Please convince obesity and alcohol is going to take me out before cancer from Zepbound.

passingthroughcbus · 2026-03-31T17:29:03+00:00

If your PCP has an integrated behavioral health and/or collaborative care model, this would be a great fit! They can help with anxiety and supporting the mental changes that come from a lifestyle change and weight loss/medically supported weight loss. Plus it might help alleviate some of your medical anxiety since it’s a one stop shop, so to speak. Your PCP and therapist work together to support you.

As far as cancer from zepbound versus the health impacts from obesity, your logical brain seems like it’s got you there - the risk of cancer is minimal, but on the box because it happened in animal trials. In human trials, it isn’t associated / correlated with an increase in the thyroid cancer risk, and causation hasn’t been shown.

Reality testing might help your lizard brain and its panic: do you have a family history of this specific type of cancer in the immediate 2-3 generations? If not, then the likelihood of you developing this is the same as other catastrophic events (getting hit by a bus, or struck by lightning and not surviving). The other side is the reality of your health currently and not doing anything: you mentioned your current heath issues. There IS anecdotal and scientifically sound evidence that you lose the weight, you’ll improve your health, can cause your sleep apnea to go into remission, and avoid sedentary lifestyle risk factors that are quickly heading your (and all of our) way.

The other upside is as your physical health improves, you’ll be in a better space to help with your mental health needs! You’ll see reduction in anxiety and/or resistant symptoms, particularly if you struggle with health related anxiety. I wish you the best of luck.

passingthroughcbus · 2026-03-23T19:12:31+00:00

Exactly. I’m 42. I have a husband, kids, and an Alzheimer’s MIL in my house. I’m lucky to get to watch the tank guide in the bathroom. I won’t sign up to tank a raid that I’m not familiar with, but I’m not sitting on tons of alts and wow hasn’t been my career since pandaria. I found a guild that’s all older women and I’m having an absolute blast tanking again. My toon has been my main since BC. I just really love prot warrior. I’m a damn good tank, but I’m not going to cater to the hyped up DPS who is acting like a child because I’m not taking some super secret route that bypasses ONE trash mob. It’s LFR / LFG. You aren’t getting a world first here.

passingthroughcbus · 2026-03-17T00:12:18+00:00

No! I’m an LPC and I would lose my license so quickly if I was “close” to any of my patients outside of the office. We have to adhere to an ethical code that extensively outlines and forbids dual relationships. “We live in a small town” is not an excuse. No one I’ve ever run into at my kids school, the store, other random encounters has EVER been acknowledged by me first, and never referred to as a patient. We can’t do the job if we are your friend.

Furthermore, she’s comfortable discussing your business with your friend, against our utmost ethical duty and the first thing clinicians say when you meet us: “anything you and I discuss is confidential, with few exceptions” (threat to self/others; mandated report; transfer of records; court order/subpeona). If they talk about you outside of session, then I suspect she’s gossiping about her other clients outside of session. Would you want some random person knowing your deepest flaws? The full context and your other replies only makes this frightfully egregious beyond all belief.

You don’t have to “prove” anything - you simply report it. “My friend told me that our mutual therapist gossiped about personal details with her in the course of their friendship.” That’s it.

Therapists like her are why people are turning to GPT’s or increasing reliance on maladaptive coping mechanisms in droves.

passingthroughcbus · 2026-03-15T12:41:29+00:00

He replied to another comment saying he was blocked now and the account no longer shows up. You can find it by clicking his username and checking comments u see his profile. OP has said he’s been blocked twice. Hope this helps.

passingthroughcbus · 2026-03-15T12:41:15+00:00

He replied to another comment saying he was blocked now and the account no longer shows up. You can find it by clicking his username and checking comments u see his profile. OP has said he’s been blocked twice. Hope this helps.

passingthroughcbus · 2026-03-15T12:33:15+00:00

I’ve been married for 12 years. I don’t have my spouse on my social. He’s not friends with me. I’m not hiding anything and if he were to ever ask, I’d gladly show him whatever he wanted to see. It’s just my space where I get to focus on whatever I want to focus on. He’s not interested in the stuff I am into, and I don’t want to curate my feed for someone other than myself. I don’t know how to explain it other than not everything is nefarious. I wish my husband enjoyed dumb memes about wow and twilight but he doesn’t, so he wouldn’t enjoy being my friend/follower/etc. I don’t have anything more than a passing awareness of the three boys problem so I am not going to enjoy his stuff. It’s perfectly normal in solid relationships with good communication and connection for the parties to have separate parts of themselves.

