7400 Hours, Psychology, Clinical Supervision

About three years ago, my friend and colleague Judy McGehee LMFT (Partners in Recovery) began a supervision program for Marriage and Family Therapist interns (people that have completed their coursework for Masters degrees) and trainees (those who are about to complete Masters degree coursework).  Borne solely out of a desire to be helpful, and pass on the ability to provide effective human service, for fun and for free, Judy took on supervising 8 or so trainees and interns.  We were joined also by a visiting therapist, Ted Aaseland, Psy.D.  A little over two years ago I joined her in this endeavor, as I care deeply about passing on how to do “The Work”.

Over the course of those years, those interns provided services to the Glendora School District and elsewhere to children and adolescents for free.  Some of these turned into outpatient clients, individuals and families, also for free.  There were also public speaking engagements for adults and adolescents, professionals and non-professionals.  After all was said and done, over 7400 hours of free therapy (not including the speaking/community education efforts) were provided, all for free.

Interestingly and tragically, there are several stories that run in parallel with this one.  Before I get there though, it would be instructive to tell you a little about this process, both from the perspective of the licensed folk/interns/trainees, and from the folk we hope we were helpful to.

Will start with the experience of the trainees/interns/licensed folk.  Most universities require several hundred hours of internship/clinical experience for graduation.  The processing of these hours is supervised by a licensed therapist (who can be a supervisor, as regulated by the Board of Behavioral Sciences), and the student must pay for this process.  Most universities, in an uncomfortable wrenching of common sense, either don’t have someone to organize/and or set up/maintain these supervision placements, or they’re simply not updated for various reasons.  The student/trainee however, is still required to do this.  To add insult to injury, the trainee when in supervision, if they can find an agency, is rarely given a real experience of being supervised at their work.  It seems flabbergasting to consider this, yet it’s tragically true.

Similarly, interns (therapists just out of school) have to complete over 3000 hours of work with patients/clients, just to sit for the two licensing exams.  They have six years to complete this process, requiring continuing education to reset their chance to sit for the exams.  That means that they have to see clients, and that those hours also have to be supervised.  Related to both this issue and Judy’s (Ted’s, and mine) efforts, we were completely unable to get other clinicians to volunteer for either of these processes (for trainees or interns)- not even a couple of hours a month, let alone the minimal 2-4 hours a week.  In light of the complaints of most people we know not feeling like they received quality supervision, this is no small issue.

The second body of material that is really important here is the students and families.  There were of course the predictable experiences with clients who struggled with behavioral problems, substance use/addiction, depression, stress, bullying, pregnancy, self esteem, eating disorders, anxiety and the like.  It was also really common to have active suicidality, reports of abuse, the precursors of “thought disorders” (schizophrenia, and the like), violence, abandonment, PTSD, mood disorders (bipolar disorder and related problems) and more.  There was psychoeducation, crisis intervention, abuse reporting, ensuring of safety, documentation, creation and use of materials, referrals to resources, interfacing with administrators/Department of Children and Family Services/other clinicians/teachers/families and more, interviewing, showing up for IEP/planning meetings and more, and oh yeah… individual and family therapy.

The interns (and will give a little credit to us as well) braved all of these issues and more.  All for free.  Seven thousand, four hundred hours of it, and the attendant signing off of supervision hours.

We met weekly for all this time, as individuals and as a group, to meet the requirements for the relevant university, and for the Board of Behavioral Sciences.  We met in between to take care of paperwork.  To problem-solve.  To handle questions.  We met for lunches, at each others’ homes, in restaurants, in parking lots.  We celebrated birthdays, mourned losses, processed issues, checked one anothers’ heads.  There was a lot of happiness, crying, efforts to glean resource support to continue the work, discovery.

There’s certainly more to be said, and obviously, more work to be done.  Though this cycle of supervision is over, we still have a lot of passion and ideas for what might be next.  The whole point of writing this though, is simply to honor the work of Michael Cardenas, Eryka Gayoso, Elva Cortez, Jessica Wilson, Jeffrey Craig, Melissa Lamoureux MS, Ted Aaselund Psy.D, and most of all, Judy McGehee LMFT.  Thanks so much for making all this matter, and letting me participate.

Who’s To Blame?

Much of my time is spent here, and in my therapy/counseling practice, attempting to get folk to honor how they feel.  That’s an oversimplification, but will leave it for brevity’s sake.  This is a daunting task because of the intensity and availability of our distractions, but I keep trying anyway.

One of the things that oft keeps this from happening is that when someone “hurts” us (shames, takes something away, etc), we find ourselves (understandably) making sense out of why they’d do such a thing.  We think more about the person in question “doing their best”, “having had a hard time” etc than we ever do simply saying “Ouch, that hurt…”, or some variation on that theme.  It’s safe to say that many of us, often don’t honor how it affected us at all.  Working on problems of low self esteem, depression, addiction, abuse and more we don’t want to “blame” anyone (nor should we), and oft go so far as to think our therapists are prompting us to “blame” that person, our parents, etc.

As for my sense of this, I think we could safely remove the word from our vocabulary entirely.  Maybe even replace it with considerations of “responsibility”.  In terms of a solution, will offer something I hope is very simple: we’re only blaming someone else for our feelings or problems, if we do nothingwith our feelings about it.

Love and Service.

Thanks for dropping by my blog page.  As the introduction notes, I am a Licensed Marriage and Family Therapist, Licensed Psychiatric Technician, and Masters level Addictions Counselor in Pasadena, California.  Though I’ve been doing some private practice for many years in addition to the twenty-six I’ve been doing inpatient work, I’ve now gone out on my own, to do just private practice.
            Providing treatment is my life’s work.  Having not just survived, but also (somewhat) gracefully dealt with some suffering of my own, I have been given not just some answers- but with those answers, also responsibility to others.  Holding on to those responsibilities is not only bad for other people, it would be unhealthy for me too.  So, very early, I started being of service.
            Having worked inpatient for so many years, I’ve been lucky (and saddened) to take care of most every type of human suffering possible.  Most of my work has been with adults and adolescents.  Depression, loss, grief, addiction, trauma, abuse, stress, mental illness (for lack of a more graceful term), relationships, desires (and need) for personal growth or “life coaching”, chronic pain, medical illnesses, family problems, couples problems and more have all been tragically present and have arguably increased over the years I’ve provided service.  There is much work to be done about all of these things and more.  It seems now that the most effective way to care for these problems is for me to see individuals, families, and couples privately.
            It was suggested by someone I consider wise that I find a way to make myself available to people when they are not able to be around me.  Aside from writing a book, providing materials from talks I do in the community, I am starting a blog.  There is much work to be done, and many answers are possible that can improve the quality of all our lives, if we’re willing to live by some principles and do some work.  My hope is that I can take you along with me as I do so, by way of communicating here.
            And so to it.

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Available Tuesday through Saturday

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