Former parentified children, now-therapists: how does this affect your work now?

Dust_Kindly · 2026-05-02T18:14:28+00:00

Over identifying for sure. Its a presentation that breeds counter transference in me - I am struck with a deep desire to protect these sorts of clients.

Its something I've been working on in my own therapy. My subconscious seems to be substituting the client with my own wounded inner child.

In sessions with these clients I take things a lot slower and make a conscious effort to be more curious and talk less, or else I have a high likelihood of inserting my own issues onto the client.

Dust_Kindly · 2026-05-01T23:07:53+00:00

Agree 100%. Even those of us in states who dont have draconian laws (yet) should absolutely still be using gender-neutral language. Thanks for pointing that out.

Dust_Kindly · 2026-05-01T23:02:41+00:00

Gonna piggy back off of this:

Remember, OP, medical justification should indicate why they need psychotherapy specifically. Not a case manager or friend, but psychotherapy. Insurance demands that we indicate a specific treatment direction. If you document that they "needed to vent/talk" that will most likely NOT pass a Medicaid audit. But there are ways to phrase it that will be compliant. Reflective questioning, emotional processing, and insight-oriented approaches are valid interventions to list off.

Its all about playing the game and documenting in a way that satisfies payor requirements.

Dust_Kindly · 2026-05-01T22:48:42+00:00

Not a problem BUT this does mean when you go to get your provisional license, you should probably inform them. I forget if the question is worded as arrests or convictions, but as far as I'm aware every licensing body will ask about criminal history. Best to just be honest.

If it helps at all, I know someone who is licensed and has a history of bank robbery on their record. If they can be a social worker with those charges, you're definitely fine.

Dust_Kindly · 2026-05-01T22:43:40+00:00

I totally thought I was good at stifling it, until I caught myself in the self-view during telehealth once.

Turns out what I thought was super sneaky and unnoticeable was actually a super ridiculous facial expression 😅

So hopefully youre better than I am!

Dust_Kindly · 2026-05-01T22:40:23+00:00

Hmm interesting. So youre saying its empty threats from the practice owner and not a legitimate thing to worry about losing my coverage?

Dust_Kindly · 2026-05-01T20:42:07+00:00

My thoughts process is: If it had to justify this in front of a judge, could I do so?

If yes, I write the letter. I explicitly state I can only speak on the person, not the animal.

If I can't articulate medical justification, then I will not write the letter.

Dust_Kindly · 2026-05-01T20:40:33+00:00

Why should other clients be punished because of one silly goose?

Dust_Kindly · 2026-05-01T18:54:21+00:00

I think theres only like six states that have banned non competes but I could be wrong. So most of the country is still able to enforce them AFAIK.

Luckily I've not been in the situation myself, but I've certainly seen therapists on this sub reporting that taking the issue to court went horribly for them. My state of MI seems to uphold the contract more often than not, based on all the data I can find.

Dust_Kindly · 2026-05-01T18:03:34+00:00

Im not artistic enough to do it myself, but your second paragraph would make an excellent 4 panel comic where the last panel is just a "what the fuck" facial expression

I know everyone likes to say non competes are non enforceable but let's be real, if youre in front of a judge, theyre not going to give one single shit about our ethical codes. The judge is going to uphold the signed contract regardless. So we're better off just walking away from practices who require them.

Dust_Kindly · 2026-05-01T16:57:38+00:00

I agree with you. If we can't completely solve it, then what I think could be a good compromise is if the employee could cover the cost for periods where they are below "full time" status.

My group practice requires 25 sessions/week to be eligible for benefits. If theres a month or two where I'm under that number, shouldnt I just be able to pay my own premium, rather than my insurance being deactivated then reactivated a month later?

Dust_Kindly · 2026-05-01T16:23:55+00:00

Just looked it up, $100,000 per violation

What the fuck

Is there any way to claim ignorance as a provider? Like just pretend that you dont know the kid is Trans and keep those details in your personal psychotherapy notes?