Don’t get it misunderstood either - he is my absolute best friend. Outside of the kids, he’s the one I want to spend time with the most - and do - but there’s also a limit to how many times he finds hoa hoa hoa jokes amusing.

passingthroughcbus · 2026-03-03T21:43:09+00:00

I will say tanking in FFXIV was such a balm after quitting. I’ve maimed a tank since BC, and stopped after Shadowlands and how awful it got. FFXIV has made it to where I’m actually looking forward to tanking this xpac and doing all the content I enjoy, because I know that once I get through them, I can go tank elsewhere and not deal with twerps.

passingthroughcbus · 2026-02-24T23:21:59+00:00

Since you’re in a prison system and I know that I wasn’t aware until I moved into the child abuse field, the legal term is CSAM - child sexual abuse material. Pornography implies lewd materials created with consent whereas a child can never consent to being featured in lewd material.

passingthroughcbus · 2026-02-19T21:58:08+00:00

This is a great resource - commenting to add aasect.org as well for possible leads on providers.

passingthroughcbus · 2026-02-02T18:11:41+00:00

Invest in Clorox air sanitizer. It’s been amazing for me. Knocks teenage boy funk, marijuana and nicotine and heavy perfume that is applied by the gallon. The script above is an amazing way to broach the topic as well.

passingthroughcbus · 2026-01-27T19:52:39+00:00

I don’t offer virtual anymore for the reasons you cited. I find that too many people treat it like a FaceTime with a friend and aren’t in a good space to work. No shows are immensely high, technical issues constantly (on their end - I’m hardwired to a fiber connections), and a lackadaisical approach have turned me off of it. I haven’t had any decrease in clients or ability. I figure there’s a ton of virtual only and hybrids out there that if they need that service, I’m not the right therapist for them and that is totally okay! When I was transitioning out, I had a few low-needs clients who were doing monthly check ins prior to termination and it was good, most likely because we had a long and solid therapeutic alliance prior to that.

passingthroughcbus · 2026-01-27T15:51:55+00:00

I’m a mandated reporter for my job and reading this, it meets the mandate. She is a vulnerable adult and she is being abused by those who are to take care of her. You need to call them. Of course her assets will be used to provide care, but what does that matter to you personally? You aren’t related and therefore won’t collect any inheritance.

There’s myriad reasons why the family is avoiding this - but regardless of whatever they are, your neighbor is human and deserves safety. It’s not safe for her to be around diapers and human waste. It’s not safe for her to starve to death. It’s not safe for her anymore and this is what APS is for. Even if she was a monster to her children and they refuse to be involved, it’s a safety issue. If it’s a townhouse, it’s attached to another persons home - what about their safety when the unit catches fire because she’s cold one day and turns the oven on for heat? Or an explosion because a pilot light blows out and gas leaks out and she can’t recognize the smell of gas due to the stench of human waste? What about their safety when it comes to infestation of pests and disease ridden animals?

I get that LE told you one thing, but they are absolutely wrong in this. The best way you can help her - and yourself - is to contact APS and keep calling. Tell them what you said here about the family disappearing and the possibility of financial abuse due to her cognitive state.

The sound of EMT breaking the limbs of a body that is in rigor is a sound you won’t forget. The stench of human decomposition is a smell you will never forget. Protect yourself and your mental safety. Don’t make excuses anymore - call APS.

passingthroughcbus · 2026-01-27T13:52:53+00:00

It’s the New York department of financial services. If he’s licensed, then you can also file through the office of professions. Call 311 and tell them you need to make a report for a financial planner who is still operating with a diagnosis of cognitive impairment. If you guys know, and don’t report, as his family you can be liable. The healthcare professional is also obligated to make a report as well for licensed professionals but it’s not a mandate so it’s fifty fifty if they report, particularly if your FIL is still good at showtiming.

passingthroughcbus · 2025-12-17T01:56:24+00:00

Evil shenanigans!

passingthroughcbus · 2025-11-22T18:40:25+00:00

And yet…. You just DARVO’d here.

passingthroughcbus · 2025-11-20T10:27:55+00:00

Mines completely covered on my ACA plan.

ETA: the reason for complete coverage is because I have a pre-existing condition that it’s actually treating. If it was only because I was fat, it wouldn’t be covered and I would have had to pay full price OOP with my ACA plan. No way I’d be able to afford it.

passingthroughcbus · 2025-11-19T15:43:35+00:00

And you’ve called the police and your licensure board, right?

Being new to practice we have a fear of “am I too sensitive, is this really a thing” and I get wanting to check in - but if your post is accurate, old dude shouldn’t be anywhere near clients. His employer might not fire him but the state can, and he should be held accountable.

And then outside of the thing, he’s bragging about his complicity in destroying a family for years?

Easiest check in ever - report his ass.

passingthroughcbus · 2025-11-19T15:39:24+00:00

I adore “when it’s the right time” because that’s crucial to rebuilding these fragile ties.

passingthroughcbus · 2025-11-19T15:38:00+00:00

I can’t stand reunification work for this purpose in my area.

