InSession Magazine- July 2024

Page 1

Page 9Passkeys: A Powerful Tool in Healthcare Cybersecurity

Page 15Navigating Telehealth Challenges in Counseling

Page 27A Therapist’s View: Reaching through the Screen and Connecting to Clients on Telehealth

Page 33Telehealth and Play Therapy

The Intersection The Intersection of Technology & of Technology & Mental Health Mental Health

Counseling Counseling

President’s Column

“Summer is the annual permission slip to be lazy To do nothing and have it count for something To lie in the grass and count the stars To sit on a branch and study clouds”

-Regina Brett

Do nothing! How is that possible with a full book of appointments or a major paper due in two weeks? Granted, it’s not easy, but it is necessary. We talk with Clients about the need to be kind to themselves – to not say “yes” when they need to say “no”. Are we practicing what we teach? Or does it seem those extra daylight hours are a reason to book later appointments? Think about yourself- yes, it’s not just ok, it’s necessary I tell my students and supervisees what I know to be true; “You cannot give from an empty tank”

It reminds me of an excellent trauma therapist whom I will call “Ado Annie”. Her devotion to this field led to the “I’m just a girl who can’t say no syndrome”. After a few exhausting years, a broken engagement, and a near loss of self, she took a break. Unfortunately, the physical damage was done, and her health never fully recovered. Not to sound like Chicken Little but her sky really was crashing down on her overburdened shoulders

Summer is the ideal time to enjoy extra hours of sunlight and PLAY---- yes PLAY.

Find an activity you enjoy that is completely different than your daily counseling work or school. If necessary, put “Me Time” in your appointment book

FMHCA’s Summer Bash is an opportunity for Students and recent graduates to connect and learn in an enjoyable program focused on their needs and interests

What will you do with your “permission slip to be lazy”?

Conferences are an important part of my professional “recharge” and replanting with new ideas AMHCA Conference went well under the leadership of our Dr Deidra SandersBurnett (past FMHCA President) Thanks to AMHCA Staff and Board Members for providing this enriching experience After the exciting bubble of Conference sessions and dinner with friends, it’s back to reality.

Meanwhile, at my home, outdoor landscaping work begins soon. Heavy lifting will be done by the professionals, but I intend to at least do some small planting and a lot of “supervising”. For a week it will feel like a new Counseling session – digging the worn-out parts, discarding what is not

Dr Kathie Erwin

Join us for FMHCA's 2024 Summer Bash, an exciting a la carte virtual event series tailored specifically for mental health counseling graduate students and registered mental health counselor interns. This dynamic series offers a unique opportunity to network with peers, learn essential industry insights, and get equipped to pass your licensure exam with confidence. Our carefully curated lineup includes expert-led sessions, interactive workshops, and networking events designed to provide you with the knowledge and connections you need to succeed in your mental health counseling career.




The Role of Self-Disclosure in Teen Counseling

Committee Updates

will be back!

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Naomi Rodriguez- Editor

Victoria Siegel, LMHC- Expert Advisor


There shall be no discrimination against any individual on the basis of ethic group, race, religion, gender, sexual orientation, age, or disability


Information in InSession Magazine does not represent an official FMHCA policy or position and the acceptance of advertising does not constitute endorsement or approval by FMHCA of any advertised service or product InSession is crafted based on article submissions received. Articles are categorized between Professional Experience Articles & Professional Resource Articles.

Professional Experience Articles are writer's firstperson pieces about a topic related to their experience as a mental health professional, or an opinion about a trend in the mental health counseling field

Professional Resource Articles are in-depth pieces intended to provide insights for the author's clinical colleagues on how to be more effective with a particular type of client or a client with a particular disorder, or tips for running their practice more efficiently Each article is labeled with their article type


The Florida Mental Health Counselors Association (FMHCA) is the State Chapter of the American Mental Health Counselors Association (AMHCA) FMHCA is the only organization dedicated exclusively to meeting the professional needs of Florida’s Licensed Mental Health Counselors

The mission of the FMHCA is to advance the profession of clinical mental health counseling through intentional and strengthbased advocacy, networking, professional development, legislative efforts, public education, and the promotion of positive mental health for our communities

Its sole purpose is to promote the profession of mental health counseling and the needs of our members as well as:

Provide a system for the exchange of professional information among mental health counselors through newsletters, journals or other scientific, educational and/or professional materials

Provide professional development programs for mental health counselors to update and enhance clinical competencies

Promote legislation that recognizes and advances the profession of mental health counseling

Provide a public forum for mental health counselors to advocate for the social and emotional welfare of clients

Promote positive relations with mental health counselors and other mental health practitioners in all work settings to enhance the profession of mental health counseling

Contribute to the establishment and maintenance of minimum training standards for mental health counselors

Promote scientific research and inquiry into mental health concerns

Provide liaison on the state level with other professional organizations to promote the advancement of the mental health profession

Provide the public with information concerning the competencies and professional services of mental health counselors

Promote equitable licensure standards for mental health counselors through the state legislature


Liza Piekarsky- Brown
Michael Holler
Dr Kathie Erwin
Maria Giuliana
Melissa Riesgo
Grace Wilson Cantor Joe Skelly
Diana Huambachano
Laura Giraldo Naomi Rodriguez
Samantha Samarelli
Kerry Conca
Laura Peddie-Bravo
Dr Bridget Glass

Passkeys: A Powerful Tool in Healthcare Cybersecurity

Professional Experience Article | The Intersection of Technology & Mental Health Counseling Exclusive Article

In the digital age, our online accounts hold a wealth of personal and sensitive information, making them a prime target for cybercriminals This extends further, even moreso, to our sensitive, protected health information (PHI) Health and Human Services (HHS) values patient PHI on the black market at as much as over $400 per record 5 , more than any other kind of information valued Thus, as healthcare providers, the pressures of maintaining strict cybersecurity protocols compound. Cybersecurity importance over the last decade increased in the healthcare sector: Abdullah Alanzi (2023) notes in a survey published through the National Library of Medicine that 96% of healthcare providers surveyed deemed cybersecurity as critical importance, but many were also worried about lack of proper security measures in place at their facilities, with high numbers agreeing that lack of data protective measures results in increased risk of data breaches (96%) and increased risk of patient harm (65%) 1 . In securing our own patient health information we collect, and store, traditional security and authentication methods, such as

passwords and two-factor authentication (2FA), while effective, are not foolproof and can be compromised (Cloud Security Alliance, 2023) 2 Passkeys, a new and emerging technology, offer a more secure and convenient way to protect our online accounts and patient data

Passkeys are cryptographic keys that are stored on a user ' s device and used to authenticate to online accounts They can be a separate, physical object (called a security key), similar to a USB thumbdrive, or located on another device, like a mobile phone. They are generated and managed by the device's operating system or a compatible password manager and are designed to be more secure than traditional passwords. They feature two components: a public key and a private key. The public key is shared with the online service, while the private key is kept secret on the user ' s device. When a user attempts to log in, the device generates a unique signature using the private key, which is then verified by the online service using the public key. This process ensures that only the user with the correct

passkey can access the account

Passkeys offer several advantages over traditional authentication methods. Passkeys are not stored on a server and are not transmitted over a network. This makes them immune to phishing attacks and other forms of credential theft. (Idmelon, 2023) 3 They save more time and effort than remembering passwords because they can be used with a single tap or a touch of a button and work across different devices and platforms Passkeys are also resistant to phishing attacks because they are not entered on a website or in an app Instead, they are generated and stored on the user ' s device, making it much more difficult for attackers to steal them

