like a watch. So today, G6 communicates to the phone and to insulin pumps in our receiver are the displays. With G7, what we've done is we've re architected the Bluetooth interface to be able to also in addition to communicating with an insulin pump or a receiver and your mobile phone, it can also communicate with a wearable device like a Apple Watch, in particular, but other watches have those capabilities, with G7, reducing the capability within the hardware to have the direct communication director watch. And then in a subsequent release, soon after the launch to commercial launches of G7, we'll have a release where we bring the director watch functionality to the customers, there's the Bluetooth aspect, which is really important, you got to make sure it doesn't impact battery life and other things. But there's also the aspect of when it is direct to watch, it becomes your primary display. And so being able to reliably receive alerts on the watch was something that initially in the architecture wasn't possible. But as Apple's come out with multiple versions of the OS for the watch, they've introduced capability for us, so that we can ensure you get your alerts when you're wearing the watch. And so that was a really important aspect for us. And it's also for the FDA to ensure that if that's your main display, you've walked away from your phone, you have no other device to alert you that it's going to be reliable. And so that's exciting progress of last couple years with Apple making sure that can happen. You know,   Stacey Simms  13:56 we're all excited for Direct to watch. Obviously, it's a feature that many people are really clamoring for. But you guys promised it first with the G five in 2017. Do you all kind of regret putting the cart before the horse that way? Because my next follow up question is why should we believe you now?   Jake Leach  14:15 Yeah, you know, it Stacy's a good question. So we are hand was kind of forced because Apple actually announced it before we did. So they basically said we're opening up this capability on the watch to have the direct Bluetooth connectivity. And of course, we were excited to have someone like Apple talking about CGM on that kind of a stage. But then as we got into the details of actually making it work, we, you know, continually ran into another technical challenge after another technical challenge, and I totally agree. I wish it would have been two years later that they talked about at the keynote, but I'm comfortable that we've gotten past those types of issues. And so and it is built into G7. So we've got working systems and so it will introduce it rather quickly with G7   Stacey Simms  14:56 and to confirm G7 has been submitted for the CE mark Because the approval in Europe, but has not yet, as you and I are speaking today has not yet been submitted for FDA approval in the US.   Jake Leach  15:06 Yeah, we're just we're just finishing up our submission, we get some validations that we're running on some of the new manufacturing lines to make sure we can build enough of these for all the customers, we want to focus to move over to G7 as quick as possible. And so we'll we'll submit you seven to the FDA before the end of this year,   Stacey Simms  15:22 just kind of building off what you mentioned about Apple and making these announcements or, you know, sometimes Apple lets news get out there. Because they I don't know if they seem to enjoy it. I'm speculating. I don't have any insight track at Apple. But I wanted to ask you, I don't know if you can say anything about this. For the last year, every time I talk to somebody who's not getting the diabetes community, but they're on a technology podcast, or they're, they're hearing things about non invasive blood glucose monitoring, right, the Apple, Apple series seven or some watch this year, we're supposed to have this incredible, non invasive glucose monitoring was gonna put Dexcom and libre out of business, it was gonna be amazing. Of course, it didn't happen. But a bunch of companies are working on this. And Apple seems to be really happy to say maybe, or we're working on it, too, is Dexcom listening to these things. I mean, obviously, they're not here yet. They they are going to come. I'm curious if this is all you kind of happy to let that lay out their speculation. Or if you guys are thinking about anything like this in the future,   Jake Leach  16:17 we pay a lot of attention to non invasive technologies. We have a an investment component of our company that looks at you know, early stage startups. We also have many partnership discussions around CGM technologies. And so when it comes to non invasive, I think we'd all love to have non invasive sensors that are accurate and reliable. You know, for many, many years since I've been working on CGM, and many years before that, there has been attempts to make a non invasive technologies work. The challenge, though, is it's just sensing glucose in the human body with a non invasive technology is not been proven feasible. It's just there's a lot of different attempts and technologies have tried, and we pay close attention. Because if if something started to show promise, we become very interested in it. And basically making a Dexcom product that uses it, we just haven't seen anything that is accurate and reliable enough for what our customers need. That's to say, there could be a use case where a non invasive sensor doesn't have to be as accurate and reliable as what what Dexcom does. And so maybe there's a product there. But we're very focused on ensuring that the accurate, the numbers that we show, the glucose readings that we present to users are highly accurate, highly reliable, that you can trust them. And so when it comes to non invasive, we just haven't seen a technology that can do that. But I know that there's lots of folks out there working on it. And we're, we stay very close to the community.   Stacey Simms  17:40 Yeah, one of the examples I gave a guy who doesn't he does an Apple technology podcast, and he was like, you know, what, what do you think? And I said, Well, here's an example. He would a scale, and you have no idea if it's accurate. But you know, that once you step on it that that number probably is is stable, then you know, okay, I gained 10 pounds, I lost 10 pounds. But I have no idea if that beginning number makes any sense at all, you might be able to use that if you are a pre diabetic, or if you're worried about blood glucose, but you could never dose insulin using it because you have no idea where you're starting. So I think that's I mean, my lay person speculation. I think that's where that technology is now and to that point, but other people outside the diabetes community are looking to one of the more interesting stories, I think, in the last year or two has been use of CGM and flash glucose monitoring for people without diabetes at all, for athletes, for people who are super excited and interested in seeing what their body's doing. So we have companies like levels and super sapient. And you know, that kind of thing using the Liebreich. I'm curious of a couple of parts of this question. If you think you want to answer it is Dexcom. Considering any of those partnerships with the G7, which is much more simple, right? fewer parts and that kind of thing.   