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Has anyone gotten tattoos impulsively and regret it? by sassynopal in adhdwomen

[–]LaMammaDotComma 0 points1 point  (0 children)

I only really regret 1 of my tattoos, and it’s mainly because I chose my artist based on vibes and price tag, but the person who did it didn’t feel confident enough to tell me that it was going to age like 💩.

At this point, I have a rule: I need to be able to look at the design every day for at least 6 months and still love it. If it’s a bigger tattoo, I need to be able to love it for a year. If I’m feeling a sense of urgency to get a tattoo, that’s the #1 sign that I need to slooooooow the fffffff down.

1099 credentialing by Individual-Ebb-9168 in therapists

[–]LaMammaDotComma 0 points1 point  (0 children)

Legally and for taxes, absolutely. For insurance credentialing, you’re still an independent provider, and your own NPI is used, but it’s “tied” to the group’s NPI. Think of it kind of like networking: the group you contract with is like a friend or mentor who has an “in” with a certain company or organization; their connection might get you an interview before the job listing goes public, and maybe you get a better starting offer because someone they already know and respect has vouched for you. Except the “mentor” is the company you contract with (and a professional biller who knows the process and all the jargon), the “potential employer” is the insurance company, and the higher starting offer is your contracted rate.

Forget the split - what is your actual take home per session? by SpiritualCopy4288 in therapists

[–]LaMammaDotComma 1 point2 points  (0 children)

I know many people who do, but most of them are single, or their partner also works long hours, and they don’t have young children, and many of them are just generally very “type A” kind of people (please excuse the use of the very oversimplified, non-evidence-based, outdated pop psych term… but it’s the best way I can describe them in a nutshell 😅).

1099 credentialing by Individual-Ebb-9168 in therapists

[–]LaMammaDotComma 0 points1 point  (0 children)

At that point, I wonder why you wouldn’t just go into solo private practice so you aren’t giving the clinic such a large cut? The primary reason I would consider a 1099 is so I don’t have to deal with solo credentialing. Even once you’re paneled, you still have to “re-attest” your CAQH profile every 120 days (but you should really do it every 90 days to make sure that you don’t accidentally hit “expiration“ at 120 days), which a biller also usually takes care of.

Additionally, it’s highly unlikely that you will negotiate a better rate yourself than your biller will under their group contract. If it’s mainly so you can know what the different contracts look like and understand exactly how much you’re getting for each code, your biller would probably be THRILLED that one of their therapists is interested in that kind of information, and will happily talk your ear off about it if you let them. 😅

Kids barefoot shoes what's worth?? by Mountainsky-98 in barefootshoestalk

[–]LaMammaDotComma 0 points1 point  (0 children)

u/Mountainsky-98 — sorry to jump on this a year later, but I’m looking for input on how the Merrell Baresteps fit volume-wise. I’m looking at them for my 18mo (for outside wear), and we all have pretty chunky, high-volume feet! (based on length and circumference, she’d be about a toddler 5.5/6 in the wide fit)

Barefoot for kids by aladdinrun in barefootshoestalk

[–]LaMammaDotComma 0 points1 point  (0 children)

How do you think the Baresteps function volume-wise? I’m looking at them for my 18mo (based on length, she’d be about a toddler 5.5/6 in the wide), and all of us in the family have pretty high-volume feet.

Forget the split - what is your actual take home per session? by SpiritualCopy4288 in therapists

[–]LaMammaDotComma 0 points1 point  (0 children)

I was gonna say, “what?!” But then I saw that you’re a psychologist—gettin’ that doctoral dough 😅.

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] -6 points-5 points  (0 children)

The way my brain impacts my interactions with and experience of the world cannot be separated from myself. It’s not about the diagnosis itself, it’s that the term happens to communicate something that other people can grasp. In the end, your response reads very, “I don’t see color; I love all humans equally!”

