PAGE 13 WHEN THE THERAPIST IS THE STUDENT: LESSONS FROM MY OWN POLYVAGAL JOURNEY
PAGE 22
THE FIRST 3 SECONDS: CULTIVATING CONNECTION FROM THE START
PAGE 33 A NEW DAWN FOR ASPIRING MENTAL HEALTH COUNSELORS IN FLORIDA: HOW FRAME & TEACH ARE LOWERING ECONOMIC BARRIERS
PAGE 44 THE THERAPIST’S MIRROR: HOW CLINICAL WORK REFLECTS PERSONAL GROWTH
Rehumanizing the Therapist & Rehumanizing the Therapist & the Therapeutic Experience the Therapeutic Experience
While summer often brings a slower pace, things are heating up at FMHCA!
This is the time of year I like to pause and review my continuing education hours filling in any gaps and seeking out fresh inspiration. If you ' re doing the same, be sure to explore FMHCA’s upcoming opportunities for both learning and connection.
Whether you’re excited about the possibilities of artificial intelligence or feeling a bit unsure, one thing is certain: AI is here to stay Our upcoming Mental Health + AI Summit will help you understand how to make this evolving tool work for you and your practice.
We also have four upcoming Regional Events to keep your skills sharp:
Therapeutic Martial Arts Levels 1 & 2
The Hero’s Journey: Using Psychodrama as a StrengthBased Tool for Post-Traumatic Growth
Qualified Supervisor Training
Therapeutic Canvas: Integrating Expressive Arts Therapy into Play Therapy Practices
And don’t miss the Annual FMHCA Summer Bash a vibrant,
uplifting event designed to empower the next generation of counselors It’s a fun and meaningful way to engage with fellow professionals and support those just beginning their journey in the field
In addition, connect with your Regional Chapter to discover local events and summer meetups. Attending in person is a great way to build relationships with counselors and students in your area.
FMHCA is so much more than our Annual Conference We are a year-round hub for professional growth and community I encourage you to take an active role whether that’s attending events, joining a committee, or simply reaching out to get involved. There’s a place for everyone here.
FMHCA is the voice of Florida’s counseling profession and that voice is strongest when all of us are engaged. Practitioners, interns, faculty, and students: we are FMHCA Add your voice to ours we’re stronger together
Respectfully,
Dr Kathie Erwin, FMHCA President
Page 8
The Unseen Scars: Finding Light in the Shadows of Residential Care
Page 11
Rolling for Connection: Tabletop
Gaming as a Creative Modality in Outpatient Therapy for Couples & Polycules
Page 13
When the Therapist is the Student: Lessons from My Own Polyvagal Journey
Page 16
Page 24
FMHCA’s Favorites
Page 27
Preventing Youth Suicide: Intervention Strategies & Community Resources
Page 19
How Therapists Can Effectively Accommodate Neurodivergent Clients for Better Outcomes
Page 22
The First 3 Seconds: Cultivating Connection from the Start
Ethical Considerations and Competency Gaps in Psychedelic Integration Therapy
Page 33
A New Dawn for Aspiring Mental Health Counselors in Florida: How FRAME and TEACH Are Lowering Economic Barriers
Page 37
FMHCA Committee Updates
Page 41
The Importance of Self-Care
Page 47
I Had a Miscarriage, Too
Page 44
The Therapist’s Mirror: How Clinical Work Reflects Personal Growth
InSession Magazine is created and published quarterly by The Florida Mental Health Counselors Association (FMHCA)
FMHCA is a 501(c)(3) non for profit organization and chapter of the American Mental Health Counselors Association.
FMHCA is the only organization in the state of Florida that works exclusively towards meeting the needs of Licensed Mental Health Counselors in each season of their profession through intentional and strengthbased advocacy, networking, accessible professional development, and legislative efforts
Let your voice be heard by becoming a FMHCA Member today!
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If you would like to write for InSession magazine or purchase Ad space in the next publication, please email: Naomi Rodriguez at naomi@flmhca.org
THE INSESSION TEAM:
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 insight 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
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
Professional Experience Article
The air in the facility often felt thick with a cocktail of emotions – anger, fear, despair, and a raw, unsettling vulnerability As a Clinical Director and Therapist in a mental health and substance abuse residential facility, I stepped into a world where the weight of severe mental illness and the grip of addiction were palpable forces. My clients, often just on the cusp of true adulthood in their early twenties, had already navigated landscapes of pain and hardship that most people couldn't imagine.
They were often a study in contrasts: young in years, yet aged by their experiences Their faces, sometimes etched with the premature lines of stress and trauma, could flicker from moments of quiet introspection to explosive outbursts of irritation and anger Violence, though not a daily occurrence, was a constant undercurrent, a reminder of the volatile terrain we were all navigating.
In those early days, I have to admit, I felt a deep-seated negativity towards mental health and its myriad, often disruptive, symptoms. It felt like an insurmountable wall, a force that stole joy and replaced it with turmoil. I saw the destruction it wreaked not just on the individuals, but on their families, their futures, and even on the dedicated staff trying to help It was easy to feel overwhelmed, frustrated, and yes, to harbor a quiet resentment towards the very conditions I was there to treat The constant irritation, the unpredictable anger, the sudden shifts in mood – it was exhausting, and at times, deeply disheartening.
But here’s the paradox: the more I found myself wrestling with this negativity, the more I felt compelled to understand it My frustration fueled a fierce curiosity I began to read everything I could get my hands on – textbooks, research papers, personal narratives I delved into the neuroscience of addiction, the complexities of trauma, the intricate workings of the brain affected by mental illness. It was a form of self-preservation, perhaps, a way to try and gain some control over the overwhelming chaos I witnessed daily.
And in that deep dive, something began to shift. The symptoms I had initially hated started to lose some of their abstract, monstrous quality. I began to see them not just as frustrating behaviors, but as expressions of profound pain, as maladaptive coping mechanisms developed in the face of unbearable circumstances. The anger was often a shield for deep fear. The irritation, a sign of an overwhelmed nervous system. The withdrawal, a desperate attempt to find safety in a world that felt inherently dangerous.
And then, amidst the storm, came the moments of undeniable joy. These moments weren't grand or dramatic, but quiet, profound shifts in connection. They came when a young person, usually guarded and withdrawn, would meet my gaze and hold it for a moment longer than usual. They came when, after weeks of silence or monosyllabic responses, someone would hesitantly share a small piece of their story, a glimmer of the person hidden beneath the layers of pain and defense
These were the moments that replenished my spirit The feeling of being allowed into their internal world, even for a fleeting instant, was a privilege that outweighed the challenges It felt like witnessing a tiny sprout pushing through hardened earth. There was a raw, vulnerable beauty in their tentative steps towards trust, in their willingness to let down their guard and reveal the hurt beneath the anger.
Mental health is indeed a struggle It’s a relentless battle for the individuals living with it, a constant negotiation with internal demons and a world that often doesn’t understand It’s a heavy burden for families, who witness the pain of their loved ones and navigate the complexities of support and boundaries And it is, without a doubt, a demanding and emotionally taxing journey for those in the helping professions. We see the rawest edges of human suffering, and it leaves its mark.