Jake Leach  18:46 Yeah, that's a great point, Stacey. So yes, G7 is a lot simpler. It was designed to be to take the CGM experience to the next level. And part of that is just the ease of use the product deployment the simplicity, someone who's never seen a CGM before, we want to be able to walk up approach G7 And just use it. There's a lot of opportunity we feel for glucose sensing outside of diabetes. Today CGM are indicated for use in diabetes, but in the future, with 30% of the adult population in the US having pre diabetes, meaning the glucose levels are elevated, but not to the point where they've been diagnosed with diabetes. There's just so much opportunity to help people understand their blood sugar and how it impacts lifestyle choices impact their blood sugar. In the immediate feedback you get from a CGM is just a there's nothing else like it. And so I think, you know, pre diabetes and even as you mentioned, kind of in athletics. There's a lot of research going on right now in endurance athletes, and in weight loss around using CGM readings for those different aspects. So I think there's a lot opportunity we're today we're focused on diabetes, both type one and type two and really getting technology to people around the globe. That can benefit from it. That's where our focus is. But we very much have programs where we look at, okay, where else could we use CGM? It's such a powerful tool, you could think in the hospital, there's so much opportunity around around glucose. Alright, so I'm   Stacey Simms  20:13 gonna give you my idea that I've given to the levels people, and they liked it, but then they dropped off the face of the earth. So I'll be contacting them again. Here's my idea. If somebody wants to pay for a CGM, and they don't have diabetes, but they're like paying out of pocket because they like their sleep tracker, and they like this and they like that, or some big companies gonna buy it and give it away for weight loss or whatever. You know, the the shoe company toms, where you buy a pair of shoes and they give one away. People are in the diabetes community are scrimping and saving and doing everything they can to get a CGM. Maybe we could do a program like that. Where if you don't quote unquote medically need a CGM. Your purchase could also help purchase one for an underserved clinic that serves people with diabetes.   Jake Leach  20:54 Getting CGM to those folks that didn't need them, particularly underserved areas, clinics. It's so important. I like the idea. It's a that's if there was a cache component that then provided the CGM to those that are less fortunate. I think that's, I like the idea. Next month is National Diabetes Awareness Month. And one of the things we're focused on for the month of November is how can we bring broader access to CGM? It's something we've been working on, you know, since we had our first commercial product, and there's still, you know, many people in the United States benefit, you know, 99% of in private insurance covers the product. You know, a lot of our customers don't pay anything, they have no copay. But you know, that's not the case for everybody. And so there's, there's definitely areas that we need to we are focusing on some of our non profit partners on bringing that type of greater access to CGM, because it's such a powerful tool and helping you live a more normal life.   Stacey Simms  21:50 In the couple of minutes that we have left. I had a couple more questions, mostly about G7. But you mentioned your hospital use. And last year, I remember talking to CEO Kevin Sayer about Dex comes new hospital program, which I believe launched during COVID. Do you have any kind of update on that or how it's been going?   Jake Leach  22:06 Yeah, so it was a authorization that we got from the FDA to raise special case during COVID, to be able to use G6 in the hospital. And so we had quite a few hospitals contact us early on in COVID, saying, Hey, we've got these patients, many of them have diabetes, they're on steroids. They're in the hospital, and we're trying to manage their glucose. And we're having a hard time because their standard of care in hospitals is either labs or finger sticks. And so we got this authorization with the FDA, we ship the product, many hospitals acquired it, and they were using it pretty successfully. What we'd say about G6 is really designed for personal use your mobile phone or a little receiver device, designed integrated with a hospital patient monitoring system or anything like that. You could imagine in the future that that could be a real strong benefit for CGM, the hospital, you can imagine you put it on, you know, anybody who has glucose control issues comes in the door. And then you basically can help ensure where resources need to be directed based on you know, glucose risk. I've always been passionate about CGM at a hospital. It's one of the early projects I worked on here. Dexcom. And I think it there's a lot of promise, particularly as we've improved the technology. So there's still hospitals today using G 600 of the authorization. And we're interested in designing a product for that market specifically, instead of right now. It's kind of under emergency years. But we think there's there's a great need there. That CGM could could help in basically glucose control in the hospital.   Stacey Simms  23:28 That's interesting, too. Of course, my mind being a mom went to camp as well. Right? If you could have a bunch of people I envision like a screen or you know, hospital monitoring that kind of thing. You wonder if you could do something at camp where there's 100 kids, you know, instead of having their individual phones or receivers at camp, it would be somewhere Central?   Jake Leach  23:46 Well, you know, what, between with the with the real time API, there are folks that are thinking about a camp monitoring system that can basically be deployed on campuses right now with follow. It's great for a family, but it's not really designed to, to follow a whole camp full of campers. But with the real time API, there's opportunities for others to develop an application that could be used like that. So yeah, there you go.   Stacey Simms  24:08 All right, a couple of G7 questions. The one I got mostly from listeners was how soon and I know, timelines can be tricky. But how soon will devices that use the G6? Will they be able to integrate the G7 Insulin pumps, that sort of thing? Sure. It's only Tandem right now. But you know, Omnipod, soon that that kind of thing?   Jake Leach  24:26 Yeah, I mean, that's coming. So I'll start with the digital partners like Garmin and others, that is going to be seamless, because the infrastructure that G6 utilizes to move data to through the API's is the same with G7. So that'll be seamless. When you talk about insulin pumps, so those are the ones that are directly connected to our transmitters that are taking the glucose readings for automated insulin delivery. So those systems were already working with Tandem and Insulet. On integrating G7 with their products have already seen prototypes up and running so they're moving as quickly as possible. So once We have G7 approved, then they can go in and go through their regulatory cycle to get G7 approved for us with their AI D algorithms. Really the timing is dictated mainly by those partners and the FDA, but we're doing everything we can to support them to ensure this as quick as possible.   Stacey Simms  25:17 Take I should have asked at the beginning, I'm so sorry, do you live with type one I've completely forgotten.   