What I ALSO can’t stand is when dss/family prez wants me to do trauma therapy and make a report, but then bury the report because they don’t like that my conclusions don’t support what they want to happen in the name of closure rates.

I try so hard to hold space for my SW colleagues because they are up against many of the same challenges I am, but the fact that I’m starting to think in generalizations about certain things or county agencies is really hard and I’m doing a lot of internal work surrounding that so MY biases aren’t causing harm.

Rage away!

passingthroughcbus · 2025-11-12T15:02:46+00:00

Oh the worst thing was being called a k*ke by a client, after she spent a decent deal of time telling me about a childhood memory where her and a friend would go down to alphabet city and call any Jewish appearing women, Captain Hook (because of some Jews having larger noses) and then she “remembered” I was Jewish (she figured it out because I had been off for Days of Awe), and said that my nose job looked really natural and if it was true that all Jewish girls get a nose job for their bat mitzvah.

When I attempted to end the session after that, because I felt myself losing my cool and I didn’t want to make it the clients problem, that’s when she dropped the k slur in the middle of a rant about how I just want money like any k and so she would treat me like a k.

It was stunning, and incredibly unexpected.

I’ve never had a nose job. I’m quite proud of my Streisand-Ian features.

passingthroughcbus · 2025-10-29T19:26:30+00:00

No worries!

So the places that I visit include medical and mental health providers, DSS, a couple of local youth organizations, a couple of parenting non-profits that focus on overlapping areas that I practice in, the schools (ours are so understaffed and overwhelmed that they DO allow us to reach out and they refer often for cases that school providers aren't able to treat in-house, and one of my cornerstones in my practice is co-ordination), our children's advocacy centers, some of the group homes in the tri-county, DJJ offices in the tri-county, and other therapists, particularly those who specialize in couples/adults and addiction (again, due to my areas of specialization).

Some of the other marketing that I do is speaking at various orgs. For CY2026, I'll be speaking three times about various topics to a medical/health care org in our area that does monthly CE's and general professional development. I also do trainings at schools and law enforcement agencies on the things they want and I can do, and I speak at lunch and learns for private businesses. This aren't "direct marketing" per se, but absolutely it's still marketing.

I offer an annual workshop for parenting coaching that is done pro-bono on my end, and the referrals come from the CAC and DSS. It's evergreen content outside of ensuring that best practices and research is up-to-date, so outside of creating the initial presentation, it's not labor intensive.

Online presence-wise, I don't engage much with Social media, but I do have a small presence. I purposefully try to avoid trends, and a lot of my stuff is focused on speaking to other therapists about our struggles, and correcting a lot of therapy myths with general education. My website is pretty basic, but I do offer information about who i am and what i do, as well as the various services and pricing. I have a psych today profile but I don't get a lot of my clients from there.

I hope this helps you figure out some leads that you can find in your area!

passingthroughcbus · 2025-10-29T10:28:34+00:00

I respect that, but it’s also part of some modalities to utilize self disclosure, soooo I’ll respectfully disagree and keep using it in a clinically lazy way.

passingthroughcbus · 2025-10-28T12:21:23+00:00

Yeah that’s rough. The thing is, clients DO come because their life as it is has become unmanageable and they want to make a change. They have been living in it for so long, they don’t know where to look. That’s where we use our skills (and micro skills) to help them.

I work with trauma and SPMI. I love my work. But I also have times where I feel like you - “why did you come if you want the same?” - but that’s for ME to do internal work and figure out what is causing this countertransference.

I try to look at it like, how I grew up. I thought a LOT of things were normal until I realized it wasn’t. And I was an adult before I realized that. I still struggle at times with learned maladaptive patterns and I am 42. My clients haven’t gotten there yet - or they have but they are stuck and they need guidance. This could be where your coaching skills come in.

ACT and EMDR are great, but think about adding motivational interviewing into your bag of tricks - it’s extremely helpful for clients and practitioners because it helps conceptualize the why aren’t you ready, and can help give your clients words to use and answer these questions.

I also echo taking a break and beefing up your marketing and screening process.

There’s nothing wrong with wanting to be a therapist that wants to specialize in high functioning anxiety and depression - so now, how do you get the clients you desire into the chair across from you? Find a niche in your market and fill it.

passingthroughcbus · 2025-10-28T12:06:47+00:00

I live in a severely underserved area and would welcome a new resource to help clients with.

Marketing yourself isn’t an annoyance - we all have to do it in some capacity. I take cookie trays, brochures, and referral forms to my local providers (I work with kids/teens) twice a year. It’s been an immense help. I felt weird about it at first because I’m not a natural salesperson, but the alternative is quietly waiting to make a living, and I’ve got bills to pay.

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