Taking on Private Insurance is Like Learning to Eat Healthy

Taking on private insurance is like learning to eat healthy.

At first you aren’t sure you want to do it. You’ve heard how hard it can be and so you’re on the fence. You enjoy your freedom and don’t want to be tied down by all the rules. It seems like so much effort. It feels too hard.

But there’s this little voice in the back of your mind saying what if? What if eating healthy could be the best thing for you in the long run? So you take the first steps in learning to eat well. You find yourself frustrated with the effort, energy, and resulting mood swings that come from being outside your comfort zone. You continue to question if it is worth all the hassle. You have a couple meltdowns.

Eventually, with persistence, you find your groove. You’re noticing it takes less effort to eat healthy. You’ve found success in having a plan in place, it feels more effortless now. 

The journey of adding insurance to your private practice is a lot like learning to eat healthy. 

The same emotional rollercoaster. The same doubts and frustration. The same growing pains. And in the end, insurance can contribute to the overall health and well-being of your business, allowing it to thrive amidst COVID-19 and beyond.

 So let’s take a look at some of the myths and practical tips to navigating insurance in private practice.

Myth #1: The Panels are Closed

It’s possible that the panels are closed, especially when we understand that insurance data on their providers isn’t very accurate or up to date. It isn’t uncommon to hear that providers listed in directories are retired, deceased, or not taking new clients. So how successful would a member (client) be in finding a qualified provider?  Encourage potential clients to reach out to their private insurance to express their concerns and difficulties. Sometimes this works to open up a panel for credentialing of additional providers in hearing that their members can’t find the services they need.

What can you do as a professional? 

·      Name your Niche: Highlight your specialties and justification for being approved as a provider. If insurance finds you are providing a service their members want, they could agree to move forward with credentialing.

·      Be Persistent: Follow up with closed panels to see if things change over time. Your persistence may pay off if you catch them in the optimal window where they are taking new providers!

Myth #2: Payment is Poor

I recommend to fellow providers that we all find a way to make peace with not being paid what we are worth. Insurance panels will report that they generate their pay structure based on comparable professionals in your area and thus, believe they are offering a competitive rate. Regardless of what they pay, is it still important to you to serve a particular population? Is it worth the effort to help people who need to use their insurance to access services? If you’ve answered yes to these questions, don’t give up on insurance just yet! Panels continue to evaluate rate of pay on an annual basis and I’ve seen the rates of reimbursement improve over time. There’s hope that they will continue to evaluate and increase rates every year.

Professional Pointers

·      Do your Research: What services does each insurance panel reimburse for and at what rate? Interview colleagues to better understand their experiences with certain panels.

·      Renegotiate as Needed: Identify the process for renegotiating your rates once you’ve been credentialed as a provider. It doesn’t mean you will automatically get what you’re asking for but it could spur insurance to take another look at rates for all their providers in hearing from you and others that a rate increase is desired.

 Myth #3: Billing is Unbearable

I agree with you that billing can be a headache. More so when we had to mail in claims or submit them by hand on CMS1500 forms. The good news is that billing has been streamlined, saving time and headaches for providers everywhere! What has streamlined billing over the past ten years? Electronic Health Records (EHR). Popular options like SimplePractice, TherapyPartner, and TherapyNotes have billing processes built in, eliminating the middleman clearing house and auto-filling some billing information based on your calendar appointments to save you both time and effort as a busy clinician.

Professional Pointers

·      Create Templates: Streamline your process even further by creating required templates in your EHR like a credit card form for collecting copays and a Mental Health Assessment to justify a clinical diagnosis required to bill each service.

·      Understand Compliance: Identify compliance requirements based on your insurance contract. Most require a diagnosis resulting from a formal intake, progress notes, and treatment plans for providers to remain compliant and pass an audit.

Myth #4: I’ll End Up Working for Free

There is understandable fear that clinicians could work for free. Insurance panels could take money back if providers make a billing error or if the member isn’t actually covered by an active insurance policy at the time of service. Combine this with confusion about what insurance plan the member/client actually has and the random names for varying plans under bigger names like Aetna and United, it’s no wonder providers feel reluctant to jump on the insurance bandwagon. It’s in your best interest to create a system and process for verifying insurance from the first contact with a client you’d like to work with. It is also in your best interest to bill regularly so you can catch any errors in a timely fashion. After all, it’s even more painful to realize you aren’t getting paid for the last three months in having waited to bill sessions at a later date. 

Professional Pointers

·      Anticipate Delays: Budget your business with anticipation of delays in payment. Most insurances take 2-3 weeks to process claims.

·      Set up EFT: Selecting Electronic File Transfer (EFT) or Direct Deposit of funds will save you some stress in seeing when funds are processed and received in your business account

Insurance doesn’t have to be so stressful. I sincerely and passionately believe that adding insurance clients to your practice will support sustainability and quality client referrals, making your business a healthy one full of growth and long-term potential in offering what you do. 