Jake Leach  25:21 I don't I made a reference to where I wear them all the time. Because, as you know, kind of leading the r&d team here, I love to experience the products and understand what our users what their experience is. And I just love learning about my glucose readings in the different activities I do. So I don't have type one. But I just I use the products all the time.   Stacey Simms  25:42 So to that end, have you worn the G7? And I guess I'd love to know a little bit more about ease of use. It looks like it's, it just looks like it's so simple.   Jake Leach  25:51 It is. Yeah. So I've participated in a couple of clinical trials where we use G7, it is really simple. One of the most exciting things though, I have to say is that when you put it on, it has this 30 minute warmup. So the two hours that we've all been used to for so many years, by the time you put the device on and you have it paired your phone, it's there's like 24 minutes left before you're getting CGM. So it's like it's it. That part is just one of the things that you it sounds awesome. But then when you actually experience it, it's pretty amazing. But yeah, the ease of use is great, because it's the applicator is simple. It's a push button like G sex where you just press the button and it deploys. But there's other steps where you're not having to remove adhesive liners, the packaging is very, very small. So we really focused on low environmental footprint. And so it's really straightforward. But probably the most the really significant simplification the application process is because the transmitter and the sensor all one component and sterilized and saying altogether, there's no pieces, there's no assembly required, you basically take the device and apply it and then it's up and running. There's no transmitted a snap in or two pieces to assemble before you you do the insertion.   Stacey Simms  26:59 I think I know the answer to this. But I wanted to ask anyway, was it when you applied for the CE mark? And I assume this would be the same for the FDA? Are there alternate locations? In other words, can we use it on our arms?   Jake Leach  27:11 And yeah, that is that is a great question. Yeah, our focus with one of our phones with G7 and the revised form factor, the new new smaller form factor and sensor probe was arm were so yeah, arm wears is really important part of the G7 product.   Stacey Simms  27:26 I got a question about Dexcom. One, which seems to be a less expensive product with fewer features that's available in Europe. Is that what Dexcom? One is?   Jake Leach  27:34 Yeah, so there's a product that we recently launched in Europe in European countries. That is it's called Dexcom. One. And what it is, is it's it's a product that's designed for a broad segment of diabetes, type one, type two, it's a lower price point. It has a reduced feature set from G6. But what it's really about is simplicity. And so in you know it's a available through E commerce solutions. So it's really easy to acquire the product and start using it. It's really to get into certain markets where we either weren't didn't have access to certain customers. And so it's really designed for get generating access for large groups of people that didn't have access to CGM before.   Stacey Simms  28:20 What does e commerce solution mean? No doctor   Jake Leach  28:23 there. So outside the United States CGM isn't no prescription required for many, many countries. So the US is one of the countries that does require prescriptions, other some other countries do too. But there's a large group outside the US that don't, but it's really around, you can basically go to the website, and you can purchase it over a website. So really kind of nice solution around think Amazon, right. You're going you're clicking on add the sensors and you're purchasing it. It's a exciting new product for us that we are happy to continue developing.   Stacey Simms  28:53 I think it might come to the US don't know. Yeah, that's   Jake Leach  28:56 good. Good question. Don't don't know. I mean, I think right now we see CGM coverage is so great access is great for CGM in the US it can always be better and extend your focus on that. But it's really for countries where there wasn't access,   Stacey Simms  29:08 I would think tough to since we do need a prescription differently. Yeah, Jake, you have been with Dexcom, almost 20 years, 18 years now. And a lot has changed. When you're looking back. And looking forward here at Dexcom. I don't really expect you to come up with some words of wisdom off the top of your head. But it's got to be pretty interesting to see the changes that the technology has brought to the diabetes community and how I don't know it just seems from where I sit and you're probably a couple of years ahead. It seems that the last five years have just been lightspeed. It has   Jake Leach  29:39 been things are speeding up in terms of our ability to bring products to market and there's a lot of things one is the development of technology. The other component is working with your groups like the FDA on you know, how do we get products to the customers as fast as possible and that that's been a big part of it right moving cheese six to class to becoming an IC GM that That was a huge part of our ability to get the technology out quickly and also scale it. I think there's a lot of aspects that has been faster. And you know, when I started Dexcom, we had this goal of designing a CGM that was reliable didn't require finger sticks that could make treatment decisions. All that and we were 100% focused on that. And as we got closer and closer, and now we have that which you six and also what you seven, then the opportunity that that product can provide, you start to really understand how impactful CGM can be around the world. And that's what I'm excited about now is I'm still excited about the technology always will be and we still have lots to do on making it better, more reliable and more integrated. But just how much CGM can do around around the globe. There's just so many things. It's beyond diabetes to so very excited about the future.   Stacey Simms  30:47 Many thanks, as always, and we'll talk soon, I am sure but I mean, I could never get to say it enough. I can't imagine doing the teenage years with my son without Dexcom. You guys, I know you did it just for me. You did it just in time. Appreciate it very much. He is doing amazing. And I can't he would not be sticking his fingers 10 times a day. So thank you.   Jake Leach  31:05 That's great to hear. Thanks, Stacy.   Announcer  31:12 You're listening to Diabetes Connections with Stacey Simms.   