While powerful, passkeys are still in their early stages of development and adoption. Several major tech companies, including Apple, Google, and Microsoft, are working together to standardize and implement passkeys across their platforms. Increasing the ease of use helps healthcare providers more easily adapt passkeys into their routines with minimal disruptions

Now more than ever, cybersecurity in the healthcare space shapes our interaction and collaboration with technology to provide quality patient care. Passkeys represent a major advancement in account security, offering improved protections, convenience, and resistance to phishing attacks. As the technology matures and becomes more widely adopted, passkeys are poised to revolutionize the way we authenticate to online accounts. By embracing passkeys, healthcare providers can significantly reduce their risk of becoming victims of cybercrime and protect their patient’s personal and sensitive information


1 Alanzi, Abdulla. (2023). Clinicians’ Perspectives on Healthcare Cybersecurity and Cyber Threats

2 Cloud Security Alliance (2023). MFA for hospitals: Password sharing workstations, and other challenges

https://cloudsecurityalliance org/blog/2023/04/05/mfa-for-hospitalspassword-sharing-workstatio ns-and-other-challenges

3 Idmelon (n d ) (2023) Healthcare security https://idmelon com/post/healthcare-security

4 Infosec Institute (2023) Hackers selling healthcare data in the black market. hcare-data-in-the-blackmarket/#: :text=Cost%20of%20Stolen%20data&text=One%20cannot% 20simply%20delete%20or,data%20from%20any%20other%20industry

5 U S Department of Health & Human Services (2015) Cost analysis of healthcare sector data breaches https://www hhs gov/sites/default/files/cost-analysis-of-healthcaresector-data-breaches pdf

Logan is a Licensed Mental Health Counse National Certified Counselor, and Qualifie Supervisor in the state of Florida He work across the LGBTQIA+ spectrum helping pa navigate aspects of development and man mental health concerns Logan specializes mood disorders, including bipolar disorde ideation, and death work, operating from a psychodynamic and cognitive behavioral lens Logan also works with LGBTQIA+ advocacy groups and aims to help other clinicians better understand the law, ethics, and ways to help

Man vs. Bear In The Therapeutic Space

This year, a TikTok trend is circulating that began by asking women if they would rather be alone in the woods with a man or a bear. This simple question ignited a far-reaching debate that highlighted some of the disparities between the masculine and feminine gender identity. Although the polarization of the genders has always been in existence, the dialogue has shifted. In this debate, the majority of women stated that they would rather be in the woods with the bear They cited the statistics on sexual assault and domestic violence along with their own experiences with unknown men Men seemed varied in their reactions Some stated that they feel saddened and don’t know what to do about this Others felt challenged and insulted, sometimes expressing this in replies that reinforce women’s apprehension.

willing to meet in person with a man, particularly in a private practice setting where there may not be any additional staff. This greatly impacts access to mental health care for male identified individuals.

Mitigating Bias

While it is accurate to say that male-bodied individuals can be dangerous to female-bodied individuals, it is important to recognize that the large majority of men have not and will never become violent with women. Female identified therapists can work to manage their own bias by first becoming aware of where and when a fear response is triggered and work to manage their own anxiety

Data USA, citing the 2022 census, notes that just over 77% of the mental health counselors in the US are female In a field where the large majority of the providers are female, one might wonder how the gender divide is influencing the therapeutic space if the man vs. bear debate is in any way representative of how women feel about being alone with a strange man. It is reasonable to conclude that not all female therapists would be

Telehealth has created a revolution in access to care for many individuals. It has also increased therapist safety in private practice. However, men may still feel the therapist's reluctance to work with them when they express anger. As practitioners, we need to do our own work to ensure that we can sit with the full range of human emotion in the clinical space.

New Learning

Becoming a competent provider means leaning into areas of

new learning Most training programs do not provide adequate instruction on gender and gender differences In order to increase therapist self-confidence when working with men, we need to seek out learning opportunities There are a few excellent books and courses that provide foundational learning. Working with a supervisor or consultation group that is specifically trained and has experience working with diverse gender and sexual identity clients will help process therapist anxiety and practice the skills necessary.

Therapy spaces shouldn’t feel unsafe for clinician or client The

man vs bear debate may have illuminated the gender issues in this country, but the therapeutic community can build a different dynamic that encourages access and offers compassionate care to all individuals

Nattalie is a doctoral student, teacher and counselor providing sex and reproductive services. She can be reached at


Join in on one of our upcoming webinars!

What Challenges face Mental Health Counselors working with Medicare Recipients

12 July 2024 | 2:00 PM-4:00 PM

Presented by: James J Messina, PhD, NCC, CCMHC Register Now

Using Individualize Strategies to Reduce Prevalence of Burnout 19 July 2024 | 2:00 PM-4:00 PM

Presented by: Brandy K. Biglow, LMHC, NCC, QS, CCTP, DBH(c) Register Now

Learning to Fly: Compassionate Healing From Trauma 26 July 2024 | 2:00 PM-4:00 PM

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Money Matters: Exploring Trauma's Impact on Money & Mindset 02 August 2024 | 2:00 PM-4:00 PM Presented by: Tiffanie Trudeau, LMHC Register Now

Changes to the New NCMHCE Narrative Licensure Exam 09 August 2024 | 2:00 PM-4:00 PM Presented by: Linton Hutchinson, PhD, LMHC, NCC & Stacy Frost, Certified Life Coach Register Now

Pregnancy Loss: Helping Families Grieve 16 August 2024 | 2:00 PM-4:00 PM

Presented by: Gary Vogel, LMHC Register Now

Beyond The Uniform: Empowering Veterans in Transition from Service to Civilian Life 23 August 2024 | 2:00 PM-4:00 PM

Presented by: Maria Giuliana, LMHC, QS, BH-THP Register Now & more here!

P.S. We are seeking presenters for our 2025 Webinar Series, learn more here

Navigating Telehealth Challenges in Counseling

Professional Experience Article | The Intersection of Technology & Mental Health Counseling Exclusive Article

With the advent of telehealth, counselors face a new frontier of challenges and opportunities. The transition from traditional face-to-face counseling to virtual platforms has been met with both excitement and hesitation; however, by understanding and addressing these challenges head-on, counselors can effectively navigate the telehealth landscape and provide quality care to your clients.

Ensuring Seamless Sessions

One of the primary challenges in telehealth counseling is ensuring reliable internet connectivity. Counselors must have a stable internet connection to conduct sessions without interruptions. Clients also need access to reliable meeting services to engage in virtual counseling effectively; Zoom, Google Meet, etc. These services must be easy to use, a system that requires a download and a meeting code to join has added clicks that can cause technical difficulties

Here are some tips for practitioners who plan to see clients virtually:

Do not spend 20 minutes of a 50 minute session dealing with a quality problem; drop and restart.

If the client has not joined after 5 minutes, contact them to see if they are having trouble joining

If you are the one having technical issues, call the client to let them know.

If the session locks up or drops more than once, call the client and offer to continue by phone.

Have a back-up plan for what you will do if you are unable to connect.

At my practice therapists conduct telehealth sessions from the office only The setting from the office feels more like a session for the client and it enables the practitioner to give them their full attention versus working from a home environment where there are distractions Joining calls from wherever you are is a bad habit as it shows a lack of commitment to the client. Imagine you are talking to your therapist and they are in the garden center at Lowe’s picking out plants!

Establishing Trust and Building Rapport Virtually

Building trust and rapport with clients is essential in counseling, and doing so virtually presents some challenges. Without the physical presence and non-verbal cues that come with in-person sessions, counselors must find new ways to establish connections with their clients. Utilizing video calls, active listening, and empathy can help counselors build trust and create a supportive environment for their clients just as you would during in-person sessions. Only when a client is established and you know how they are doing just through the tone of their voice, should you consider conducting sessions strictly over the phone.

