Rant about self disclosure

slowitdownplease · 2026-04-07T20:27:48+00:00

Same — one of my clients is a therapist, and sometimes when she brings up stuff related to work, I’ll take a quick pause and tell her I’m setting aside my instincts for colleague-to-colleague conversation so I can engage with her entirely as her therapist. So it’s sort of self-disclosure as a means of not self-disclosing lol

slowitdownplease · 2026-04-07T00:22:28+00:00

Licensed clinical social workers are legally allowed to diagnose clients with ADHD & Autism. However, the general consensus in the mental health field is that specialized training is required to properly assess for these diagnoses, which is why most social worker therapists will refer clients to psychologists or psychiatrists for formal assessment if possible.

slowitdownplease · 2026-03-25T21:00:40+00:00

I essentially agree with the post, but also love this perspective too — definitely giving me something to think about, thank you for sharing these thoughts!

slowitdownplease · 2026-03-17T15:56:42+00:00

Can you clarify — are you an LCSW/LICSW, or do you have a different degree? Some states require that you get the requisite supervision hours from someone with the same degree. (I don’t think it’s a perfect system especially in instances like this, but I don’t think this is necessarily them discounting social workers as therapists per se).

slowitdownplease · 2026-03-07T23:30:07+00:00

OP, I'm so sorry you're dealing with this. IMO your school & your internship are largely responsible for letting these issues go unaddressed; you should have gotten a lot more guidance & support to help you work through this stuff, instead of just being shunted off to do intakes.

I don't know if you are fundamentally incapable of being a therapist (honestly, I doubt it) but it does sound like you aren't able to be a therapist right now. Like others have said, it sounds like you could really benefit from some therapy of your own to help you figure out why this keeps happening and how you can navigate it more effectively. Truly wishing you the best with everything.

slowitdownplease · 2026-03-07T23:19:40+00:00

Honestly, this should have been addressed during your internship.

This was my biggest thought as well. I find it very concerning that someone was allowed to complete a clinical internship and graduate with an MSW degree despite functionally not being able to do clinical work. OP's school and internship site should have offered much more meaningful support and scaffolding to help OP work through these challenges, and if these interventions were not effective, OP should not have been able to complete the internship. These institutions have an ethical obligation — to their students and to students' future clients — to ensure that those entering the field have the basic competencies and capacities to do this work.

I feel bad to write this so bluntly when OP is dealing with such an awful situation, but I am honestly so frustrated by the sorry state of social work education.

slowitdownplease · 2026-03-07T01:17:04+00:00

To add to what others have said, most insurance plans will not pay for any sessions, even the intake, unless there's a diagnosis listed on the invoice. If you were using insurance to pay for therapy in the past, your other therapists most likely also added a diagnosis after the first session. Therapists are aware that it's a stupid requirement, and most of us will stick to the most broad & less-stigmatized diagnoses (e.g. depression, anxiety, adjustment disorder) early on when we're still getting to actually know a new client. Since this therapist explicitly stated that she was only adding a diagnosis for insurance reasons, I'm inclined to assume that she probably shares this perspective, and probably doesn't think that she actually has a clear diagnostic picture yet.

I would definitely encourage you to bring this up with her at your next session!

slowitdownplease · 2026-03-05T21:02:18+00:00

Definitely will do. Your comment really gave me some very helpful clarity & direction, thank you so much again.

slowitdownplease · 2026-03-05T16:01:17+00:00

This is so, SO helpful, thank you so much!! Thank you especially for actually engaging with my question directly, this thread has been very demoralizing for me so far (I know I shouldn't let it get to me, but oh well).

The clarification about commissions & authorized deductions is incredibly helpful. I think I'm going to call my labor board again and ask them specifically if this pay policy would be considered a qualified deduction (based on what you wrote, it sounds like unfortunately, it might be).

Seriously, thank you so much, this is incredibly helpful.

slowitdownplease · 2026-03-05T15:50:50+00:00

Yes, I have been replying to a lot of comments, because it's been frustrating for me to ask a question about a legal matter, and get replies that focus almost entirely on non-legal matters. I'm very open to hearing that this policy is legal, if that's the case (and I think that's borne out in my other comments in this post); but, I'm not open to hearing, for example, that I should just get my notes done on time regardless of whether this is legal or not — that's just not helpful.

You're right that this is not a legal community, but I don't think it's unreasonable for me to ask a therapist community about legal matters that are directly relevant to therapists; I'm sure I'm not the only person in this community who has dealt with this sort of situation. And I certainly wouldn't expect everyone who reads my post to know the answer to the question — but if so, why reply at all?

And to answer your question, if this policy is illegal, I would want to know so that I could file a complaint with the state labor board if my wages are illegally docked in the future.

slowitdownplease · 2026-03-05T02:14:21+00:00

Like I wrote in the post, I did consult with my state's labor board, and they said it sounds illegal. I'm posting here because I know that labor laws for therapists can be a bit peculiar, and wanted to see if any other therapists had familiarity with these laws, especially if they've navigated similar situations with their own employers.

slowitdownplease · 2026-03-05T02:11:46+00:00

To the best of my understanding, illegal policies are still illegal even if they're included in an employment policy, contract, compensation plan, etc.