Stacey Simms  31:18 As always more information at diabetes connections.com. And yeah, but that last bit there, I can say nice things. I mean, I really do feel that way. And I can still ask not so nice questions. Like if you're new, quite often, I will open up a thread in our Facebook group. It's Diabetes Connections of the group to gather questions for our guests. And I did that here with Dexcom, there's usually quite a lot of questions, I do have to apologize, I missed a big one. Because of the timing of the interview, I promise I will circle back around next time I talk to Dexcom. And that is all about the updates for iOS and for new phones, and how you know, sometimes Dexcom is behind the updates. What I mean by that is that they lag behind the updates. So you can go to the Dexcom website, I'll put a link up for this for Dexcom products that are compatible in terms of which iOS and that kind of thing. And they are behind. And Dexcom will always say they've said very publicly that they are working hard to catch up. But I guess the question that a few people really wanted to know was why, you know, why do they lag behind? What can be done about that? So they know, but I think it would be a good question to ask. So Sarah and others. I appreciate you sending that question. And I apologize that I didn't get to it this time around. And I'll tell you, you know, it's not something we've experienced, but I think it has to do and I'm speculating here more with the phone with the the newness and the the model of the phone sometimes then for the updates, especially if you don't have your updates on automatic. So I guess I'm kind of saying the same thing. But what I mean by that is Vinny, and I have very old phones. I have an eight. I'm not even sure he has the eight. We are terrible parents and I don't care about my phone, I would still have a Blackberry if that were possible. So I can't commiserate. I'm so embarrassed to even tell you that I can commiserate with the updates, because it's just not something that we have done. Benny, definitely if he were here, trust me. It's like his number. I would say it's his number one complaint that it's really high up on the list of complaints to the parenting department in our house. And yes, Hanukkah is coming. His birthday is coming. There will be some new phones around here. I'm doing an upgrade. I'm sure both of us have cracked phones. Were the worst. Oh, my goodness. All right. Well, more to come in just a moment. But first Diabetes Connections is brought to you by Dexcom. And this is the ad I was talking about earlier in the interest of full disclosure. But you know, one of the most common questions I get is about helping kids become more independent. I get asked this all the time at conferences for virtual chats in my local group. These transitional times are tricky. And we've gone through this preschool to elementary elementary to middle middle to high school. I can't speak high school to college yet, but you using the Dexcom really makes a big difference. For us. It's not all about sharing follow, although that's very, very helpful. Just think about how much easier it is for a middle schooler to look at their Dexcom rather than do four to five finger sticks at school, or for a second grader to just show their care teams a number. Here's where I am right before Jim. At one point, Ben, he was up to 10 finger sticks a day, he didn't have Dexcom until the end of fourth grade not having to do that made his management a lot easier for him. It's also a lot easier to spot the trends and use the technology to give your kids more independence. Find out more at diabetes connections.com and click on the Dexcom logo. I don't know about you, but I am getting a ton of email already about Diabetes Awareness Month and that is November this time of year I usually get I'd say 120 emails that are not snake oil, right one in 20 emails that maybe make sense for something we want to talk about on the show here that I would share on social media and I'm just inundated with nonsense. So I hope you are not as well. But I gotta say Diabetes Awareness Month this year. I've been pulling in My local group and talking about what to do because usually I highlight a lot of people and stories and I'll I'll still do that, I think, but I got to tell you people are, um, you know, this, we're all stressed out. And while it's a wonderful thing to educate, I always think Diabetes Awareness Month is not for the diabetes community, right? We are plenty aware of diabetes, this is a chance to educate other people. And that's why I like sharing those pictures and stories on my page, because the families then can share that with their people. And it's about educating people who don't have diabetes. But gosh, I don't know this year, I'm going to be just concentrating on putting out the best shows that I can I do you have a new project I mentioned last week that we're going to be talking about in the Facebook group. By the time this airs, I will have the webinars scheduled in the Facebook group. So very excited about that. Please check it out. But what are you doing for Diabetes Awareness Month? If you've got something you'd like me to amplify, please let me know. You can email me Stacey at diabetes connections.com. Or you can direct message me on the social media outlet of your choice. We are at YouTube, Facebook, Twitter and Instagram. That's where Diabetes Connections lives. I'm on Tik Tok, or Snapchat or Pinterest. Oh my gosh. All right. Well, that will do it for this week. Thanks as always to my editor John Bukenas from audio editing solutions. Thank you so much for listening. I will be back on Wednesday. live within the news. Live on Facebook and now on YouTube as well. Until then, be kind to yourself. Benny: Diabetes Connections is a production of Stacey Simms media. All rights reserved. All wrongs avenged

Advocacy in the Wake of Looming Mental Healthcare Workforce Shortages Curt and Katie chat about the looming (and current) mental health workforce shortages. We talk about the exodus of mental health providers, legislation and proposed bills that seek to address these shortages, and what modern therapists can do to advocate for the needed changes. We also talk about inadequate or harmful strategies (like cheering, scholarships, and subway sandwiches) that are often implemented by agencies and legislatures. We provide individual and collective calls to action.   It's time to reimagine therapy and what it means to be a therapist. To support you as a whole person and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age. In this episode we talk about: Recent data that shows that there will be huge workforce shortages in coming years The difficulty for folks in accessing mental health services in all sectors The reasons that mental health workers are leaving the profession High caseloads, higher acuity Systemic burnout, jaded supervisors The inadequate “support” of mental health workers with subway sandwiches, cheering heroes Legislation that has gone through to support healthcare workers in receiving mental health Legislation that funds hiring more workers Bills addressing scholarships to increase folks going to school for mental health The problem with scholarship bills versus loan forgiveness bills Bills working to decrease wait times for those seeking services Creating and filling in mental health treatment needs with paraprofessionals, peer counselors Navigating funding and worker shortages with new treatment planning The challenge in “steeling our hearts” to make choices in how we work and who we work for Both individual and systemic action that we can take to address these issues A request for the National Guard to come in and staff residential treatment centers The importance of taking action now to get involved in legislative advocacy   Our Generous Sponsor: Turning Point Turning Point is a financial planning firm that's focused exclusively on serving mental health professionals. They'll help you navigate all the important elements of your personal finances, like budgeting, investing, selecting retirement plans, managing student loan debt and evaluating big purchases, like your first home. And because they specialize in serving therapists in private practice, they'll help you navigate the finances of your practice, as well. They'll help you navigate bookkeeping, analyze the financial implications of changes like hiring clinicians or diversifying your income sources. They'll even help you consider strategies like the S-Corp tax election. Visit turningpointHQ.com to learn more and enter the promo code Modern Therapist for 30% off their Quick Start Coaching package. Resources mentioned: We've pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance! Mercer Report on Major Shortages of Healthcare Workers Senate Passes Legislation on Mental Health for Health Care Professionals Rand Report on Transforming the US Mental Healthcare System CA Bill would decrease wait times for mental health services Opinion: Exodus of mental health workers needs state response Send legislative bills to curt@therapyreimagined.com to get ideas on advocacy and responses.   