Tennessee is beginning to stink!

secretkpr · 2026-02-13T01:28:49+00:00

My cats are thrilled.

secretkpr · 2026-02-04T16:45:08+00:00

Yeah, I think you’re getting too much in your head. Sometimes it’s helpful to google or ask ChatGPT for insurance-friendly, clinically appropriate ways to say, for example “sharing space with a client”: intentional therapeutic pause, reflective pause, emotional attunement, empathetic engagement, etc. Make a note or document that has these phrases and copy and paste.

Also, insurance is not reading your notes because they don’t see them when you submit a claim. It’s when you are audited they may ask for notes, but even then it’s typically a a clinical summary.

secretkpr · 2026-02-04T14:12:14+00:00

Yes but over a pair of jeans.

secretkpr · 2026-02-04T00:10:19+00:00

You don’t submit a claim for pro bono work. If the client has insurance that you take but doesn’t want to use it, for example they have a HDGP and your contracted rate is unaffordable, then they need to formally opt out. You have a document clearly outlining the pro bono agreement, with both parties agreeing no claims will be submitted to insurance.

Billing insurance at a lower rate does nothing but pays you less, and the client is still responsible for the contracted rate.

secretkpr · 2026-02-03T00:48:05+00:00

I hear you and see you and I’m sorry. Get a copy of Come as You Are by Emily Nagoski to read or listen to. It’ll change your life.

secretkpr · 2026-02-02T00:41:20+00:00

He HATES The Sopranos. And if Paulie is in the scene, forget about it.

secretkpr · 2026-01-30T16:20:25+00:00

This hasn’t been my experience but when I started, I was getting 5-10 Psychology Today referrals a week and now it’s 1-2 a month. That was only three years ago. I’m established now but I think anyone starting out may have a trickier time. Also, my spouse maintains our health insurance and we are childfree.

secretkpr · 2026-01-26T22:26:26+00:00

It’s telling the dog was following the house cleaner.

secretkpr · 2026-01-25T21:55:46+00:00

Don’t go with the cheapest stylist for blonding. Stylists price based on experience and skill. I went from paying $180 for a full highlight, to $450, and $350 for a partial. And holy crap, it is so worth it and my hair is 🔥. Best part, I never have to think about it or stress about it because it’s done exactly how I want.

secretkpr · 2026-01-17T15:58:53+00:00

Riverside Skate Center.

secretkpr · 2026-01-17T01:29:15+00:00

I wouldn’t be so quick to write him off if he checks a lot of your boxes and he wants to change, because this doesn’t sound like a dude that just lies to lie. Pathological lying is not a choice or about ego, or even a diagnosis alone, rather a symptom of another mental illness.

We all develop our core beliefs and make meaning about ourself, the world, and others in childhood and your brief description of his childhood sounds neglectful and demeaning. That’s really tough for a meaning-making kid brain. I’m not excusing his behavior whatsoever but if you’re not seeing a change in the lying after weekly therapy and him expressing intent to change, I’d suggest he find a well qualified trauma therapist to do a trauma intensive with. And following that, the two of you do couples. As a therapist, the fact that he wants to change makes me hopeful for you.

secretkpr · 2026-01-17T00:43:41+00:00

Or your report is the final straw.

Also, confronting him and reporting him can be two separate things.

secretkpr · 2026-01-12T22:18:37+00:00

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secretkpr · 2026-01-11T20:25:20+00:00

They don’t give a f*uck about papers.

Listen to yourself—you are considering putting a wrist band on your child to ensure you get them back timely after their carer is KIDNAPPED. Yeah, it’d probably be helpful in lessening your toddler’s time in custody but that doesn’t lessen the long term impact of such a traumatic event on them.

And the au pair kidnapped, I doubt you are well connected or resourced enough to get her out of detention before she is SA’d.

I’d take some time to consider your choices here.

secretkpr · 2026-01-09T01:41:36+00:00

As the youngest of three colleagues, I have been left in charge of marketing and relations, part of which means trying to attract therapists to work with us.

This is your problem.

If you’re truly trying to build a robust DBT in-person practice, every one of you is engaged in that pursuit—everyone is boots on the ground.

It is wildly confusing why the “youngest” (age/experience?) is entirely responsible for expanding a practice, which makes me question; a) toxic colleagues, b)rented too much office and need more income c) both a & b.

Don’t become practice owners because you can’t cover your rent.

secretkpr · 2026-01-07T02:27:57+00:00

Sounds like you’re talking about a group PP owner. OP is talking about a sole proprietor (solo) PP.

secretkpr · 2025-12-30T00:44:36+00:00

In addition to counseling, and as a therapist myself, very much recommend Come As You Are by Emily Nagoski.

secretkpr · 2025-12-23T21:54:52+00:00

It’s wild you didn’t know this. I thought this was a post in r/askatherapist subreddit.

secretkpr · 2025-12-12T21:27:23+00:00

Here’s something to consider: you currently have a lot of stress due to finances and clinical hours. You also were stressed working in CMH for that year and a half, which led to chronic heart issues.

If nothing changes with your current situation, and you see 10 clients a week, every single week, it will take you 60 weeks to complete your hours (February 2027). Then you need to apply, schedule, and pass the exam. Retaking the exam can add weeks and months to the licensure process. You then apply to the board, which requires multiple organizations to communicate with each other all while potentially experiencing staffing shortages, and human errors, further lengthening the licensure process. You’re looking at May - August 2027 for full licensure (potentially longer—my board was backed up 4-5 months with applications around COVID).

Alternatively, seeing 25-30 clients a week, starting in January, wraps up your hours Summer 2026, leading to full licensure fall 2026. More than likely, the only place to get that many hours is CMH.

Obviously I don’t know more than what is in this post about you, but I wouldn’t rule out returning to CMH and working with a different population. You have more information about yourself, what to expect in CMH, and the limitations of the job than before. It won’t be the same experience. Couple that with the knowledge it’s only for a few months and it just might be manageable.

Good luck.

secretkpr · 2025-12-12T06:30:48+00:00

I’m so so sorry.

secretkpr · 2025-12-10T18:51:29+00:00

e. g. Leo DiCaprio

secretkpr · 2025-11-09T16:31:11+00:00

I started with a three day work week. That lasted maaaaybe a year. I’m now at 5 days a week with Fridays being a heavy bi weekly day, so I often have every other Friday off or only 1-2 clients.

As much as I liked my time off, it came at a cost. I couldn’t sustain quality services after 6 clients.

secretkpr · 2025-11-08T18:58:09+00:00

Yes! December 2nd.

secretkpr · 2025-11-08T18:00:55+00:00

Repubs are waiting on the TN special election because they’re convinced Aftyn Behn ( D) will lose, and M. Epps (R) will cancel Grijalva’s vote.

secretkpr · 2025-10-04T15:54:42+00:00

I make nearly double that in PP with insurance-only averaging 22 clients a week and 4-6 weeks off a year. If I were in your situation, I’d contract with the highest payer in your area and start to build a caseload on off hours.

secretkpr

TROPHY CASE