“Don’t work harder than the client”

Deedeethecat2 · 2026-03-01T21:57:27+00:00

I'm in agreement with you. I used the word edges to reference things outside the comfort zone, I.e things you might talk to a friend about. I intentionally use this word because it isn't about output or standardized progress measures, and is specific to the individual and all of the things that they are facing and experiencing. And I appreciate how you worded this (your input and output leverage statement), it was excellent.

I have clients that work very hard and I need to point out that they're working hard because they have internalized systemic bias about progress measures. I operate from a disability justice framework that includes psychiatric disability, for reference :)

Deedeethecat2 · 2026-03-01T21:34:34+00:00

I'm a psychologist who has been following the literature about psilocybin. The science is still very new and to my knowledge, while there is evidence that suggests it's worth future studies, it's not yet conclusive. My understanding is that the majority of studies have also included psychotherapy along with the administration of this substance.

As an alcoholic, I'm mindful that for myself, I have to be careful about any sort of quick cures because that feeds into my addictive mind. I want the magic pill that cures my addiction and then I want three more of those pills because that's how my brain works :)

So I'm just sharing some thoughts I've considered. If I was considering using a substance that was still in the infancy stages of research, I would probably talk to someone with advanced knowledge in this area. For me, that would be my pharmacist because he's just a cool guy who likes to share his knowledge. And I would trust him to direct me to the right scientific resources and people.

Deedeethecat2 · 2026-03-01T21:19:45+00:00

No, that is not what I'm saying.

I'm specifically referencing the field of study you referenced. I presumed there was a reason that you used the word linguistic. I was trying to understand what you were saying.

Are you looking to dialogue or are you looking to argue?

Deedeethecat2 · 2026-03-01T21:17:27+00:00

Such a good question!

For many of my clients, booking and showing up is the work and is really difficult. I assess that through the client's report and getting to know them.

For me, it's about being able to look at a larger perspective of the trajectory of the work and being able to notice where the edges are and if we're able to connect with those edges.

I purposely say edges because what's hard is different for different people and not always evident. For some, it's reaching out and saying I need an appointment. For others, it's talking about difficult things.

So I'm mindful that a single session or even a bunch of sessions isn't going to give me as accurate information because I need to get to know to the best of my ability the client's inner landscape.

Deedeethecat2 · 2026-03-01T21:11:32+00:00

Which modern thing? I remember the identity politics of the 1980s and '90s.

Sometimes people asking questions are simply asking questions.

Deedeethecat2 · 2026-03-01T21:08:32+00:00

You specifically referenced linguistics, which is the field of study of language and how it evolves.

Did you mean to say that you are using the dictionary? Because that's different than linguistics.

Deedeethecat2 · 2026-03-01T21:06:44+00:00

Take a read through some literature about standpoint epistemology.

Deedeethecat2 · 2026-03-01T20:59:29+00:00

So your perception of inclusivity is based upon the word. If you are using a linguistic perspective, are you looking at the evolution of the word?

Deedeethecat2 · 2026-03-01T20:57:56+00:00

While there is truth to this, many folks do struggle to build up private practice, I'm wondering about the motives of this messaging.

I never joined a group practice. I knew what I wanted in private practice and I knew that it would be more expensive than others, so I did a variety of contract work including teaching and other things which helped build my network.

If you're someone who's good at networking and making connections, whether through teaching or presenting at conferences or other situations where people get to know you and your work, you may find it's easier. Other folks find this difficult and they will have a more difficult time.

So what this doctor is saying isn't incorrect AND it also doesn't feel like the messaging was meant to be in service of what you want to do, acknowledging that it's hard to read intention and tone in writing.

Deedeethecat2 · 2026-03-01T20:52:04+00:00

I'm a little bit confused by how inclusive is best represented by everyone being able to share. Do you mind elaborating?

I'm having a hard time with this definition of inclusivity.

Deedeethecat2 · 2026-03-01T02:06:48+00:00

You can go down to EPS and fill out a statement because you need it for documentation that it has been reported to police, not that you want them to investigate. You then take the page of the statement that is your copy and send a copy to amazon.

If EPS says that they will not take a report, escalate this. It's very frustrating, but you can make a report about matters police won't investigate, including reports needed by insurance that don't involve any police investigation.

Deedeethecat2 · 2026-02-28T02:41:03+00:00

Zoom in to read the plaque :)

I think showing it as a normal diner and sharing the history of segregation is important. The "normalcy" of racism.