But my time in residential care, despite the initial negativity and the pervasive challenges, taught me a profound truth: within the struggle lies immense resilience. Within the anger, there is often a desperate longing for connection Within the withdrawal, there is a deep need for safety And within the darkness, there is always the potential for light
The joy I found in those small victories, in the moments of connection and vulnerability, became my anchor. It was a reminder that even in the most challenging circumstances, the human spirit yearns for healing and connection. It solidified my belief that even when the symptoms are loud and disruptive, the person beneath them is still there, waiting to be seen, heard,
and understood
Working in that facility wasn't always easy, and the scars of those experiences remain. But so too does the profound gratitude for the moments of shared vulnerability, for the trust that was tentatively offered, and for the privilege of witnessing the quiet, courageous journey towards healing that unfolded within those walls. It was a powerful reminder that even in the face of immense pain, hope, connection, and the possibility of change are always present
Teresa Bridges, LCSW, is a dedicated mental health professional originally from Milwaukee, Wisconsin, who has called Florida home since 1998. She earned her Master's Degree in Social Work from Florida Atlantic University and became a licensed Clinical Social Worker in 2023. Teresa’s career in substance abuse and mental health began as an intern at a treatment center, where she quickly advanced to become a therapist and later served as Clinical Director Recently, she stepped down from her director role to pursue her passion for providing mental health therapy to the community on a broader scale Currently, Teresa practices as a mental health therapist in private practice, offering services to clients across the state of Florida. In addition to her professional work, she is also a talented singer and performs with an eleven-piece band known as "Motown Magic."
As a psychotherapist and clinical sexologist, I've come to view the game table not just as a leisure space but as a clinical one Over the last few years, I've integrated tabletop games into my outpatient practice, particularly with couples and polycules seeking to build trust, communication, and shared emotional experience The results have been compelling In a world saturated with digital distractions and relational burnout, analog gaming offers something rare: a structured environment where turn-taking, collaboration, and creative problem-solving come together to create emotional intimacy.
Tabletop games offer a low-stakes setting in which players can explore roles, practice communication, and engage with each other in novel ways. In therapeutic terms, this creates a "third space " where patterns can be observed and shifted. Couples who may otherwise struggle with direct emotional disclosure
often find that discussing strategies for a cooperative board game opens doors to deeper communication For polycules, the games become a collaborative arena to work on inclusion, voice equity, and emotional awareness. Who takes charge? Who feels heard? What happens when a partner zones out or becomes directive? All of these dynamics show up at the table. Games like Fog of Love, The Mind, and Decorum become experiential entry points for deeper relational work.
Co-Regulation: Cooperative games can serve as an emotional barometer. When a group wins or loses together, it surfaces shared emotional states and offers opportunities for co-regulation and repair.
Perspective-Taking: Role-playing games, in particular, support empathy-building When partners embody fictional characters, they often access emotional material that's otherwise difficult to express
Narrative Repair: Games allow couples and polycules to reauthor parts of their relational story. Winning together, surviving a campaign, or laughing through chaos can counteract narratives of disconnection and conflict.
I’ve witnessed more than one couple say, “That’s the first time we’ve laughed together in weeks,” after a game night in session. I’ve seen polycules cry after completing a mission that symbolically mirrored real-life healing. These aren’t outliers they’re reminders that play is not just for children, and therapy does not always need to begin with the hard conversation Sometimes, it begins with a shared goal, a set of dice, and the willingness to play As clinicians, we’re often searching for new ways to reach the people we serve Tabletop gaming, when used intentionally, offers a trauma-informed, neurodivergentaffirming, and emotionally accessible way to facilitate growth. It’s not a gimmick; it’s a language and for many, it speaks more clearly than talk therapy ever has.
Written By: Dr. Josh Littleton, LMHC, C
Josh Littleton, LMHC, NCC is a Florida based psychotherapist and clinical sexologist. He specializes in LGBTQIA affirming care, relational wellness, an use of narrative and creative interven therapy. He integrates tabletop game with couples, polycules, and families reconnection and identity exploratio
It was during a seemingly ordinary session just me, my client, and a growing tightness in my chest that I realized something was off, and it was not just in the chair across from me. As a therapist specializing in complex trauma and PTSD, I was wellversed in nervous system dysregulation and routinely taught clients coping skills and regulation strategies to navigate it. But I had never been taught nor practiced how to use these same skills in the moment, while sitting in the therapist’s chair and experiencing my own dysregulation
When we share heart-space with a client, there is constant reciprocity between our nervous systems, shaped by the process of neuroception my nervous system sees the safety in yours, and thus feels safe itself. If I was dysregulated in session, that was not only something I needed to address for my own grounding and presence it became a clinical responsibility. My physiological state directly impacted the client sitting across from me, who had come to this space in pursuit of healing.
Learning about Polyvagal Theory (Porges, 1995), the vagus nerve, autonomic states, and neuroception, gave me a new language to describe something I had always felt but could never quite name. I began to recognize how often I operated from a sympathetic state: energized, focused, productive, but subtly braced for impact. It was not until I hit a wall during a particularly demanding season balancing a full caseload,
supervision, and dissertation work that I slipped into what I later identified as a dorsal vagal collapse. I felt numb, disconnected, and strangely robotic in session. I could still say the right things and offer the right interventions, but I was no longer with my clients in the way I once had been. That was the moment I understood the difference between knowing about nervous system regulation and feeling it in my own body. Embodied awareness, I realized, is not optional for the therapist; it is essential for connection and healing to take place
Once I began tracking my own nervous system in real time, my clinical presence began to shift. I became more attuned not just to my clients’ cues, but to my own internal rhythms: my breath, posture, tone of voice, and the subtle signs of activation or shutdown in my body. Rather than pushing through sessions on autopilot or over functioning in the face of a client’s distress, I practiced pausing, grounding, and (co-)regulating. This created more space in the room for the client, for the work, and for the relationship itself. I found I could better sense when a client was approaching overwhelm and pace our work accordingly My approach to rupture and repair also softened as I was no longer afraid of moments of disconnect because I trusted my ability to return to regulation and guide the client back with me
One of the most important takeaways from my polyvagal journey is this: your regulation is the intervention. Before any
technique, tool, or theoretical model, it is our presence, regulated, attuned, and embodied, that creates safety and possibility for change I now approach both my personal and professional life with a deeper commitment to noticing and nurturing my nervous system. I try to build in anchoring moments throughout the day whether stepping outside between sessions, humming softly to reset vagal tone, or placing a hand over my heart and exhaling slowly. These small, ordinary acts help me return to myself so I can return to the work. Polyvagal awareness is not a destination; it is a daily practice of remembering that we are not just minds doing clinical work we are nervous systems in relationship.
This work continues to remind me that healing does not simply flow from therapist to client. It moves in both directions, shaped by the quality of presence we bring into the room. The more I learn to listen to my nervous system, the more connected my work becomes. So I leave you with the question that continues to guide me: What is your nervous system telling you and what does it need to feel just a little more safe, soothed, and supported right now?
References:
Porges, S W (1995) Orienting in a defensive world: mammalian modifications of our evolutionary heritage A Polyvagal Theory. Psychophysiology, 32(4), 301-318. https://doi.org/10.1111/j.1469-8986.1995.tb01213.x
Written By: Rebecca Nelson, LMHC-QS
Rebecca Nelson, MA, LMHC-QS, Ph.D. Candidate, is the founder of Rebecc Nelson Psychotherapy LLC, a trauma recovery-focused practice with office Florida and Texas. She specializes in treating PTSD, anxiety, mood, and substance use disorders using EMDR, DBT, Polyvagal Theory, and Ketamine-Assisted Psychotherapy. Rebecca also provides clinical supervision and consultation, with a focus on traumainformed care and the integration of modern, evidencebased approaches to support deep healing and lasting change.