Relevant Episodes: Why Therapists Quit Why Therapists Quit Part 2 The Return of Why Therapists Quit Bilingual Supervision The Burnout System Gaslighting Therapists Waiving Goodbye to Telehealth Progress Kaiser Permanente Strikes Episodes: Modern Therapists Strike Back Special Episode: Striking for the Future of Mental Healthcare   Connect with us! Our Facebook Group – The Modern Therapists Group  Our consultation services: The Fifty-Minute Hour Who we are: Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making "dad jokes" and usually has a half-empty cup of coffee somewhere nearby. Learn more at: www.curtwidhalm.com Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt's youthful energy, so that she can take over the world. Learn more at: www.katievernoy.com A Quick Note: Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We're working on it. Our guests are also only speaking for themselves and have their own opinions. We aren't trying to take their voice, and no one speaks for us either. Mostly because they don't want to, but hey.   Stay in Touch: www.mtsgpodcast.com www.therapyreimagined.com Our Facebook Group – The Modern Therapist's Group https://www.facebook.com/therapyreimagined/ https://twitter.com/therapymovement https://www.instagram.com/therapyreimagined/   Credits: Voice Over by DW McCann https://www.facebook.com/McCannDW/ Music by Crystal Grooms Mangano http://www.crystalmangano.com/   Transcript (Autogenerated)   Curt Widhalm  00:00 This episode of modern therapist Survival Guide is brought to you by turning point   Katie Vernoy  00:03 Turning Point financial life planning helps therapists confidently navigate every aspect of their financial life from practice financials and personal budgeting to investing Tax Management and student loans. Visit Turning Point hq.com. To learn more and enter the promo code modern therapist for 30% off their quickstart coaching package.   Curt Widhalm  00:24 Listen at the end of the episode for more information.   Announcer  00:27 You're listening to the modern therapist Survival Guide where therapists live, breathe and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Curt Widhalm and Katie Vernoy.   Curt Widhalm  00:43 Welcome back modern therapists. This is the modern therapist Survival Guide. I'm Curt Widhalm with Katie Vernoy. And this is the podcast for therapists that looks at uncomfortable things in our profession. And this is another one of those episodes that does that. And we are talking about the already developed but looming and worsening mental health workforce shortage across America. And this actually, some of the stuff that we're going to talk about today also has impact worldwide. So for our international listeners as well, we're gonna talk about YouTube. But there's been this little thing called COVID-19 pandemic. And those of us in the know, before the pandemic knew that Mental Health Access was not great in pretty much all parts of the world. And we follow along workforce issues and work with our legislature and the US government on some access issues in our advocacy efforts, and continue to have an interest in continue to provide advocacy on this. And as we're looking at the next few years, it's going to get worse, that we are seeing a exodus of workers from the mental health workforce, we are seeing a lot of reports from research organizations, we can talk about some things out of research group called Mercer and their reports that things are looking bad in the next five years as far as mental health workers that there is a exodus of workers here, Katie and I have talked before about how hard it is to become even eligible for some of these positions. And it's going to get a whole lot worse,   Katie Vernoy  02:54 paired with what people were, colloquially calling a mental health pandemic. You know, the second, the second wave of pandemic is a mental health pandemic. And I think, for me, I'm actually seeing this in my own practice, I open for new clients, and I'm getting calls from folks who can't find someone who takes their insurance, who are not getting calls back. I mean, there are already issues with folks being able to access mental health treatment when they want it. And we've also got this worker Exodus. And I think the the broad strokes of this, I think, are that there are, at least locally, you know, for me, I don't know that many people that take insurance, you know, many people have gotten off insurance panels, I'm getting off insurance panels because of the, what they pay. And I think it's something where people want to use their insurance, people also, at times need higher levels of care. And those beds are not there. I was reading an article out of Colorado where there there are folks who are staying in I think solitary confinement because they can't get into mental health facilities when they've been determined that that's the appropriate type of incarceration. Not that that's kind of what we're talking about today. But but there are so few mental health workers across the breadth and depth of our field, that people are not getting the services that they need. And there are big impacts on our community. So this is already happening. But it's it's something where we are also leaving the profession, and that's pretty terrifying.   Curt Widhalm  04:34 And we've been talking about this for a while we had a episode earlier this year on why therapists quit. We had several follow up episodes to it. But in looking at the trends, and I'm looking at the Mercer report here, we are looking at some major mental health shortage of workers. The Mercer report talks About that they're expecting 400,000 mental health workers will leave the occupation entirely over the next five years. And that's going to be leaving mostly public mental health employers with a shortage of 510,000 spots us nationwide. Getting into the reasons why we've covered in a number of other episodes, super high case loads, you know, large case loads, the very quick return to business as normal in a lot of situations. And this is echoed, really largely at the time of this recording I'm seeing early reports of this is really impacting places like college counseling centers that are a month into the new year to two months into the new academic year by the time that this episode drops, and are seeing increases from last year's already increased rates of seeking services by over 20% year over year. So they are facing increased calls for services with a drop in available workers to come in and provide services. The experience of these workers is also that the crises that are coming in are bigger and more severe than they have been in the past. So we're getting this perfect storm of more need higher need and fewer people to do it. And most people in our profession, as caregivers tends to want to help out but it does lead to just this really systemic burnout problem. That is easier for a lot of people to go and not work in this profession. Because it is just so taxing at this point.   