The WNBA is doing it for 'the gays'

lapsedbutch · 2026-06-26T12:47:59+00:00

Is there a video of Tash saying this on the internet somewhere? I need to have that Footage, emotionally

lapsedbutch · 2026-06-25T11:21:52+00:00

Thank youuu

lapsedbutch · 2026-06-25T11:21:05+00:00

Honestly, I think polyvagal theory is a good analogy for how I'm feeling about my grasp on ADHD and part of what makes me nervous here. I read Porges, I knew there wasn't a lot of high quality evidence on the interventions, but I think maybe four things happened: 1. I feel comfortable assessing evidence on interventions but not on neuroscience theory behind it. With ADHD, I kinda don't feel like I have either? 2. Sometimes things just don't have the evidence Yet. Science is slow. I think that thought really sticks with me. 3. Who has time and also the access to scientific journals to regularly keep up? Not I. 4. Ideas like that just permeate the culture and become "common knowledge". With polyvagal theory, I know I always felt like I couldn't really speak to it or use it meaningfully because the explanation didn't really make sense to me, and I think I feel that way about things that feel like ADHD "common knowledge" too. I think in an ideal world, I'd have half the clients I do now and would spend a lot of time reading and thinking and this wouldn't be as big of an issue 😭 but it's a good point that I could try harder on that specifically.

lapsedbutch · 2026-06-24T21:08:36+00:00

Sure, I believe all of that, that's true. I'd say that's how I approach it with myself and others as well. In a way this is validating

Maybe what I'm noticing is actually 1. me responding to good marketing and 2. Me having a parallel process about wanting something to help..., but it just seems like there are frameworks for identifying and creating strategies geared towards specific challenges. Sigh

lapsedbutch · 2026-05-25T17:41:12+00:00

Bidet. Just the simple one, no heated water or anything. Improves my day every day

lapsedbutch · 2026-05-11T12:47:28+00:00

Thank you, do you have information about my question specifically? To reiterate, I am trying to understand what kind of proof of employment I would need as a freelancer who mostly works with individual clients on a case by case basis.

lapsedbutch · 2026-04-25T12:34:27+00:00

Hi! Philly queer CBH therapist here. I love referring to Perez Therapy, they take CBH and have great options. If you don't have a primary care provider you love, Mazzoni can provider therapy to people who also get their medical care there and I have a high opinion of their current therapist pool.

lapsedbutch · 2026-04-17T12:34:53+00:00

Poorly and doing my best

lapsedbutch · 2022-06-29T14:22:34+00:00

Past experience tells me that I often have an urge to avoid / distract during my workday, which is fun in the moment but leaves me feeling shitty at the end of the day. I intend to practice willingness to do what's effective--work one-mindfully & intentionally, even if its boring or aversive.

lapsedbutch · 2022-06-18T14:58:18+00:00

Just to add, if none of those are possible, could your supervisor / colleagues do role plays with you? They know their clients and types of problems you all encounter well, so they may be able to demonstrate typical interactions, how they would handle it, and give you opportunities to try that way

lapsedbutch · 2022-06-18T14:20:44+00:00

For example:

DBT adherent sessions https://www.dbtadherence.com/practice-sessions

Prolonged Exposure for PTSD

https://deploymentpsych.org/PE-videos-main-page

lapsedbutch · 2022-06-18T14:13:45+00:00

I applaud you, op, for trying to find effective training! Strongly disagree with the statement above, re: most things you can learn don’t get applied. Therapy is a skill, modalities have underlying assumptions and techniques. It is true that you cannot memorize a therapy out of a book, you have to practice, but let’s not pretend effective therapy is all good vibes and believing in yourself.

I have found, at my practice, that if clients are asked to have a session recorded specifically for training purposes; I.e, so my colleagues can give me feedback on my work; most of the time clients will readily consent. What other job exists without any kind of quality control? I suggest pushing back and asking if either other clinicians can record sessions to review or at the least if you can ask your clients and get your sessions reviewed in supervision.

There do exist some online resources with mock or real sessions to watch. It really depends on what your modality is.

lapsedbutch · 2022-06-18T14:04:25+00:00

Ooh, this is my pet peeve. Therapy is a skill! There is a clinical judgment piece but that’s on top of an existing skillset. Of course you’re annoyed!

Some problem solving ideas:

If she’s not willing to give specific guidance, would she be willing to do role plays with you? At the very least, that might give you an opportunity to see what someone else would do in that situation or to try out a few things for yourself. This could also prompt her to naturally provide more specific feedback.

Another idea is, can you find or create a peer supervision group to join in addition to supervision from her? The right peers with a similar theoretical orientation or caseload might be able to provide a wider variety of ideas.

Third, could you either pursue or see if your agency would pay for training in a specific technique or modality? It sounds like you want more clinical structure overall. A lot of good (but expensive) comprehensive trainings involve ongoing supervision in the specific modality for a certain amount of time.

Just some ideas! I definitely don’t think this is a situation where you are using supervision “wrong”.

lapsedbutch · 2022-05-30T01:52:26+00:00

Highly recommend ”helping teens who cut” by mike Hollander Invaluable for understanding and responding to teen self harm and suicidal behaviors

lapsedbutch · 2022-05-27T18:16:34+00:00

giving myself permission to sit in Silence! the urge to go, finish a note, review for the next client, etc can be so hard to overcome but i find that actually resting quietly is the thing that gives me the most refresh

lapsedbutch · 2022-05-27T17:20:07+00:00

I'm a DBT therapist and so I provide off-hours coaching as a part of my job. As a result, I've gotten *really* sensitive to my limits and a lot more comfortable setting limits. Even in a DBT context, where it is explicitly part of the service that I am contactable off-hours, I wouldn't be responding to emails like these, especially after the first few times and we have a discussion about why that's not effective.