Embracing Flexibility and Adaptability

Telehealth offers counselors the opportunity to embrace flexibility and adaptability in their practice. By utilizing various communication methods, counselors can cater to the diverse needs of their clients Flexibility in scheduling sessions and adapting to clients’ preferences and needs can enhance the counseling experience, and promote better outcomes

Be cautious around opening too many lines of communication with clients.

Remember, you are paid for your time, if you provide your phone number and email to clients, this opens the floodgates, and “one quick question” turns into long text exchanges which is unpaid therapy and sets the expectation to your clients that you are available to them 24/7 It’s almost impossible to come back from this once it starts. As empaths, I understand you want to help but you have to set boundaries.

While telehealth presents its own set of challenges, counselors can overcome them by embracing the evolution of counseling

practices By addressing connectivity concerns, building trust and rapport virtually, prioritizing privacy and confidentiality, and embracing flexibility with appropriate expectations around availability, counselors can provide quality care to their clients in the digital age With a proactive and adaptable approach, counselors can navigate the telehealth landscape with confidence and continue to make a positive impact in the lives of those they serve.

The integration of telehealth in counseling represents a new and exciting chapter in the field, offering counselors the opportunity to reach more clients and provide care in innovative ways By acknowledging and overcoming the challenges associated with telehealth, counselors can create a

brighter future for themselves and their clients

William is the founder of Counseling Hope, a private practice with locations in Windermere, Maitland, and Orlando Bill earned his Master's degree and Specialist Degree in Me Counseling from the University of Florida He co graduate training at Harvard Medical School and is a Nationally Certified Counselor Bill enjoys helping new grads learn how to navigate the business side of working in a private practice

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Working With Older Adults

As Licensed Professional Counselors gear up to provide services to Medicare clients, it's paramount to possess a thorough understanding of the aging population. Statistically, it's evident that the number of Americans aged 65 and older is experiencing a significant surge Projections suggest that by 2050, this demographic will encompass 82 million adults, marking a substantial increase of 47% Consequently, the current age composition of the US population reflects an unprecedented level of aging (NAMI, 2024)

The mental health needs of this population are distinctive It is frequently observed that individuals in this age group undergo a shift in perspective as they age Concerns about external judgement and attachments to worldly matters often diminish This shift occurs due to personal growth, loss, life experiences, and changing daily life activities. Some of the changes that older individuals experience include an increased self-acceptance of themselves and others. They often let go of expectations about living up to societal norms and cultural expectations. As they embrace this self-acceptance, they frequently lower their expectations of others as well.

Additionally, aging individuals often engage in higher-order thinking, enabling them to embrace impermanence, comprehend their spiritual growth on an existential level, and cultivate a greater capacity to live in the moment and embrace mindfulness Recognizing these shifts allows Licensed Professional Counselors to incorporate specific aspects of existential therapy into their practice

In reviewing Existential Therapy 101, several topics stand out as particularly meaningful for this population Irvin Yalom (1980) delineates four primary ultimate concerns: death, meaninglessness, isolation, and freedom He portrays these as the givens of existence or an inescapable part of being human, asserting that every individual must confront these concerns through deliberate choices to actualize their individual potential. Keeping these four concerns in mind counselors can lay out the foundation for working with this aging population.

Death: Confronting the reality of mortality can evoke feelings of anxiety, fear, and occasionally depression. As individuals in this age group start to experience the loss of loved ones, confronting

one ' s own mortality becomes inevitable Exploring personal and societal beliefs on this topic can assist individuals in reconciling their own belief systems and spirituality

Meaninglessness: As individuals age, they often engage in reflection upon their life's choices, accomplishments, goals, and missed opportunities Questions about the significance of their existence and whether their life holds meaning become prominent. Additionally, considerations about their legacy and whether they will leave behind an impact on their family, community, or society arise. They may ponder whether they can move beyond their regrets or mistakes and continue to find purpose.

Isolation: While existential questions can amplify feelings of loneliness and isolation, particularly for individuals lacking meaningful social connections or opportunities, directly addressing these issues can often prompt individuals to explore unconventional avenues for making new connections in unexplored areas of their lives. Moreover, it's crucial to make peace with solitude as a friend and companion in its own right.

Freedom: Aging frequently entails a loss of identity, marked by significant changes in one ' s physical appearance, health, and cognitive abilities, resulting in a departure from one ' s familiar sense of self. However, through exploration, individuals can discover solace in the freedom to craft the person they aspire to be. This involves adapting within the spectrum of mental health, cognitive function, and physical well-being. With this newfound freedom, they can discard outdated societal norms that may have previously hindered them and instead cultivate a lifestyle that celebrates their authenticity

Another highly effective treatment theory with older individuals is narrative therapy Narrative therapy stands out as a profoundly impactful approach for working with older individuals By providing a platform for reflection on life experiences, it enables them to weave together the threads of their personal narratives Encouraging older adults to share their life stories not only illuminates their strengths and resilience but also offers a deeper understanding of their values and beliefs, aiding them in navigating the journey of aging with grace and wisdom.

Empower older adults to explore alternative narratives that defy prevailing or negative portrayals of themselves. Through this process, they can actively rewrite their life stories to align with their evolving identities and aspirations, ensuring they remain the architects of their own journeys rather than being constrained by perceived societal norms or expectations. As

they go through this process they can reflect on the legacy they wish to leave behind and how they want to be remembered by future generations

It's crucial to acknowledge the vulnerability of older adults in a societal landscape that often overlooks the value of aging In such a context, feelings of inadequacy, invisibility, and marginalization can be pervasive Creating a safe and supportive space for older individuals to openly discuss these emotions is paramount. Additionally, compiling comprehensive resource lists can be immensely helpful, encompassing not only emotional support services but also practical assistance such as utility and food aid. Familiarizing oneself with community programs offering these services ensures that older adults have access to the support they need, both emotionally and physically, in navigating the challenges they may encounter.

It is truly exciting to join the mental health community as we begin focusing on serving older adults in our neighborhoods. This demographic faces unique challenges, including an increased risk of depression. Sadly, many older adults will not seek treatment influenced by feelings of isolation and the misconception that depression is an inevitable part of aging. It is time we dispel that myth--depression is not a normal aspect of growing old With determination and compassion, alongside my colleagues, I eagerly anticipate working with this population By challenging stigmas, providing education, and offering accessible mental health support we can offer transformative experiences for the older adults within our communities


NAMI (2024, January 30) National Alliance of Mental Health Retrieved from National Alliance of Mental Health Web site: nami org/mhstats

Yalom, I D (1980) Existential psychotherapy New York: Basic Books

Julie is a Licensed Mental Health Counselor She has worked in the community since 1990 During that time she has taken on many different roles She has been an Elementary School Teacher, a Community Orga and an Intensive Case Manager, and has also worked as an adult facilitator in an Intensive Outpatient treatment She teaches at South University in West Palm Beach, FL in the CMHC program and supervises others to attain their licensure

Ask the Expert

FMHCA Member Questions Answered by President and Managing Partner of The Health Law Firm, George

AQMost states have a state law or an administrative rule enacted by the applicable board that states what must be contained in a psychotherapists's records Florida does not have a statute, but it does have a rule adopted

What forms and records should I be using in my solo practice counseling clients? by the board of mental health professions It is Rule 64B4-9 002(2), Florida Administrative Code, which requires that the record must contain: "basic information about the client including name, address and telephone number, dates of therapy sessions, treatment plan and results achieved, diagnosis if applicable, and financial transactions between therapist and client including fees assessed and collected." It also requires that it shall: "also include notes or documentation of the client’s consent to all aspects of treatment, copies of all client authorizations for release of information, any legal forms pertaining to the client, and documentation of any contact the therapist has with other professionals regarding the client "

There are many free forms offered to mental health counselors and other psychotherapists online Take advantage of these Download theses, compare them, and decide what works best for you and keep them

However, ones that we do not routinely see that you should include are the following:

Medical History form which includes: (1) the names and contact information on all current and former treating physicians, especially psychologists and psychiatrists, and those prescribing medications that the client is taking; and (2) prior hospitalization such a Baker Act and psychiatry in-patient treatment It is very important to know any prior mental health diagnoses and exactly who made theses Make sure the history form you use includes these.

