counselor – Licensed Mental Health Counselor

Being A Psychotherapist: Things School and Books Can’t Really Prepare You For Part Two: Suicidal Clients

3 Feb 2015by Torey C. Richards, LMHC2 Comments

Another thing school and books can’t really prepare you for are suicidal clients. Sure they cover the subject of suicide in graduate school, but the training of dealing with suicidal patients is usually very brief. There are many great books on working with suicidal clients and I have read a few, but I don’t think anything can really prepare you for sitting face to face with and working with a suicidal patient.

From my experiences, there are many types of suicidal clients and they all have to be taken seriously.

There’s the client who doesn’t really want to commit suicide, but they like to self-injure and that self-injurious behavior may lead to an accidental suicide. These are often the most common types of clients, often called “cutters” and they tend to be the most frustrating since a lot of them have cluster b type personality disorders such as borderline personality disorder.

When I worked in a high school I had a whole group full of students who self-injured and ended up involuntarily hospitalizing at least one every month because while they said they weren’t suicidal, they were definitely at times flirting with death.

This picture was taken of one of my former students who likes to cut. The next day she had twice as many cuts on her arm and I was forced to involuntarily hospitalize her.

There’s also the suicidal client who is extremely depressed or emotionally unstable and talks about death and suicide a lot. They typically don’t self-injure and have never tried to commit suicide and don’t think they ever would, but they talk about it so often and their emotional pain is so deep that when they leave your office you often wonder if this will be the last time you ever see them.

These type of clients can also be very stressful to deal with. Often when I have had clients like this I found myself worrying about them when I wasn’t even at work, when I was on vacation, when they didn’t show up for an appointment and sometimes I even dreamt about them.

One patient in particular was diagnosed with a terminal disease and she didn’t want to die a slow death. She didn’t think she would kill herself, but all she talked about was death and dying and her depression was so deep that it was hard to not be concerned about her when she missed an appointment. Eventually I had to hospitalize her after one particularly draining and emotional session when she couldn’t promise me she wasn’t going to go home and try to kill herself. Everything inside of me was screaming she would. She was angry that I hospitalized her against her will, but told me in later sessions that she had every intent of going home and killing herself that day and thanked me.

Another type of suicidal client is the one who never talks about suicide. Some are impulsive, but many just keep their thoughts and feelings buried deep inside. They may never even tell anyone that they are in pain. They just attempt or commit suicide without any real warning signs. These clients take not only you by surprise, but everyone else in their lives too.

I once worked with a student for two years dealing with the grief of a parent and then one day he gave me a card thanking me for helping him. It was our last session, he was doing great. Less than a week later I got a call from his family telling me he had attempted suicide and was in critical condition at a local hospital. I was stunned. I rushed to the hospital and nearly broke down in tears as I looked down at his lifeless body. I kept replaying our last sessions together, our last interactions, his last words to me, trying to figure out what did I miss. Thank goodness he came out of his comatose state after a few days and I was grateful that he not only lived, but that I had the opportunity to process his suicide attempt with him. I didn’t miss anything. He had suddenly decided he didn’t want to live any more and wanted to be with his deceased parent.

A couple of years before that I had been part of a crisis team that was sent to two different schools after two students had killed themselves apparently out of the blue. One was a popular jock that killed himself and stunned the whole community because no one, not even his closes friends knew that he was in so much emotional and psychological pain. His friends, family and even school staff members were blaming themselves for not seeing signs that weren’t even there.

The other student apparently killed himself on impulse in the midst of an angry dispute with his girlfriend. He told her he was going to hang himself. She didn’t believe him, but that’s exactly what he did. He had no history of being suicidal and no one saw it coming.

In my nearly 8 year career as a psychotherapist I’ve dealt with hundreds of suicidal clients. My main job right now is interacting with inmates who have been flagged as suicidal. Luckily I have not had one client commit suicide although I have had a few who have made serious suicide attempts landing them in the emergency room.