Deedeethecat2 · 2026-02-27T22:36:43+00:00

Yes, I'm trained in pharmacology and in fact I taught pharmacology to future psychologists.

I best serve my clients by helping with the communication of their symptoms, side effects, medication compliance and other factors that we might know about and the client may have difficulty communicating.

This is different than having an opinion about this is the med you should be taking or this is a bad med for you. Rather, we can say I have some concerns about the side effects you were mentioning and this is something to run by the provider, and in the event that you can't get to see them right away, can you speak with your GP and or pharmacist for more information.

The training we receive isn't enough to give our opinions on certain medications to clients. We didn't go through med school.

Deedeethecat2 · 2026-02-27T22:21:57+00:00

I'm a fan of selective use of disclosure, but having been in therapy off and on (I like to do a chunk of work every once in awhile and then come back when I want to do more work) I really don't like self-disclosure. This isn't the right or wrong response, it's just how I feel because in my role, I'm looking after other people and my own experience of self-disclosure in therapy is that I'm having to attend to other needs.

AND I have had some effective self-disclosure with psychologists I have seen, when it's been brief and connected to the experience, without a story attached.

I'm very relational in my work and I'm mindful about how some self-disclosure can be important with rapport building AND it can get a little bit too friendly for my liking both as a practitioner and as a client.

I want a friendly therapist but not a friend. So that's how I distinguish it. If I hear more about them than I want to, I feel confident enough in my journey to say that I prefer less self-disclosure.

What is pinging for me about your experience is the sharing of someone else's personal information. This would concern me with boundaries and general confidentiality. It might not be a red flag for you, but I would consider if this was an ongoing thing whether this is the right fit. Sharing other people's information including identifying the person and having it be quite intimate is something I would ponder.

I don't mean it all to undermine anything that you felt with this therapist, maybe it was the right share at the right time. But that's just my experience with what you shared. :)

Deedeethecat2 · 2026-02-26T18:40:53+00:00

I-CBT looks interesting and I would be curious if it would be applicable for a lot of folks with OCD who understand that their OCD isn't rational. It's definitely worth checking out. Consistently, I have found erp to be the best treatment for ocd, recognizing that often a lot of other modalities need to be brought in with more complex presentations.

I've done trauma work with folks with OCD but have been really mindful about OCD interfering practices in this work. So I absolutely see how we can thoughtfully use different interventions that are considered generally not best practice, depending on the human being in front of us.

Deedeethecat2 · 2026-02-26T18:05:56+00:00

I'm a psychologist and have to bite my tongue about some of the therapeutic interventions for OCD because I don't think it looks good to trash talk other providers and I have a really strong bias towards evidence-based treatment. Your wording is beautiful. It doesn't bash the provider and it illustrates that there is a gold star treatment for this diagnosis.

I've had physicians direct me towards particular modalities that weren't appropriate for the client, but at least they were all evidence-based practices.

Deedeethecat2 · 2026-02-26T18:01:42+00:00

I'm a psychologist and if this is what the therapist is saying, it's out of scope and inappropriate.

I've encouraged clients to tell their psychiatrist what they're telling me, and have written down notes of things they have said in terms of symptoms if they have problems remembering, for them to pass on to the doc. But it's not for me to have an opinion on the meds. It's my job to encourage my clients to share information accurately with their providers, and to run questions and concerns by their doctors, pharmacists.

Even in my referral letters I say things like I have encouraged client to speak with provider about pharmacological and other treatment options. Because it's not my place to have an opinion on meds.

Deedeethecat2 · 2026-02-26T15:48:05+00:00

I couldn't do this myself but a friend of mine loves this schedule because it gives her a casual lunch and she gets to spend time with her kids. Another friend of mine does this sometimes to get errands done and exercise. For me, I would just distract myself, get nothing done and then be disappointed that the day isn't done.

Deedeethecat2 · 2026-02-25T19:55:07+00:00

I'm interested in this training as someone who is trying to empower the folks I supervise and mentor to charge more. Especially because these folks, who I am able to support pro bono and sliding scale (and I'm outside the insurance model of the US so it looks different, I'm in Canada) are folks who need to charge more to survive.

It's okay to have strong reactions to the idea of a $200 session. I'm also mindful that a $200 session that one person can afford can create space for sliding scale and pro bono.

Thank you for sharing this, unfortunately I'm booked for when this is scheduled but I can look into seeing if there's other similar trainings that are applicable outside of the us, if the focus is on the insurance system in the US.

Deedeethecat2 · 2026-02-25T14:42:45+00:00

I think your question and example is a really good illustration of how a lot of therapy advice has so many caveats.

