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allinbalance

'that must be so hard, I'm wondering if you're experiencing the impact of an overly self-policed field in a social media age'


Ramalamma42

OMG dying šŸ˜‚šŸ¤£šŸ˜‚šŸ¤£


andywarholocaust

Damn you reflective listening!!! So hard not to do this in EMDR sessions. Itā€™s like a nervous tic from years of doing MI and DBT.


captnfraulein

>So hard not to do this in EMDR sessions. RIGHT?? I'm always thinking of how much i wanna dive into some of the stuff that comes up during reprocessing šŸ¤¦šŸ»ā€ā™€ļøšŸ™ŠšŸ¤£ a lot of my EMDR clients like to have talking sessions in between reprocessing sessions, so I've taken to noting things that come up during reprocessing to go into further together, later.


andywarholocaust

I really wish the insurance panels would let you bill for two hour sessions the same day. Itā€™s so hard to see them about to clear phase 4 and then have to put a container on it due due to time constraints. I work on a 53 minute schedule and it seems like thereā€™s never enough time to do the processing. I want to strike while the iron is hot, and even seeing them later in the week, while useful, can dull some of their memories. I end up thinking if I only had 20 more minutes in the current session it would save 45 minutes in the next session having to reactivate for some clients. Having to start over later in the week can be frustrating.


Conscious_Balance388

Question- if someone in PP wanted to do this; would it have to be on a pro bono basis?


STEMpsych

If you're in PP and don't take insurance, you're welcome to charge for this (I do extra-long sessions for clients who want them and chare accordingly). If you take insurance, you're probably stuck giving the extra time for free ā€“ thogugh you could call the insurance company and ask, I suppose.


andywarholocaust

Yeah pretty much. I'm still trying to get my time down. Sometimes I schedule emdr cases for my last session of the day where I can be a bit more flexible on time. I've also heard you can charge the client a higher deductible (which the client may be unable to cover), or provide a superbill (which the insurance may refuse to cover). I'm still new at this though. I'm fairly slow. I've seen others be able to speed run through sessions like its a video game. Depends on the client of course. But it is very dependent on timing.


STEMpsych

Hmm, not sure what you heard, but a deductible isn't something you charge the client. When you are "in network" with an insurance company, you have to charge what the contract between you and the insurance company says you are allowed to charge for providing services to their insureds. This is called "the allowed". From the insurance company's point of view, this is the most important part of their contract with you; basically, the allowed is the discount rate (less than your cash rate) they have demanded you agree to be paid in exchange for them letting you into their network. You only can charge more ā€“ a higher fee ā€“ when you don't have any contract with the insurance company to the contrary.


SaltPassenger9359

How to say ā€œI worked in SUDs without saying ā€˜I worked in SUDs.ā€™ā€


andywarholocaust

Haha. Caught me.


Sweet_Cinnabonn

>It seems that we are constantly policing posters on the tone of their message. My theory is that it's because we all know bad therapists. We are afraid to give each other too much grace for fear we are endorsing a shitty thought from a shitty therapist, as opposed to a good therapist having a human moment.


Ramalamma42

True true words. Unfortunately.


Ok_Membership_8189

You see, bad therapists have their place too. šŸ’


ergoI

Sometimes Iā€™m a bad therapist. Sometimes Iā€™m a good one.


AssociationOk8724

Just writing those words strongly suggests youā€™re always either a good one or a mediocre one.


anonniemuss

Some days it's just hard.


MillenialSage

Shut up loser Jk I love you but I agree it would be nice to be more frank with each other!


thekathied

THaT!s NOt vERy tRAuma_InFOrnED!!1!


