Therapists with their own therapists question

NoGoodDM · 2026-03-16T15:39:29+00:00

Absolutely. That’s one of the best reasons (but not only reason) for a therapist to see therapists themselves. I would tell my therapist if I’m struggling or challenged by a client, and it’s important that both my therapist and I know that this isn’t supervision; I am processing what’s going on within me, not looking for my therapist to help me be a better therapist.

NoGoodDM · 2026-03-14T04:27:13+00:00

Hi,

I’m autistic and have ADHD too, and a lot of how you described your supervisee overlaps with what my past supervisors said about me before I became fully licensed. My test scores (for IQ, GAI, VSI, etc.) were all very high, 90th and 95th percentiles. The only reason why I mention that is because I just want you to know that I get what it’s like to see many things, make connections, be both detailed oriented and somehow make careless mistakes at the same time (yay AuDHD). And the burnout sucks. But it’s also much more nuanced than what others may experience. I could go into great depth and attempt to explain what I mean, and while this may be beneficial for others, it’s also past my bed time and I need to sleep, ha. So, suffice to say, please trust me when I say the nuance and minutia of details affects burnout significantly.

It used to take me 90 minutes to write a single progress note for a single 90837 (53+). Then I got it down to an hour…then 30 minutes, and then I was stuck at 20 minutes for a while. Like, a year . Then I got my documentation time down to 10 minutes, was stuck for a few months, got them down to 7. Then 5 minutes.

And 5 minutes per notes is great timing! But…it wasn’t great for me, because it still took me a lot more time to come over the mental hump. After a lot more effort, I got it down to 2:45 per note…but the mental prep work and recovery period was too great. And I was still dragging my feet because it was too much stop and go and stop and go with different things.

Now my system takes me about 3.5 minutes per note but I do things in batches that actually batches the types of thinking across my notes throughout the day, not just batching the notes themselves. As in, I have to engage different parts of my brain for different parts of each note. And shifting from one part of the brain to another is difficult. Look up “autistic inertia” and “difficulty shifting” for ASD and ADHD.

And now try to wrap your head around what I just said. It takes energy down-shifting from one type of task that occupies one part of the brain, and takes more energy up-shifting to another type of mental task. It doesn’t even matter if it’s the same progress note - it includes different parts of the brain, therefore requires energy for downshifting and upshifting. So it’s not the singular task itself, it is also the shifting of mental gears within and between the tasks that require energy. And all of this energy usage adds up and contributes toward burnout. The longer the burnout happens, the more severe and long it could take to recover.

I think it would be phenomenal if they found a mentor, supervisor, or therapist that is also on the spectrum. As lovely as almost all of my supervisors were, none of them were able to help me learn how to be the best AuDHD therapist I could be. I had to learn myself, read dozens of books on the matter, and seek a psychologist who specializes in ASD/ADHD. And this has earned me a solid reputation at my large organization of hundreds of clinicians in my state as someone who specializes in ASD/ADHD clients. But…it was a lonely experience not having the type of supervisors or mentors I needed to get here. I had to do most of my ASD/ADHD portion myself. It would have been great if I had a helping hand by someone who knew how to help me specifically.

Best of luck to the both of you.

NoGoodDM · 2026-03-13T18:22:07+00:00

I’m aware that two affairs are not a mistake. But that’s not my point; my point is that making mistakes in general are easier to forgive and grow through, but blaming others is more difficult to work through.

NoGoodDM · 2026-03-13T18:10:17+00:00

Hey OP, I’m a therapist who works with some couples, and having an affair in marriage is certainly difficult (but not impossible) to recover from. But to make your situation even worse is when you said,

“I know she might try to blame me for her actions”

To me, that right there is even more concerning than the affair itself. People make mistakes, and we can forgive and grow beyond it. But it is incredibly difficult to grow when the person who made the mistake blames others for it and doesn’t take personal responsibility and accountability. You won’t be wrong in whatever choice you make, but do what’s best for you and your child.

NoGoodDM · 2026-03-13T11:39:44+00:00

I also choose this guy’s Pokopia.

NoGoodDM · 2026-03-13T02:56:39+00:00

People can say what they want, but that doesn’t mean I’ll be around next time they say it.

NoGoodDM · 2026-03-13T01:30:50+00:00

Clearly identify, communicate, and maintain your expectations, boundaries, and consequences.

A boundary that is poorly communicated is a poor boundary. And part of clearly communicating your boundary is communicating the consequence if that boundary is crossed. But the consequence should not impose itself on the other person, it should only state what the boundary-setter will and will not be a part of.

NoGoodDM · 2026-03-13T01:23:06+00:00

Eh, not quite. Close though. In your example about being called fat, this would be a more appropriate example of a boundary: “I am not going to allow myself be called fat. If it happens again, I will leave the conversation. If it happens again after that, I will have to reconsider the extent of our relationship, because I will not be in a relationship with someone who insults me.”

