My Keynote at Colorado Counseling Association’s 2024 Annual Conference

“How’s it going?” My close community kept checking in on me as a I prepared to give my keynote at the Colorado Counseling Association Annual Conference in Keystone the next day. “I keep crying at certain parts of my speech,” I shared. I’d already given myself a grief hangover just writing my speech, now I was doing my best to stay composed as I said it out loud. “It’s okay to cry, your message is important,” each of them said. I agreed with them and continued to prepare. When it was time, I stood in front of almost 300 members of my community and introduced them to the term confidential grief. Defined by Dr. Lena Salpietro as losing a client to suicide and not being able to talk about it, I invited the audience to apply confidential grief to all the experiences in our industry that feel secretive due to feelings of shame, guilt, and judgement from others. I named the Big Five Fears of client suicide, client death, client violence, subpoena, and grievance as examples. We got to know our shame monsters together as a group. I had chosen to share my personal and professional journey of becoming a Confidential Grief Specialist. 

To help my colleagues understand the impact of confidential grief, I took them through six impactful and painful points in my 14 years as a therapist. These were stories that weren’t public knowledge due to confidential grief, and I named them as moments of self-doubt, shame, and leadership trauma. We grieved the loss of community members to violence and clients to suicide. We shared outrage at circumstances outside our control. And this time, I didn’t cry so hard that I lost my place. Instead I carried that emotion with me as I embodied vulnerability to a group of people I felt I was just starting to know more fully. 

As the talk continued, there were invitations to laugh, cry, and connect. I shared how I’d learned from my experiences that introversion is welcome (and necessary sometimes), vulnerability in leadership is allowed, and stories eliminate isolation in our field and as humans seeking connection against burnout. We talked about how to combat confidential grief through building community, showing up fully, and creating healing spaces for ourselves and others. I introduced bread crumbs imagery as bite-sized messages of hope and healing for folks to find when they were ready. Lastly, I shared a beautiful image on screen to start and close the talk. “There are not enough words” became an anchor amidst waves of emotion that come with confidential grief, and I invited my audience to share those words with others.

After my keynote was finished, I was given the gift of my community approaching me in both in the moments after and for hours into the next day to share their stories. You felt safe to share your losses of client suicide, your leadership trauma, and how you needed the term confidential grief to feel more seen. I heard countless exclamations that having a name for your experiences (both confidential grief and leadership trauma) was encouraging you to heal from here. I’m confident in the ripple effect of collective healing that will come from this gathering of clinicians, and find myself full of gratitude and with ‘not enough words’ to express the profound effect this experience will have on me for years to come. Thank you from the bottom of my heart for the collective healing and sharing together at CCA’s annual conference, I can’t wait to hear where your journey takes you from here.

A reflection on my Keynote titled Combatting Confidential Grief, Colorado Counseling Association Annual Conference

The Human in the Helper: I’ve had it happen twice

Caitlin loves her job and it shows. She works with youth involved in the juvenile justice system and has loved that system for over 15 years. It’s a career choice not many colleagues would commit to, especially when working with a population that assumes greater risks of loss, compassion fatigue, and vicarious trauma. Even though she finds her work rewarding, Caitlin has also experienced every Adverse Psychological Event (APE) known within our field, including the not often talked about ones, like client violence directed towards others. “I had two clients murder people in the community.”

Caitlin is willing to share her story to help others while also acknowledging how difficult it can be. “I had four deaths in an 18 month span,” she recalls. For her two clients who killed people, these tragedies happened after they had closed out of services. “The support I received around this happening was different because they weren’t active clients.” Caitlin reflected on how the support was minimal in supervision and consultation because of the clients not being active on her caseload. She named how it felt like leadership was relieved to not have to staff these cases, and redirected her to focus on her current caseload of at-risk kids. She heard messages like, ‘It sucks that that happened. What are you doing for your current suicidal kids?’

Although Caitlin understood the focus of leadership on current clients, this messaging didn’t help her healing process as a person. She found herself questioning if she’d done enough for her clients. If there was something she missed. And then there was the grief. “I was surprised that I felt so much grief for the kids who engaged in violence. I thought things must have been pretty bad for them to do this.” Caitlin’s compassion confused colleagues, who did not hold compassion for her former clients at all, instead labeling them murderers and engaging in black and white thinking. “They are still traumatized kids,” Caitlin named.