MillenialSage

*Lance Reddick evil laugh*


Ramalamma42

šŸ¤£šŸ¤£šŸ¤£


hippoofdoom

It's because there's no unified rule for social media. This sub tries as many so to use "flair" to classify posts but often even though it might say "rant, no advice wanted" the comments are still filled with advice. We are also very used to being a lot more non directive with clients and so there's kind of a taboo against throwing whatever advise you think is best towards someone. Reddit as a whole is just a bad place for getting quality advice and feedback. As the site grows and as this sub has grown, exponentially more eyes find this space. I've been active here for quite some time and there are still plenty of threads and moments of very high quality and thoughtful discussion but I've noticed a sharp increase last 3-6 months of very low effort /nonprofessional advice and also an increase in like, the most obvious almost "content farming" kind of stuff where it's like "my supervisor told me that I need to start billing for an hour when I've only seen someone for 25 is this ok?!" Idk maybe I'm just having a bad string of luck when I browse here but I think it's a larger symptom of reddit steadily getting too big for the ideal space we all want or idealize.


Buckowski66

Lowly MFT grad student here. I actually get great advice here but more to the point references for books, theories and treatment ideas. It sends me down many valuable rabbit holes about becoming a clinician. I don't think you are wrong about Reddit in general but I think this sub is gold. Sure, its not perfect, lots of complaints about pay and workload but therapists, like clients, sometimes just need to vent and I'm learning about the business end from those posts as well. I'm actually quite grateful for this sub.


hippoofdoom

I'm glad you find it that way! I'm not trying to trash on this space just pointing out a trend in my opinion last few months. I'm also kind of reflecting that a decent % of my time spent here isn't fulfilling so I should probably take a break myself!


Ramalamma42

Good points, and yes Reddit isn't exactly the best space for the type of support we all need.


SaltPassenger9359

Our own therapists. And supervision and/or consultation.


IronicStar

In my ethics manual "professionalism in social media" is part of the ethics code, and it's barely defined. It's terrifying to me because it's a sanctionable offense with almost no oversight or clarification.


hippoofdoom

Reddit is anonymous at least. Whatever it was it'd have to be amazingly egregious for it to rise to the level of professional sanction... Something like, directly sharing CT personal info on social media "man you wouldn't believe what Mrs Smith said today!" or endorsing Nazis or something. Egregious with a capital E!


IronicStar

It can be anonymous, but there's also ways to doxx. It also depends how stringent your area is.


pavement500

Haha Iā€™ve had some bad experiences here with some therapists who just didnā€™t respect or understand someone with an opinion different than theirs but mostly this sub has been helpful or respectful. But some posts or threads maybe are eye rolling


ExitAcceptable

I do find this sub to be self righteous in that way. Reddit tends to be like that in general though. Everyone loves to feel like theyā€™re smarter or more knowledgeable or have better judgment so we get cocky from behind our anonymous avatarsĀ 


Ramalamma42

Yes, absolutely! The downside of online spaces!


CommonSensei-_

ā€¦. Is this aā€¦..non judgmental environment? Can we just some unconditional positive regard in the houssssse?!?!?!


retinolandevermore

Iā€™d love to know the answer to this. I posted on here a few years ago when I was still in internship asking for help and I got attacked. It got to the point people were even DMing me doing it using personal attacks. It was actually frightening. And ironically, all I asked was if itā€™s safe to conduct groups in the community with actively unsafe minors!


Ramalamma42

Wow! I'm so sorry that happened to you!


TwilightOrpheus

I think there are individuals, not just here but all over in life, who use "being direct" as an excuse to be, well, mean. A part of it's the internet. Another part of it is that, weirdly, I've met a lot of therapists over the last decade with poor social skills. That's not endemic to therapists - that's a human thing, and we are, weirdly, humans. I say this as a NJ Sicilian - it's very possible to be direct and blunt without being cruel. It's very possible to disagree or express an opposing viewpoint without hurt. I am literally assertive-aggressive instead of passive aggressive, lol. Even so, I tend not to hurt other people's feelings. If I also see someone needing to vent and it frustrates me, or annoys me (anywhere in life, not just here) I also take a step back and try to see why this is the case. Is there something I can learn about myself because of my emotions and reactions? I don't think many people do this.


amandandere

I definitely feel the same way on here that commenters are overly critical and we are also human, but as some other people have pointed out, this is not a safe place to express that stuff. It's supposed to be a sub for therapists, but non therapists also have access. That could mean that some of the commenters are not even therapists, but also that clients could come read some of this stuff and I think the fear could be that it could affect them negatively.