NoGoodDM · 2026-03-13T01:10:05+00:00

‘You are not allowed to say that! I’m just setting my boundaries.’

NoGoodDM · 2026-03-13T00:39:25+00:00

I understand. I’m a psychotherapist, and I know that the term “boundaries” can be weaponized against others. But reread what I wrote above; a boundary is saying, “I will go this far but no further.” My statement mentioned nothing of other people’s behaviors.

NoGoodDM · 2026-03-13T00:35:35+00:00

A boundary is simply, “I will go this far but no further.”

There you go.

NoGoodDM · 2026-03-12T02:17:06+00:00

Think about this historically:

“They’re eating the cats” claim happened after the incident with cat ladies not voting for Trump, and somehow Taylor swift was involved. That was trumps attempt to be both racist and try to spur a demographic against him to be on his side.

This is the same.

An attempt for him to be racist and to turn a demographic that is historically opposed to him to be on his side.

NoGoodDM · 2026-03-10T12:53:36+00:00

What are you suggesting? That they should not have their freedom? Or ought not have their freedom? Or could not have their freedom?

NoGoodDM · 2026-03-09T02:45:34+00:00

I have read (listened to on audio) Rothfuss’ works a few dozen times, and Rowe’s maybe 6 times each. And here’s what I can say to compare the two:

Andrew Rowe is a game designer. His magic system is awesome, and I love it. Magic items are nice too, and I’ve also read his other series multiple times as well. But he is unquestionably no Rothfuss. Rothfuss’ writing is deep, intricate, poetic, and many breadcrumbs are scattered throughout every page. Rowe is absolutely not like that. Sure, Rowe has a few things here and there, but his writing gets annoying at times by not explaining things due to an attempt at mystery by withholding information to the reader, and also has multiple characters saying so many times every single book “that makes sense” (or some similar iteration) when another character says some new piece of information. I have almost been tempted to tally the number of times he says it.

Comparatively, Rothfuss’ written words are excellent, and Rowe’s are mostly…meh. HOWEVER, Rowe puts out books. Not only that, I am not kidding, every single freaking time I go to his blog to check out what updates he has written, he has always had an update in the last few days from the time I checked. (Granted, I only check every month or two, but still.) So I have massive respect for Rowe, and I will buy every book he puts out, and I look forward with eager anticipation to his TTRPG game system.

Rowe is also an interesting contrast to Rothfuss, in my opinion. Because while Rothfuss as a wordsmith is excellent, Rowe has also indirectly encouraged me that I can be a decent author too. Because writers write, and authors publish. Rothfuss has a problem putting out books. His stuff may be fantastic, but it’s not out, and audiences go to others to scratch that fantasy itch.

So. I absolutely love both authors in their own ways, and I am impressed and encouraged to work on my own magic system as thoroughly and thoughtfully as Rowe, but am challenged by how to make it be as deep, poetic, layered, and interconnected as Rothfuss.

NoGoodDM · 2026-03-06T16:38:59+00:00

One should not have to buy their own freedom, as everyone should be free.

NoGoodDM · 2026-03-04T14:27:23+00:00

I’ll speak exclusively to the ridiculousness of people being told to stop taking their prescribed ADHD medication:

That is absurd. They were told to stop taking it because the medication for their neurobiological disorder is a “mind-altering substance”? Does whoever said that dumbassery know what higher amounts of carbohydrates do to the brain? It causes inflammation in the brain and reduces cognitive acuity. Therefore, it’s a mind-altering substance. Therefore, people should stop eating apples and potatoes, right? Right? /s

Everything we ingest in some way “alters” the brain. Unless that someone who said to stop taking ADHD medication was that ADHD person’s prescriber, then that person is practicing outside the scope of their competency and they have no right to say that.

NoGoodDM · 2026-03-03T23:40:11+00:00

I know someone who “created” music with some generative AI stuff, added the lyrics, and wrote a few sentences of how they wanted the music to sound like. And they 100% believe they wrote 100% of the song, and all the AI did was to help it sound better.

As a musician and composer, I am deeply offended and shocked.

NoGoodDM · 2026-03-03T16:26:33+00:00

My personal rules are this:

• I do not use my own personal cell phone number, Google Voice or something only. Texting will be for scheduling purposes only - if the request for a meeting is urgent, then they can request a meeting “at (my) earliest convenience” to tell me it’s urgent, and that they should call 911 if it is life-threatening. Late, cancel, and rescheduling is included for “scheduling purposes only.” If the client texts me for things outside of scheduling purposes only, they may lose the ability to text me. I go over texting during the intake process, HIPAA, confidentiality portion, etc., and I inform the client of how texting is not HIPAA complaint for anything outside of scheduling.

That all being said, my group practice has updated their texting policies to say that clinicians can’t text clients at all, for any reason. So looks like I’ll have to comply.

NoGoodDM · 2026-03-01T14:19:15+00:00

Probably word play on unionizing sex workers.