Studies suggest that:

1 in 4 interns/trainees will have a patient who attempts suicide at some point during their training and 1 in 9 will experience a completed patient’s suicide.
25% of psychologists and 50% of psychiatrists will experience a patient’s suicide.
1 in 6 psychiatric patients who die by suicide die in active treatment with a healthcare provider.
Approximately 50% of those who die by suicide in America will have seen a mental health provider at some time in their life.
Work with suicidal patients is considered the most stressful of all clinical endeavors. One third of psychotherapists who experienced a patient’s suicide subsequently suffer from severe emotional distress. Several factors may contribute to such severe distress including failure to hospitalize a suicidal patient who then died; a treatment decision that the therapist may feel contributed to the suicide; negative reactions from the therapist’s institution; and the fear of a lawsuit by the patient’s relatives.
25 % of family members of suicidal patients take legal actions against the patient’s mental health treatment team.

As a coincidence, just as I was finishing this post I was informed that an inmate just purposely swallowed 18 Ativan pills in an attempted suicide and is being rushed to the hospital.

Being A Psychotherapist: Things School and Books Can’t Really Prepare You For Part One: Mental Fatique

25 Jan 201525 Jan 2015by Torey C. Richards, LMHC5 Comments

To be a psychotherapist takes years of school and a lot of reading and writing about various aspects of human behavior. Many students fresh out of school with not much patient contact or real therapeutic hours under their belt, think that they fully know what it is like to be a therapist. They don’t. While school and books definitely prepare you for sounding like a trained therapist, nothing but real experience and hundreds of hours of patient contact, can prepare you for even the basics of what it’s like to be a therapist.

Many people who see me doing my job say, “I want to do that” and I never discourage them. I just tell them that if they are doing it from their hearts then they should pursue it. If they are doing it because they think it pays well, then they should seek another career. If they are doing it because it looks easy, then they should definitely seek another career. Even students who have spent years in undergrad and then graduate school are disillusioned and thus disappointed when they actually start seeing clients of their own. A few, those meant to truly be in the field, will love it, even when it’s frustrating. Others will hate it, but stay because they’ve fooled themselves to believe they are supposed to be therapist, and most end up becoming very bad therapists… or program directors. A large portion will leave the field altogether and seek employment that is more fulfilling and they should.

So what are the things that school and books can’t prepare you for when it comes to being a psychotherapist? Well I will cover one topic every now and then instead of trying to cram a top 10 list, but we’ll start with mental fatigue.

Being a psychotherapist is exhausting. Sure it’s not the same as lifting bricks all day, but it’s a different kind of exhaustion. People will say, all you do is sit and listen all day, how can that be exhausting. Well actively listening, being thoughtful, sustaining alertness, using your memory and paying attention to someone for 50 minute stretches throughout the day is very draining. Not to mention the stories you hear and have to process. Stories that are sometimes so sad that you have to hold yourself back from tears, or stories that trigger counter-transference issues because they remind you of some part of your own life.

There is also other things that make it taxing such as doing notes, scheduling, dealing with insurance companies and billing. There’s also that part about managing risks, having to figure out how much of a risk someone is to themselves or others. My main job right now is assessing suicidality in inmates who have exhibited a risk for suicide. It can become very stressful.

On top of that, sometimes your friends and even strangers who meet you and find out you’re a psychotherapist will treat you differently.

Strangers will either be fascinated and want to tell you about their problems, or a “friends”, or they will not talk much out of fear that you are always analyzing people. We do know how to turn it off, well at least turn it down. Your friends will most likely have you as their default free therapist, yet will not offer you much advice/help since “you’re a therapist, you should be able to figure out your own problems.” Oh, I’ve heard that too many times.

It can be exhausting because being a therapist, once you’ve done it long enough, becomes who you are. You don’t leave it behind at 5pm, even when you think you do. It’s always there with you and if you aren’t careful and don’t take care of yourself, it will drain you.

The link below is to a very well written article that details some of the hardest and most exhausting parts about being a therapist.

The One Thing Every Psychotherapist’s Partner Doesn’t Get.

Therapist are Humans Too

My Journey To Becoming A Therapist

18 Apr 2013by Torey C. Richards, LMHC6 Comments

“What made you want to become a therapist?” That’s one of the most frequent questions I get asked by adults, many who marvel at me as if the ability to sit with, empathize, listen to and accept someone just as they are is some mystical superpower bestowed upon a select few.