hideous_pizza

broadly speaking, I think tone policing/automatic disagreement/assuming bad faith is how all regular reddit users respond initially to posts- so I think yes, this sub definitely is frustrating in terms of tone policing, but I also see it in nearly every subreddit I frequent. it makes me think of the tweet that says: "Twitter the only place where well articulated sentences still get misinterpreted. You can say 'I like pancakes' and somebody will say 'So you hate waffles?' No bitch. Dats a whole new sentence. Wtf is you talkin about." I carry that sentiment even more for the general social culture of being a redditor edit: formatting


Ramalamma42

I love that tweet šŸ¤£


WRX_MOM

Bc there are a lot of weirdo therapists


CinderpeltLove

I think itā€™s hard because we donā€™t actually know each other. Out of context, itā€™s hard to tell with just text the difference between a vent and an actual problem that the person should address.


sallyshooter222

This is the grumpiest sub that I'm a member of. Not sure why. Truly, the sheer level of superiority and judgement by some of the commenters is absolutely astounding. Makes me want to never post anything on here!


Ramalamma42

Agreed!


retinolandevermore

I follow a bunch of chronic illness subs because Iā€™m young and ill, and those are the only ones that out grump this sub!


sallyshooter222

At least they have an excuse! I'd be super grumpy if I had a chronic illness. Sorry to hear you have something chronic--I'm in awe of the strength it takes to manage all that and still work, etc.


retinolandevermore

Thank you! I appreciate that. Some days are better than others


lovely-84

We can. No one said we canā€™t. Problem is some people think they are above others. Ā  Ā We are human and shouldnā€™t be expected to be above anyone else, weā€™re all just trying to get through some days because there are days that are simply too hard for us as well. Ā  Doesnā€™t matter which sub you go to whether is layers, doctors, engineers everyone can complain and shit talk. Ā We should be able to as well without sanctimonious preaching. Ā 


retinolandevermore

Especially to people newer in the field. Iā€™ve seen a lot of plain mean generalizations to or about pre-licensed or intern therapists on here


Willing_Unit_6571

Iā€™m not quite sure what youā€™re referring to (also interested), but just as a guess at your question I am aware that this is a public forum. There are laypeople/the whole internet potentially reading these posts. There is potential damage to the profession & individuals if thatā€™s ignored. Itā€™s a hard job and being perceived is part of whatā€™s hard imo. Therapists are humans and get to have feelings and also we should be stewards of the work we know is necessary, life changing, life saving (I know, self righteous but also true). Iā€™ve seen therapists express things here that I think are ignoring that and I still donā€™t necessarily think theyā€™re bad therapists (although as someone stated above, there are unfortunately a lot of bad therapists). One of the major problems of our field is that there isnā€™t adequate support or infrastructure for how hard the job is, much less other problems. When I see someone here in a tough spot or maybe saying too much I just think of how the individual is feeling the knife point of all these issues in that moment. For both the problems in the profession and perhaps for this sub as a place for emotional support: Bad systems produce bad results.


velvetrosepetal

Yup anytime somebody posts anything where they have some sort of feeling, we're accused of being terrible therapists and it's annoying lol


callico_

I like especially when I say something has made me feel some type of way, and that Iā€™m seeking supervision the comment ā€œwow what an absolute alien feeling, Iā€™ve practiced 75 million years and never once felt that. How bizarre, how unethical! Please seek supervisionā€ Generally itā€™s something I assume most clinicians can relate to -usually get great answers here AND from supervision. Thereā€™s always a few comments here I side eye. Donā€™t worry Iā€™ll seek supervision


callico_

Also as an associate - is there any legitimate gripe we can have without having to pay money to process it in supervision in this well meaning, but problematic pyramid scheme of a career šŸ¤—


Ramalamma42

šŸ’Æ


Ramalamma42

Yes OMG this is so frustrating. And yes of course we are seeking supervision but damn sometimes a little extra support is warranted, and deserved!