Waiver of HIPAA Privacy Regulations or Consent Authorization for any video tele-health sessions.

Waiver of HIPAA Privacy Regulations or Consent Authorization for any communications via e-mail or text messages, along with the specific type of information that may be shared Consent to treatment and waiver of confidentiality, signed by all parties, for any joint sessions, couples counseling, or counseling of a minor with a different parent present Disclosure of Fees: Be sure to disclose the fees that will be charged for each type of service you may provide the client, including the fees (be sure to include co-pays and deductibles) if insurance pays or if insurance does not pay.

If you are likely to be treating clients covered by Medicare and you may in the future provide (and charge for) services not covered by Medicare, you should have a form called an "Advance Beneficiary Notice" or "ABN " This advises the client that the services you provide are not going to be paid by Medicare This is also a good place to include charges for administrative acts that you might perform in the future such as completing forms for disability claims, responding to subpoenas for records or information, testifying as a witness in a civil trial, etc

Mr. Indest is board certified by The Florida Bar in the legal specialty of health law. He is the President and Managing Partner of The Health Law Firm, based in Orlando, Florida. The information provided in this article is for educational and informational purposes only and does not constitute the provision of legal advice. Have legal/ ethical questions? Submit them here! Select questions will be answered by The Health Law Firm in the next issue of InSession Magazine’s Ask the Expert column.

Please note: only FMHCA members can submit questions. Not a member? Sign up here.

A Therapist’s View: Reaching through the Screen and Connecting to Clients on Telehealth

Professional Experience Article | The Intersection of Technology & Mental Health Counseling Exclusive Article

Before March 2020, the start of the COVID 19 pandemic shut down, most therapists conducted therapy and counseling sessions by sitting face to face with clients. The client and therapist expected to be in the same room and city and time zone. We gazed at each other from couch and chair, or in my case, rocking chair and loveseat. I knew how tall my clients were, how they sighed and took sips of water and teared up at various points in the session I passed tissues, shook a hand, occasionally hugged, and accepted payment in real time I noticed what shoes they wore! How a rain-soaked jacket was hung on the hook in preparation for our talk

Everything changed when in person sessions were no longer possible and therapists turned to the computer screen to continue treating clients. What a change and what a learning curve. First, there were technical issues. Then privacy concerns and dogs and cats and coffee and messy desks and pillows and living rooms and family members or the UPS man at the door causing a pause in session There was so much connecting done on how to actually connect, to make the screen between us seem less of a barrier

I found that younger clients adapted more quickly to on line sessions and appreciated the ability to switch from work calls to

therapy without a commute No traffic, parking or building in extra time to get to therapy

Yes, we did it. The switch to telehealth is officially made. But I think it’s important to look back for a moment and see what has been lost and what can be reclaimed.

My supervisor always stressed the “container” and the “space” we as therapists hold for our clients When the place where we meet is not their home, an office or the car (so many car sessions!), I think it can be transformative. How often have you welcomed a client into your office, given them a moment to get settled, and watched as eyes tear up in anticipation of talking about their week? Now, we hold that space virtually for our clients. We notice their background, the way the light falls in the room, if they seem rested or distracted, if they’ve had time to take a break before switching from everyday life to therapy.

I find myself spending more time really studying my client’s faces, and asking more questions about how they are showing up in session. Are those tears I’m seeing? I’ll ask. Or, is it a good time to bring up a certain subject, one that may involve a family member who is working in the next room. The extra, careful attention is worth it, when clients seem visibly relieved that their context is taken into account. I also recommend somehow trying to recapture the time that naturally occurred after a session, before telehealth. When clients walked home or back to their cars, before the busyness of the world came rushing in again. A lot happens in therapy, and I found that what I referred to as the “marination” time yielded benefits and insights that could be discussed when we next met.

At this moment I am a fully virtual therapist, but I am not a remote therapist. My skills have sharpened to reach through the screen, to not see it as a barrier to good work, but as an adaptation. My clients may see more humor from me these days, more curiosity about their surroundings and the state of their days. As I continue to grow in this field, and explore the worlds of those who come to work with me, I hope I can bring some new skills to the virtual session.

Noreen is a psychotherapist in NE Florida Licensed in Florida, Washington State and California, Noreen enjoys working with clients looking for help with anxiety, life changes, relationship challenges and living lives of joy a new member of FMHCA, Noreen is currently accepting new clients www counselingmadisonpark com

Bridging the Gap: Helping Veteran Women Transition to Civilian Life

Professional Experience Article

As a mental health professional specializing in veteran care, I have worked with many brave individuals transitioning from military to civilian life. This transition can be particularly challenging for veteran women, a group that often finds itself at the intersection of multiple identities and challenges (Koenig et al , 2014 Through my work, I've employed several evidencebased methodologies to support these veterans, including intersectionality, the Total Force Fitness framework, narrative therapy, and the Gottman Method This article will delve into these approaches and highlight veteran women ' s unique challenges veteran women face By addressing the unique needs and experiences of veteran women, we aim to bridge the gap in the literature and advocate for more tailored support interventions in this underserved population.

Understanding Intersectionality

Intersectionality, a concept coined by Kimberlé Crenshaw, is crucial in understanding the unique experiences of veteran women (Meade, 2020). It recognizes that various aspects of identity, such as gender, race, sexuality, and class, intersect to create distinct experiences of oppression and privilege (Dallochhio, 2021). In my practice, applying an intersectional

lens helps me to appreciate the complexities of each veteran’s experience. For instance, a Black female veteran might face different challenges than her Caucasian or male counterparts, both during and after her service. This understanding allows for more tailored and effective therapeutic interventions.

Total Force Fitness Framework

The Total Force Fitness (TFF) framework, developed by the U.S. Department of Defense, is another cornerstone of my approach. TFF is a holistic model emphasizing the importance of physical, psychological, social, and spiritual health (Rubin, et al , 2012; Walter, et al , 2010) I can better support veterans in their transition by addressing these areas comprehensively For example, encouraging physical fitness not only improves physical health but also enhances mental well-being and social connections Similarly, fostering social networks and community engagement can alleviate many veterans' feelings of isolation post-service.

Narrative Therapy

Narrative therapy, developed by Michael White and David Epston, focuses on the stories we tell about our lives (Meade,

2020) For veterans, this approach can be incredibly empowering Many veterans have internalized narratives of trauma and loss, which can impede their transition By helping them re-author their stories, narrative therapy allows veterans to recognize their strengths and resilience. In one instance, a female veteran who struggled with PTSD found new meaning 4 by reframing her story from one of victimhood to one of survival and strength. This shift not only improved her mental health but also her outlook on life and her future.