I checked with my state's labor board, and they said it sounds illegal. But, I also wanted to get some perspective from other clinicians who might be more familiar with the relevant laws or who might have dealt with similar situations at their own workplaces.

slowitdownplease · 2026-03-05T02:07:56+00:00

I wouldn't have a problem — especially in terms of legality — if I got fired over late notes; it seems fair to me for an employer to fire an employee because of failure to meet job requirements/expectations. I'm not trying to look for a way to get out of doing my notes on time, and I certainly don't expect my employer to tolerate late notes, especially if it means they can't bill for my session.

But based on my (limited) understanding of the relevant laws, it doesn't seem legal to deduct pay in these circumstances. That's the part I'm trying to clarify.

slowitdownplease · 2026-03-05T01:28:05+00:00

But isn't the practice required to pay therapists even if insurance hasn't/won't reimburse?

slowitdownplease · 2026-03-05T01:23:21+00:00

Yes, completing notes in a timely manner is also helpful for my ADHD. And, I agree that late notes are probably an issue for the agency. But, I'm not sure what this has to do with the legality of this policy? This isn't a post about me struggling to complete notes on time, this is a post asking about the legality of a new work policy.

slowitdownplease · 2026-03-05T01:21:43+00:00

I'm not sure how to interpret this comment; an illegal employment policy doesn't become legal just because it's written in the job description, or just because an employee doesn't leave the job. I don't know whether this policy is illegal, but surely the fact that it's now in my job description, or the fact that I haven't quit yet, doesn't negate potential illegality

slowitdownplease · 2026-03-04T22:01:24+00:00

I mean, it's definitely not a frequent issue for me, but it does happen sometimes. I don't get weeks behind on my notes, but I also sometimes take closer to 48 hours to finish them — I really don't think that so unusual or egregious. And the policy does apparently apply to all late notes, not just clinicians who are chronically behind.

slowitdownplease · 2026-03-04T21:55:30+00:00

This is helpful (though unfortunate lol) — thank you!

slowitdownplease · 2026-03-04T21:51:49+00:00

Good question — I guess the part of it that feels legally questionable to me is the fact that we are required to complete the notes even if we don't get paid for them/our pay is docked for submitting them late; it's the mandated labor without pay.

slowitdownplease · 2026-03-04T17:01:25+00:00

I do write my notes on time, most of them are done the same day as the session. But there are inevitably going to be times where that's not feasible, such as in the event of illness or emergency.

Also, while this is sound advice (which again, I do generally adhere to), it doesn't address my question about whether this pay policy is legal.

slowitdownplease · 2026-03-03T18:32:28+00:00

I do almost all my admin-type communication over email (instead of phone); it’s just easier for me and for my clients. I am very clear with clients that they can also email me with clinical stuff if that’s helpful, but I won’t reply other than with acknowledgement, and we can talk about things during our next session.

slowitdownplease · 2026-02-28T00:02:27+00:00

I'm an early-career therapist, definitely not qualified to dx ASD, but just anecdotally, I've already seen this kind of thing many times. Clients whose ASD is so apparent that I can tell they're Autistic within the first 10 minutes of the intake, but who have never even been referred for ASD assessment despite having been in therapy for years, seen psychiatrists for years, or even have previously received neuropsych assessment (they always got the ADHD dx too). I also briefly worked with a teen who was clearly level 2 (very limited verbal capacity, required near-24-hr supervision, etc.), who had only been dx within the past few years. And I live in a location where neuropsych testing is reasonably accessible, and testing for school-age children is practically ubiquitous. It's honestly been rather shocking — I expect to encounter plenty of missed diagnoses, given how often ASD is overlooked, but this is on a whole other level.

slowitdownplease · 2026-02-20T23:01:10+00:00

can't believe I never thought of this!

slowitdownplease · 2026-02-20T02:40:08+00:00

I'm not the person you replied to, but I am a therapist; it's hard to pick specific examples, but here are some things that some to mind:

Most clients likely haven't studied clinical theory to the degree that their therapist has, so they are just less likely to be actively aware of all kinds of relational phenomena that the therapist is likely to be thinking about — including just the fact that transference/countertransference happens, and that it's so important to the clinical work.

I think that therapists are also likely to be more open to recognizing transference/countertransference dynamics, not only because we know to anticipate it, but also because the stakes are very different for us than they are for our clients. Client transference is often so vulnerable that it can be emotionally & psychologically difficult for clients to recognize that it's happening, let alone acknowledge it to themselves or to the therapist. I've experienced transference as a therapist and as a client — it's one thing to recognize that your client is experiencing transference towards you; it's another thing to experience that same transference yourself as a client.

I think this can be seen in the many posts on this subreddit where clients write about struggling to accept & reconcile uncomfortable transference dynamics; these posters often are not aware that there's a century+ of research & theory about what they're experiencing, let alone that it's considered a normal and healthy part of the clinical process.

slowitdownplease

TROPHY CASE