Katie Vernoy  06:57 Yeah, I think it's something where, when I've had in the past, short staffing, you know, whether I was a mental health provider or, or a supervisor or manager, what we by and large do is take more cases, do more work, just try to keep going, you know, everybody needs us. We can't say no, it's it's really hard. It's all of those things. I was thinking I was picturing Adriana, you know, when she came and talked on our episode around the same thing happening for bilingual clinicians. But just this idea of I can't say no, they need us and so that this these gigantic case loads that are both systemically problematic, but also personally problematic because there's just no way to keep that pace up. And so folks burn out and leave really early. But even if they make it through I mean, we've we've had this this conversation and the burnout machine and you know, so we won't go too far into this but it's just it's such a bad situation where not only are the clinicians, overworked burned out, usually not getting paid much more because oftentimes the cuts happen there. And their supervisors and managers have broken away from the day to day grind of seeing huge case loads, but are jaded and not necessarily the support that those clinicians need. And so they might as well have left the profession.   Curt Widhalm  08:24 And we specifically talked about this in our gaslighting therapists episode did at the beginning of the pandemic and there's a part of me that really likes having been right but there's also a part of me that is like, we knew this was coming and and so frustrated just in this was so predictable that yeah, this is just Ah,   Katie Vernoy  09:00 yeah,   Curt Widhalm  09:02 Calm down.   Katie Vernoy  09:06 Oh, go ahead.   Curt Widhalm  09:07 But this is where we haven't changed the way that we take care of the workers. I mean, maybe what we've changed is given them a second subway sandwich party each month and   Katie Vernoy  09:19 Or like cheering WOO HOOO! way to go thank you heroes   Curt Widhalm  09:23 some sort of banner that that promotes You are a hero. But But I mean, it's it's stuff like this and it's stuff like, okay, we are seeing some of this response in legislation. There's a bill was passed by both houses of the US government. Moving on, will link to it in the show notes, but as a bill written by Senator Tim Kaine to promote and look into interventions for preventing burnout. in mental health and healthcare workers, and this is widely celebrated is Alright, we're going to be getting to the problem of why so many people are leaving the profession, how can we address this to keep people in. And these funding bills are continuing to miss the point in looking at this bill, my first response was, oh, we're gonna blame the individual mental health practitioners and the healthcare workers. The bill is literally about promoting mental health care and looking for ways to promote resiliency. And I know that the $30 million that is being spent to investigate this is going to result in do more yoga and have thought about therapy. As mental health workers, we know that we need to go to therapy, it's not dealing with all of the access issues, it's not dealing with all of the giant caseload issues. It's not being able to have good workplace practices. It's no set Principal Skinner meme of like, is it that's the problem? No, it's the workers. They're misinformed, that is just going to continue to reinforce this as a problem. And my big bold prediction is that in a couple of years, they're gonna say, well, we spent $30 million on it, and it didn't fix anything. So we probably don't need to invest in mental health workforce issues for a while. Hmm.   Katie Vernoy  11:33 Yeah, I think one of my I'm going to put this on my to do list right now is figuring out if that does go through, is there a way for mental health providers to actually get on task forces and those types of things? Because I think there's, there are possibilities, if there's money going toward it, it has not been decided current, let me be a little Pollyanna for a second and then decided that's not been decided. And maybe if our modern therapists across the country, go and try to get into these committees and at these tables and talk about what you were just saying, as well as different payment structures, and just like, just drop the RAND report right in front of them and say,   Curt Widhalm  12:11 That's just it! They're paying for more investigations to end up with things that are already in existence?   Katie Vernoy  12:20 Yeah, well, alright,   Curt Widhalm  12:23 we'll have a call to action about what we can do with that next step with the way that grant money is going with Health and Human Services. Maybe not today, follow us on our social media, and we'll figure it out, we'll figure out exactly who needs to be called on that. Now, some of these other bills that I'm seeing, they do provide for money for hiring more workers, General Manager, those are good.   Katie Vernoy  12:49 Yeah, let's hire more workers, give them some money, give them give them money and and autonomy, that's probably not happening, but give them give them money.   Curt Widhalm  12:58 Now, there's other bills to address behavioral healthcare work shortages. This also goes to other health care workers. They have their own podcast. We're talking about behavioral healthcare workers here. There are other bills that are addressed towards scholarships for improving access in particularly like rural areas. But with telehealth, I'm seeing a lot of these just in general, like let's get more people into school to be licensed for these positions. And these, in my opinion, are generally misguided and bad bills.   Katie Vernoy  13:33 And scholarships are bad   Curt Widhalm  13:35 Scholarships don't address the problem and actually may end up increasing the problem.   Katie Vernoy  13:43 Because why did they increase the problems? My friend this is, it seems like a lot of a lot of people I know they got these scholarships, and to help them get through.   Curt Widhalm  13:53 scholarship money tends to increase the overall cost of tuition and expenses that universities charge free money that's available for universities to take in, the more that it raises the cost for all students who don't get the scholarships. Because if the tuition can go up, because it's being covered by somebody else, this actually then ends up creating barriers for people who maybe, you know, not qualifying for the scholarships, still not able to pay for school, they end up taking out large loans. Now, what I'm saying is, this scholarship bills should be directed towards loan forgiveness, as opposed to paying for tuition, same dollar amounts. But if you are aware of anything, start talking with your legislators about how this money actually can impact the workforce as opposed to just filling some University's endowment fund a little bit more or being able to get three Subway sandwiches in student appreciation. We're just going to have an economy of Subway sandwiches. That's that's the way we're talking about this.   