u/Arizona-LCSW

Call the board and ask them. If no answer, leave a message. They are pretty responsive.

Beth Rontal Documentation Wizard I took her class two years ago from Pesi. She also has classes on her website

That sounds like you cared about your patient deeply.

When this comes up, I look my client in the eyes, and very politely and respectfully say..

"Look at the way I live my life. Look at the career I chose, where I spend my time, where I spend my money. Look at the way that I treat people. If you can't figure out what my belief system is based on how I live my life, then I am doing something wrong." That's my complete answer.

Edit: I value integrity. It's important for me to live my life in a way which is in alignment with my belief system. And for that I am downvoted. Y'all are interesting.

Sorry. I wasn't paying attention. At least you responded in a way that was gentle and kind. I wish there was more gentleness and kindness on reddit.

Who is paying for therapy?

If the patient is paying out of pocket, then that's fine, I'll just be your friend, for the 53 minutes that you are sitting in my office.

If insurance is paying for therapy, then I have an ethical obligation to the insurance company to provide therapy, and to tell them whether or not you are doing the work of therapy, and making progress.

Scary, Thank you for taking time to reply.

I live and work in a small town. Any suggestions for finding three competent board members?

I agree with you. Many rules and policies will be state specific.

PM., I'm trying to say this humbly. I don't really see myself completing against anybody. The agency here in town is so bad.. that I could do a poor job of providing therapy services... and it would still be a big improvement over the agency which is here now.

There is a lot of poverty in this town. I already have a PLLC. I started my private practice a few months ago. I could hire another 1 or 2 therapists, and the other therapists could take care of people who have insurance through their employer.

There are some large businesses in this small town, along with a handful of people who actually do have money. Businesses and individuals generally do not want to donate money to a for-profit business. They generally want to give donations (or grants) to nonprofits.

PM, I appreciate your Candor/honesty. It sounds like you have a lot of experience behind you.

If I was in a big city, I probably would not try and create a nonprofit. However, I live and work in a small town. The only competition in this town is... a behavioral health agency which is horribly run. No one in this town is getting better.

I've heard a lot of people complain on different subreddits. Complain that their community behavioral health agency is horrible and treats them horribly. But I don't hear anybody saying, "let me see if I can do better." I know it's not going to be easy, and that's why I am asking for help.

If you take your original post, and you reword it somehow, there's a good chance that you can repost it to the therapist subreddit.

I heard about score mentorships 10 years ago. I forgot about the program. Thank you for the reminder.

I can look into it. I would be amazed if they actually had someone in my specialty, in Az, but again, I'm more than happy to look into it. Thnx

Orca,

There's actually a degree for that? Masters Degree in nonprofit management?
I didn't know that. Thanks for the info. That being said..

I have an MSW and LCSW. I still have student loans. There is no way I can afford to pay for more schooling. It's not like I'm starting from scratch. I already know a lot.

If you have any suggestions on where I can learn more (by video), I would be more than happy to hear your suggestions.

Any suggestions on where I could go to find a mentor? Or where I could find other people who are running nonprofits, specifically in bhavioral health?

Wib, I have done Market research. I live and work in this small town. I know this market.

I already know the majority of the problems in this small town. The local health department and one social service agency have already done a proper needs analysis. If I need a report, I can get the report from them. In reality, most people who work in social services in this town already know what the problems are. No one is willing to actually step up and create a solution.

I have already decided how I want to proceed. I want to try to create a nonprofit. Same question as above. Suggestion on a podcast?

Mar,

The university that I attended did such a bad job of finding internship placements for their students.. that in my last year of my MSW program.. they placed me at an internship that had no idea what the DSM was.

After I graduated, my first job was at a community behavioral health agency. On the day that I started, I had no idea how to do an intake, no idea how to write a progress note. (I was never taught those things in my internship.)

About 4 weeks after I started, my supervisor handed me my first client with DID. Over the next three years, I worked with:

4 clients who had a diagnosis of DID

1 client who I'm pretty sure had DID

1 teenager I (unofficially) diagnosed with DID

I never did any trauma work with those clients. I pretty much showed up, ask them what they needed help with, and helped them. (More like case management and peer support services). The agency had 1 lady who was an expert in trauma. If any of the DID clients wanted to work on their trauma, I would transfer the client to the expert. I learned a lot from those clients.

I worked at a medical clinic. Leadership agreed to the following schedule. They gave me intake slots on the following days and times.

I did only 1 intake per day. 4 pm was always taken first.

Week 1 Monday at 8 am Tues at 10 am Wed at 1 pm Thurs at 4 pm

Week 2 Monday at 4 pm Tues at 1 pm Wed at 8 am Thurs at 10 am

Week 3 Tues at 4 pm + 3 other days

Week 4 Wed at 4 pm + 3 other days

That way, no matter what a person schedule was, they would be able to schedule an intake at a day and time that work for them.

Meg, Your post sounded like an insult. The OP is asking for ideas. You don't have to cut the OP down. People don't need criticism and judgment. People need kindness and gentleness.

Kids with ADHD need exercise. Once you give the kids exercise during the day, they usually have an easier time falling asleep at night.

Weighted blanket ???

Pesi. NASW. Also... just Google it.

Ann, Lamb which is basted with the right sauce tastes delicious!

It sounds to me that you have figured out what works for you. Nice!

OP,
Do you have the option to create intake slots on your schedule? For example, intake slots are green. Your front office staff can only schedule intakes in the green slots.

Between November 15th and January 10th, individual therapy gets slow. Patients cancel therapy sessions because they are busy with the holidays.

Nov 15 - Jan 10, crisis gets extremely busy.

People who are not in therapy throughout the year, who do not learn coping skills, who do not know how to use their coping skills.. they melt down during the holidays.

I have seen the same pattern for 8 years.

In the United States, most people are uncomfortable with silence.

If I am in session (and also my normal everyday conversations with people), if I need a moment to think about something I will literally say the words " Give me a minute to think." I will stop looking at the other person, I will drop my gaze, and look at something In front of me or look down at the floor. My facial expression and my body language make it pretty clear to other people that I'm thinking about something period

Most of the time it works. Sometimes, people are so uncomfortable with silence, they will just keep on talking. Which is hard for me. Cuz I can either listen to another person talk, or I can process something that person said, but I can't do both.

OP, It sounds like you are trying to do what is in the best interest of the client. I hear respect and compassion in your words. I give you a lot of credit for that.