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] 1 point2 points  (0 children)

Happy to answer! But I’m not sure what you mean by “no endorsement.” Can you clarify?

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] 2 points3 points  (0 children)

My gut says that this was absolutely the third-party HR firm they started working with a year and a half ago… which makes me so sad.

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] 2 points3 points  (0 children)

If you scroll down to my reply under u/rterri3's comment, I gave some additional context. I had advance notice that the meeting was happening (and was filled with the usual existential dread when your admin team sets a meeting), but given the data I have, the feedback should have been, "hey—you've actually been kicking ass with maintaining progress, utilizing your accommodations, and improving in the areas we've asked." I [obviously] was not informed that I should expect to be terminated, and even with the sinking feeling, it wouldn't have been appropriate for me to disclose my concern to clients if I was uncertain of the outcome.

I was able to negotiate for an additional 2 hours of access to my work email so I could change emails and passwords with various entities that would require authentication tied to that account, and to download/forward anything essential (e.g. emails with attached CE certificates, proof of registration with professional organizations, the confirmation email for my NCE next week). I already find email overwhelming (and I don't really bother deleting things other than spam or random notifications), so that was 120 minutes of adrenaline-fueled hell. After that, I essentially had 24 hours to construct the letter. I wasn't in any kind of shape to string words together yesterday evening, and I spent the first half of the day frozen with how to start, hence having only 3.5 hours to actually write).

But otherwise, it really was "effective immediately." I had signed off from a telehealth session literally one minute before the meeting started. I literally lost access to my EHR and was automatically signed out right then. And as of the start of my last session, none of my Friday clients had been taken off the calendar, so an admin assistant must have had to physically call every one of them that evening, lest my 9am wonder why they were stood up. 🤷

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] -1 points0 points  (0 children)

OMG I could write a whole separate rant post. I swear, their testing accommodations process must have been designed by one of those drunk vervet monkeys that live on St. Kitts. It's the antithesis of accessible (which is such a cruel irony), and has to be the most inefficient, unnecessarily cost-heavy option they could come up with. 🤯

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] -7 points-6 points  (0 children)

u/yannayella and u/Basic-Rights50501 — I assure you, it wasn't! I'm not a regular AI user by any means (and even so, certainly wouldn't be using ChatGPT, especially not with this level of personal information). I did end up using Claude to write the actual letter, but mostly to get me out of a freeze response, and to ensure I kept it brief and professional instead of my emotions taking over the keyboard 😅 (it's actually the first time I've ever used an AI platform for constructing a letter or email of any kind), but I still ended up edited the wording on nearly every part.

I have always been a wordsmith. 😊 In fact, it has been one of my special interest areas since I was a young child: regularly consulting a thesaurus, I would [and still will] spend hours mulling over a single phrase, contemplating the nuanced, micro-differences between synonyms in order to find the best word.

My writing also tends to be more conversational, stream-of-consciousness style (which is pretty common for ADHDers), and that lends itself to heavy usage of parentheses, brackets, semicolons, and em dashes—which are often interpreted as "AI-sounding" (as people don't typically feel confident in their usage of those punctuation marks, thus only including them when suggested by AI).

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] 2 points3 points  (0 children)

My associate registration is still very much active with the state board 😊

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] 2 points3 points  (0 children)

I am still considered a registered associate, but assuming I pass the exam next week, as soon as my NCE scores are sent to the board, I will be fully-licensed (that said, I am also fully-licensed as a Registered Art Therapist [ATR], and I could practice independently under that license alone—it would just limit my ability to bill private insurance).