A trauma lens helps Caitlin remain in this work with her clients, as well as her abundant compassion for what her clients have been through.  Even so, the losses still took a toll on her. She felt acute symptoms of grief in the first month, with flare ups anytime she saw her former clients in the news for their trials or sentencing. She had recurring nightmares with her clients in them. “They were always calling out for help. Someone had to help them.” What helped Caitlin most was having one colleague who understood what she was going through, because they worked with the same population. “One time I came into her office and cried,” Caitlin shared. “My mentor said, ‘Caitlin, you are working with people through some of the darkest moments of their lives. That doesn’t always mean they come out of the darkness by following your light.’”

Caitlin reflects on the importance of having a colleague or mentor who can hold this heaviness with us. Someone who aligns with our beliefs and gives us space to heal. Someone who supports the ugly cries and the dark humor. Someone who reinforces we aren’t alone. She also encourages colleagues to do their own psychological first aid, making sure to eat, sleep, and move their bodies. “You will want to freeze. Honor all your feelings. You will experience every stage of grief.” Caitlin doesn’t have any plans to pivot from this population because she operates from a belief that what we do as mental health professionals still matters. “For every horrible thing that happens, there are 10-20 that don’t end up that way. Those horrible things are still the minority.” Caitlin’s story provides a beacon of hope in light of something that feels so heavy and so powerless. We feel honored to be able to share her messages here.

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about the Human in the Helper Series!

Breaking Free of Confidential Grief

Photo by Luke Besley on Unsplash

I first discovered the term confidential grief when researching for my latest book on helping clinicians heal from client suicide. In what felt like a sign from the universe, the September edition of the Counseling Today magazine arrived, and had an article titled Counselors Share What It’s Like to Lose a Client to Suicide. I felt compelled to reach out to Dr. Lena Salpietro, one of the quoted professionals who shared the importance of validation and empathy from mental health leadership to clinicians who’d lost a client to suicide. I couldn’t agree more with her statements and I was beyond excited that not only were people talking about the life-changing experience that is losing a client to suicide, but that there was a name for the behind-closed-doors experience of grieving a client loss.

According to the original research study published in July 2023, confidential grief describes the secrecy of our pain and grief when losing a client to suicide. Out of fear, shame, and perceived judgement from our peers, mental health professionals don’t feel safe to share that they are going through grief and loss, and thus attempt to grieve in private. It also feels confidential because client matters remain confidential, which means we can’t share our experience as openly as if it was a loss from a different part of our life. All of these things add up to an experience where clinicians are suppressing their emotions, attempting to compartmentalize their grief, and could result in them leaving the field due to the lack of support.

So here I am inviting colleagues to break free from confidential grief. How do we bring client suicide into the light? How do we prepare clinicians for this life-altering experience? For folks who’ve felt comfortable sharing with me thus far, I’ve often heard that nothing prepared them for this experience. With 1 in 4 therapists predicted to lose a client to suicide in their career, this is adding another layer of pain that could be easily addressed. How do we create safe spaces for this grief? Here are a few ideas for mental health leadership:

1. Attend to the person first, professional second.

When a client dies by suicide, the first thing we focus on as mental health leaders should be the clinician standing in front of us in shock. How do we help them navigate this event with compassion? Do they want to talk about it? Do they want to sit here and experience the flood of emotions with someone they trust? Do they need us to cancel their appointments for the day so they can go home? We can offer various things that could support them in a time where they may feel frozen in place.

2. Talk about it!

Let’s normalize that clients die by suicide. Let’s talk about it in graduate school, in community mental health, in internships, and in private practice. Let’s explore it with supervisees as a possibility so they can feel more prepared. So much more healing can be accessed if we normalize the possibility of this happening within our field.

3. Create spaces for healing

Since suicide will happen for 25% of us, how do we create spaces for healing? Is it a one-on-one conversation? A support group? A journey to self-discovery? A healing retreat? The more healing spaces we can offer, the more clinicians can move towards post-traumatic growth. What spaces do you know of? What more can be added for colleagues experiencing client loss?