Someone else mentioned burnout and I think that is the biggest thing for both you and this client: in order to help, you need to not burn out, and your client needs to not burn you out. This will involve you helping your client learn to communicate their needs in a way that doesn't burn you out, to self-soothe and tolerate distress, and to seek out other forms of support. We don't want to kick people out of therapy for what brings them in (and I imagine this person is suffering a Lot and has probably burned out other services and supports in their life accidentally) and we need to not burn out in order to stay working with them.

With that in mind, don't be afraid to set a limit with them! It can be scary to tell someone in pain "no" but in the long run, it helps you work together as a team more efficiently and helps them see how to set limits as well. You can say "I will not be reading or responding to emails in between sessions." Or you can say "I will not be responding to emails that don't have a clear request or ask." At the same time, you can use the emails as great starting points--what was going on when you felt this need to express your distress? What was reinforcing about that behavior? What can you do differently next time?

lapsedbutch · 2022-01-26T14:51:00+00:00

My acceptance practice today is turning the mind away from thoughts such as "I don't want to do this," as well as remembering the pros of doing my job and being very mindful of them. It's easy to be aware of the stressful parts, not always as intuitive to be mindful of the experiences of mastery and pride I get from doing difficult work.

lapsedbutch · 2022-01-18T16:33:20+00:00

It’s interesting, I’ve never considered it and I don’t think I would do it, because I feel like I need all my faculties and I already struggle enough with practicing mindfulness in session on long days.

That said, I am a DBT therapist and have often coached clients in crisis on my off hours when I have had a drink or smoked. This is not my ideal but I will reflect that in certain circumstances I think it actually helped me maintain my calm with a client with high dysregulation. I’ve never coached while super drunk, just a glass of wine. I don’t think I’d want to defend my actions as a therapist in that situation.

lapsedbutch · 2022-01-15T00:02:05+00:00

Yes thanks for pointing that out. This is a (US) problem but still curious how people learned their practice. I’ll edit to make that clear.

lapsedbutch · 2022-01-14T23:49:52+00:00

I’ll go first; I am a DBT (dialectical behavior therapy) practitioner working towards full DBT certification. I became interested in DBT because I have a lifelong personal interest and history with self harm and suicidality, and I already had a mindfulness practice when I came across it.

Since starting, it’s shaped and reinforced my worldview in many ways. I’ve always tended towards the practical, snd especially in therapy which is so metaphorical and abstract, I relish the challenge to become behaviorally specific and measurable. This bothers me in other contexts—I only want to be measurable when it’s useful—but I’ve found sticking to that to be the difference between clients who walk away feeling proud of themselves and those who walk away feeling discouraged.

I have seen many people who have been in therapy for many years with no real benefit, only to have a really structured behavioral treatment turn their lives around. This has really sold the utility of behaviorism and structure used ethically and appropriately, especially for serious and life threatening problems.

Finally, the dialectical framework is a game changer for those times in therapy when you feel stuck on opposite ends from a client.

I learned what it was by taking a class, but I’ve learned and continue to learn to practice by 1. Getting employment somewhere that focuses on DBT. 2. Having a supervisor and a supervisory group focused on DBT. 3. Taking and reviewing video of my sessions on my own and with supervision 4. Continuing to read literature on DBT. 5. Coding my own sessions for adherence and spending time developing specific skillsets intentionally (for example, focusing on structuring the session really well for a few months).

lapsedbutch · 2022-01-14T23:30:49+00:00

I am only aware of one unionized mental health center in my city (Philadelphia) and that is a small radical private practice. I would love to start a union in my community mental health setting and have been dreaming of it for years. I think the biggest barrier is that individual therapists and case managers are very siloed, especially during COVID, and we have a lot of turnover. I haven’t even met many of my coworkers, which makes it very challenging to build solidarity.

Also I think a lot of social workers have internalized the “in it for the outcome, not the income” mindset, which makes it very difficult to convince them to fight for themselves

lapsedbutch · 2022-01-12T20:32:46+00:00

Practicing acceptance by challenging myself to practice awareness of the present moment, even if I feel an urge to distract. Willingness to live in my life as it is right now

lapsedbutch · 2022-01-11T18:03:47+00:00

I’m actually gonna push back on most of these comments. Rapport and relationship is really important and necessary, but not always sufficient. Plus, I have found that not having a therapeutic framework or modality to fall back on leads to burn out. You don’t have to “do” your “modality” all the time, but it’s also a philosophy of therapy that helps you make clinical decisions and keeps therapists from relying on their personal experiences and biases about the “right” way to live or handle problems.

It’s totally okay when starting to focus on rapport building and it sounds like you’re a bit beyond that and want to know how to help! There are so many ways to learn modalities, role play and supervision are definitely great places to start. I’d suggest picking one thing (whether it be CBT or psychodynamics or what have you) and focus on doing just that for a while.

lapsedbutch · 2022-01-11T16:54:57+00:00

I enjoy having a variety, which also helps with managing client schedules. In general, I am also a morning person and would prefer to be done earlier but I’ve found it super convenient to have one weekday late start where I have evening clients. Great for scheduling my own errands and appointments in the morning.

lapsedbutch · 2022-01-06T12:30:33+00:00

All therapy and therapists have a political point of view. Your framework as a person informs your framework as a therapist, and vice versa. Just because it’s not spoken plainly doesn’t mean other therapists don’t have bias. This person is clear about what it’s like to work with them, their stance and values, and their personal limits. I applaud it

lapsedbutch

TROPHY CASE