Many follow that question by saying that they wouldn’t be able to deal with talking with “crazy people” or emotionally disturbed children all day without going crazy themselves, even saying that they can’t deal with their own children, friends or family members when they are angry, sad or being irrational.

There was a time when I thought that counseling was something any and everyone could do, but now I know that not everyone can or should be a therapist. I’ve met some very bad therapists, people who may have had the education and credentials to counsel people, but definitely didn’t have the heart, patience or personality that is just as important if not more so.

Thankfully, most of these counselors learned pretty quickly that sitting down and helping someone unravel the complexities of their lives weren’t for them and ended up either getting out of the helping profession all together or moved to a part of the field that was less people oriented, such as working for insurance companies or becoming program directors.

I’ve witnessed teachers, administrators and other professional adults with good intentions do some very bad counseling. Some even made me cringe at either their bad advice, judgmental attitudes or total lack of empathy and I honestly was very thankful and relieved that these individuals weren’t officially counselors.

Being a therapist pretty much comes natural to me. Growing up I was always a very intuitive, carrying and empathetic person. I was always in touch with my feelings and would spend ours alone just trying to figure out why I felt a certain way. That curiosity soon lead to wandering why other people felt certain ways and why they did or didn’t do certain things. People watching became one of my favorite past-times.

In high school I was the person that girls would call and talk to about their problems with their parents, friends or boyfriends. I enjoyed helping them figure out and solve their problems just as I enjoyed sitting in deep reflection about my own. I was probably one of the only boys in my high school that keep a journal and read self-help books.

Still, at that time I wasn’t even thinking about becoming a counselor. At that time I was interested in becoming a writer, an artist, a dentist or a meteorologist.

In college I decided I wanted to lean towards becoming a writer or an English teacher. I enjoyed writing just as I do today and it was writing that lead me to psychology. I was always interested in making my characters real and multi-dimensional which lead me to reading books on character development and eventually personalities and personality disorders.

There I found my love for psychology.

Soon I started taking every psychology course I could because I found it interested, but even more so because it helped with my writing. This is where I came in contact with Dr. Skinner who was not only my favorite psychology professor, but also became one of my first and most important mentor. He was always encouraging me to further my education in psychology which is one of the main reasons I decided to go on to graduate school.

In graduate school I initially was going to become a guidance counselor because I wanted to work with teenagers, but after taking all the courses required for guidance counseling, I still felt a hunger to learn more about psychology and counseling in general and so I transferred to the counseling and psychology track which was a lot of hard work when it came to reading, writing papers and giving presentations almost constantly.

It was learning the stuff I loved which is why I maintained a 4.0 throughout graduate school while working as a substitute teacher.

It was in graduate school that I started doing official counseling, and I was terrified! To graduate from the program you had to do a 1,000 hour internship, not with friends or people I already knew, but complete strangers. To make it worst, I knew that I never wanted to be a substance abuse counselor and yet, my internship was at an inpatient substance abuse facility. I was determined to hate it.

I grew up in an inner-city neighborhood. I grew up around drug addicts. I already had my prejudices about people who used drugs and didn’t want to have to deal with them more than I already had growing up.

My dad also had struggled with substance addiction pretty much my whole life. He had been in and out of numerous treatment facilities and I had decided that substance abuse counseling just didn’t work. I tried my hardest to get my internship site changed, but couldn’t.

By the end of my 1,000 hour internship filled with individual, group and family counseling, I had a new respect for those who struggle with addictions and their families. I met people who had been trying to get sober since the 1970s! I met a popular high school football coach who gave up everything, his wife, kids and his prized job for alcohol.

I met women, mothers and daughters, so addicted to drugs and alcohol that their families had them committed to treatment and they were some of the sweetest women you could ever meet, who struggled everyday to control their cravings and stay clean.

Sure it was hard work, sometimes frustrating, disappointing and hard breaking (relapse is a b*tch), but it helped me deal with one of my own demons… it helped me understand my father and his battle with addiction so much better. It allowed me to forgive him.

After graduating I moved on from addiction counseling, perhaps it was still too close to home, and went to work in a psychiatric hospital. I always wanted to work with the severely mentally ill.

In the Diagnostic and Statistic Manual of Mental Disorders (DSM) taught to us in school, I had learned so much about schizophrenia, bipolar disorder and other conditions that are rarely seen, yet I wanted to experience them face to face.