There are lots more ideas in my book Moving from ALERT to Acceptance: Helping Clinicians Heal from Client Suicide. This book captures ideas for clinicians wanting to heal, as well as ideas for the mental health leaders helping them with that healing. You don’t have to do this alone. I recently shared with a colleague that I identify as a Confidential Grief Specialist to therapists amidst other roles of consultant, trainer, and course creator. For years, colleagues have been sharing with me their hardships and challenges, everything from family abuse to trauma, to substance use, to client death. It’s one of the reasons I started surveying colleagues on their career experiences with Adverse Psychological Events (APEs) as mental health professionals. Although confidential grief exists because of the loss of clients to suicide, I believe this term can be expanded to cover all sorts of career-related stressors, which create the potential for burnout within our field. Adverse Psychological Events can include client suicide, client death, client violence, subpoena, and grievance. All are disruptive and painful for clinicians, all are not spoken about freely because of fear, shame, and judgement.

Let’s break free of confidential grief together. We have a name for the experience, now we can offer something different! I know there are many of us out there wanting to create a safe, empowered container for clinician healing. Let’s share what we are doing to combat confidential grief and connect soon in our efforts to support colleague healing!

The Human in the Helper: My lips were purple

Liliana loves to take her morning walks. She’s usually accompanied by her fluffy white dog, a loving companion as they take in the vast beauty Colorado has to offer on various trails. Yet the serenity and meditative quality of her walks was disrupted five months ago. “I got off the plane and was dizzy. I thought that they didn’t decompress the plane properly.“ Liliana described ignoring her body’s messages as she attempted to resume life at home after traveling. She felt tired but didn’t think anything of it, laying down after her meetings one day to take a nap. “My son took me to the hospital because my lips were purple and I was struggling to breathe in my sleep.”

Liliana collapsed in the Emergency Room, and was rushed into treatment and emergency surgery for a pulmonary embolism. “I can’t take this life for granted, I don’t know what could happen next.” That was three months ago. Liliana has since learned that her medical crisis didn’t have a clear cause, which adds to the frustration she feels for herself and her family. “I have to take things one day at a time. Some days I need to rest or I need oxygen. Other days I feel good.”

Although this event holds medical trauma Liliana is still working through, it isn’t her first medical crisis where she’s had to rework how she operates. Liliana was diagnosed with thyroid cancer while pregnant with her son. “I had been conditioned to push through, to go-go-go.” Now she says she’s changing up how she works for herself in private practice. “Everything goes around medical appointments or how I feel that day.”

When asked how she’s coping with this significant life change, Liliana shared she’s embraced her love of writing. “I write poetry. I take time to write. I had to write. It helps me tune into my body.” Liliana described a recent experience with a spa service where her body said no. “I told the technician that it was a no-go, and started to cry as soon as I was outside. I didn’t know why.” So Liliana went home to write. Her body remembered something and was attempting to protect her, even though her mind couldn’t remember. “I’d passed out, I couldn’t remember all that happened in the ER that day.”  Her doctors later filled her in, stating she’d had a near fatal experience.

Although medical trauma can be heavy, Liliana wants colleagues to know that they can adapt. “Have a plan and be prepared to pivot as well.” She’s doing this herself when scheduling speaking engagements, consultations, clients, or new supervisees. “I’m up front about having a medical condition that looks like a disability. I let them know there’s a possibility of a pivot if my body says no.” Liliana says her community has been understanding and flexible. She offers referrals to anyone who needs more consistency than she can offer right now at this time in her life.

“I’m embracing my humor,” she shared. “I’m taking in all these things I didn’t think I’d notice.” Liliana is describing her increased mindfulness and gratitude practice after her medical crisis. She named being able to walk, to work, to do what she loves as gifts in her life. She also identified an aspect of surrender into the unknown. Pivots and changes to her schedule can feel like a daily occurrence. Liliana is approaching life with immense gratitude and intentionality. We know others can do it too. Whether it’s found within client work or through daily walks in nature, anyone can adopt this mindfulness practice in support of their health and well-being. 

Liliana’s latest poetry, shared with permission.