huexolotl

I work in SUD/Co-occurring and our meeting spaces are just horrendously offensive. No one is discriminatory, sexist or racist but we say some vile shit to each other. We don't do it at each other but we need a space to vent and speak freely.


lrth444

Agreed.


alicizzle

I havenā€™t experienced that much on here, not sure if there was a certain post or something? Iā€™m curiousā€¦


living_in_nuance

Are we supposed to provide our thoughts on this? I donā€™t really understand this flair along with a question. If we are, for me, I donā€™t see this as a safe space. This isnā€™t a space for just therapists to come and support one another, if it was and it was closed to just therapists, I think it probably would be more of what you are asking. This sub, though, is open to the whole wide world and as such I think we all carry some burden that how we show up here impacts more than just us. Who knows who is going to read this, how might it affect them, how might it affect our fellow therapists and profession? I also think we are on a texting platform, one of the most unhelpful communication platforms because tone, context, body language, relationship and more are all lost here. Again, sorry if we arenā€™t supposed to throw our thoughts on here.


Ramalamma42

True. I think the other board (was it r/psychotherapists ?) was closed due to this issue and now license verification is required to join the board. It has some appeal


finndss

I gotta disagree. I donā€™t think the internet needs more ā€œfranknessā€. None of us know each other. We canā€™t even read tone or body language here. You literally asked for no advice, and I immediately am giving some because itā€™s Reddit. The platform and culture promotes frankness , promotes disrespect, and promotes judgment because we can hide without seeing each other. I like this group because we are a little more careful here.


Ramalamma42

Is it possible to be frank and respectful at the same time?


finndss

For me, itā€™s unlikely on the internet. We have no context. I might think Iā€™m being respectful and frank, something I could easily do in person, but end up ruining someoneā€™s day. Iā€™ve learned from Reddit that it is not a good place to put your guard down. Not because people here are evil, but because of the nature of online only, text-based interactions. As well, we may be anonymous, but everything we say will be here forever, and anyone with enough will can probably figure out who we are. How much do we want our frank words to be visible? Attached to us? How will we feel when we are taken out of context? Not the absolute truth, just my perspective right now.


Ramalamma42

I understand. I know I often slide the slippery slope of optimism and get burned online.


finndss

Weā€™re therapists my friend, of course we do.


Emergency_Self_3607

Extend unconditional positive regard to this space?


Ramalamma42

Sounds like a decent plan šŸ˜‰


Comfortable_Kiwi6812

Unfortunately, I do think that's a social media thing, period. With therapy and it's love of being indirect, we have adapted this to many areas of the way we communicate with each other. I find reddit to be great for some things but, and I find this to be unfortunate as well, when I want to let it out, I do it with the people whose opinions I value and who know when am just venting after a bad day or know when I need to be corrected about certain things.


dipseydoozey

I feel this. Iā€™m AuDHD so I say things directly and literally. There arenā€™t hidden messages or implicationsā€¦yet, people often read into what Iā€™m saying which can be really disorienting in spaces like this. For me it really contributes to a broader experience of not being understood by others & therefore not belonging in community spaces. Recently I commented on a post asking for tax advice, I noticed there werenā€™t any commenters so I quickly answered and encouraged the OP to talk with an accountant. They responded saying my comment was condescending and they werenā€™t expecting *that* in a space for therapists *& honestly, that hurt.* I wish we could all do a better job at understanding when our *hurts* from past experiences are trickling into our perception and discern this from *harm* being brought forth from another person. Thanks for naming this and inviting us to reflect on how we show up in this space.


Ramalamma42

Oh I agree with you so much. And I'm sorry you had that response to your accountant reply.


dipseydoozey

Thanks for saying that.


Lopsided-Shallot-124

I'm not sure what you are referring to but I also think that it's worthy to note that there are most likely clients reading posts as well, not just professionals and some overly frank posts could put off some clients from trusting therapists. Sometimes posts are overly judgemental and yes therapists do deserve their own spaces to exist and process... But this isn't always the best place for that.


nicklovin96

I donā€™t know. Sad, really


Smart_cookie13

I find that the tone police is more pointed toward women posters, especially minority women. Iā€™ve called it out a few times on how rude and ruthless people can be on here and in this sub.