To learn more about adding insurance to your private practice, check out our webinar, Investing in Insurance: Strategies for Private Practice which features more on the 4 Myths and 20+ Tips of adding insurance to your private practice, making it work well for you!

Brand Basics: Three Foundational Elements When Branding Your Business

Let’s keep it simple. As a therapist, YOU are your brand. That’s right, people are looking at your website, social media, and any other material they can find, trying to decide if you are relatable, competent, friendly, and approachable. They are making a snap judgement not by your credentials but by what you say you work with, and how you look, dress, and sound (if you have videos). It’s important to keep this in mind when growing your business. There are several elements of brand to consider when starting or strengthening your practice so let’s take a look at them here.

1.     Select the Name of your Business

Step 1: Identify Words that Describe You and What You Do

For many of us starting out, we get stuck on the initial piece of building a business—the name! What name will capture what you do? Who you are? The people you serve? Consider asking for key words from colleagues or current clients about how they would describe working with you. Remember that you are your brand. Therefore whatever key words they share could be a starting place for finding the name of your business.

Step 2: Focus on Future Thinking 

Also consider if you would expand or add additional services in the future of your business. You might be considering online coursework, writing a book, or adding other providers to your practice. By thinking ahead, you can avoid some of the challenges that come with having a brand or name that doesn’t capture how your business has evolved. Challenges that some colleagues have shared as 1) naming their business their first and last name, but then wanting to bring on other therapists as a group practice and 2) wishing they’d kept the business name more broad to cover other services such as ABC Counseling vs. ABC Therapeutic Services to allow visitation, case management, etc. to be added as they grew.

Step 3: Recognize Identity Confusion and Trademarks

Yes, I’ve saved the scariest for last when it comes to naming your business. Not everyone is well versed in the rules of Intellectual Property and trademarks. Start with a general search of the name you are wanting to use via Google. Does it already exist as an established company similar to yours? Next, visit the trademarks database and do a search. If someone owns the name already, you can’t use it. If you do, you’re asking for legal action around trademark infringement and a possible lawsuit. Third, visit your state’s small business site to do a search of business names registered there. Are there other companies in your state with a similar name? Would you be confused with their business, making it difficult for potential clients, customers, and Google to find you? 

As you can imagine, this is an overwhelming first step in creating a business. You may want to consult an IP attorney for further in-depth research on the name you are considering. 

One last tip? Consider making up a name or word that doesn’t yet exist! Or spelling something uniquely. It simplifies concerns of trademark infringement and copyright and could make your business easier to find in being unique when put in a google search!

2.     Build Your Brand

Congrats, you’ve successfully navigated through the name selection process! Now it’s time to build your brand with a Brand Book and logo. Were you aware of Brand Books before this blog? I didn’t know what they were until marketing and graphic design experts gave me an education. A Brand Book identifies elements of your brand including:

·      Colors

·      Fonts

·      Placement of logos on materials

·      Tone of voice

·      And more!

Why is this important? Because if you expand and/or hire marketing and social media support, for example, it will be important that they stay on-brand when creating new content for you in order to embody the essence of your business. Look at this from the lens of big businesses. Let’s take Target for example. Target uses specific fonts in their marketing. They have a particular shade of red that is recognized with their bullseye logo. And every time they release an advertisement, there is placement and tone of voice to consider. They don’t deviate from these recognizable elements of their brand. 

So in exploring what your Brand Book would include, you may start with a logo. There are affordable options for unique logo creation with freelancers through Fivver and Upwork.com. You can also hire a larger company that will do research as well as create the design, ensuring your logo isn’t too similar to other entities out there to support your unique presence in the world of business.

3.     Invest in First Impressions

You’ve created your brand foundation with a recognizable name and logo. Now it’s time to make a quality first impression on potential clients! First impressions include your website and YOU. Therefore it’s suggested that you invest in professional photos that can be used throughout your marketing strategy, including your website and social media presence. Consider photos of you speaking, moving, learning, and with props. Create photos that highlight what you do and what you offer within your business. Most importantly, invest in photos that capture your essence! 

Essence can also explain why video is becoming more popular in marketing. Consider investing in a professional video of you and your business. There are some amazing companies out there that make it an enjoyable and rewarding experience, leaving you with a quality video to post on your website and social media as you see fit.

You did it! You’ve navigated the three foundational elements of creating your brand! Once you have these three items crossed off, it becomes easier to build your brand presence within your community. Knowing that there are a ton of resources out there but I’m asked frequently who I’ve used and valued, I’ll leave you with some local professionals that have been helpful to the building of my three businesses here in Denver, CO for your consideration.*

Colorado Resources*

Photos of You and Your Brand: Jessica Christie Photography, Denver, CO https://jessicanchristie.com

Printed Marketing Materials including flyers and business cards: Smudge Pot Creative, Arvada, CO http://www.smudgepotcreative.com

Website Design with SEO Elements: Liv’N Design, Boulder, CO http://www.livndesign.com

Intellectual Property Consultation: Berg Hill Greenleaf Ruscitti Law Firm, Denver, CO https://bhgrlaw.com

*I do not receive incentives for naming these businesses and they do not represent an exhaustive list of professionals in Colorado. Please research and select your services independently and accordingly.