I spent three years working overnight in the psychiatric hospital giving psychological evaluations and crisis counseling to some of the most fascinating people ever.

I’ll never forget talking to a rather lucid schizophrenic woman who was having visual hallucinations. She gave me the best explanation of visual hallucinations ever, better than any professor or textbook I had ever read.

I remember trying to calm down a paranoid schizophrenic woman who was shaking like a leaf because she believed a killer was locked in the hospital with us and was specifically trying to kill her.

And I remember giving an evaluation to a tomato red faced woman (all the blood vessels in her face had broken) who had just been released from the hospital after trying to hang herself after finding out her husband was cheating on her.

So many experiences came from my time there, but I knew I was missing out on truly developing my counseling skills. One of my goals was to become a licensed mental health counselor, which is a whole lot of extra work after graduate school and I believed to be a great therapist, I had to know how to not only assess, diagnose and do crisis counseling, but also how to do more traditional counseling with clients who had more everyday type problem.

I still longed to work with children as well so I left the hospital and started working at an inner city high school, focusing mainly on anger management and substance abuse, but soon my job description expanded to include pretty much any and everything that stood in a child’s way of being able to concentrate and focus on their school work.

This is where I learned to work with defiant teens, broken families, damaged teens and teens who just needed someone to guide, care for and encourage them. This is where I saw our future, both promising and disheartening.

While here I also attained my goal of becoming a licensed mental health counselor and continue to learn every single day.

One of the most important things I learned is self-care and to take breaks for myself. Carrying the weight of so many other peoples problems can sneak up on you and break you down before you know it. Sometimes when people know you are a counselor, they will purposely or inadvertently dump their problems on you and that includes family and friends. It becomes important to take the counseling hat off sometimes and if that means going and sitting some place alone, then that’s what I will do.

Being a counselor/therapist is a very rewarding career, but it is probably one of the most mentally and emotionally draining careers I can think of. I enjoy the skills I have developed to analyze people, to read body languages and to be able to already have some ideal what’s going on with a person before he or she even says a word, but sometimes it’s hard to turn that off which sometimes impact my personal life.

One minute a friend will be asking me for advice or wanting to talk to me about a problem, but they don’t want me to “counsel” them. Then the next minute when I make a statement, they will stay “get out of my head” or “stop analyzing me”.

Sometimes I am more comfortable when I am in the counseling role and I will find myself retreating to that mode whenever I am uncomfortable or meeting someone new… not always a good thing. I realize it’s a defense mechanism I use where I limit the amount of information a person knows about me while I gain tons of information about them. That isn’t really fair, but I do it all the time and most people are so happy to talk about themselves that they never call me out on or even notice it.

Lastly, another thing I’ve learned is that being authentic with someone… being present with them and actively listening does miracles. There’s been times when I listened to someone and was present with them, but had no real ideal what to do or say, and after our session they were so grateful to me for listening to and helping them. It’s amazing. Sometimes I didn’t even say a word and yet they would be so grateful. That’s why I stress so much on listening, rather than talking in this blog. I believe that listening sometimes solves more problems than talking, lecturing or berating someone.

Therapist are Humans Too

STDs and Pregnancy Scares: My Week In Review

3 Feb 2013by Torey C. Richards, LMHCLeave a Comment

Last week was a super busy and crazy week. It seemed like I couldn’t get a handle on anything. On top of the many clients I already see, the referrals were pouring in and I only got a chance to meet with a couple of those, the most serious ones, two girls who had attempted suicide recently and had been hospitalized.

I met with both of them once and just kind of introduced myself, explained what counseling was and wasn’t since neither one of them had ever been in counseling before, and then started trying to build rapport with them. Both are very damaged young ladies, but I think we all are to some extent. They both, just from their presence, scream some type of past history of abuse to me, and one is living with a parent with a severe mental illness and drug addiction, so you can imagine the affects that will have on a teenager.

Besides that I had two clients that thought they might be pregnant. One is 17 and one is 16 and the sad thing is, as much as they say they don’t want to be pregnant, I think they really do want to be pregnant because neither one of them are doing anything to prevent becoming pregnant. If they aren’t pregnant, then it’s probably only a short matter of time before they will be.