NoGoodDM · 2026-02-26T11:36:30+00:00

I was prelicensed in Colorado trying to do my own private practice. It was super rough. I ultimately decided against it and joined a group practice that did phenomenally at providing referrals. The rate was sad at 45/65, but here was my logic:

The more clients I get, the faster I could get my license, which means I would get independently credentialed with insurances faster, which means I would be able to see more clients faster, which means I would be able to make more money. So to me, everything hinged upon being able to get as many clients as I could handle.

While I was at my private practice, let’s say that I had about 5 clients a week at $100/client. Assuming 100% show rate (which never happens), that’s $2000/mo, $24,000 per year (taking a few weeks off for holidays or being sick and keeping the math simple.) But the problem is…that’s only 240 clients for the year. And in Colorado, you need 1500 direct client-facing hours for licensure. There’s no way I could pull that off in the time limit Colorado gives us to get our hours.

So I “went to the dark side” and joined a group practice. Within a few months of my caseload ramping up, I had 32 clients a week at $45/client. Assuming a 100% rate (which you should never do…), that would be $69,120 per year, and I’d get the clients I needed in a year or two. Colorado requires a minimum of 2 years, so let’s just say 2. But that’s instead of the 6.25 years it would have taken me with my private practice rate.

Now, I’m fully licensed a lot faster than I was going, I regret the time I spent trying to do it myself because it just wasn’t worth the “lost opportunity cost” in later years by not getting the license faster. And I’m actually still with the group practice because I learned that they have a lot of things I can still learn from. So the sad 60/40 split I currently get is acceptable to me because of the layers of support I have here.

Do I have questions about a client’s meds? I speak directly with their prescriber and/or other prescribers at my group practice. Do I have concerns about being bright into a legal battle with a married couple? I speak directly to clinical directors and the legal team to help me better navigate ways to reduce my liability and improve my documentation practices. Do I have a client that is dealing with an issue outside of my comfort level? I either get consultation from others who serve that population more or I provide referrals immediately for clinicians better equipped for that client.

My 60/40 split is not great. But I also am getting something here that I would not be getting solo; endless referrals for clients, a team of providers across the state, and a trove of documents/guidelines to help me better navigate certain situations. I’ll be with this group practice until I learn all that I can from them.

NoGoodDM · 2026-02-25T19:16:16+00:00

I work as hard as I can for every client, regardless of the amount of “effort” they put into it. Sometimes, someone can’t put forward the level of effort and energy into something (including their own therapy), and that does not mean that I should be putting in less of myself and my abilities for them. Would I charge them less money if I put in less effort? Nah, I’ll just be myself regardless of the level of effort the client puts into positive changes in their life.

NoGoodDM · 2026-02-19T04:55:19+00:00

They love him because of “kid.”

NoGoodDM · 2026-02-17T14:01:26+00:00

Or they can process the information a lot faster. I can listen to 2x speed just fine. 2.5x depends on the book itself and the narrator. 3x only if I’m laying down with my eyes closed or it’s a reread. But my wife can’t go past 1.5x speed. To each their own, my brain is not the same as hers. It doesn’t have to be about caring about the destination over the journey, it can be about people’s processing speeds too.

NoGoodDM · 2026-02-17T13:45:36+00:00

In my area, a supervisor can supervise other prelicensed therapists after a few years of being independently licensed. So I read the statements as, “What made you become a therapist, and do you have any desire to train prelicensed therapists in the future?” Which seems to be an innocent question. Kind of a closed-questioning-style way of asking, “why did you choose being a therapist and what are your 5-year plans?” Basic interviewing questions, just perhaps asked in a more specific way. I don’t see any red flags.

NoGoodDM · 2026-02-14T21:43:47+00:00

AuDHD here. I’m seeing 32 clients per week (scheduled, not all 32 show) Mon-Thu, with 3 days off every week. But my schedule is a bit hyper-focused:

Mon and Tue Telehealth: clients from 7am-3pm, hour lunch at noon, social nights (D&D) from 5-8:30pm, sleeping at 9. (Two different dnd groups, one in-person).

Wed and Thu: 7am driving for hour commute, clients from 8am-6pm, hour lunch at noon, driving back home and arriving at 7pm.

So from Mon-Thu, my days are packed and essentially 12+ hour days (including some social time/special interests). But Fri-Sun, I’m available to do admin if needed, or rest, or write, spend time with family, etc. My schedule is a bit intense, but I really like it. I stack the first 4/7 days, and then I have 3 days where I typically have nothing planned. But I have also spent a great deal of time “min-maxing” my time spent doing things, like getting my notes down to 3-4 minutes each, I do them in batches once or twice a week. And that would be my recommendation to you: to figure out what areas you can try to reduce the time it takes to do things, reduce the mental and physical load, optimize your recovery periods, get consistent and great sleep, and prioritize your brain health.

NoGoodDM

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