Supervision Starter: 13 questions to ask before taking on a new supervisee

It can be challenging to determine compatibility and good fit when exploring the supervision relationship. If you are offering supervision in private practice, it is important to remember the responsibility and liability you hold for any clinician under your care. 

What are their ethics? 

What’s their background and training? 

What contracts and agreements need to be put in place to support the professional supervision relationship?

Supervision doesn’t have to be scary. Let’s take a look at some important questions that can aid in the exploration process for best fit within the supervisory relationship!

1.  What aspect(s) brought you to contact and interview for supervision?

This question can identify the clinician’s requirements like pursuing supervision for licensure, credentialing, or internship needs.

2. What is your most recent college degree______________and major___________________ 

Does this match what you can offer as a supervisor? Does this aid in decision making in being aware of their program rigor and preparation for the field? Does this match their resume?

3. What is your experience working in the mental health field?

How is their experience compatible with their next steps in professional growth? Has this helped them identify preferred populations, desired niche, or further training goals?

4. Do you have any specific/special training/certificates in the mental health field other than your degree?

This question can identify a supervisee’s career goals and supervision needs specific to pursuing certification or additional credentials. Will they need a supervisor who is approved to sign off on a specific credential? Does the supervisor have a similar focus or field of expertise?

5.  Describe your career aspirations?  How can supervision help you attain them?

What’s the clinician’s end goal? Examples may include private practice, registered play therapist or EMDR certification.

6.  What qualifications/characteristics do you look for in a supervisor?

An important questions that can bring context to fit in the supervisory relationship! Are they self-aware of what they need in regards to support, administrative needs, and clinical case conceptualization?

7. What are your strengths and weaknesses?

This question encourages exploration into how you can support them in professional growth through the supervision relationship.

8. How do you manage self-care?

Can be helpful in gaining insight into their work-life balance and ability to remain objective under pressure with client needs and/or career demands.

9. Explain your perception of boundaries?

Has the supervisee had experience enforcing boundaries in the therapeutic relationship? How successful were they? Is this an area of strength? Growth?

10.  Are there any client populations, referral behaviors, family belief systems, etc. that you would not feel comfortable working with? Why?   

A supervisee’s response can provide clarification of fit for populations served within their work, limits when working with certain populations and/or diagnoses, and can identify growth opportunities when working with a diverse clientele.

11.  What is your favorite client population to work with? Why? 

Can support niche development and referral compatibility. 

12.  Have you ever had a complaint filed against you in the mental health field?

 Does this match records with their licensing board? Can you verify their current status and standing with licensure?

13.  Do you have malpractice insurance?

An important component that may be required by you as the supervisor in taking on the supervisee.

The questions we’ve included are a great starting point to get to know a potential supervisee’s wants, needs, and skill set. Not only can you identify their current standing, but resopnses can also streamline goal setting should the professional relationship progress! Supervision is one of the most fulfilling professional relationships a mental health clinicians can cultivate! Streamlining your start with these questions can put you on the path to compatibility and best fit.

Originally posted by Khara Croswaite Brindle, MA, LPC, ACS at www.empowermentmodelsupervision.com/empowering-blog on 3/10/2020

The Badge of Busyness and the Battle with Burnout

Burnout is being talked about a lot right now amidst COVID-19. It can feel so sneaky that you don’t even know it’s there! Known for holding us back, sitting on our chests, or making us feel low, you may think it’s just that you need a vacation. After all, you’ve been working a lot lately. But what about when a vacation doesn’t fix it? What about when you find yourself returning from a break, not feeling any better about the work that is waiting for you?

It has happened to me. I’d take a planned break or vacation and not fully decompress. I’d take work calls and emails because as a small business, we’ve been told to stay responsive. I’d answer texts from clients about their appointments, because even though I’d shared I’d be out of town, they’d forgotten and I didn’t want them to show up at the office when I wasn’t there. I’d schedule meetings for right when I returned, sometimes going straight to the office after getting off the plane. I’d skip lunch and eat dinner late. I’d shorten my time away to get back to work. Can you see all the problems? I had such poor boundaries! 

Poor boundaries because I had been taught to hustle to get results. I had been taught to be responsive, efficient, and constantly productive. I had been taught that rest was for retirement. I had been taught to wear the badge of busyness. When I found myself tired, irritable, and unhappy, I was told that my 20s were for working hard to make my dreams of work-life balance possible later. Later. How much later? I’ve known for awhile that I’m going to work for 50 years of my lifetime. I also know that I’m called to work as an ‘elder millennial’ because I’m chasing purpose and impact alongside some of my peers. I’ve tried to pep talk myself through burnout, telling myself I was kicking ass and taking names. And I was, until I realized I was driving myself into the ground.