Neither of them are mentally mature enough to be mothers, despite their biological maturation. One is really naive and I am sure she thinks that being pregnant will make the boy she’s sleeping with (who is not her boyfriend) commit to her. The other has severe low-self esteem and is very emotionally unstable, she says she is ready to be a mother, but mentally she acts about two years below her chronological age.

Talking to these young ladies, it’s clear that neither one of them have any idea of the dedication and sacrifice that goes into being a parent, but they don’t see a baby as a responsibility, but as a solution to one problem or another.

Still on the topic of teenage sex, another female client came to me crying because she thinks she may have a sexually transmitted disease. I referred her to the school nurse and then to a community clinic since she doesn’t want her mother to know.

This girl is very sexually active and at 16, claims she has had about 20 sexual partners. She doesn’t open up much, but I am working on helping her build her self-esteem and I am almost 100% sure that there is a history of sexual abuse, but she hasn’t disclosed that as of yet. She talks a lot about her mother, whom I haven’t met yet, but from what the she says, her mother seems to be just as promiscuous and I am sure that affects this client’s behavior and relationships with males.

We did talk about her father whom she felt abandoned her when she was young and I think that explains at least in part why she is always trying to be with one guy or several. That on top of her mother’s influences on her and her low self-esteem (she once told me that the only thing she likes about herself was her hair), all contribute to her risky sexual behavior.

She’s supposed to go to the clinic this week so hopefully she’ll find out that everything is okay or at least is treatable.

And then on Friday, while I was facilitating a group, I looked up and saw two female sheriff detectives standing at my door. I was immediately dismayed because I had no idea what they wanted to talk to me about. Ends up, one of my clients reported being sexually abused and the detectives were there to ask me what I knew about it.

It initially felt a little intimidating, like an interrogation because none of the answers I gave them seemed to be concise enough, and they kept pushing, but I was treading on giving them information I knew I legally and ethically should give them while also respecting my clients confidentiality by not giving them information unrelated/unnecessary to their investigation.

In the end I think I did both well, but it was definitely an experience. It was my first time ever having to deal with detectives in that manner although I make suspected abuse and neglect calls to child services all the time.

That was a rather stressful way to end the week on top of everything else, but I left work on Friday and ran four miles with one a friend which was a great way to distress while venting. Taking care of yourself physically, mentally and spiritually is a must in the helping professions or you’ll succumb to burnout and compassion fatigue, places I know all too well and try to prevent with every fiber of my being through self-care, which is sometimes easier said then done.

Therapist are Humans Too

Am I An Effective Counselor? A Case Example On Counselor Effectiveness And Struggles When Working With A Client

21 Jan 201321 Jan 2013by Torey C. Richards, LMHC4 Comments

Often as a counselor, it’s not always easy to know when I am truly being effective in helping clients live better lives. This can be difficult because clients often lie, not only about their feelings, but also about their behavior, about following through with treatment recommendations and even about getting better.

Clients often put up lots of psychological defenses and resistance that make it difficult to know how effective treatment is being. Many of them learn how to better mask their symptoms, while all the while their depression, anxiety, compulsions, etc. are still raging inside of them, causing marked distress.

Of course there are many ways a counselor can try to verify the effectiveness of treatment such as assessment tools and reaching goals set forth in treatment plans, but most clients know how to fake those as well.

One of the most powerful ways to verify if treatment is being effective is through my own observations of the client during sessions. Clients who are depressed or anxious for example, tend to display those affects during therapy and as they progress, those symptoms tend to decrease and the clients whole persona will seem to improve.

Of course there are the times when a client will tell me how much they have changed, how much I have helped them or how much better they feel from counseling. And times when teachers or parents will tell me about the improvements they have seen in a student I’ve been working with, but sadly, in the school based program I do most of my counseling at, that type of feedback isn’t as common as I would like it to be. Still, when it happens, it feels great.

Case Example

For a little over a year now I’ve been working with a client we’ll call Suriyan. Suriyan came to me after she lost one of her parents suddenly. She was obviously grieving so I started working with her through her grief and put her in my grief counseling group. It was obvious almost immediately that Suriyan was grieving harder than anyone else in the group which consisted of other students her age, all whom had lost a parent within the last year.