Join in on one of our upcoming webinars!
The Basics of Non-Directive Play Therapy Skills
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Presented by: Andrea Mann, MS, NCC, LMHC-S, RPT-S, CAdPT-A Register Now
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08 Aug 2025 | 2:00 PM-4:00 PM
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Presented by: Lauren Ramnath Daharry, LMHC Register Now
P.S. We are seeking presenters for our 2026 Webinar Series until Nov. 1st! Learn more HERE
The national suicide rate among adolescent youth has risen significantly over the years, surpassing other causes of youth fatalities. Suicide during childhood and adolescence is ranked as the second leading cause of death among these age groups. A 2022 study found that suicide was the second-leading cause of death for youth aged 10–14, and the third-leading cause for those aged 15–24 Between 2007 and 2021, suicide rates for youth aged 10–24 increased by 62 percent (SAMHSA, 2024)
Over the years, various factors have contributed to the rise in youth suicide, including but not limited to: bullying in schools, heightened symptoms of depression, the impact of the COVID19 pandemic, grief due to a loss of a loved one, and the growing influence of social media and technology, which also encompasses cyberbullying
These elements are reflected in numerous statistics, highlighting the devastation that affects not only families nationwide but also the communities these young individuals once belonged to. It is important that we recognize this as both a national and global crisis in order to implement the necessary changes and interventions to reduce and prevent the suffering and premature loss of our future generation
Youth suicide is a complex and sensitive issue with numerous determinants. These variables affect not only the individual youth but also extend to societal influences. The underlying cause of suicidal thoughts in youth often stems from pain and a
sense of hopelessness, leading them to believe that things will never improve Known risk factors for suicidal ideations and behaviors include previous suicide attempts, mental illness, trauma-related adverse childhood experiences, family dynamics, isolation, and feelings of hopelessness. A 2017 study (Ertl, Crosby, & Blair, 2020) found that, disproportionately, female youth exhibit the highest rates of nonfatal suicidal behaviors, while male youth have the highest completed suicide death rates. Understanding that interventions like traditional therapy, which were common 20 years ago, may not resonate as much with today’s youth is pivotal. Community leaders and resource providers must consider a variety of approaches when addressing mental health concerns. Some individuals may choose not to seek formal treatment at all, instead turning to family members or peers for guidance Many mental health issues among youth may go unnoticed or undiagnosed For suicide prevention efforts to be effective, they must go beyond traditional clinical settings and reach those who have not been diagnosed or have not yet received the appropriate treatment (Ertl, et al., 2020). Preferences for handling mental health issues independently may vary across different contexts; therefore, it is essential to be culturally aware and competent in addressing the sociocultural factors at play. For instance, black individuals and other minoritized groups may feel pressured to "be strong" and persevere without seeking help due to cultural norms that frame mental illness as a "white man’s issue" (Castro-Ramirez, Al-Suwaidi, Garcia, Rankin, Ricard, & Nock, M. K., 2021).
Strategies and Community Resources:
Preventing youth suicide requires a collaborative decisionmaking approach that involves the youth, recognizing the importance of community engagement in the development of "gatekeepers". Ertl et al. (2020), defines the terminology of gatekeepers as community members, including teachers, coaches, and healthcare providers, who are trained to recognize individuals at risk for suicide and refer them to appropriate treatment or support services Some approaches include: Faith-Based and Mental Health Integration: Faith leaders can incorporate information regarding mental health challenges, suicidal thoughts and behaviors, into their work and teachings. They can also help by strengthening connectedness in their faith community, which is a key factor in decreasing youth suicide (Johnson, Harwell, Miller, & Rosenblum, 2024).
Community Engagement and Activities: Community-based programs, such as mentorship initiatives like Big Brothers Big Sisters of America, and volunteer services, offer invaluable opportunities for youth engagement. These
programs focus on fostering personal growth by providing social supports, helping young individuals feel connected and reducing feelings of isolation (SAMHSA, 2024)
Individual Psychotherapy: Individual therapy offers emotional support, helping youth express their emotional challenges. While this approach can be effective for some, it is imperative for it to be a client-centered treatment approach. As some youth, may find this method of treatment unsatisfactory due to past negative experiences or a lack of trust in the provider (Horowitz, Tipton, & Pao, 2020).
Group Therapy and Peer Support: Offering peer support led groups can help youth share in their experiences with one another navigating through the challenges they face Programs like Bring Change 2 Mind (BC2M) is a mental health awareness club focusing on schools with a high enrollment of historically underserved groups In addition, Sources of Strength is a peer-led, evidence-based suicide prevention program for secondary schools This program trains students to be peer leaders and connects them with adult advisors, both at school and in the community (Horowitz, et. al, 2020).
Youth Suicide Prevention Is a Community Responsibility:
Adolescence is a time of significant developmental change, both physically and emotionally. It is also a period of vulnerability, as youth navigate a variety of pressures, from social relationships, to the influence of social media and family dynamics. These elements can sometimes contribute to feelings of hopelessness, isolation, and suicidal ideations. Allowing mental health support to be more accessible, whether through school-based programs, peer-groups, faith leaders, or community engagement can provide youth with the opportunity to seek help when desired. Additionally, reducing stigma around seeking help is just as important in encouraging those who are struggling to reach out and not feel ashamed of their feelings Understanding the conditions that lead to youth suicide is essential in shaping proactive, targeted interventions Building a culture of care that prioritizes mental health, especially during
adolescence, could be a powerful step toward reducing suicide rates among youth and saving the lives of generations to come (Cha et al , 2018)
References
Center for Faith-based and Neighborhood Partnerships (2022) Youth Mental Health and Well-being in Faith and Community Settings: Practicing Connectedness Retrieved from www.hhs.gov.
Cha, C. B., Franz, P. J., Guzman, E. M., Glenn, C. R., Kleiman, E. M., & Nock, M. K. (2018). Suicide among Youth: Epidemiology, (Potential) Etiology, and Treatment. Journal Child Psychology Psychiatry, 59(4):460-482 Retrieved from www ncbi nlm nih gov
Ertl, A., Crosby A. E., & Blair, J. M. (2020). Youth Suicide: An Opportunity for Prevention. Journal of the American Academy of Child & Adolescent Psychiatry, 59(9):1019-1021. Retrieved from www.ncbi.nlm.nih.gov.
Horowitz, L , Tipton, M V , & Pao, Maryland (2020) Primary and Secondary Prevention of Youth Suicide, 145 (2): S195-S203 Retrieved from www hhs gov
Johnson, B. J., Harwell, E. J., Miller, C., & Rosenblum, L. B. (2024). Hope: A Guide for Faith Leader to Help Prevent Youth Suicide. Retrieved from www.hhs.gov.
Mata-Greve, F , Johnson, M , & Blanchard, B E (2022) A Longitudinal Examination of Cultural Risk Factors of Suicide and Emotional Regulation Retrieved from www apa com Substance Abuse and Mental Health Services Administration (SAMHSA) (2024). Suicide Prevention Strategies for Underserved Youth. Retrieved from www.pcssnow.org.
Tiffany Jackson, LMHC, MBA, NCC, is a nationally certified counselor and certified intervention training trainer in the state of Florida.