The Gottman Method

While traditionally associated with couples therapy, the Gottman Method has valuable applications for individual therapy as well (Gottman, 2018). This method, developed by Drs. John and Julie Gottman, emphasizes the importance of building healthy relationships. For veteran women, who may face strained family dynamics or difficulty in establishing new relationships, these principles are particularly relevant. Techniques such as emotion coaching and conflict management can improve communication and relational skills, which are essential for a successful transition to civilian life

Addressing the Literature Gap

Despite these effective methodologies, there is a notable gap in the literature concerning veteran women (Schultz, et al, 2023) Research and resources often focus on male veterans, leaving the unique needs of female veterans underexplored This gap highlights the necessity for more research and tailored interventions By sharing my experiences and successes using these methodologies, I hope to contribute to the growing body of knowledge and advocate for more comprehensive support systems for veteran women.


Transitioning from military to civilian life is a complex and multifaceted process, particularly for veteran women who navigate the intersection of various identities. Through the application of intersectionality, the Total Force Fitness

framework, narrative therapy, and the Gottman Method, I have seen significant positive outcomes in my practice. However, much work remains to be done in addressing the specific needs of veteran women It is my hope that continued research and tailored therapeutic interventions will close this gap, ensuring that all veterans receive the support they deserve as they embark on their civilian journeys By sharing these insights and advocating for evidence-based practices, we can better serve those who have bravely served us


Dallocchio, M. (2021). Women Veterans: Examining identity through an intersectional lens. Journal of Military, Veteran and Family Health, 7(1), e20210028. Gottman, J. M., & Gottman, J. S. (2018). The science of couples and family therapy: Behind the scenes at the" Love Lab". WW Norton & Company. Koenig, C. J., Maguen, S., Monroy, J. D., Mayott, L., & Seal, K. H. (2014). Facilitating culturecentered communication between health care providers and veterans transitioning from military deployment to civilian life. Patient Education and Counseling, 95(3), 414–420. Meade, V. (2020). Embracing Diverse Women Veteran Narratives: Intersectionality and Women Veteran’s Identity. Journal of Veterans Studies, 6(3), 47. Rubin, A., Weiss, E. L., & Coll, J. E. (2012). Handbook of Military Social Work. In Google Books. John Wiley & Sons. Handbook of Military Social Work - Google Books Schultz, D., Hunter, K. M., Skrabala, L., & Haynie, J. G. (2023). Improving Support for Veteran Women: Veterans’ Issues in Focus. Rand Health Quarterly, 10(2), 10. Walter, J. A., Coulter, I., Hilton, L., Adler, A. B., Bliese, P. D., & Nicholas, R. A. (2010). Program Evaluation of Total Force Fitness Programs in the Military. Military Medicine, 175(8S), 103–109.

Dr McIntyre founded BrightView Center, LLC, offering telehealth services in Florida With over ten years of experience; six years in privat practice, Dr McIntyre specializes in supporting veterans and civilians in promoting mental wellness She earned her DSW from the University of Kentucky and MSW from the University of Southern California SASSI certified and Level 3 Gottman Method provider, she guides individuals to a BrightView in life

Telehealth and Play Therapy

Professional Experience Article | The Intersection of Technology & Mental Health Counseling Exclusive Article

The counseling world has changed drastically since the COVID19 pandemic. Counseling used to have clients come into an actual brick-made office. Since COVID, counseling has changed drastically to support clients through teletherapy. As the changes to our profession take place, we as counselors have to start getting more and more creative in the ways we provide counseling services, especially to children

Counseling children and adolescents in my profession I have learned to be creative while doing teletherapy. Some ways I have learned to be creative is by creating time to dance to the emotion the client feels and even working on bibliotherapy by sharing my screen and then drawing about the story and how it connected to what they are going through, just an example. However, apart from this, there are play therapy techniques a counselor can also use in their teletherapy sessions.

One thing that I need to let you know is to use what they have Children love to show you their toys and their rooms, therefore, conducting emotion-led scavenger hunts around their house is a good way to get them moving and have them find things they want to share with you. Some questions can be “Show me something that makes you laugh”, “Show me something that makes you feel calm” and even “Show me your favorite toy”. It

is important to let the parents know that the child will be moving around for them to know it is part of the therapy session. When I do this scavenger hunt, I not only learn from the children but build rapport as well. I sometimes even include the parents for them to learn from each other and build their relationship or see how they connect with each other.

Another thing I do with the little ones via teleplay therapy is play board games. Yes, you read right, board games! There are many board games that you can find online. My clients tend to like Concentration, Uno, and Connect 4. Some websites allow you to send the child/parent the link for them to join you in the game. I use Concentration and Connect 4 to help clients learn how to breathe before reacting on impulse. It is amazing to see them grow from getting upset because they lose, to learning to stop, breathe, think, and play, to win the game Uno is one I use to build rapport, however, sometimes I add emotions to the color What I do is tell them to think of a memory or time they felt, angry (red), happy (yellow), sad (blue), anxious (green), or silly (wild), and sometimes we even incorporate coping to those emotions, such as “what should you do if you feel ?” Most of my clients like this because they are not just staring at me and talking.

Apart from the strategies mentioned above, some platforms, such as Zoom have games and apps embedded into them I have used their Pictionary, Riddles, and some others to break the ice or close a session. These apps are good because they allow you to keep an eye on the client while using the app.

Sometimes the clients might even know an app that is already in the platform and ask you to play it, make sure to check the app before using it with a colleague to ensure it is good for the session, however, it is always good to see what the client finds interesting, which is why I have played “Among Us” with a client to build rapport This game also allowed me to talk about wearing a mask and not knowing what people are feeling This helped the client connect to the information we had been talking about for weeks that did not make sense to him. To conclude, remember that technology helps us provide telehealth and for children it allows us to get closer to their

world Use the technology to build your counseling sessions and learn more about them Use play therapy to build rapport and engage the client in session while learning about their emotions and coping strategies.

Odalis is currently pursuing a doctorate in counseling education and supervision at Liberty University. She is a licensed menta health counselor in Florida and is nationa NBCC. She is an assistant director at a clin own private practice. She specializes in tr trained She is involved in many professio advocates for the profession in her leadership positions

Navigating the Complexities of Running a Mental Health Private Practice

Professional Resource Article

Running a mental health private practice is a challenging yet rewarding endeavor. Many therapists enter this field with a passion for helping others, but they often find themselves unprepared for the complexities of managing a business. This article aims to provide clinical colleagues with practical insights and tips for running their practice more efficiently. The Transition from Clinician to Business Owner

Many therapists receive little to no training in practice management during their academic studies. Business courses are often offered as electives and typically cover basic business terminology and creating a business plan. As a result, therapists transition from being students to team members in another organization and finally to launching their own practices without adequate support

This shift can be daunting. Therapists go from having the backing of a larger organization to facing the challenges of entrepreneurship alone. This transition can lead to feelings of isolation and burnout, especially if they are unprepared for the

business aspects of running a practice

The Financial Realities of Private Practice

One of the primary reasons therapists choose private practice is the potential for autonomy and increased revenue However, many fail to appreciate the true costs of running a business Administrative fees such as office space, licenses, taxes, professional fees, and marketing can quickly add up

Therapists often find that they are taking home a smaller percentage of each dollar earned than they initially anticipated. In response, they may increase their client caseloads to compensate for these expenses. While best practices recommend 20-25 direct service hours per week for clinicians in traditional private practice, it is not uncommon for practitioners to see 30 or more clients weekly This increased workload can lead to burnout and negatively impact client care

Maintaining Professional Support Systems

Once therapists achieve licensure, the requirement for supervision typically fades away The unfortunate reality is generally due to the belief that supervision is solely a prerequisite for independent practice However, maintaining a support system is crucial for facilitating the integrity of clinical care. Many licensed clinicians fail to maintain adequate systems of support, which can lead to professional isolation and impairment.