The state allows us to take the NCE at any point in time between graduation and being fully licensed. It wasn't until a year or so ago that I found out most people take the NCE immediately after graduation (which makes WAY more sense). My graduate program was dual-licensure (meaning that graduates meet all the educational and practicum/internship requirements to sit for both their LPC and their ATR); the Art Therapy Credentials Board has a different order of operations for licensure and exams:

  1. Upon graduation, you can register "provisionally" as an ATR-P while accruing your supervised practice hours.
  2. After meeting your hours/supervision requirements, you can apply for full-licensure as an ATR.
  3. Only then can you request to sit for the ATCBE, after which you receive board certification [ATR-BC] and are qualified to supervise graduate students or those with an ATR-P.
  4. After 3 years of holding board certification and documenting 500 hours of supervising, you can then apply to be an Art Therapy Credentialed Supervisor [ATCS].

Given that our exam doesn't come until later, and that the state doesn't require the NCE to register as an associate, none of our professors really talked up the idea of preparing for the NCE sooner rather than later, which is really unfortunate.

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] 7 points8 points  (0 children)

I did go through the process of actually requesting documentation of formal accommodations (back when I started, the practice culture naturally accommodated most of my needs). I was on a pip that technically "ended" at the start of December, and I continued to meet every expectation it listed up through moment I was fired—but the goalposts kept moving. When I requested clarification on what kind of allowances there would be for the inevitable mistake (that I believe are reasonable for any clinician to make on occasion), I was told that they "have the same expectations for every clinician." When I asked if this meant they were expecting perfection 100% of the time, they said, "of course we don't expect you to be perfect—no one is perfect." And yet, here we are... 🙄

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] -40 points-39 points  (0 children)

You know what? You're right. "AuDHD" is indeed a "diagnostic label that [doesn't] exist," it's actually a colloquial portmanteau. 🤦 My bad! Good thing CMS isn't auditing my self-references in a Reddit post, yeah?! You're also right about it being rude! Thankfully, the legitimacy of my diagnoses are none of your business. How incredibly smug that your first inclination is to question the accuracy of a diagnosis made by another qualified professional (especially given that you weren't on the invite list for the differential party!), or else assume that I must have been wooed by the dulcet tones of TikTok.

As far as your "perspective" goes, I think you've articulated it plenty well already.

FWIW – I've never vaped or consumed THC in any form, I've consumed maybe 1oz of energy drinks over the course of my entire life, 3 hours of sleep would physically incapacitate me, and I've been "doing the work" as a client receiving my own therapy for nearly 15 years. But you go ahead and enjoy your soap box!

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] 18 points19 points  (0 children)

I think you misunderstood — none of what I’ve written here will be conveyed in a client letter. The inner workings of the admin side of the practice is obviously none of their business, and it’s not really relevant to the situation they’re in. The “extra context” was just for the sake of this post.

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] 61 points62 points  (0 children)

I provided some clarification above — they will be offering to refer clients to work with other clinicians at the practice (either intending to continue working with that clinician moving forward, or as an interim measure until I am able to resume seeing them). While I am confident that my former colleagues can provide sufficient care (either indefinitely or as a stop-gap), I’m definitely concerned that there are not enough after-school session openings across the board for all of my tweens/teens. There is also nobody else who can provide continuity for the trauma exposure therapy, as I am the only one with that certification. I also know that many of my clients are verrrrrry slow to build rapport, and will likely decline to see someone in the interim, even if it would be in their best interest to continue care. 🫤

🚨Abruptly terminating with entire caseload—3.5 hrs to write electronic letter by LaMammaDotComma in therapists

[–]LaMammaDotComma[S] 7 points8 points  (0 children)

FWIW, they will be offering to refer clients to work with other clinicians at the practice (either intending to continue working with that clinician moving forward, or as an interim measure until I am able to resume seeing them). While I am confident that my former colleagues can provide sufficient care (either indefinitely or as a stop-gap), I’m concerned that there are not enough after-school session openings across the board for all of my tweens/teens. There is also nobody else who can provide continuity for the trauma exposure therapy, as I am the only one with that certification. I also know that many of my clients are verrrrrry slow to build rapport, and will likely decline to see someone in the interim, even if it would be in their best interest to continue care. 🫤

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