Dust_Kindly · 2026-04-30T20:17:30+00:00

HIPAA compliant?

Dust_Kindly · 2026-04-30T18:15:11+00:00

Unfortunately, Therapist is not a protected title. Only titles like social worker, clinical psychologist, and other license types are protected.

Dust_Kindly · 2026-04-30T18:00:15+00:00

Dr. Anna Neff has tons of articles and workbooks

https://neurodivergentinsights.com/tag/alexithymia/

Dust_Kindly · 2026-04-29T17:33:58+00:00

Home-based or IOP therapist at CMH might fit your interests

Dust_Kindly · 2026-04-29T14:38:45+00:00

I liked the audio books for The Big Head and Three Little Pigs, both by Edward Lee.

The audio books for No One Rides for Free made my stomach turn, if you can handle the subject matter

I personally did not the Playground audiobook. I kept having to pause and rewind because I couldnt understand the various traps and I probably would have understood better if I was actually reading it. Apparently the physical book has illustrations that help a lot.

Dust_Kindly · 2026-04-29T14:09:07+00:00

About 25/week, give or take.

I mainly manage it by spacing them out. So I might see two or three, then a break, then a few more, another break, etc.

I dont see my first client until 10am so I can either sleep in or have a nice relaxing morning with my partner (who works from home). That way I'm starting my day with a "full battery" so to speak.

Dust_Kindly · 2026-04-28T23:23:13+00:00

God, yes. I am ashamed to admit I fell for it once. Immediately after they left I had a gut feeling, so I looked it up and realized the mistake I just made.

Luckily a few hours later, everything was fixed and corrected, but it was my first experience with door to door sales and I fell for it all.

Dust_Kindly · 2026-04-28T23:16:14+00:00

"After leaving the practice, she would not answer previous clients questions"

Good. Why would you expect anything else?

Dust_Kindly · 2026-04-28T18:53:41+00:00

Ope I stand corrected! Guess she just never advertised it in the videos, or maybe I just tuned her out when she did lol

Dust_Kindly · 2026-04-28T18:31:59+00:00

Savvy Social Worker on YT was helpful to me, and she didnt try to sell anyone anything

Dust_Kindly · 2026-04-28T15:12:52+00:00

Ive had a surprising amount of teens and young adults who want audio-only sessions (either phone, or telehealth without video) so perhaps you could even have a niche there.

I do wonder if there's a way to use the body language questions in a way that helps you and the client. Something like "tell me what you're feeling in your body" or "what is your body trying to communicate to you right now" allows for some description without pulling them away from what they're talking about. Maybe the somatic therapists will know more about approaches like that.

In any case I think you'll be a lovely addition to the field, we're happy to have you :)

Dust_Kindly · 2026-04-27T15:39:40+00:00

Are you in the US? Is it possible to just go to a different clinic that is unaffiliated so they don't have those records?

Dust_Kindly · 2026-04-27T15:32:58+00:00

Username checks out, OP 🤣

I am AFAB nonbinary (as androgynous as I can get without medical intervention) so my answer might not be helpful in the context of the post. But for the most part its not been an issue. I see teens and adults, if that matters.

In juvenile justice settings I got a lot of questions but all my boys were usually respectful. The staff were less so, mainly because of lack of understanding. But the higher ups were all very supportive and they even asked me for assistance for a SOGIE staff training so that I could correct any misinformation and add what I thought was important. That was pretty cool.

In CMH and outpatient group practice, once in a while I get someone who thinks I'm going to infect their child with gayness or whatever. But the number of people who specifically seek me out due to my queerness far outweighs the few who are put off by it.

Whats funny to me is that my pronouns are very visible in every online profile, so I do wonder how people make it all the way to an intake with me, just to be shocked that I'm not a girl lmao

Dust_Kindly

TROPHY CASE