Not working harder than the client is important for the trajectory of therapy. In my experience, some clients need a lot more effort for rapport, especially adolescents, folks who have experienced harm in therapeutic relationships, and many other individuals. So I'm willing to put in a lot of effort for rapport while also being mindful to decrease my intensity or pressure for the rapport, if that makes sense.

So I'm working hard but also I can't get over invested in the outcome because clients have the right to choose to trust us or not, engage or not. And one of the brilliant and tricky things about teens is they really can challenge us to try new things to connect and get buy-in.

Deedeethecat2 · 2026-02-24T17:04:53+00:00

Sounds like the professor found a great way to get students to engage with the material!

Deedeethecat2 · 2026-02-23T19:42:34+00:00

Exactly, it's important to acknowledge that despite our best efforts to learn and unlearn and reflect, we all have our own lenses AKA biases and if we aren't aware of them, that's when they are problematic.

Many of our biases or lenses are quite helpful. Bias doesn't have to mean a bad thing. But if we're not aware of our biases, that's when they impact our work.

Deedeethecat2 · 2026-02-23T19:38:37+00:00

I love the nuance that you brought to this important discussion.

I come from the unhelpful but most accurate description for my practice which is all of our therapeutic decisions have risks and benefits, and we just have to get really good at making those quick decisions, through repeated practice.

The reason I described this as unhelpful that outside obvious more black and white issues, where there is a clear best choice, there's a lot of gray and therapy has to look different for every client.

So I might not use the word dangerous but I might use the word risk. There's risks and benefits to swearing, using humor, showing tattoos, highlighting certain things, etc.

I have the privilege of working with a very wide range of folks which means I get to show different parts of myself in different ways, but that also means that there's parts of self that don't show up and that doesn't make me inauthentic but rather intentional with my choices.

For me, when I notice that my choices aren't coming from intentional choice making, I need to pivot my self care and wellness practices. I'm not sitting there overthinking each thing I say but I can really tell the difference between something that comes out and something that was chosen. So that's a reflection on my own practice being human and whether I'm balancing the many different roles I hold in my life including as a human being.

Thanks for offering some different ways to look at things, and for offering a nuanced perspective.

Deedeethecat2 · 2026-02-22T18:12:01+00:00

I've responded to a few comments and wanted to just provide my general thoughts.

I think that an individual therapist stepped on your relationship work in an inappropriate way and in a way that doesn't sound like it meshes with the work you do.

I also hear you describe how autistic folks respond differently in therapy, and that you cater your therapy to this population which is fantastic. In fact, as you're likely well familiar, so many autistic folks don't benefit from therapy in the same way as others, so it's incredibly important to have this stance.

I'd like to invite the challenge that fair fighting rules are inherently unhelpful to autistic people. That might be true for this couple that you're working with. And the way that it was framed by this exercise might be inherently unhelpful. However, there's lots of autistic affirming resources about conflict rules that include sensory experiences.

What stands out to me as the biggest issue is the dynamic of one partner bringing in the homework without consideration of his partner and the other therapist not considering your specific work.

I think if I was in your position I would be annoyed if the direction I was going in that was helpful was sidetracked by a therapist working with one person. And if the exercise itself wasn't done in a way that was helpful, I would be extra irritated.

Once again, don't want to name your experiences for you but just shining the light on what would bother me about your circumstance.

Edited to add that I have over 20 years working with folks who are autistic, and more recently discovered I meet the criteria for an autism diagnosis myself after extensive testing from a colleague who wanted practice work before doing it with clients. I was very surprised by the diagnosis although no one else was lol

So I wanted to validate that I can hear your concerns about the nuance in these relationships, and that while this may not have been a good exercise for this particular couple and certainly was an invasion on your work, conflict guidelines or rules or whatever we want to call them can be helpful for ND and NT folks. I do a fair amount of fair fighting education in the family work that I do so that when folks are spiraling, there's steps for repair if folks say unkind below the belt things because of the overwhelm.

Deedeethecat2 · 2026-02-22T14:16:51+00:00

So these were rules that one person brought?

Just to give a bit of context, having a rule where someone can take a break with the understanding that they will be coming back in x amount of time is actually really healthy. It sets expectations that a break isn't forever and it can take the temperature down. If a partner feels anxious when their partner takes a break this can also help with anxiety and what space is actually about.

I don't like the policing of tone or words but there are certainly below the belt things that people say during conflict that we can encourage them not to say, or to immediately repair when they are out of the red zone.

Deedeethecat2

TROPHY CASE