Katie Vernoy  15:10 So so we can try to increase the workforce by either hiring people somehow making education cost less. There's there's another bill that I saw, and I think there's one in California right now. But there's a lot of them, I think, across the country that I'm sure are happening, but it's working to decrease wait times for clients, patients seeking services. And on the face of it, this is potentially bad, because then there's a legislative, potentially legal responsibility for mental health providers to take more clients more quickly. However, this is the part that I think is really interesting. And this is where I think there's a challenge for us. If insurance panels cannot keep clinicians in their in their roles, and cannot keep up with these wait times. I'm wondering what happens if we don't jump to this action here? Am I getting into cartel territory?   Curt Widhalm  16:14 No, I don't think you are, because on one   Katie Vernoy  16:17 The Cardigan Cartel is taking this on!   Curt Widhalm  16:21 On one hand, the history of a lot of these insurance companies is whatever fines that they end up paying, are going to be probably cheaper than what they would have paid out in services anyway. And we've talked about this and things like the the episodes on the Kaiser Permanente strikes in the past, but these are billion dollar companies. fines to them are just, you know, shifting some numbers over from profit margins. It doesn't. These things, these bills like this are really well intended, but they don't address workforce shortages either. Yeah, and potentially even gives some of these insurance companies the opportunities for having a defense of, there's no workers for us to actually hire to shorten these labor times. which then leads to what has also traditionally happened in the workforce, which is that, well, this seems like a great time for mental health professionals too heavy, really good impact on legislation. Traditionally, worker shortages have been addressed by creating or filling in with more paraprofessionals. Now that if the really high barrier to entry positions are going to need a longer pipeline, it's being able to provide things like peer counseling services, peer support specialists, and, well, those are good, it's not something that addresses the specific problems that we're facing as licensees or for our pre licensed listeners on the pathway to being licensed. All the more reason for you to be involved with advocacy to address the specific issues. But my, you know, not Pollyanna, like, Debbie Downer piece of this hair is in unless you really take action right now, in all of the free time. And with all of that not burnt out energy that you have. History suggests that without really good action on this, we're not going to get the very needed changes that we've identified 1015 years ago, that have all come to a head here and will likely come to a head at some other position again, in the future. We need the action now to continue to call legislators to be involved in the bill writing process. So that way, it can be better. Otherwise, it's going to be filled in by paraprofessionals. And continuing to just replicate the same problems that we're seeing in our workforce system.   Katie Vernoy  19:10 There's there's a few things that you're saying that i i agree with, but I also think that they don't have all the pieces to it. And so speaking to my experience with some of these public mental health contracts and those types of things, when there is a financial shortage, so they're the funding goes away, because you know, and around near and around 2008, when, you know, the great recession began, there was a lot of funding that went away for mental health services. And so there were really creative ways that folks added some of these positions. So there was paraprofessionals case managers, there was different types of codes that could be used at or slightly lower rates. And there was also this huge push for evidence based practices to you know, kind of create these different funding streams and kind of pull money from here and There. And what I really saw is that there was this combination of how do we make this cost less? And how do we take care of people with a lower cost. And with, you know, there wasn't a workforce shortage at that time, I don't think I feel like there's always a little bit of a workforce shortage and public mental health. But that's a whole other conversation. But it's one of those things where there was, there wasn't money to pay people. And so they did create these positions. But since that time, and I think this, this is accounted for in the RAND report, as well, there's been a real efficacy seen with these multidisciplinary teams. So I don't want to say like, hey, let's get out and make sure that we get to keep all the work, because I don't know that that's necessarily what we need to do, I think we need to make sure that the work that we're doing, suits our expertise and suits, what is needed. But I think, at that time, there was creativity that was both kind of mercenary, as well as actually improving mental health care. So I don't think it's black or white, like, Hey, this is just because of a workforce shortage that we need to bring in people who have different qualifications. I also think, and this is very much aligned in what you were saying that there is a tendency to make do because it's not a nameless, faceless mental health problem. It's this client and that client and this group in that group. And I think, when we are looking to make a difference right now, I think there's looking at how do I steal my heart against wanting to solve this systemic problem myself. And that is both in how we how we run our practices, but it also can be in where we get employment, when a when an agency gets a contract. So they get let's say, they get a $500,000 contract, to provide services, if they cannot fulfill it, they they lose the money. And so for public mental health providers, they actually need to say stay staffed. And we can actually make a difference in who gets to keep their money by making sure we're very diligent in where we go to get employed, and where we stay employed and where we do the work. And so there there's there is I feel like there is an element of us choosing whether or not large app companies gets our employment, whether there's, you know, public mental health organizations that don't that do shady work, whether they get our employment, you know, like, we do have a value there beyond like insurance companies and their gigantic war chests being able to fight against some of these things. So maybe that was all over the place. But I think it's something where I don't want to say like, Hey, we can only do legislation, because unless we have power in and how we choose to do our work. I think there's not going to be change anyway.   