Identify Burnout

What can burnout look like? It can be fatigue, irritability, depression, and numbness. It can be a loss of trust, working too many hours, and saying yes when we want to say no. For me it was all these things and more. My experience included avoiding the news and movies that made me think of work. It was increased criticism, controlling behaviors, and having a short fuse. It was me being unrealistic of deadlines, lost pleasantries in emails, and avoidance of socializing because it felt like too much work. Does any of this resonate with you? Perhaps you too are experiencing burnout.

Remove the Badge of Busyness

Burnout happens to all types of people and we can look at society as one piece of the bigger puzzle. As Americans, we’ve been encouraged to work full-time jobs with multiple side hustles. For some, it isn’t even a choice in needing to make ends meet. American culture has created the badge of busyness, celebrating how busy we all are as if it’s some sort of victory. Brene Brown speaks to this in one of her books on vulnerability, sharing how it doesn’t serve us to celebrate the badge of busyness and how instead, we need to revisit work-life balance as a part of our purpose. If we can slow ourselves down, perhaps we can pivot and reprioritize differently. By asking ourselves, “is this aligned with my goals or is this just busyness?” we can strategize our next move for the better. Removing the badge of busyness is just one strategy to achieving balance over burnout. 

Are you ready for more strategies to tackle burnout? Check out our Balance Over Burnout on-demand course, offering 5 strategies to address burnout for both you and your clients. 

Interested to learn if my burnout journey has a happy ending? Check out my new book Perfectioneur: From Workaholic to Well-Balanced. One Therapist’s Guide to Get You There for more on my story as well as additional tips to achieve your own work-life balance!

Pivoting in Practice: How to Embrace Business Change within a Pandemic

We’ve been riding the rollercoaster of this pandemic for months. It’s almost hard to believe. We can’t even begin to fathom the full results of this event and the impact on our businesses. As therapists, we know we must fortify ourselves for the mental health crisis that comes with COVID-19. As a colleague, I’m hearing that we are burning out, stretched too thin by grief, anxiety, and tragic loss. In the grand scheme of things, this means we will need more mental health professionals to carry the load. It also means therapists are maintaining smaller caseloads to allow for self-care in the face of overwhelm. As business owners, we are clenching our muscles and leaning in. As entrepreneurs, we are rallying. Now is the time for pivoting and planning. Months into COVID-19, we are looking for ways to pivot to allow our practices and businesses to not only survive, but thrive.

Planning to Pivot?

Pivoting is a term in business for shifting gears, changing direction, and/or finding new focus. As private practice owners, we get the opportunity to pivot in order to address life’s changes and challenges in ways we feel are a good fit for our business. For some of you, pivoting means:

·      Offering telehealth

·      Providing webinars

·      Speaking online

·      Developing online coursework

·      Writing blogs or a book

·      Identifying a secondary income stream

It can be exciting to start new endeavors, and it can also be challenging. Let’s recognize that creativity can feel limited when other responsibilities require your attention and stress levels are so high that they may hurt your ability to focus. You don’t have to do this all in one shot. You don’t even have to do this alone. Here are some ideas to help you move deeper into a creative mindset to better your business.

Schedule Time for Creativity

That’s right. Put it in your calendar. Where can you find time to work ON your business rather than in it? Can you map out time for brainstorming? Writing? Course creation? Conversations with other inspiring entrepreneurs? I too have learned that if I don’t schedule it, it doesn’t happen!

Move your Body

Have you ever noticed that some of the most brilliant minds are depicted as pacing in movies when trying to figure something out? There is a reason for that! Movement allows deeper processing, especially when it’s a repetitive, low-energy motion like walking or pacing. So get outside and take a walk, allowing your mind to mull over the possibilities at an easy pace.

Remember your ‘Why’

No matter where you decide to take your business, be sure to slow down enough to check in on your ‘why.’ Does this new endeavor support your values and brand? Does it support your mission as a person and as a professional? Carry a notebook and write down ideas as they come to you. Run new ideas by a trusted colleague or friend to see what they think. 

Invigorating Investments

For many entrepreneurs, if the pivot aligns with their business, it can feel both exciting and invigorating to have a direction to go and plan of action to take.  You see, entrepreneurs enjoy building and creating and they feel much more emotionally invested when creating something new or worthwhile. I hope that you too can experience the excitement (dare I say giddiness?) of pivoting in your practice to support your mission, vision and brand. Check out my book Perfectioneur: From Workaholic to Well-Balanced launching June 1st for other ideas on how to thrive as a driven entrepreneur. I can’t wait to see what you create!

Supervision Success: Leveling up with the ACS Credential

Supervisors are taking their role to the next level with the Approved Clinical Supervisor (ACS) credential. As mental health professionals continue to expand on their therapeutic skills and advance within their profession, it’s becoming more common to see an emphasis placed on training and preparation when identifying yourself as a clinical supervisor in the field. 

Gone are the days of working in the field for “x” number of years to justify your readiness to mentor and supervise others. With the complexities of supervision including liability, responsibility, clinical competence, ethics, and brand recognition, agencies and organizations are sending supervisors to additional training to assist them in growing into the role of supervisor in ways that are both ethical and empowering. Private Practice clinicians are also offering their services as supervisors when focusing on niche populations or specialties. Therefore it’s important to take a closer look at the ACS credential and how it can help your professional goals.