Recognizing that every person’s mind works differently is essential in mental health care. Neurodiversity emphasizes that differences like autism, ADHD, and dyslexia aren’t flaws but part of human variation As awareness grows, it’s clear that tailored approaches can make therapy more effective for neurodivergent clients However, many therapists still struggle to meet these diverse needs Adapting your practice isn’t just about being inclusive it leads to better engagement, trust, and results.
Understanding Neurodivergence and Its Impact on Therapy
Defining Neurodiversity and Common Conditions
Neurodiversity includes a range of conditions where brain wiring differs from typical patterns Autism, ADHD, dyslexia, sensory processing disorder, and Tourette syndrome are some common examples These conditions affect how people think, learn, communicate, and process sensory information Did you know that approximately 1 in 54 children in the US is diagnosed with autism? Recognizing these figures helps us understand the growing need for adapted mental health care.
Clients with neurodivergent brains often communicate and
learn differently. For example, someone with autism might process information literally and prefer clear instructions. Those with sensory sensitivities might find bright lights or loud sounds overwhelming Traditional therapy spaces can feel like sensory overload or make clients hesitant to speak openly Recognizing these challenges allows therapists to build better trust and create safer environments
The Importance of Inclusive Language and Attitudes
Words matter Using respectful, affirming language reduces stigma and encourages clients to share more openly Instead of calling someone "disordered," focus on strengths and abilities Avoid framing behaviors as problems see them as differences Phrases like “neurodivergent individual” or “person with autism” acknowledge identity without judgment. This attitude builds respect and safety in the therapy room.
Physical
Make your office welcoming for all senses. Use calming colors and soft lighting to avoid overstimulation. Soundproof rooms or quiet corners help reduce noise. Add tactile objects like stress balls or textured fabrics so clients can self-regulate. Simple
changes like these make a big difference for sensory-sensitive clients
Communication Strategies
Use clear, straightforward language Visual aids can enhance understanding think charts, pictures, or written instructions Some clients might prefer alternative communication methods like communication devices or written notes. Check in regularly to see if they understand or need additional support.
Establishing a Consistent and Predictable Routine
Many neurodivergent clients thrive with routines Plan session structures that are predictable but flexible Let them know what to expect at each step. Slight schedule changes should be communicated well in advance. Consistency reduces anxiety and helps clients feel more secure.
Tailoring Therapeutic Techniques and Interventions
Adapting Evidence-Based Practices
Standard treatments like cognitive-behavioral therapy (CBT) can work well if adapted. Focus on strengths and interests instead of deficits. For example, using a client’s passions to teach coping skills boosts engagement. Mindfulness practices might need to be shortened or modified to match processing styles. Being flexible makes evidence-based methods more effective.
Utilizing Sensory and Processing Strategies
Incorporate sensory breaks during sessions. Simple activities like stretching, deep breathing, or using noise-canceling headphones allow clients to self-regulate. Movement-based strategies can also help think of incorporating some gentle stretching or standing exercises. These techniques support emotional regulation and focus.
Incorporating Client-Centered and Strength-Based Approaches
Encourage clients to share what works best for them. Focus on their natural talents and strategies they already use to cope. Help them see their strengths and empower them to become self-advocates Building on what they’re good at fosters confidence and independence
Building Collaborations and Resources
Partnering with Families, Caregivers, and Support Systems
Ask families and caregivers for insights about the client’s routines, triggers, and strengths Collaborate to create personalized plans Sharing this information results in consistent care across settings It also supports the client’s progress outside the therapy space
Connecting Clients with Community Resources
Point clients toward local and online support groups tailored for neurodivergent communities Many organizations offer training, advocacy, and social activities These connections reinforce progress made in therapy and help clients feel less isolated.
Attend workshops, join networks, and read the latest research on neurodiversity. Keeping up-to-date ensures your practice remains effective and respectful. Learning from the neurodivergent community itself can deepen your understanding.
Avoid framing neurodivergence as a defect. Respect how clients see themselves and honor their experiences. Some prefer identity-first language, like “autistic person,” over clinical labels. Listening to what clients say about their identities plays a vital role in ethical practice.
Cultural background influences how neurodivergence is viewed and addressed. Be aware of cultural, racial, and socioeconomic factors that impact therapy. Addressing these multiple layers helps ensure you respect each client’s unique story.
Meeting the needs of neurodivergent clients requires awareness, flexibility, and genuine respect. Small changes like sensory-friendly environments, clear communication, and collaborative planning can transform therapy into a space where everyone can thrive. Committing to ongoing learning ensures you stay ready to adapt and serve diverse populations. The result? More meaningful connections and stronger outcomes for clients who deserve inclusive, affirming care With each step forward, we help build a mental health system that embraces the beautiful spectrum of human minds
Written By: William Carmody, M.Ed., Ed.S., MBA, LMHC, NCC
William is the founder of Counseling Hope, with locations in Maitland, Windermere, and Orlando. Bill earned his master's degree from the University of Florida. He completed post-graduate training at Harvard Medical School and is a Nationally Certified Counselor. Bill enjoys helping new how to navigate the business side of working in a private practice.
It happens in a blink: the door opens, the Zoom camera flickers on, or the client’s name is clicked into the EHR system. That’s when it begins. Not the therapy itself, but something more subtle and equally essential: intimacy.
In my years as a clinician, I’ve come to deeply respect the first three seconds of every session Those fleeting moments, often overlooked, hold significant influence over the direction and tone of the therapeutic relationship They set the pace, shape the power dynamic, and either invite or inhibit vulnerability
In EMDR training, a single sentence landed in my body like truth: “Our systems know when we are in connection.” It’s not just about what we say, but about the energy we bring into the room. Before a word is spoken, our nervous systems pick up on whether we’re truly present. That moment of attunement is felt, not declared.
There is an art to it.
Whether I’m greeting someone in person or joining a virtual session, I’ve learned to pause before that first contact. I ask myself, what kind of presence do I want to offer right now? Calm, warm, grounded Not perfect, never perfect, but attuned Even virtual settings don’t exempt us from this responsibility A warm smile, a small wave, a breath before logistics-these are our tools
It’s in those early seconds that a client, especially a new one, begins to decide whether this will be a space they can trust. Not because I say, “This is a safe space,” but because they feel it. The nervous system doesn’t wait for cognitive reasoning. It reads tone, eyes, posture, rhythm. Our clients often arrive carrying shame, grief, rage, or fear. Their sensitivity to nuance can be astonishing. That’s why our opening gesture matters so much.
Hozier’s song "Movement" captures this beautifully He speaks to the power of presence, how someone’s very being can shift the energy in a space It’s not about physical motion alone, but about the emotional charge that rides within it Likewise, as therapists, our presence alone can create profound emotional shifts. We don’t need choreography; we need consciousness.
I remember one session when a new client appeared on screen for the first time. She looked unsure, her eyes darting slightly, her body held tightly I felt the impulse to dive into intake questions, but something told me to pause I softened my expression and said simply, “I’m really glad to meet you ” Her shoulders dropped That small shift, my presence meeting her uncertainty with warmth, was the real beginning of our work Later, she told me, “I didn’t know why, but I just felt like I could breathe with you.”