Some of the ways clinicians have sought to address the quality of their service delivery has been to group their practice, participate in online communities, and some have limited the way they practice One growing trend has been to increase affiliation by way of social media groups There are several limitations to this practice given the diversity of training and expertise present in public platforms Seeking support on a public platform alone may create greater liability for clinicians Yet another approach therapist commonly used by some therapists opt to start group practices when their caseloads exceed their preferred capacity. While this can be a great solution for many, it is essential to consider whether managing employees aligns with one ' s career goals. Group practices require different departments, such as Human Resources, Payroll, IT, and Maintenance. Managing these aspects can be overwhelming for those who excel in one-on-one interactions but lack experience in leading a group.

Financial Management and Growth Strategies

Effective financial management is critical for the success of any private practice. Therapists should work with an accountant to create a specific course of action to accomplish financial goals. Additionally, collaborating with a private practice business

coach can help identify industry-specific strategies for diversification

Understanding the cost of scaling and determining whether the practice can afford to grow is essential. Therapists should be clear about their target audience and work with their ideal clients as much as possible to aid in compassion satisfaction Building margin into the schedule to capitalize on peak performance days and hours is also crucial

Budgeting Tips

Track All Expenses: Keep a detailed record of all business expenses, including office supplies, rent, utilities, marketing, and professional fees

Create a Monthly Budget: Develop a monthly budget to monitor income and expenses This will help you identify areas where you can cut costs and ensure that you are not overspending.

Set Financial Goals: Establish short-term and long-term financial goals for your practice. These goals will guide your budgeting decisions and help you stay focused on growth and sustainability.

Common Financial Pitfalls

Underestimating Start-Up Costs: Many therapists underestimate the initial costs of setting up a practice

Ensure that you have a realistic estimate of these costs and have sufficient savings or financing to cover them.

Inadequate Pricing Strategies: Setting your fees too low can undermine your financial stability. Research the going rates in your area and consider your expenses when setting your prices.

Ignoring Taxes: Failing to set aside money for taxes can lead to financial stress. Work with an accountant to understand your tax obligations and set aside funds regularly.

Long-Term Financial Strategies

Diversify Income Streams: Consider offering workshops, training, or online courses to diversify your income. This can provide additional revenue and reduce reliance on direct client services.

Invest in Professional Development: Continually invest in your professional development to stay competitive and offer high-quality services. This can lead to higher rates and more clients.

Plan for Retirement: Establish a retirement savings plan to ensure financial security in the future. Consult with a financial planner to explore your options.

Marketing Strategies

Marketing is crucial for attracting new clients and growing your

practice Here are some effective marketing strategies tailored for mental health practices:

Build a Professional Website: Your website is often the first point of contact for potential clients. Ensure that it is professional, easy to navigate, and includes essential information about your services, qualifications, and contact details.

Optimize for Search Engines (SEO): Use search engine optimization (SEO) techniques to improve your website's visibility on search engines. This includes using relevant keywords, creating high-quality content, and ensuring your website is mobile-friendly.

Utilize Social Media: Social media platforms like Facebook, Instagram, and LinkedIn can help you reach a broader audience Share informative and engaging content, interact with your followers, and promote your services

Content Marketing: Create valuable content such as blog posts, articles, and videos that address common mental health issues This can establish you as an authority in your field and attract potential clients.

Networking: Build relationships with other healthcare providers, local businesses, and community organizations. Networking can lead to referrals and collaborations that benefit your practice.

Online Directories: List your practice in online directories that are most consulted by your ideal client. These platforms can increase your visibility and attract new clients.

Technology and Tools

Leveraging technology can streamline administrative tasks and improve the efficiency of your practice. Technology is heavily relied upon to run a practice successfully. Finding cost-effective options will aid in achieving established financial goals. One approach is to identify options with multiple features. Here are tools and technologies to consider:

Practice Management Software: Practice management software can help you manage appointments, billing, client records, and other administrative tasks

Telehealth Platforms: Telehealth platforms enable you to offer virtual sessions, expanding your reach and providing flexibility for clients.

Electronic Health Records (EHR): EHR systems store client information securely and streamline documentation. Accounting Software: Accounting software can help you manage your finances, track expenses, and generate financial reports.

Scheduling Tools: Online scheduling tools allow clients to book appointments easily and reduce the administrative

Client Portal: A client portal provides a secure way for clients to access their records, complete forms, and communicate with you. Many practice management software options include client portals.

Secure Messaging: Secure messaging platforms ensure that communication with clients remains confidential.

Work-Life Balance

Maintaining a healthy work-life balance is essential for preventing burnout and ensuring long-term success. Here are some strategies to achieve this balance:

Set Boundaries: Clearly define your work hours and stick to them. Avoid checking emails or doing work-related tasks outside of these hours.

Schedule Breaks: Incorporate regular breaks into your schedule to recharge and prevent fatigue. Short breaks throughout the day can improve focus and productivity.

Delegate Tasks: Delegate administrative tasks to support staff or consider outsourcing tasks such as billing, marketing, or IT support. This allows you to focus on client care and other critical aspects of your practice.

Prioritize Self-Care: Engage in activities that promote physical, mental, and emotional well-being This can include exercise, hobbies, meditation, and spending time with loved ones

Set Realistic Goals: Set achievable goals for your practice and personal life Avoid overcommitting and recognize your limits.

Seek Support: Maintain a support network of colleagues, friends, and family. Talking to others who understand your challenges can provide emotional support and practical advice.

Time Management: Use time management techniques such as time blocking, prioritizing tasks, and using productivity tools to make the most of your work hours.

Advanced Clinical Support

Ongoing clinical support is crucial for maintaining high standards of care and professional growth. Here are some ways to access advanced clinical support:

Peer Supervision Groups: Join or form peer supervision groups with other therapists These groups provide a platform for discussing cases, sharing insights, and receiving feedback.

Professional Organizations: Participate in national and local professional organizations such as the American Counseling Association (ACA) and Florida Mental Health

Counselors Association (FMHCA) These organizations offer resources, training, and networking opportunities

Continuing Education: Engage in continuing education courses and workshops to stay updated on the latest research, techniques, and best practices in your field. This can also fulfill licensure requirements.

Clinical Consultation: Seek clinical consultation from experienced therapists or supervisors. Regular consultation can help you navigate complex cases, ethical dilemmas, and professional challenges.

Mentorship Programs: Participate in mentorship programs where you can receive guidance and support from seasoned professionals. A mentor can provide valuable insights and help you develop your skills

Research and Reading: Stay informed by reading professional journals, books, and research articles Keeping up with the latest developments in your field can enhance your clinical skills and provide new perspectives on client care

Legal and Ethical Considerations

Navigating the legal and ethical landscape of private practice is essential for protecting your clients and your practice Here are some key considerations:

Confidentiality: Ensure that all client information is kept confidential and secure. Use encrypted communication tools and secure storage methods for client records.

Informed Consent: Obtain informed consent from clients before beginning treatment. This includes explaining the nature of the therapy, potential risks, and the client's rights Professional Liability: Carry professional liability insurance to protect yourself in case of legal claims This insurance can provide coverage for legal fees, settlements, and other related costs

Ethical Standards: Adhere to the ethical standards set by your professional organization and licensing board. This includes maintaining boundaries, avoiding dual relationships, and practicing within your scope of competence.