What is the ACS Credential?

The Approved Clinical Supervisor (ACS) Credential* requires a total of 45 clock hours of clinical supervision training specific to providing clinical supervision or becoming a clinical supervisor, which must include each of the following content areas:

1.     Roles and functions of clinical supervisors

2.     Models of clinical supervision

3.     Mental health–related professional development

4.     Methods and techniques in clinical supervision

5.     Supervisory relationship issues

6.     Cultural issues in clinical supervision

7.     Group supervision

8.     Legal and ethical issues in clinical supervision

9.     Evaluation of supervisee competence and the supervision process

There are several organizations and entities that offer trainings that meet this criteria. Supervisionary is one of them, with bolded items above fitting both ACS training requirements and Supervisionary’s 4.0 CE Hour, NBCC Single Program Training titled: The Empowerment Model of Clinical Supervision**

What’s required for the ACS?

In addition to training content, the ACS candidate must submit proof of:

1.     A minimum of 100 hours of supervision, to be endorsed and signed off by licensed mental health professional with supervision experience. 

2.     Have 4000+ hours of mental health experience post masters or doctorate degree with proof of licensure

3.     Professional Disclosure Statement

4.     Transcript from master’s level or higher education

5.     Application fee

All of these items would then be submitted as part of your application in order to be considered for the ACS credential, awarded by Center for Credentialing and Education (CCE). ™ 

Where do I get training?

The CCE website includes a directory of Approved Continued Education Providers (ACEP) through NBCC that can be of assistance when finding training in supervision, including university programs and private entities offering workshops or trainings face-to-face or online. 

Check out the ACEP directory to find trainers at: https://www.nbcc.org/search/acepdirectory

Maintaining your ACS Credential

If you’ve already completed the initial requirements for your ACS credential, congratulations on joining the ACS professional community! You know the next step in celebrating your commitment to quality supervision is maintaining good standing. ACS credentials are renewed every 5 years and must include 20 hours of continued education specific to supervision. Therefore we hope you’ll consider Supervisionary once again for further training or material focused on supervision to enhance your skills!

To engage Supervisionary in our 4.0 CE hour training, please visit www.empowermentmodelsupervision.com or email us at empowermentmodelsupervision@gmail.com

Congratulations on exploring the next step of your professional journey by considering “leveling up” as a clinical supervisor! We are confident you will find the experience as engaging and rewarding as we do and we look forward to bringing the community together through meaningful trainings and quality materials!

Written by Khara Croswaite Brindle, MA, LPC, ACS

*As noted by CCE at https://www.cce-global.org/credentialing/acs

**The continuing education program "The Empowerment Model of Clinical Supervision" has been approved by NBCC for NBCC credit. Supervisionary, LLC is solely responsible for all aspects of the program. NBCC Approval No. SP-3446

Originally written by Khara Croswaite Brindle, MA, LPC, ACS for www.empowermentmodelsupervision.com/empowering-blog on 05/11/2020

Frequently Asked Questions in Suicide Prevention

Disclaimer: This information is for educational purposes only and is not therapeutic advice nor a substitute for therapy. It should not be used to diagnose or treat any mental health problem. If you are located within the United States and you need emergency assistance please call 911 or go to your nearest emergency room. If you are located within Colorado you may also call the Colorado Crisis Line at 844-493-TALK (8255).

What if suicide happens again within our community?

            That may happen. If and when that happens, our goal is to give resources and support to the survivors. You have the right to be concerned as each suicide impacts, at minimum, 135 people. But, when we provide support to survivors of suicide, we are also opening up healthy conversation about suicide and it’s impact, which may help us prevent further suicides in our community.

In response to suicide, what if I can’t handle it?

            It’s understandable that you would feel that way. Everyone is afraid of suicide and responding to it can feel terrifying. But you don’t have to handle it perfectly for yourself or anyone else.  The point is to be authentic and compassionate and continue these hard conversations. Be aware of what you are comfortable with and prepared for, be gentle with yourself and take it in small steps. We all want to put our capes on and save lives. Recognizing the urge in yourself as well as the fear are the first steps in holding boundaries and compassion together.

How is technology contributing to rising risks of suicide?

            Technology is moving so fast, we can barely keep up! There is new research coming out all the time but the one thing we know so far is that 3 or more hours of social media a day increases risk for suicide. On the other hand, social media and technology apps can make access to support around suicide faster and easier to obtain. The point is not to reject technology or social media all together, but to limit it’s use and focus on meaningful connections and helpful resources. 

What’s happening to our youngest generation that is putting them at greater risk for suicide?