In our field, we talk a lot about building rapport, establishing
trust, and coregulation But often, the gateway to all of that is built before a single word is spoken It’s a felt sense
Of course, I haven’t always been fully attuned to that dynamic. Early in my training, I remember rushing to open the office door for a new client while my mind was still in the previous session. I smiled automatically, but I felt the disconnect. The client, already anxious, seemed startled and withdrawn. It took several sessions to ease that initial tension and rebuild trust I’ve never forgotten that moment
Since then, I’ve created small rituals to help myself arrive. Sometimes it’s a single deep breath. Sometimes it’s a hand over my heart, just out of the camera’s view. These are brief but grounding, designed to orient me not just to the session, but to the person in front of me.
Still, I recognize that being fully present isn’t always easy Some days, we carry emotional weight that we can’t simply set aside But I’ve learned that even on the harder days, when I don’t arrive composed, if I stay emotionally available, something meaningful can still unfold. Vulnerability, when paired with attunement, can forge a connection that’s honest and deeply
human It’s not about perfection; it’s about authenticity And in that authenticity, trust can take root
The art of relationality begins in those first three seconds. It’s quiet, humbling work, and it matters more than we often acknowledge.
Written By: Desiree Nazarian, LCSW, CPTT CSAT
Desiree Nazarian, LCSW, is a relational trauma therapist with a somatic and psychodynamic orientation Her work is relational, intentional, and rooted in helping clients heal, build self-worth, and foster healthy intimacy. She specializes in betrayal, compulsive sexual behavior, and system regulation. As a first-generation Ir she brings cultural insight and compassion to her practice. Desiree is also trained in EMDR and Somatic Attachment, offering individualized, holistic care for lasting transformation.
Red light therapy offers a range of potential benefits, primarily focused on skin health, pain management, and wound healing. It can stimulate collagen production, reduce inflammation, and improve circulation, leading to potential improvements in skin tone and texture, wound healing, and pain relief. Emerging research also suggests potential benefits for cognitive function and mental well-being.
Instructions
Ingredients:
1 and 1/2 cups (188g) all-purpose flour
1 teaspoon baking powder
1 teaspoon baking soda
1/2 teaspoon salt
1 teaspoon ground cinnamon
1/4 teaspoon ground nutmeg
1 and 1/2 cups (345g) mashed bananas (about 4 medium or 3 large ripe bananas)
6 Tablespoons (85g) unsalted butter, melted (or melted coconut oil)
2/3 cup (135g) packed light or dark brown sugar (or coconut sugar)*
1 large egg, at room temperature
1 teaspoon pure vanilla extract
2 Tablespoons (30ml) milk
1.Preheat oven to 425°F. Use cupcake liners.
Schedule blocking, also known as time blocking, is a time management technique where you divide your day into specific blocks of time, each dedicated to a particular task or activity. This method helps in focused work, prioritizing tasks, and making the most of your time.
Collagen peptides are made by breaking down whole collagen proteins into smaller pieces. When taken by mouth, collagen peptides seem to build up in the skin and cartilage This might help improve some skin and joint conditions
2.Whisk the flour, baking powder, baking soda, salt, cinnamon, and nutmeg together in a medium bowl. Set aside. In a large bowl or in the bowl of your stand mixer, mash the bananas. On medium speed, beat or whisk in the melted butter, brown sugar, egg, vanilla extract, and milk Pour the dry ingredients into the wet ingredients, then beat or whisk until combined If adding nuts or chocolate chips, fold them in now
3 Spoon the batter into liners, filling them all the way to the top Bake for 5 minutes at 425°F, then, keeping the muffins in the oven, reduce the oven temperature to 350°F . Bake for an additional 16–18 minutes or until a toothpick inserted in the center comes out clean. The total time these muffins take in the oven is about 21–23 minutes. Allow the muffins to cool for 5 minutes in the muffin pan, then transfer to a wire cooling rack to continue cooling.
Carefully crafted using handpressed glass beads and handblown glass, the Icon collection is irresistibly charming, so sip-worthy, and makes a beloved gift, cheers!
Improve your study or work experience with the smear-resistant and ink-free technology of the Sharpie Gel Highlighters. Its advanced gel formula resists smudging across pen, marker, and ink jet inks and won't bleed through paper, ensuring clean and clear marks Each Sharpie highlighter is durable and longlasting with the ability to stay uncapped for days without drying out. The bullet tip design enables precise highlighting and underlining, making it highly versatile.
This portable studio makes plein air artistry chic, compact, and 100% mobile. Tucked into a smart felt case, it unfolds into a complete setup palette, easel, brushes, paper, even a detail pen ready to go wherever inspiration dares to wander
Five-piece collection includes:
Shower Melts (eucalyptus, rosemary, mint, and menthol crystals), Succulents Soap (bergamot and vetiver), Bath Soak (lavender and eucalyptus), Lip Balm (peppermint),
Body Oil (lavender, geranium, and ylang-ylang)
Everyone loves the feeling of being snuggled up in a blanket, especially when they’re working from home But fleecy throws covered in cartoon characters aren’t always great for company video calls, and they tend to get caught in the wheels of your office chair This wearable, fleece-lined wrap keeps you both cozy and meeting-ready, and won’t get caught underfoot.
Slide the stretchy inner midsection to your chair, secure with buttons, and your newest accessory is always on call and camera-ready. The open front lets you stand and sit without having to shift or drag a blanket with you, and it’ll always be right where you left it on your chair.
Protect your head from the sun with fashionable flair
These packable hats are handmade of 100% cotton and feature a charming crocheted flower chain. The wire brim adjusts to keep the glare out of your eyes, whether running errands or relaxing on the beach.
Your water bottle doesn't fit in your purse and falls out of your backpack side pockets. (We know it's not just us.) This stylish, hands-free bag is the solution.
There are cats that got your tongue, and then there’s this feline friend who’s got your glasses. You’ll never lose your frames again with Rafael del Campo’s handmade holder.
The one card game you’ll always win
Fidget tools are wonderful for relaxation and focus, but they can have the opposite effect if they’re loud or distracting These ingenious silicone spheres are wonderfully engaging but discreet to use. With magnets hidden inside, they snap together in endless formations, while the soft-touch design ensures quiet use in the office, classroom, library, or wherever you need a little hands-on stress relief.
Let’s be honest: A pint of ice cream is a single serving, meant to be devoured right out of the container. The only problem? Chilly hands and melting ice cream where hot meets cold but no more.
Professional Resource Article
Psychedelics such as MDMA, psilocybin, and ayahuasca are gaining attention for their therapeutic potential in treating PTSD, depression, and anxiety. Backed by clinical research and FDA “breakthrough therapy” designations, this psychedelic renaissance has spurred growing public interest and increased use of these substances for healing. As a result, more clients are turning to mental health professionals for help integrating their experiences, often following ceremonies or retreats outside of clinical contexts.
This rising demand has revealed a significant gap: most clinicians lack formal training in psychedelic integration therapy, raising concerns about competence, ethical boundaries, and cultural sensitivity. Common issues include managing suggestibility, providing informed consent, and avoiding the misuse or appropriation of Indigenous practices. This article examines the ethical considerations and competency gaps mental health professionals must navigate as psychedelics move closer to mainstream use It offers practical
recommendations to support safe, effective, and culturally respectful integration work.
Psychedelic integration therapy refers to non-psychedelic sessions that support clients in making sense of their past psychedelic experiences. Unlike psychedelic-assisted therapy, which involves the administration of substances such as psilocybin or MDMA within a controlled clinical setting, integration therapy occurs after the psychedelic experience and focuses on translating insights into lasting behavioral and emotional change (Earleywine et al., 2022).