Through individual counseling I realized that one of the reasons Suriyan was grieving so hard was because she had a pre-existing issue dealing with depression and self-injury, and on top of that, unlike the rest of the grief counseling group, her grieving is what we call complicated grief. Her parent had not only died suddenly, but she blamed her parent for dying and blamed herself for allowing her parent to die, although her parent died of a disease neither one of them had any control over. They had lots of unfinished business she was internalizing.

She felt that her parent was her best friend and had chosen to abandon her.

Suriyan initially was very resistant to counseling. She rarely participated in group and in individual sessions she would cycle between talking about her feelings, to being extremely angry, to totally shutting down. On top of that, she was cutting herself to deal with the pain and anger, and had become suicidal. She wanted to be with her parent. Her thought was, if my parent didn’t want to be here with me, why should I be here.

I was extremely worried about Suriyan, especially as the weeks went by and her depression wasn’t lifting. I was throwing everything at her, counseling wise, to try to get her to understand that she needed to let go of the anger and guilt she felt for and towards her parent. I felt like I was failing her and wanted to refer her to another counselor, but she didn’t want to see anyone else. As little as I seemed to be helping her, we had built a pretty good therapeutic relationship.

I started reading academic journals on grief, referring to other counselors for clinical advice and reading books as fast as I could to try to find new techniques, but ultimately patience on my part and time appeared to be the most effective technique.

In time her depression seemed to lift and she was able to talk about her parent’s death without placing blame on herself or her parent. She started participating in group, following my recommendations and keeping a journal to write in, which also seemed to help. By the end of last school year she had stopped cutting herself, was happier and was definitely in a better place.

Then summer came.

I tried to make sure over the summer she had access to counseling and even to me if needed, but when school started back this year she was almost even more depressed and upset about her parent’s death than when I first met her.

Now she was even more resistant to therapy, often missing appointments, yelling at me in session and walking out of sessions when I tried to get her to talk about things she was trying to avoid, like her suicidal thoughts, self-injury and how she was dealing with her parent’s death.

She would always come back, always wondering if I was mad at her or upset, which I never was. I knew her outbursts and “resistance” were also ways she was testing my claim of unconditional positive regard for her. She was suicidal again however. She had once been a highly motivated student, a senior with a dream to go to one of the top university’s in Florida, but now she claimed to not care about that or even graduating high school. She saw no point in anything.

She was also cutting herself again and one day in my office, after recently cutting herself in school and saying she wanted to kill herself, I had to have her involuntarily hospitalized. She was furious with me, but I knew at the time I had no choice and it broke my heart seeing her taken away, but I was positive I had did what was best for her.

She yelled that she would never come see me again or forgive me, but a week later she was released from the hospital and we settled back into a regular counseling routine. She was angry with me, but was actually thankful and told me that had I not had her hospitalized that day, she was positive she would have went home and killed herself.

Over the next few months we had our moments of resistance, but I wanted to continue to push her and to keep her goals in mind because I knew that once she got through this fog, she could be lost without guidance. I kept reminding her of her dreams and encouraging her to focus on the bigger picture. She is a brilliant young lady with huge aspirations that tended to get lost in the darkness of her depression.

There were some sessions when she didn’t want to talk so we worked on her college application or essay. Other times we just talked about random things, but through random conversation, we would end up talking about whatever was bothering her. In time she stopped cutting herself and her depression started lifting again. She started to focus on school although she had giving up somewhat on her dream of going to her first choice of college. I think she was afraid that she wouldn’t be able to take getting rejected, but I kept encouraging her to have faith while also preparing her just in case she got rejected. Still, the Universe seemed to be smiling upon her. She was winning award after award and was even “Senior of the week” recently.

She still had her bad days like over the Christmas break, which was only her second Christmas without her parent, and she will have other bad days, but she is moving forward and smiling a lot more. On top of that, she told me this past Friday that she had just gotten an acceptance letter from her first choice university. Not only did she get accepted, her first semester and perhaps even more, are already paid for including room and board. She was so excited and I was one of the first people outside of her family that she called to tell.

I was so happy because I know how much she wanted this and what this would do for her self-esteem and the doors it will open for her future. She would not only be the first person in her family to go to college, but she is going to probably the top university in the state of Florida.