Documentation: Keep accurate and thorough documentation of all client interactions, treatment plans, and progress notes. Proper documentation is essential for continuity of care and legal protection.

Cultural Competence: Provide culturally competent care by understanding and respecting the diverse backgrounds and experiences of your clients Engage in ongoing cultural competence training to enhance your skills

Continuing Education: Stay updated on changes in laws,

regulations, and ethical guidelines related to mental health

practice Regular continuing education can help you remain compliant and provide the best care for your clients

Practical Tips for Running a More Efficient Practice

Work with an Accountant: An accountant can help you create a financial plan that aligns with your goals They can assist with budgeting, tax planning, and financial forecasting, ensuring that your practice remains financially healthy.

Engage a Private Practice Business Coach: A business coach with experience in the mental health field can provide tailored advice and strategies for growing your practice. They can help you identify opportunities for diversification and expansion.

Clarify Your Target Audience: Knowing your ideal client allows you to focus your marketing efforts and improve client satisfaction. Working with clients who align with your expertise and interests can lead to better outcomes and increased job satisfaction

Build Margin into Your Schedule: Design your schedule to include breaks and time for administrative tasks This approach can prevent burnout and ensure that you are working at your peak performance during client sessions

Collaborate with Other Professionals: Sharing expenses with other therapists or professionals can reduce your administrative costs. Look for opportunities to share office space, marketing efforts, or administrative staff.

Maintain a Support System: Continue to seek supervision or consultation even after achieving licensure. A clinical mentor or consultation community can provide valuable

support and help you maintain high standards of care

Focus on Compassion Satisfaction: Working with your ideal clients and engaging in activities that bring you joy can enhance your overall job satisfaction. Compassion satisfaction can prevent burnout and improve the quality of care you provide.


Running a mental health private practice requires more than clinical skills; it demands business acumen, financial management, and strategic planning. By understanding the financial realities, maintaining professional support systems, and seeking guidance from mentors and business coaches, therapists can navigate the challenges of private practice and build successful, sustainable careers.

Implementing the tips and strategies outlined in this article can help therapists run their practices more efficiently, reduce the risk of burnout, and continue providing high-quality care to their clients.

Dr Simmons is the Co-founder of The Collective Wellness Institute, offering comprehensive mental health services She holds a Doctorate in Counselor Education and Supervision, is a licensed clinician in Florida and Virginia, a professional speaker, consultant, and mentor Dr Sh’nai has successfully run her mental health practice for six years She is committed to serving as a professional resource for clinical colleagues

The Role of Self-Disclosure in Teen Counseling

My introduction to professional counseling began in January of 2023 at AMIKids MiamiDade North. I had been on the metaphorical (sometimes literal) couch on the other side several times throughout my life and felt that the combination of schooling and my own experience as a client made me exceptionally well-prepared for wherever I was placed In some ways, I was right – in others, my experiences as a troubled teen myself fell flat

I was tasked with counseling young boys of ages ranging from 13-19 referred to this site by the Department of Juvenile Justice as part of their commitment or parole requirements. AMIKids serves the community by teaching vocational and educational skills alongside providing individual and group therapy In theory, it’s all meant to culminate in successful reintegration into society Of course, with the caveat that this is returning said teens to the exact environment and circumstances that resulted in their incarceration and trauma in the first place In school, we learn the importance of appropriate self-

disclosure and its influence in building a strong therapeutic alliance. Answers to how this is properly done can range – selfdisclosure, then, seems like more of an abstract art than an exact science One person I met recalled, “I’ve been with my therapist for 3 years and all I know about her is her name ” For someone who tends to be an open book, the thought of keeping my personality locked behind a rigid persona was daunting In hindsight, of course, this was never the case Thanks to my time as an intern, I realized firsthand the benefits of sharing and relating to clients – specifically with teenagers.

My first-ever client was a dream Emotionally vulnerable, outwardly sensitive, and able to spend an entire hour-long session sharing every thought and experience he could think of My second client was similar enough Maybe not quite so eloquent at expressing his feelings, but showing up each week with a new experience or belief to unpack and process. Somehow, despite the vast trauma that comes from living in North Miami as a young black man, their desire to communicate

and share has overridden the typical closed-off effect we associate with teens I thought my luck would last forever My third client was a major reality check During one of our first sessions, he posited a dilemma for me: he would share, but only if I did the same. He was distrustful of me, of the institution, of the whole process, and the world that had consistently failed him. I didn’t know what to do: what was worth sharing? What would have been helpful? How could I give him what he wanted – solidarity and connection – while remaining the professional I needed to be?

During our 6 months together, our sessions were consistently challenging They pushed me in a way I still don’t have a name for I described it to my supervisor as playing mental chess –each session left me drained and unsure if I was helping. One day, I told him I regularly attended therapy and had since I was a teenager. I didn’t go into detail about what led me there, but I utilized my experiences as a client to let him know I had been in that position; I knew what it was like to share your pain with a stranger. I can’t tell you that it was a lightbulb moment and he started sharing every deep dark secret he ever had. Sessions were still challenging, and inconsistent. But he began to trust me and understood, on some level, that my purpose went

beyond administering assessments or regurgitating coping skills

In my current practice, my caseload consists almost exclusively of teenagers. I’m still trying to strike a proper balance between fun and serious, relatable and authoritative. In my experience, self-disclosure with teenage clients is incredibly essential to the establishment of a therapeutic relationship and rapport. I’m careful not to share details about my personal life or impose my beliefs or opinions, but I have found that they crave the security and safety that comes with knowing, to some degree, who is sitting in the chair in front of them

Leira is a recent graduate, obtaining her MS in Counseling from Nova Southeastern University She recieved her BA from Florida International University in International Rel science Her areas of interest include socio on mental health, trauma in minority comm systems, and epigenetics

FMHCA Committee Updates

Registered Intern & Graduate Student Committee Committee Chair: Laura Peddie-Bravo, LMHC, NCC

Greetings! While our committee may seem quiet, please know your Committee Chair and Co-Chairs have been hard at work! Our next meeting will take place during FMHCA’s annual “Summer Bash,” on Tuesday, July 30th from 12:00 pm to 1:00 pm. The Graduate Student and Registered Mental Health Counselor Intern Committee is a committee specifically designed for Graduate Students and RMHCI's to meet together and discuss current concerns, challenges, and offer each other support with the backing of licensed professionals. We aim to discuss a number of relevant challenges for the two specific groups and address any participant questions that arise! We are hoping to make this a space where Graduate Students and RMHCIs can come together for support and leave feeling more prepared and competent for their future in mental health counseling! If you have any questions prior, please reach out to either the FMHCA Office at Office@FLmhca org or After the July 30th meeting, that will leave two meetings for the remainder of 2024 which will take place in September and November. We look forward to seeing you at the next meeting!

For your planning purposes please know we will have an inperson event at the 2025 Annual FMHCA conference on Wednesday, January 29th, 2025 from 6:30 pm – 7:30 pm This will be a great opportunity to get to know us and ask any questions you may have. We hope to see you there!

Regarding the Summer Bash, you can read more about and sign up for the Summer Bash here The FMHCA Annual Summer Bash is an event designed especially for our Graduate Student and Registered Mental Health Counselor Intern members The Summer Bash has everything one needs for licensure in the State of Florida Have a great summer!