            There is a combination of factors we are tracking in youth, including perfectionism, pressure, lack of social connection, and social media use leading to an unrealistic perspective of success and how they compare themselves to their peers. Fortunately, there are some things we can do that can combat these trends. Most significantly, research tells us that having meaningful connection with even one supportive adult can make a tremendous difference. This is particularly true for youth in the LGBTQ+ population. Our goal is to actively look for ways to help this generation make meaningful connections. It’s not a one and done, it’s complicated. And we need to continue to explore what we can do to support this generation.

What if the person who died by suicide didn’t show any warning signs?

            It’s a common experience for individuals to feel like there were not any signs or they missed them. Often, that’s because, no one person has access to seeing all of the signs that might be there. A student may not share things with their parents. A teacher or a coach may notice things that a best friend didn’t. This is why we have to respond to the threat of suicide as a community and surround our youth with a culture of support. Missing warning signs adds to our fears and yet, suicide is preventable. A person who doesn’t show any signs at all is the exception or outlier. Most people who die by suicide have experienced extreme pain for days, weeks, or months. Our goal is not to look for signs of suicidality, but to look for signs of pain and disconnection and see what we can do to repair the hurt and regain hope. 

Won’t asking a person about suicide give them the idea?

            No. Research shows that asking about suicide when the person is having thoughts of suicide actually brings them relief in being able to talk about it. 

What could I say or do that would make it worse for someone who is experiencing suicidal thoughts?

            Yes but you don’t need to worry. The wrong things to say are easy to avoid. Be sure that you are not minimizing, shaming, blaming, or catastrophizing and instead, you are listening deeply and letting the other person know that you care about their experience. It’s fear that makes us say the thing we shouldn’t. If you start by courageously listening and expressing empathy before you try to move to next steps or solutions, you will naturally find the flow of the conversation that supports the person without making it feel worse for them. 

What do I say to a person when I’m uncomfortable talking about suicide?

            If you aren’t comfortable having the conversation about suicide, find someone who can help! It’s okay to share how you feel and authentically own it. Ironically, it can help the person much more if you are honest. Being truthful and authentic will serve the person suffering much more than having your body language not match your words of reassurance. Simply be sure to let them know that you care about them, and are not judging their experience but rather, are owning that your own experience is making you uncomfortable and talking to someone else would be more supportive for both of you.

As a friend or community member, how can I help someone who is thinking of suicide?

            Knowing that suicide is more about pain than death can help each of us sit with someone we care about to explore that pain, develop compassion, and help them access life-saving resources. There are professional resources, social resources, and internal resources to support someone experiencing suicide. Professional resources would be mental health supports, the national hotline, the text line, and more. Social resources include community support where we can also engage other people to support the person who is suffering. Internal resources would be the person finding things that they live for and help them cope. The best conversation isn’t one conversation, but to have many conversations to compassionately listen and help the person access any or all of these resources as needed.

Why are mental health and suicide rates on the rise?

            There are more stressors and risk factors know now than ever before. Each person has a way of responding to stressors in their lives, with technology, isolation, and other risk factors impacting the rising rates of anxiety, depression, and suicide. Our goal is to combat these stressors by continuing healthy conversations and consciously creating a culture of courageous connections.

Let's save more lives!

Dear Colleagues,

You may be noticing that suicide is showing up more often in your work with clients, whether they are experiencing a crisis themselves or navigating the stress or loss of a coworker, peer, friend, or family member.

Did you know that the American Association of Suicidology reported in 2018 that each death by suicide, at minimum, impacts 135 people? For every suicide death, at least 135 people are affected!

Now if you are like me, this number had a powerful effect on how I think about holding space for suicide in my therapy practice. Holding space for the teen who says no one would care if they were gone. Or the adult who thinks their family would be better off without them. And the young adult who declares that if they haven't figured out how to have a quality life in the next (2.5/5/7) years, they are ending it all. What it's like to hold compassion for their pain, the very pain your client wants to escape from, resulting in suicide becoming a possibility.

For so many of us, our suicide experiences are both personal and professional. As a survivor of suicide loss, I lost two family members to suicide before I was 18 years old. This absolutely shaped my career as a therapist and, like for so many of us, impacted my desire to know more, to understand, to heal.

Fast forward to my first job out of graduate school. One of my first client cases was an 8-year-old who had attempted suicide twice. I was responsible for assessing safety needs going forward and supporting the family with healthy reunification.

For you in your therapeutic work, you are seeing suicide show up, rippling out into the communities you are connected to and serve. And perhaps it shocks you to know that suicide assessment and prevention is not a topic well studied in some graduate programs, resulting in many professionals navigating suicide from a place of fear!

If this feels relatable, you are not alone! Combine this with the rising rates of suicide at a national level and suicide being the leading cause of death for 10-24 year olds in Colorado and we have a perfect storm of paralysis in the face of suicide.And yet the paralysis can be navigated. Navigated well for both the client and you as the professional. 

That's why you are here. You recognize that you are seeking support, insight, resources, and tools to navigate suicide in your work! You are in the right place by considering this course! I am honored to work alongside you in this journey and congratulate you on facing the problem head on! 