While psychedelic-assisted therapy aims to elicit breakthroughs during altered states of consciousness, integration therapy helps clients process those experiences afterward. It may involve exploring emotions that surfaced during the journey, making meaning of symbolic or spiritual content, and aligning newly gained awareness with day-to-day life (Brennan & Belser, 2024).
Clients seek integration therapy for various reasons Some experience unresolved trauma that resurfaces during psychedelic sessions and requires careful, trauma-informed processing. Others enter a spiritual crisis, marked by confusion, existential distress, or identity disruption, after intense visionary or mystical encounters. Even when the experience is positive, the sheer intensity can leave individuals overwhelmed or disoriented.
Effective integration often includes practices that engage the emotional, physical, and spiritual dimensions of healing, along with support from trained professionals or community-based networks While not all clients require formal integration therapy, for many, it provides a crucial container for grounding insights and fostering long-term growth.
The rapid rise in both clinical and non-clinical use of psychedelics marks a major shift in the landscape of mental health care. Substances such as MDMA and psilocybin are on the brink of FDA approval, and public interest continues to grow as promising research highlights their potential for treating conditions like PTSD and depression. Simultaneously, an increasing number of individuals are turning to psychedelics in naturalistic settings, such as retreats, underground ceremonies, or self-directed use, often without clinical supervision.
This surge in use has clinical implications A growing number of therapists report that clients are bringing psychedelic experiences into the therapy room However, many clinicians feel unprepared to address these experiences safely and effectively due to limited formal training. While conversations around psychedelics are becoming more common in practice, a lack of adequate knowledge leaves providers unsure how to support clients navigating powerful and sometimes destabilizing experiences.
Compounding the issue is the absence of standardized certification or credentialing pathways for psychedelic integration therapy Without clear legal or ethical guidelines, clinicians must navigate complex questions about scope of practice, informed consent, and client safety on their own (Pilecki et al., 2021). This lack of structure creates both clinical risk and professional uncertainty.
Most mental health training programs currently offer little to no instruction on psychedelic therapy or integration. Psychedelic literacy among trainees remains low, with many learning about these substances through informal sources such as social media, an approach that does not reliably increase clinical competence
To meet the evolving demands of the field, counselor education programs must begin incorporating evidence-based instruction on psychedelics and their integration Without structured, ethically grounded training, the profession risks being unprepared for the growing number of clients seeking informed, competent care after psychedelic experiences.
As psychedelic integration therapy enters mainstream clinical conversations, ethical clarity becomes essential. The American Counseling Association (ACA) Codes of Ethics provide a strong foundation for navigating this emerging terrain. However, the unique nature of psychedelic experiences introduces nuanced challenges in core areas such as competence, informed consent, boundaries, cultural sensitivity, and client safety.
Clinicians must not offer services they are unqualified to provide. Without formal training in psychedelic integration, there is a risk of misunderstanding the psychological and physiological impacts of non-ordinary states, potentially leading to ineffective or harmful interventions. The ACA Code of Ethics stresses that therapists must pursue appropriate education, supervision, and ongoing professional development before engaging in work involving psychedelic content.
Informed consent is not a one-time disclosure but an ongoing process, especially critical in integration work, where clients may revisit intense, confusing, or destabilizing experiences. Clinicians must clearly communicate the scope of integration therapy, set realistic expectations, and be vigilant about uncritically reinforcing delusional or maladaptive interpretations of psychedelic experiences.
Therapists must maintain clear boundaries, particularly in a field where clients may have participated in non-traditional or communal ceremonies that blur relational roles. Sharing personal psychedelic experiences or engaging in dual relationships, especially in underground settings, can create ethical breaches. The ACA Code encourages clinicians to exercise sound judgment, self-awareness, and cultural humility in managing such complexities.
Many psychedelics, such as ayahuasca or peyote, originate in Indigenous traditions. Therapists must avoid appropriating these practices without understanding their cultural and spiritual significance. Incorporating Indigenous elements without proper context risks misrepresentation and harm.
Ethical practice requires cultural competence, consultation with knowledgeable sources, and deference to traditional lineages
Harm reduction approaches must be carefully balanced with legal and ethical responsibilities. While therapists may support clients in processing experiences with illegal substances, they must avoid actions that could be construed as endorsing or facilitating use Respecting client autonomy while upholding professional integrity requires careful documentation, risk assessment, and adherence to current laws
Ultimately, ethical integration therapy demands more than rule-following, it requires reflective practice, consultation, and a commitment to evolving professional standards. As the field develops, therapists must remain vigilant, ensuring their interventions are safe, culturally respectful, and grounded in both clinical wisdom and ethical care.
As client demand for psychedelic integration therapy increases, so does the need for clinicians to be equipped with specialized competencies. Training programs such as those offered by Fluence, CIIS, and Naropa have begun to define frameworks that prepare clinicians for this evolving work These models emphasize harm reduction, trauma-informed care, recognition of spiritual emergencies, and somatic processing, each of which is essential to providing ethical and effective integration support
Competency development in psychedelic integration therapy involves cultivating specific clinical skills that address the complex and often sensitive nature of these experiences. Rather than assuming abstinence as a treatment goal, harm reduction empowers clinicians to meet clients where they are, minimizing risks while supporting personal agency and autonomy This approach is particularly relevant for clients who use psychedelics outside clinical settings, allowing therapists to provide nonjudgmental care while maintaining ethical boundaries
Equally important is a trauma-informed framework, which recognizes that psychedelic experiences can unearth unresolved trauma. Trauma-informed care emphasizes creating a sense of safety, offering choice, and fostering empowerment throughout the therapeutic process. This approach helps prevent retraumatization and supports both emotional and nervous system regulation
Psychedelic experiences may also trigger profound spiritual or existential crises. Clinicians must be able to differentiate
between a spiritual emergency and a psychiatric condition such as psychosis, responding with cultural sensitivity and a capacity to hold space for clients in moments of transformation
Recognizing the significance of these states and integrating them respectfully into therapy is essential.
Because trauma is often stored somatically, body-based approaches can be especially effective in integration work. Skills such as tracking body sensations, grounding, and titration help clients process their experiences in ways that support nervous system regulation and deepen emotional integration
Collectively, these competencies form the foundation of safe and responsive psychedelic integration care
Consider Jane, a client experiencing anxiety and depression following a traumatic ayahuasca ceremony In one scenario, Jane's therapist lacks trauma training and encourages verbal exploration without attending to her dysregulated nervous system. Jane becomes overwhelmed, feels unsafe, and eventually terminates therapy.
In contrast, a well-trained therapist recognizes Jane’s trauma cues, establishes safety, and uses somatic and mindfulnessbased techniques to help her process what surfaced during the ceremony This trauma-informed, embodied approach supports healing and encourages Jane to re-engage with therapy
Competency development is not a one-time training. The evolving nature of trauma research and psychedelic science requires clinicians to pursue ongoing education, supervision, and reflective practice. Training must also be tailored to specific populations and contexts, acknowledging that a one-size-fitsall approach can undermine cultural nuance and client safety. Without these competencies, therapists risk doing more harm than good. But when integrated into professional development, they form the backbone of safe, ethical, and transformative care
Psychedelic integration therapy is a rapidly evolving field that demands a commitment to ongoing learning, ethical clarity, and cultural responsiveness To support clients safely and effectively, mental health professionals must invest in continuous education, engage in ethical referral practices, develop cultural humility, and utilize supervision and consultation
Continued education is foundational. Clinicians should seek out specialized training such as the UC Berkeley Psychedelic Facilitation Certificate Program, which emphasizes culturally sensitive, relational approaches to integration. Supplementing formal training with scholarly literature, like the integration
guidelines developed by Greń et al (2023) can deepen understanding of both clinical frameworks and ethical responsibilities Participating in professional communities of practice also allows therapists to stay informed about emerging research and to exchange insights with peers.