Government Relations Committee

Committee Chair: Aaron Norton, PhD, LMHC, LMFT

We are now between legislative sessions, which is when the GRC shifts it’s focus temporarily away from legislation to liaison work with government agencies, including targeting policies and rules that relate to our profession. The GRC has identified three areas to address before the next legislative session starts: The policy manual of the Division of Vocational Rehabilitation (DRV), which is under the Florida

Department of Education, clarifies that DVR only accepts mental health diagnoses for eligibility determination made by LMHCs if they are under the supervision of psychologists, psychiatrists, or physicians The GRC intends to advocate for this policy to be revised, given that LMHCs are well-qualified to assess and diagnose mental disorders without supervision form another healthcare professional Policies established by the Florida Department of Education list psychologists and social workers but do not specifically list LMHCs as professionals who can offer mental healthrelated accommodation recommendations for students.

The GRC intends to advocate for counselors to be added to this list, as counselors are just as qualified to assess students with mental health-related disabilities as social workers are.

The Florida Board of Psychology adopted a rule clarifying that psychologists do not release raw test data to clients or clients’ representatives (e.g., attorneys) without a court order This rule is often cited by psychologists when responding to subpoenas asking for release of “raw test data” and is consistent with ethical guidelines and federal copyright and “trade secret” laws The GRC recommended to the FMHCA Board of Directors that we request that the 491 Board consider a similar rule that applies to counselors, social workers, and marriage and family therapists. In addition to it being helpful to refer to such a rule when responding to requests for raw data, such a rule would also constitute an additional rule that supports our capacity to administer and interpret psychological tests.

The Florida Psychological Association (FPA) and FMHCA’s GRC have created a subcommittee that has been assessing FPA’s request that FMHCA endorse a particular approach to preventing targeted school violence. The subcommittee has had several meetings, including one with the Vice Chancellor of FDOE and are still preparing recommendations on how FMHCA can be helpful to schools in this area

The GRC also created a subcommittee that is planning a webinar for members on how to interact with their legislators We intend to make this webinar available soon, along with a recommendation that members schedule an appointment with their senators and representatives.

Legislative Update: What happened to our bill?

As many members are already aware, SB 210 and HB 297 were not passed this legislative session which would have renamed "registered mental health counselor interns" as "licensed associate mental health counselors. The bill made excellent progress in the House but never cleared its first committee in the Senate (the Senate Health Policy Committee). Despite meetings with the legislative aide for the Chair of that committee and the bill sponsor and a phone conference with the staff director of that committee, we were unable to identify any specific opposition in the Senate, but we learned that on the House side there was communication between the Florida Psychological Association and the House co-sponsor involving some opposition to the bill. Each year, only 6- to 15% of bills pass, so our bill's death is certainly not uncommon and may have simply been an issue of the Senate committee having too little time to focus on too many bills Rep Traci Koster and Senator Danny Burgess appear to both be interested in sponsoring our bill again this coming legislative session, so we will continue lobbying for this bill Some additional bills members may be interested in were not passed, including:

SB 878 /HB 51 Art Therapy

SB 68: Social Work Licensure Compact

SB 70: Public Records and Meetings/Social Work Licensure Compact

SB 164: Solutions for Mental Health Professional Shortages

SB 252: Psychiatric Treatments

What Happened at the Last 491 Board Meeting?

GRC members attended the most recent 491 board meeting on 5/23-5/24/24. We noted that most of the licensees who were disciplined failed to keep appropriate records, whether treatment plans, progress notes, financial transactions, or consent forms. There were also a few boundary violations, and two practices were sanctioned for failing to verify online that clinicians joining the practice were actively licensed.

Military Committee

Committee Chair: Maria G. Giuliana, LMHC, Qualified Supervisor LMHC/LMFT, US Navy Veteran, FMHCA President-Elect

Every year, nearly 200,000 military members transition out of service and reintegrate into civilian life These individuals bring with them unique experiences and challenges that require specialized support, particularly in the realm of mental health However, too often, mental health professionals approach veteran care with a “friendly” attitude rather than being fully “ready” to address their specific needs. To truly support veterans, counselors must move beyond being veteran-friendly to becoming veteran-ready. Here’s why and how this transition

can make a significant difference

Becoming veteran-ready is an ongoing process that requires commitment, education, and empathy. By moving beyond a veteran-friendly approach to one that is truly veteran-ready, mental health counselors can make a profound impact on the lives of those who have served. This readiness not only benefits veterans but also enriches the practice of mental health professionals, fostering a deeper understanding of the diverse experiences that shape our society

For mental health counselors looking to become veteran-ready, FMHCA offers resources such as webinars and conference sessions specific to Military Counseling Competency. The Military Committee also holds a monthly zoom meeting on the last Thursday of each month that is open to all members. Together, we can ensure that our veterans receive the care and respect they deserve, helping them to thrive in their civilian lives.

Join Our Monthly Meeting: Invitation to Enhance Military Counseling

Our upcoming monthly gathering is designed to nurture a supportive environment for counselors committed to the welfare of our military community. These meetings are an excellent opportunity for professional development, knowledge exchange, and staying abreast of the latest advancements in military counseling

What You Can Expect:

Case Staffing and Peer Support: Engage in meaningful discussions on challenging cases, drawing on the collective wisdom and experiences of your peers.

Latest Developments: Keep updated with the most up-todate news, events, and training opportunities specific to military counseling.

Our Collective Goal: We strive to ensure every member is equipped with the highest level of competency, enabling the provision of unparalleled care to our heroes and their families

Who Should Participate?

Professionals currently counseling military members (active, retired, or former) and their families. Those interested in specializing in military counseling. Students, interns and new professionals.

Let’s Make a Difference Together!

Share your unique experiences, resources, and strategies. Connect with peers navigating similar challenges and achievements.

Enrich our collective knowledge base to better support our

military heroes and their loved ones

Mark Your Calendar! Join us on July 25, 2024, at 12:00 PM for our next meeting and become a vital part of our mission towards excellence in military mental health counseling.

Together, let's foster a culture of collaboration, learning, and growth, ensuring the military community receives the support and understanding they richly deserve

Save the Dates & Spread the Word! Let’s amplify our impact through collective effort.

Jul 25, 2024 12:00 PM

Aug 29, 2024 12:00 PM

Sep 26, 2024 12:00 PM

Oct 31, 2024 12:00 PM

We always welcome new members. Interested in joining the Military Committee? Attend the next meeting. Contact the Chair at or contact The FMHCA Office at office@flmhca org to be added and gain access to updates posted in the committee forum

Indigenous Mental Health Outreach Committee Committee Chair: William F. Gouveia, Ph.D, CCJAP

Dr Bill Gouveia and Dr Mark Baez presented a webinar on the most effective strategies to be employed by indigenous therapists working with native clients struggling with Substance Abuse Disorder

The webinar focused on therapeutic strategies that integrate aspects of Indigenous thinking into treatment such as a focus on spirit, group and social healing, restoring the emotional, ceremonies and catharsis.

An important factor in preventing youth from turning to substance abuse is promoting a sense of belonging to one’s culture, a strong spiritual/tribal bond, the opportunity to discuss problems with family, friends and tribal elders. This focus has three principles: Introspection (cultural humility), Communication, Continuation of culturally responsive services.

The Medicine Wheel includes Spiritual, Mental, Emotional and Physical alternatives to drugs Traditional approaches to Substance Abuse Treatment includes: Sweat Lodges, Powwows, Drum Circles, Meditations, Sun Dances, Smudging Ceremonies, Vision Quests

The Red Path Program was explored that utilizes culturally sensitive treatment models: Re-Activist Psychotherapeutic Model; FIT Feedback Informed Treatment Model; TIC Trauma Informed Care Model, RISE Model, Works Model.

Finally indigenous therapists were reminded that PTSD intergenerational trauma is prevalent in most native communities and must be addressed.

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