Curt Widhalm  23:19 You're talking about individual issues here. While there's also such big systemic issues that do need the focus, and well, I think that there's a lot of individual efforts that we can make in our own practices, that it almost just kind of ignores the problem. I'm looking at an opinion piece in the Oregonian from September. And this was penned by Heather Jeffries, Executive Director of the Oregon Council on behavioral health. Cheryl Ramirez, Executive Director of the Association of Oregon mental health programs, and rice bowl and director of the Oregon Alliance. And their public call includes some things that very much speak to this kind of stuff, increasing funding to recruit and retain staff, reducing administrative burden. Those things are great, providing cash supports for organizations struggling with the financial impacts of increased costs and insufficient revenue. Fantastic. Publicly recognize and appreciate the workforce, throw more Subway sandwiches at them, maybe misses the point. Yeah, but the one that stands out to me is that they are asking the National Guard to be deployed to staff residential facilities. Hmm. We are in such a crisis, that the heads of behavioral workforce associations are coming together and saying we need people who Have nothing as far as training to be called in by the government to come and provide staffing here. And I point all of this out because we feel an individual responsibility to take some of these steps ourselves. There is only so much that each one of us can do that really needs to be able to address this, especially as a lot of these legislative waivers are ending and not, you know, being progressed things like, you know, telehealth supervision waivers that are, you know, going to be gone at the end of October in California where Katie and I practice but in this lurch where we talked about this in our in our most recent episode with Ben Caldwell is due to the legislative process, there is going to be systemic barriers, that rather than expanding some of this energy more for us to help the one or two or five more people on our caseload that we can take on to have a greater impact, spend those one or two or five hours where this can actually impact 1000s of people in a much better way. Even if it means looking more for long term changes in short term changes right now,   Katie Vernoy  26:32 I want to do a yes, and because I think it is hard, and we'll do some of the legwork here. This is what we've been talking about with not focusing in on a conference this year, we will do some legwork. And we will try to help have some specific guidance on how we make some impacts here on legislation, policy, that kind of stuff. But I think we also need to be very conscious about the choices we make collectively and individually on where we get hired where we do our work, what we charge, because if there is a path to status quo, the legislative efforts won't go through. Right. And so we have to push back against the status quo of poor insurance reimbursements ridiculous, or bureaucratic burdens on organizations, like we need to push back on those things, individually and collectively, or it doesn't matter how many of us go in, there's, you know, we're a small workforce, kind of an in comparison to some of these gigantic, you know, other types of organ, you know, profession. So, all of us just saying, like, I'm going to take two or three fewer clients and going and fighting on the hill is not going to necessarily be sufficient, I think we need to do both.   Curt Widhalm  27:56 We do need to do both, right? It's, it's like the gaslighting episode where it's like, this is stuff that is predictable that legislative changes are gonna be five, six years from now, where it's like we, we told you, so stop, stop complaining about stuff five or six years from now, because the call for action is right now. Legislators know that mental health needs to be addressed. What they don't know is what needs to be addressed in mental health. And that's where that call to action is. And I know in some of my early online conversations, when I point these things out, the response is, well, this is at least addressing the short term thing that's good enough. And right now, having been involved in advocacy for as long as we have addressing good enough for right now does not change the problems that are going to be way bigger five years from now. And I agree. And this is really where it's giving up some of our short term action that, you know, still may not be kind of our perfect sort of answers to everything. I mean, we do have several more decades of podcasts that we need to make. But we do need to actually address some of our problems in in our systemic part of our profession, and get this stuff off the ground. We have been doing some of the legwork on we will organize some of this stuff. We encourage you to start looking at what bills are going to be written in your respective jurisdictions. Send them to us send them to me, curt@therapyreimagined.com, c u r t at therapy reimagined.com. I'll give you at least you know some ideas of things to start talking with your legislators about and if your legislators aren't reading Mental Health stuff be calling their offices and saying, what are you doing to address mental health stuff in our profession, in our state in our in our country? Because the stuff that is being written is really what   Katie Vernoy  30:15 Subway Sandwiches   Curt Widhalm  30:16 it's Subway sandwiches. So thank you for giving me something so we don't have it explicit on this episode.   Katie Vernoy  30:25 I think we're in agreement, I think both of us just have a different take on it and and what can be done more readily. You are very adept at the advocacy at the legislative level. And I think that is something where we need to, we all need to get better at it. And we need to be at some of these tables, we need to be talking to our legislators. I 100% agree. I think if we are working for places who are exploiting us, at the same time, we are undermining our efforts. So that's all I'm saying.   Curt Widhalm  30:55 Okay, I agree with that.   Katie Vernoy  30:58 Overall, you know, kind of summarize in the call to action is really assess where you are in this in this time, in this really pivotal time. For our profession, are you working in a way that supports you and the work that you want to do? Have you created bandwidth so at the same time, you can advocate and make changes at the larger scale so that you're both supporting yourself standing by your principles and how you are going to work and pushing for larger systemic change.   Curt Widhalm  31:42 Be in touch with us, follow our social media. Take those Subway sandwiches and tell your supervisors where to put them. And until next time, I'm Curt Widhalm with Katie Vernoy.   Katie Vernoy  31:55 Thanks again to our sponsor Turning Point   Curt Widhalm  31:58 we wanted to tell you a little bit more about our sponsor turning points. Turning Points is a financial planning firm that's focused exclusively on serving mental health professionals to help you navigate all the important elements of your personal finances like budgeting, investing, selecting retirement plans, managing student loan debts and evaluating big purchases, like your first home. And because they specialize in serving therapists and private practice, so help you navigate the finances of your practice as well. They'll help you navigate bookkeeping, analyze the financial implications of changes like hiring clinicians or diversifying your income sources. They'll even help you consider strategies like S corp tax collection,   Katie Vernoy  32:35 And for listeners of MTSG you'll receive 30% off the price of their quickstart coaching intensive just enter promo code modern therapist when signing up. And don't forget to visit TurningPointhq.com to download your free finance quickstart guide for therapists.   Announcer  32:52 Thank you for listening to the modern therapist Survival Guide. Learn more about who we are and what we do at mtsgpodcast.com. You can also join us on Facebook and Twitter. And please don't forget to subscribe so you don't miss any of our episodes.    

The Kings opened the season in Portland Saturday, but their announcers weren't there.  What a  joke!  The arenas are full, most teams are sending their announcers on the road, but not the Kings.  This isn't high school...send your announcers to road games!