Ethical referral practices are equally essential. Practitioners must ensure clients are fully informed about the legal status, risks, and potential benefits of psychedelic experiences, and be prepared to refer them to more qualified professionals when appropriate Culturally informed referrals should match clients with providers who can attend to specific cultural or spiritual needs, especially for marginalized populations Therapists should also remain mindful of professional boundaries, particularly when discussing personal experiences or when touch arises in integration settings.
Cultural humility must be at the heart of integration work. Therapists should engage in intersectional training that addresses racism, privilege, and oppression, especially when working with clients of color Respecting Indigenous practices and acknowledging the traditional roots of many psychedelic substances can help prevent cultural appropriation and foster a more ethical therapeutic environment
Finally, supervision and consultation are critical for maintaining safe and effective care. Models such as EMBARK, which center the participant’s experience, offer helpful frameworks for guiding integration work (Brennan & Belser, 2024). Connecting with experienced consultants ensures that therapists can navigate complex client presentations and respond skillfully to challenging or adverse outcomes
As the field grows, it is essential that counselors approach psychedelic integration with thoughtful preparation and ethical rigor. By grounding their work in education, humility, and collaboration, clinicians can help clients turn powerful experiences into meaningful, lasting transformation.
Conclusion
As interest in psychedelic integration therapy continues to grow, mental health professionals are faced with an ethical imperative: to ensure that their knowledge, skills, and practices are adequate to meet the complex needs of clients navigating these powerful experiences. Without proper training and ethical guidance, well-intentioned care can inadvertently cause harm, undermine client autonomy, or perpetuate cultural insensitivity.
Psychedelic experiences have the potential to catalyze profound healing, but only when integrated through safe, competent, and ethically grounded therapy. This work requires more than
enthusiasm it demands clinical rigor, cultural humility, and a commitment to ongoing professional development
Mental health counselors in Florida and beyond are uniquely positioned to lead this effort. By pursuing education, seeking supervision, and engaging in ethical advocacy, clinicians can help shape the future of psychedelic integration in a way that honors both the science and the soul of this work. FMHCA members are encouraged to take an active role in developing responsible integration services, both to support their clients and to uphold the integrity of the counseling profession
References
Brennan, Bill, and Alex Belser, EMBARK Psychedelic Therapy for Depression: A New Approach for the Whole Person (New York, NY, 2024; online edn, Oxford Academic, 6 Mar 2024), https://doi org/10 1093/9780197762622 001 0001, accessed 9 June 2025
Earleywine, M., Low, F., Lau, C., & De Leo, J. (2022). Integration in Psychedelic-Assisted Treatments: Recurring Themes in Current Providers’ Definitions, Challenges, and Concerns. Journal of Humanistic Psychology, 0(0). https://doi.org/10.1177/00221678221085800
Greń J, Tylš F, Lasocik M, Kiraly C. Back from the rabbit hole. Theoretical considerations and practical guidelines on psychedelic integration for mental health specialists. Front Psychol. 2023 Oct 12;14:1054692. doi: 10.3389/fpsyg.2023.1054692. PMID: 37904908; PMCID: PMC10613493.
Pilecki, B , Luoma, J B , Bathje, G J et al Ethical and legal issues in psychedelic harm reduction and integration therapy Harm Reduct J 18, 40 (2021) https://doi org/10 1186/s12954-02100489-1
Written By: Minh Ngoc Ngo, LPC-IT
Minh Ngoc Ngo is a pre-licensed professional counselor and psychotherapist based in Superior, Wisconsin. She specializes in traumainformed care, integrating EMDR, somatic therapies, and psychedelic harm reduction and integration. Minh Ngoc works with individuals navigating anxiety, PTSD, spiritual crises, and complex trauma. She currently provides therapy through her private practice, the Mind-Body Program, and is pursuing her Ph.D. in Counselor Education and Supervision at the University of the Cumberlands.
Professional Experience Article
As a counselor educator, I witness firsthand the passion and dedication of students embarking on their journey to become Licensed Mental Health Counselors (LMHCs). I also see the significant economic hurdles they often face – from managing tuition and living costs to navigating unpaid internships and the eventual burden of student loans These financial pressures can be daunting, sometimes diverting talented individuals from pursuing or completing their path to licensure, especially in critically underserved areas However, I’m filled with renewed optimism thanks to recent legislative actions in Florida that promise to alleviate these burdens: the expanded Florida Reimbursement Assistance for Medical Education (FRAME) program and the new Training, Education, and Clinicals in Health (TEACH) Funding Program.
For years, the dream of becoming an LMHC has been intertwined with the reality of financial strain Many students juggle part-time jobs while undertaking rigorous academic coursework and accruing the extensive clinical hours required for licensure The period of internship, while invaluable for experiential learning, is frequently unpaid, forcing students to stretch resources further or take on additional debt. This economic reality not only impacts the individual student but also has broader implications for our communities, potentially limiting the number of counselors available, particularly those willing or able to work in Health Professional Shortage Areas
(HPSAs) where the need is often greatest.
The FRAME program offers a significant beacon of hope for licensed professionals Recently expanded, this initiative is designed to encourage qualified health care practitioners, including LMHCs, to practice in underserved communities by providing loan repayment assistance [1][3] For mental health professionals, this can mean reimbursement of 25% of their loan principal, up to a total of $75,000 over four years.[1] This is a substantial incentive that can directly reduce the long-term financial burden associated with graduate education, making it more feasible for counselors to commit to working in areas that desperately need their expertise. The 2025 application cycle is already underway, closing May 30, 2025, and while it includes a new 25-hour volunteer service requirement, the potential for significant loan reduction is a powerful motivator.[1][3][4][5]
Complementing FRAME is the TEACH Funding Program, set to take effect on July 1, 2025. While FRAME assists post-licensure, TEACH addresses a critical period during training. The TEACH Act will reimburse qualified facilities – such as community mental health centers, federally qualified health centers, and other non-profits serving low-income patients in HPSAs – for costs associated with training students. Specifically for "behavioral health students," this reimbursement is set at $15 per clinical training hour provided by the facility
From my perspective as an educator, the TEACH program is a game-changer for student interns While the funds go to the facility, this initiative directly encourages these vital community sites to open more internship slots and potentially offer stipends or cover supervision costs. By offsetting the financial and administrative load on these training sites, we can expand the availability of quality clinical placements. This means students may have more opportunities to gain experience in diverse settings, particularly those serving Medicaid recipients and underserved populations, without the added stress of finding sites that can afford to host them. It allows students to focus more on their learning and client care, rather than solely on the financial viability of an internship placement
Together, the FRAME and TEACH programs, as part of Florida's broader "Live Healthy" initiative, create a more supportive pathway into the mental health profession.[5][7] FRAME helps alleviate the debt that can deter counselors from working in public service or underserved areas, and TEACH helps open the doors for students to gain the necessary experience in those very settings. This synergistic approach can significantly reduce the economic barriers that have historically existed. As counselors and counselor educators, we have a role to play in ensuring aspiring counselors and students are aware of these opportunities and are prepared to navigate the application
i ifi i
by the state in our profession and in the mental well-being of Floridians [4] It’s a heartening development that acknowledges the vital role of mental health counselors and takes tangible steps to support the next generation, enabling them to build sustainable careers while serving our communities most in need. While more is needed, this is a promising advancement for mental health counseling in Florida.