 It’s hard…body.  by Liliana Baylon

It’s hard to listen to you, body. 

I was conditioned to ignore you. 

To not trust you. 

To rely on others to diagnose you. 

Yet, you keep insisting. 

And I keep pushing through. 

Have patience with me! 

Is hard work, what you are asking of me! 

I’m getting to know you, 

To learn from you, 

To lean on you, 

To be curious about you, 

To recognize what you are asking of me, 

To understand what you are feeling, 

To answer your call. 

Keep talking to me. Keep insisting, please! 

Teach me what I need to learn. 

Keep being patient with me. 

I’m learning from you. 

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share with the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about The Human in the Helper Series!

The Human in the Helper: This isn’t something essential oils are going to fix.

Gabrielle shows up as vibrant, friendly, and personable, which serves her well as a mental health leader and Licensed Clinical Social Worker. She’s made quite the name for herself as an entrepreneur and consultant serving therapists and professionals around burnout and burnout prevention. With her passion, beautiful tattoos, and love of Zumba, it’s hard to believe she’s already experienced significant professional burnout in her career.

“I woke up one day and hated it,” Gabrielle shared. “My clients were no longer my ideal clients. I didn’t have the boundaries I needed. I kept hearing my own voice in my head say, ‘this is how it is.” But Gabrielle found out that things could be different. She was venting about how tired she was to a colleague in another industry one day. Their response? Sell your practice. 

“I found myself fantasizing about selling, but with the number we came up with, it didn’t seem worth the work.” At least at first. Gabrielle spoke to how she’d entered the mental health industry while working three jobs, and was subscribing to the hustle and grind culture of being a Millennial. “I believed that the harder I worked, the better it would be.” Which lead to burnout. Gabrielle recalls how she worked a job where she and her colleagues were expected to work long hours, take their work computers home, and come in on Saturdays or Sundays to get caught up.

Gabrielle then moved into private practice, rapidly growing into a group practice serving a community in need. She acknowledged that she built her business fast with the same drive of previous jobs and hadn’t worked on all of her own stuff as a person and professional. “This is what business ownership is about,” she told herself when she felt it catching up to her. Then she got the call to sell her business. “I had to ask myself, what do I want my life to look like?”

Gabrielle is a trailblazer in the mental health community by challenging the assumptions that success means a full private-pay practice or group practice ownership. “I have no regrets, this is alignment with my values,” she said of selling her practice. When asked what she wants other therapists to know, she shared, “you can create your dream life! There are so many options.” She warned against comparison to colleagues or listening to the ‘shoulds.’ She named how therapists have set high expectations for themselves, saying “we didn’t talk about the risks of burnout in school.”

When reflecting on her current roles of being a business and burnout consultant, Gabrielle shared a story of how an old job asked for self-care tools to be donated to their self-care room for employees. “This isn’t something essential oils are going to fix.” We have to agree.

To learn more about Gabrielle and how she can help colleagues and professional communities heal from burnout, visit her website at https://gabriellejulianovillani.com/

Things happen to us as humans, even as we support our clients as professional helpers. Do you have a story you want to share with the mental health community? Email us at croswaitecounselingpllc@gmail.com to learn more about The Human in the Helper Series!

Therapeutic Connection is the Key to Client Success

Research continues to demonstrate that the therapeutic relationship is the most important factor in client success. Therapeasy, a brand new therapist matching service, is actively thinking about this from the very beginning by exploring best fit criteria for successful matching of clients and therapists through their algorithm-based online platform.

The vision for Therapeasy was born because it's co-founders realized that the personal problems they each experienced in accessing mental health care were not unique to just them. Unfortunately, they share similar stories with frustrated people everywhere. Therapeasy's mission is to improve wellbeing by making connections, facilitate healing, and eliminate stigma in mental health care. 

Based on what we know now, I'm honored to have collaborated with Therapeasy to explore what clients are needing from professionals in order to find the best and most successful match! Check out my conversation with Therapeasy Co-Founder Jonathan Just.

What are clients saying they need from therapists to determine best fit?

Jonathan: “When we first started doing research for Therapeasy (it was only an idea at the time), we conducted a widespread market survey and were able to gather nearly 400 responses. This was extremely important to us as we began work to formulate the Therapeasy matching algorithm. 