Link to the online class: https://savinglivesseries.mykajabi.com/offers/Ga4H4BBR

Let's save more lives!

With gratitude,

Khara

To My Fellow Therapists, Let’s Slather on the Emotional Sunscreen

Spring has been in full swing even as we feel like we’ve taken a pause in this pandemic. Although we may be staying in place, the weather is moving and shifting towards summer. For many of us, weather and the ability to get outside have been vital components to staying sane these last few months. The pleasure of feeling the sun on our faces, the breeze in our hair, inhaling fresh air, and experiencing the sounds of nature can almost transport us into feelings of normalcy.

Normalcy. Normal. A new normal. A phrase that has appeared to help us better articulate how COVID-19 has impacted our way of living and the ripple effects on our habits, behaviors, and mental health. With spring comes new energy, growth, and restlessness. We’ve seen this in the desire for stay-at-home orders to be lifted, the desire to get outside and have social gatherings, and the desire to go back to seeing clients in person. But what about restlessness as a sign of mental health? There are plenty of articles reporting that a mental health crisis will follow as the result of COVID-19 and will be long lasting. Our mental health communities have been working several months straight to support individuals and families with the changes and stresses that have come in waves. As therapists, we’ve prepared for this to some degree, having built practices working with people experiencing anxiety, depression, and trauma. Yet being human ourselves, we are also holding anxiety and dread for what’s to come simultaneously with holding onto hope that it will get better.

Spring Challenges

You see, COVID-19 wasn’t the only challenge to hit us hard in March. Springtime is considered a challenge because it’s known as a time for increased mental health crises. Spring is a time when those who experience the lows of winter and clinical depression related to the darker months start to shift to having more energy. With more energy comes more risks. For individuals experiencing suicidal thoughts, do they now have the energy to make an attempt? For individuals diagnosed with Bipolar disorder, are they experiencing a burst of energy that puts them at greater risk due to increased manic behaviors? Imagine how these worries each spring can combine with the anticipated increase in hopelessness related to COVID-19. For people who have lost jobs, houses, businesses, and loved ones, hopelessness and grief weighs heavy as the weeks accumulate. In fact, as we enter into another month of the pandemic, we may all be grieving the loss of anticipated events or perceived normalcy that summer could bring. The hopes for a planned vacation, a summer break, a slowing of referrals to allow us to regroup. Like a clenched muscle, we feel we must hold on and don’t yet have permission to relax. There continues to be so much that remains unknown about the future months, adding to the rollercoaster of mood as we struggle with not knowing what to plan for or what to look forward to in the ever-shifting weeks to come.

Balance Over Burnout

There is some lightness to balance out the heavy. Mental health professionals are feeling the powerful beauty of connecting with clients on something they too are experiencing in real time. They are embracing raw emotions, vulnerability, and fear. They are expressing gratitude at being able to work via telehealth. They are standing in awe of their clients’ resiliency. 

Therapists are also feeling the burnout of working longer hours and struggling with work separation in working from home. We are human, we are helpers, and we are feeling called to assist others at the risk of caring for ourselves. In connecting with colleagues, it is not uncommon to hear that we feel obligated to help and to remain available. Maybe this would be doable if it was just our clients we were supporting, but for many of us, we are supporting the fear and anxiety of our loved ones, family, and friends as well. It’s a lot to hold, and more than two months in, it’s starting to wear us down.

Slather on the SunscreenWhat can we do to address the growing fatigue as first responders in this pandemic? It’s time to slather on the emotional sunscreen. Embrace this visual of shielding against negativity and practicing professional boundaries. Allow the application of sunscreen to be a gentle and important reminder to protect ourselves from the damage of poor boundaries at the risk of getting burned. Burned by the heavy. Burnt out by the demand. Burnt out by the constant holding of hope and compassion for others. Protecting our emotions. The fight against COVID-19 and its impact on mental health is not over and we are fighting to stay strong.

Reapply Every Two Hours 

So let’s take inspiration from BuzzFeed’s 10 Facts About Sunscreen Most People Don’t Know Due to Marketing Tricks. It is recommended we reapply sunscreen every two hours that we are in the sun. In this case, our metaphorical sun represents all the present stressors, glaringly bright and hard to ignore. They make us uncomfortable, irritable, and tired. So we must take precautions. How do we address the sleepiness and lethargy that too much sun brings? How do we step away, regroup, and restore our energy? How do we protect our empathetic skin from over-exposure to harmful elements that can hurt us, leaving us blistered, raw and achy? We must find a way to reapply our emotional sunscreen to fight off fatigue and feeling drained. Sunburn and burnout have discomfort in common.

More than ‘Make Do’

Discomfort is something we know well as therapists. We are masters at sitting in the discomfort of others to help them heal. We are skilled at compartmentalizing, successfully ignoring our own discomfort to help others. Recall the time you held your bladder so as not to interrupt a session? Or took a call after hours because you could? Or came to work with a head cold so as not to disrupt your client’s momentum? We make do in the face of discomfort, perhaps engaging in the bare minimum protective measures to keep it all moving along. Much like makeup with low SPF. It isn’t enough protection for longer exposure to the sun. Sure, it can serve for short spells or quick outings. But when it comes to sun (stress) exposure of the mental health crisis we are currently facing, minimal SPF isn’t going to cut it. We are in this for the long haul and we don’t want to get burned. We need more emotional sunscreen.