She was so thankful for, “All you have done for me. For not giving up on me and for to encouraging me to follow my dreams.” I was nearly in tears because I was so happy for her, but I was quick to remind her that everything she has done to get to this point is all her and not me. She did all of this and I was just there to help guide her, but she did all the hard work. It was important to me that she took credit for her achievement so that she would know she could achieve anything she set out to, by herself if she had to.

When I got through talking with Suriyan, I was able to sit back and see how far we had come together and say that counseling had been effective. Sure it’s not done, she still has some tough days ahead, but I’ll work with her through those days until she goes off to college and even then, I will make sure she is in contact with a good counselor and make sure she is aware of the great support groups they have on campus.

I don’t do this type of work for me, I do it to help people live their best lives so this is not about me being a good counselor. There are times when I am unsure of if I am a good or effective counselor, but there are days and clients like this, when I can look back and reflect and say, yes, I am a good counselor.

Therapist are Humans Too

My New Intern…

22 Aug 201219 Aug 2012by Torey C. Richards, LMHC1 Comment

After years of dodging the bullet, my luck has finally run out. I am getting an intern.

I never wanted an intern. I like to work alone (most counselors/therapist do). I enjoy coming to work and not being responsible for anyone except myself, yet this week that’s all changing.

I’ve heard from fellow counselors that interns can be great assets if they are good, and major burdens if they aren’t. We are largely responsible for them and it can be like babysitting, so how on Earth did I get stuck with an intern?

Every few months as students approach their last semesters of graduate school, they have to complete approximately 1,000 hours of internship work. Usually when my company starts assigning us interns from the various masters programs, I just pretend to be busy and that has worked in my favor, up until last Monday.

As we sat in a meeting and met the interns I quickly scanned the room. There were six counselors including me, and four interns. I breathed a sigh of relief. Surely I would escape the curse of being assigned an intern once again.

As usual I sat quietly, doodling in my notebook in an attempt to look preoccupied and listened closely as the interns were being assigned.

I tried to rationalize why my superiors would not give me an intern.

I was the only male there and all the interns were female. Surely they wouldn’t assign me a female intern.
My office is quite small, there isn’t enough room for two people to work out of comfortably.
My school is in the inner-city and has a reputation for being rough, most of the other counselors worked out of much nicer schools in much nicer areas.

My chances seemed pretty good and they were.

We were down to one last intern, another counselor and myself. I just knew they would give the intern to the other counselor, after all she has been with the company for over 17 years. If anyone could mentor, teach and guide a new, soon to be counselor it would be her.

And they did! They did give the intern to her, but then she stated she was moving offices and didn’t think she would have room for an intern. I felt gravity pulling my face to the floor. Seriously?

And that’s how I got stuck with an intern.

After they gave me my intern, we had a short meet and greet. I was not excited and my disappointment probably showed in my face and tone as I asked her why did she want to be a therapist, did she know anything about the school she had just been assigned to, a school that has seen it’s fair share of stabbings, shootings and deaths.

Yes I know I was not being as nice as I usually am, but I was annoyed and irritated.

There’s enough things to worry about working with teenagers and the last thing I wanted to be worried about was some naive intern, whose total sum of understanding human behavior and psychology mostly comes from $200 textbooks.

Don’t get me wrong, I love text books, but from experience kids in grad school tend to think they know everything because they got an “A” in a class when in all actually, they have just begun to scratch the surface of understanding human behavior with all it’s complexities.

To my surprise she stated she prefered to work in the inner-city with kids who came from violent and impoverished backgrounds.

Okay, she gets a point for that. Most interns I’ve met come from pretty prestigious programs and believe that all their clients will be upper middle class, college educated, well adjusted individuals with simple neurotic problems that can be cured at the rate of $140 an hour.

To be fair, she seems nice enough. She’s graduating from Virginia Tech so I know she should be smart enough. Only time will tell if she is capable enough to actually work with kids who live in neighborhoods that often resemble war zones.

I definitely want to change my attitude and try not to look at her as a burden. I want to teach, guide and mentor her as someone did me when I was in her shoes five years ago. So, in a way, I look forward to seeing how this plays out. I will keep you posted.