What we learned is this: the number one characteristic considered when searching for a provider is area of expertise, which is an indicator of competency. But the number two characteristic considered is personality fit, which is an indicator of compatibility. Personality fit was indicated to be even more important than logistical factors such as location, price, and even appointment availability. This means that clients would be willing to drive further, pay more, and even move their schedules around in order to see a provider that they considered a "good fit " But as you know, especially if you have tried any online dating sites, personality can often times be difficult to determine and measure. This is why most therapist directories don't include personality fit, and why we made the decision to make it a priority for our algorithm.”

What do clients saying about the Therapeasy Profile that helps them find the best fit therapist? 

Jonathan: “I'd say that it's the interpersonal style preference that I mentioned previously that helps people find their best fit. Users have the ability to choose their preference between therapists who emphasize action and results, or are quiet and caring (as an example). Their preference is then matched up against the interpersonal assessment results on each provider profile, that helps contribute to each compatibility score. We also just recently added provider cultural competency to our algorithm. This option can be extremely important to underrepresented POC groups, LGBTQ+, and those with disablities who want to find a therapist who looks like them, or understands the community of which they are a part of. Since implementation, a full 1/3 of our users indicate that they are seeking a therapist who has cultural competency and experience working with clients of these backgrounds.” 

I've noticed therapists can get stuck in listing off their schooling and credentialing on a professional profile rather than speaking to their ideal client. How does Therapeasy help therapists capture the heart and authenticity behind their message? 

Jonathan: “I have definitely noticed that as well. It's understandable right? Many providers have put in a lot of time, effort, and money into their education so it's only natural for degrees and credentialing to be very important to them. Our market survey results however, indicated that certification and credentials were much lower on the list of search considerations. Of course I'm not saying that education is not important, but it simply isn't as important to many people seeking care as other factors. 

This is why Therapeasy profiles don't feature a list of what school you went to, when you graduated, or how many credentials you have. Instead, we highlight a bio section where each provider is encouraged to share a bit about what makes them and their practice special. It is often this message that people will connect with, prompting them to reach out and start a conversation.”

What tips do you have for therapists setting up their profiles that adds to success in matching with their ideal clients? 

Jonathan: “Great question. One practice that we started early was providing insights and tips to our providers to help with continuous profile optimization. The easiest and often quickest way to ensure a match turns into a client is to make sure that your profile photo is a good one. You might think that this is super obvious, but you would not BELIEVE the amount of profiles with below par photos. 

What I mean by that is: blurry/out of focus, low resolution, cropped, far away, or out of date (yes we can tell that the photo is 30 years old). Believe it or not, it makes a difference. My tip would be to use a headshot, taken in natural lighting, against a non-distracting background. If that sounds overwhelming, just find a teenager to help take it with their phone. No need to hire a professional these days! 

Another tip I'd give relates to the perspective and language used in the profile bio section. If the first place people look is at your photo, the next thing they will do is read your bio. I think that a well written bio speaks directly to the reader, instead of describing from a third-person. Using conversational language to describe what makes you/your practice special or unique is what can really help connect and attract clients who are looking for exactly what you have to offer. Instead of attempting to write something that will appeal to everyone, speak directly to your ideal client. These are just a couple of simple tips to help optimize any profile.”

This is all amazing! What else can we highlight in Therapeasy's efforts? 

Jonathan: “Therapeasy is currently and temporarily offering their therapist matching service to all Colorado providers, absolutely free. Due to the COVID-19 crisis, we understand that business this year has been challenging. Because more people now than ever are seeking mental health care, we want to make sure that providers in our communities have the ability to promote and connect with those who have a high compatibility to their practice. This means that it costs $0 to create a provider profile and start getting matched today. 

Therapy for me has changed my life and saved my marriage, which was only possible because I was able to find the right therapist. For anyone thinking about starting therapy for the first time or looking for a new therapist, I encourage you to log on to Therapeasy to find yours now.”

Thank you to Jonathan and the rest of the Therapeasy team for your passion and innovation in helping clients and therapists match successfully! Create your profile as a mental health professional at https://therapeasy.co