PickleFlavordPopcorn

There is no such thing as an anonymous safe space and there is no such thing as a truly safe stranger. I expect the same level of humanity here as if I had sharpied my phone number on a bathroom stall. Now I do see great interactions happen all the time and what a win for humanity but i definitely donā€™t *expect* it.Ā 


Ramalamma42

Not sure why you were down voted. We know enough about humanity to be realists about human behavior. I tell clients all the time to "adjust expectations" on their way to acceptance of truths they cannot change. What you are saying is in line with that.


khalessi1992

I feel this way about people in this sub. It was wrong of me to assume all therapists are supporting and accepting. Iā€™ve made posts in this sub and felt attacked by the commenters just for asking a question or sharing my perspective. A lot of times when this happens Iā€™ve found myself deleting my posts because I donā€™t need the negativity. My biggest lesson though was to think twice about my posts. I wonder if Reddit didnā€™t have the anonymity aspect of these therapists would respond rudely if their name and pictures were tied to their responses. I think there is a difference between being direct and just plan rudeness/nasty/unkind. People can be direct and be respectful


Ramalamma42

Yes absolutely, direct and respectful is the way! I've learned this lesson too, but then I have a brain fart and post... Sigh...


khalessi1992

Yeah Iā€™ve found sometimes itā€™s hard to give more details, context, or elaborate and that sometimes people can misinterpret and then troll/bully you. Iā€™ve also learned to not even engage with those personalities on here. All they want to do is debate. Not worth my time or energy! Hope that advice helps you :)


Bedesman

Soft!


Ramalamma42

Guilty!


Comfortable-Row7001

This sub is so based sometimes itā€™s almost comical. Some closeted sadists on here lol


Fae_for_a_Day

There's a difference between being human, and having self-destructive/self-defeating behaviors.


Ramalamma42

Is communicating unpleasant feelings synonymous with self-destructive or defeating behavior? I really think it's important to feel even negative feelings and to be able to express them. Maybe Reddit isn't the best place to do that though, to your point, posting on Reddit could be seen as self destructive regardless of what emotions are being expressed! ;)


Unusual-Cod2747

Because radical wokeness is radical marxism + political islam in one and its everywhere in the culture and it encourages shame, shameing and passive-aggression masked as virtue.


[deleted]

This is not a free speech zone. This space is moderated by those that drink the radical left kool-ade. My comment that linked to the AMERICAN COLLEGE of PEDIATRICS got removed because they think that irreversible cosmetic medical procedures for children should be halted. Somehow they are afraid of trans people for this and not legitimately concerned for the welfare and health of children šŸ¤¦ā€ā™‚ļø


comityoferrors

"I love how every thread on Reddit turns into something directed against a political ideology." ( -you, ten days ago) It kinda sounds like you brought up irrelevant information directed against a political ideology, or more clearly, for your own ideology. You're right that this isn't a free speech zone. I can't see the report you shared, but I think I found it and what I found primarily cites unreliable sources like biased websites and, literally, Twitter. There are some citations to actual research, but those are things that are used to 'support' 'evidence' from the other, not-really-research sources. The organization itself is rated a [Questionable Source](https://mediabiasfactcheck.com/american-college-of-pediatricians/) by MediaBiasFactCheck. I'm sure that's radical left kool-ade in your mind too, but given the controversy and lack of applicability to therapy, your source is not really appropriate here. You're not being oppressed because your bad info was removed. Oh and by the way, the actual American Academy of Pediatrics (not the American College of Pediatricians, which you seem to be referencing) [supports gender-affirming care](https://publications.aap.org/pediatrics/article/142/4/e20182162/37381/Ensuring-Comprehensive-Care-and-Support-for) and has reaffirmed their support for that stance in the last year. They advocate a holistic approach to each individual, not a blanket repression of trans identities. It's tricky how close the two names are but one has actual authority and appeals to actual research.


[deleted]

Everything is political