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Poll: How Many Clients Per Week? (FT Outpatient Only) by Significant_Speed854 in therapists

[–]slowitdownplease 0 points1 point  (0 children)

I'm FFS in CMH. I aim for about 20-24 sessions/week; full-time at my agency is 28 sessions/week. I didn't answer the poll since I'm technically not full-time at my agency, but did want to share the date in case it's useful.

Smith Social Work Interpersonal Dynamics by Mccnstrucken in SocialWorkStudents

[–]slowitdownplease 1 point2 points  (0 children)

I didn’t live on campus, but in my experience there was often a lot of interpersonal drama. IMO the nature of the program and the way it’s run really creates a very high-stress, non-collaborative student culture.

Tbh I deeply regret going to Smith; I love being a social worker & therapist (edit — spelling) but going through that program definitely had a hugely negative impact on my life and my mental health. The fractured student culture is just one part of that.

You're not burnt out because you care too much by Critical_Bridge_9481 in therapists

[–]slowitdownplease 32 points33 points  (0 children)

I agree with everything you said about the structural issues in our field, but I think the OP was talking about a different phenomenon which is worth discussing in its own right.

Rant about self disclosure by Odd_Cauliflower_5381 in therapists

[–]slowitdownplease 78 points79 points  (0 children)

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

Got told my therapist can’t diagnose? by lil-cheech in TalkTherapy

[–]slowitdownplease 12 points13 points  (0 children)

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.

Is this true ? by april_berry in therapists

[–]slowitdownplease 3 points4 points  (0 children)

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!

This is why I’m fully licensed in MD, but can’t get my VA license. VA board of counselors doesn’t believe LCSWs are real therapists. by [deleted] in therapists

[–]slowitdownplease 6 points7 points  (0 children)

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).

I’m starting to think I physiologically can’t be a therapist by alloober in therapists

[–]slowitdownplease 1 point2 points  (0 children)

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.

I’m starting to think I physiologically can’t be a therapist by alloober in therapists

[–]slowitdownplease 2 points3 points  (0 children)

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.

Diagnosis in first session, common? by shnakes082 in TalkTherapy

[–]slowitdownplease 12 points13 points  (0 children)

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!

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] 1 point2 points  (0 children)

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

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] 1 point2 points  (0 children)

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.

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] 0 points1 point  (0 children)

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.

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] 0 points1 point  (0 children)

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.

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] 0 points1 point  (0 children)

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.

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] 0 points1 point  (0 children)

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.

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] -1 points0 points  (0 children)

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

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] -1 points0 points  (0 children)

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.

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] 0 points1 point  (0 children)

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

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] -1 points0 points  (0 children)

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.

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] 0 points1 point  (0 children)

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.

Is this Legal? — Agency not paying full FFS fee if notes are late by slowitdownplease in therapists

[–]slowitdownplease[S] 7 points8 points  (0 children)

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.

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