Check Your Expiration Date

More time. More stress. We need to check our own expiration dates when it comes to how much we can handle before we require a break. Last week and this week, I have seen an increase in therapists sharing how tired they are and expressing how they feel like they need a break. This is quickly followed by a disclosure that they cannot leave those they are trying to support during this pandemic out of obligation or guilt. I can relate to this thought process. I can relate to the obligation and responsibility we all feel. We’re helpers. However, I’m also going to champion that all of us take a much-needed break in the near future. Staggered it if need be and timing it to allow rest and restoration. It doesn’t have to be extravagant and it doesn’t have to be long. Sunscreen that has expired is no longer considered effective. If we push past our expiration date, we too are no longer effective. We must honor our own expiration dates and the physical and emotion signs of burnout. Notice the signs that we need to rest and restore in order to do right by ourselves and by our clients.

Maybe it’s a stretch to make a connection between sun, stressors, sunscreen, and burnout. Maybe it isn’t. There’s something reassuring about the idea of getting to a place where we can be mindful enough in our plans to remember to apply sunscreen. Can we apply the emotional sunscreen needed to help us engage in meaningful work without getting burned? Can we show up, remain authentic, and be healthy role models for our clients on taking breaks to avoid burnout? It may not be easy task, but it is doable with practice. They say it takes 30 days to make something a habit. Let’s slather on some emotional sunscreen by summer.

Check out Croswaite Counseling PLLC’s Balance Over Burnout, an online course that introduces 5 tools to prevent burnout for therapists and professional helpers.

Check out BuzzFeed’s full article on 10 Facts About Sunscreen Most People Don’t Know Due to Marketing Tricks here.

An Introduction to The Empowerment Model of Clinical Supervision

What makes a great supervisor? What about a not-so-great one? It has been both surprising and affirming to hear the community’s stories of mental health clinical supervision, including the need for something different, something modern, something more. For many of us, we’ve had a challenging experience where we felt unsupported or unheard by a supervisor. And since research tells us many people leave a job because of their bosses, this becomes even more critical in community mental health where our boss can hold roles as our supervisor, leader, auditor, biller, advocate, and colleague, just to name a few.

Modern Approach to Supervision

So where does one start to improve their supervision experience? There is growing popularity to seek the Approved Clinical Supervisor (ACS) credential when working in the role of supervisor in mental health.  The ACS credential is helping mental health professionals pursue further training and competency in the role of supervision. And yet one of the most referenced handbooks on supervision in support of the ACS training modules was written and released in the early 2000s. Not surprisingly, we need a modern updated approach as the challenges faced in community mental health and beyond require an upgrade. Having worked in community mental health and actively participated in the professional development of a team of 15 green therapists for several years, my awareness of supervision needs was intensified after having a hard supervision experience followed by a heavenly one. My last supervisor in community mental health showed me with her actions what it meant to be empowered and to empower others as a leader and supervisor. Through her insight and my own experiences in the role of supervisor leading to successful, happy supervisees representing the next generation of mental health professionals, The Empowerment Model of Clinical Supervision was defined.  

What is The Empowerment Model?

What does it take to be an empowered supervisor that can empower others? An exploration of redefined roles within the supervisor and supervisee relationship is a place to start. The Empowerment Model names and defines roles of:

·       Self

·       Leader

·       Researcher

·       Teacher

·       Consultant

·       Colleague

You’ll notice that the role of counselor from previous models is intentionally omitted for several reasons, including to respect boundaries and avoid dual roles in the supervisory relationship.

How is it different?

Beyond The Empowerment Model reflecting modern roles within a fluid model rather as opposed to a traditional stair-step model, our initial research findings also indicated that supervisees who were engaged in The Empowerment Model by their supervisors showed significant improvement in categories of General Supervision, The Administrative Counseling Process, The Clinical Counseling Process, and The Conceptualization Process compared to the control group. A model that can be applied for professional growth in both supervisors and supervisees including common ethical and clinical dilemmas in community mental health, why wouldn’t we want to embrace a modern model that supports collaboration and connection?

Where do I learn more?

If we’ve caught your interest in applying The Empowerment Model to your own work as a supervisor, leader, or therapist, you are in luck! 

We offer:

1)    interactive trainings with CEs

2)    a book on Amazon with 33 vignettes for application of the model

3)    a workbook to explore and apply the concepts to your own experiences

all found at our website: https://empowermentmodelsupervision.com

Are you ready to explore what you need in a supervisor? Or ways you can grow into this role in your professional career? We are confident that you will find the materials offered by Supervisionary, LLC approachable, engaging, and empowering to your professional development, and can’t wait to see how it enhances your work within our shared communities of mental health!