Sources 1 floridahealth gov 2 fdohframe com 3
atlanticbehavioral com 4 govdelivery com 5
flboardofmedicine gov 6 floridasnursing gov 7
hipaajournal com 8 flsenate gov 9 flsenate gov 10 wqcs org 11 wildapricot org
Written By: Bethany R. Russell, Ph.D, LMHC, RPT, NCC
Dr. Bethany R. Russell is an Assistant Professor in the Department of Counseling at Florida Gulf Coast University. She specializes in play therapy, sensory processing sensitivity in children, trauma-informed care, and family systems approaches. Dr. Russell maintains a private practice in Babcock Ranch, Florida, where she supports children, adolescents, and families experiencing mental health concerns Her research focuses on change mechanisms in play therapy, integrated behavioral health in pediatrics, and the applications of artificial intelligence in mental health treatment
Provided by Committee Chairs
Get Involved! View all of FMHCA’s Committees here.
Registered Intern & Graduate Student Committee Committee Chair: Laura Peddie-Bravo, LMHC, NCC
Greetings! As a reminder, this committee is dedicated to the interests, concerns and needs of graduate students and registered interns New: you can now invite a friend or colleague to a meeting and that person can attend up to two meetings this year for FREE! Also, we are now meeting regularly on the fourth Thursday of each month from 11:00 am – 11: 59 am FMHCA has migrated to the Zoom platform, and our new monthly meeting link is linked here.
In May, we welcomed our first guest speaker, Kerry Conca, LMHC, and FMHCA’s Southwest Regional Director. She shared what the role of Regional Director is and shared her expertise with Psychodrama. Our next guest speaker will be Dr. Aaron Norton for the July meeting, which will take place during FMHCA’s annual Summer Bash What is FMHCA’s Annual Summer Bash? “Join us for our 2025 Annual Summer Bash, scheduled from July 23rd to July 25th This virtual event series offers a variety of sessions tailored specifically for master's level counseling graduate students and Registered Mental Health Counselor Interns. We have curated a lineup of community leaders, speakers, and organizations to impart invaluable knowledge and expertise, helping you build a strong professional foundation for your counseling career.” You can learn more, obtain the schedule, and register for Summer Bash at the following link: 2025 Summer Bash Due to The Summer Bash, our July meeting will take place Thursday, July 24 from 2:00 pm – 3:00 pm. th
Last but not least, congratulations to our committee co-chair, Jessi Broom! She graduated from FAU in early May, and she is a Registered Mental Health Counselor Intern! She is now a Registered Intern Co-Chair alongside Lauren Malone. This means we have an opening for a Graduate Student co-chair. To be a co-chair, one must be a FMHCA member in good standing. To be considered for the position, please contact either Laura Peddie-Bravo, Lauren Malone, or Jessi Broom at Office@FLMHCA.org.
We hope you will join us for our next regularly scheduled meeting which will take place on Thursday, June 26 11:00 am –11:59 am th
Military Committee
Committee Chair: Maria Giuliana, LMHC, QS
Strengthening Our Ranks: Military Cultural Competency and Community Care
As mental health counselors, we know that cultural humility and shared understanding are cornerstones of effective care. For those of us serving veterans, active-duty service members, and military families, developing deep military cultural competency is not just an asset it’s an ethical imperative.
In our recent May 29 Military Committee meeting, FMHCA members came together to:
Review policy shifts impacting military service (e g , transgender-service restrictions, gender-affirmation care rollbacks, VA community-care streamlining).
Discuss practice challenges, including referral patterns, copay changes, and expanded weekend treatment hours. Identify training needs around moral injury, transgenderinclusive care, and contemporary deployment experiences.
These conversations underscored a vital truth: no single clinician can navigate the complexities of military mental health in isolation Whether you’re new to working with veterans or a seasoned practitioner, connecting with peers brings fresh perspectives, real-world case insights, and shared resources that enhance client outcomes
Bridging the Civilian–Military Divide: Military service entails unique stressors rigid hierarchies, missionfocused psychology, deployment trauma, and reintegration challenges An informed grasp of military life fosters trust, encourages authentic disclosure, and accelerates therapeutic rapport
Enhancing Clinical Efficacy: Research consistently shows that culturally competent care leads to better engagement, reduced drop-out rates, and stronger treatment gains By understanding military vernacular (e.g., “the deployment bubble,” “unit cohesion”) and systemic structures (e.g., Tricare, VA community-care pathways), we tailor interventions to our clients’ lived realities.
Advocacy & Collaboration: Counselors with militaryspecific expertise become invaluable patient advocates
navigating VA documentation requirements, educating interdisciplinary teams, and informing policy discussions
Moreover, sharing best practices through networks like FMHCA’s Military Committee amplifies our collective impact.
Join Us July 31: Share, Learn, and Grow Together
We invite all FMHCA members from emerging clinicians to veteran-serving specialists to our next Military Committee meeting:
Date: Thursday, July 31, 2025
Time: 12:00 PM ET
Location: Zoom (link to be provided via email)
What to Expect:
Brief policy update on VA community care and pending budget negotiations
Peer-led discussions on moral injury interventions and trans-affirmative military care
Breakout rooms for case consultation and resource sharing
Opportunities to connect with counselors who share your passion for serving military populations
Note: Our Military Committee meets on the last Thursday of every month mark your calendars for ongoing professional support and collaboration
Help us build a robust community of military-competent counselors dedicated to excellence in care. See you on July 31 at 12 PM ET, and each month thereafter on the last Thursday!
Ethics Committee
Committee Chair: Melissa Riesgo, LMHC
My name is Melissa Riesgo, LMHC, and I am honored to serve as the new Chair of the Ethics Committee for FMHCA. It is a privilege to take on this important role, and I am committed to promoting the highest standards of ethical practice across our profession.
Since the start of my term, our committee has already had the opportunity to respond to several member inquiries These early interactions highlight the ongoing need for clear guidance and support when navigating ethical concerns in our work. Please know that the Ethics Committee is here as a resource for all FMHCA members. Whether you are facing a challenging situation, seeking clarity on professional boundaries, or simply looking for reassurance, we are here to help answer your questions and point you in the right direction.
Our first official committee meeting is scheduled for Friday, June 27 I am looking forward to collaborating with a team of dedicated professionals who share a strong commitment to
Facilitator: Maria Giuliana, LMHC, QS
Note: The EIC Collaborative is not an official standing FMHCA committee but a member-requested support initiative.
In our rapidly changing social landscape, counselors committed to serving marginalized populations must continually refine their skills, expand their networks, and strengthen their resolve.
On May 30, FMHCA’s Equity, Inclusion & Community (EIC) Collaborative convened via Zoom for a focused session that underscored the vital role of peer collaboration, mutual support, and cultural competency in our work
The meeting opened with an honest look at the emotional toll of holding space for anxious clients while navigating our own stressors Attendees shared practical approaches to:
Boundary-setting around news and social media
Creating calm home environments as “emotional sanctuaries”
Cultivating self-care routines to sustain resilience
By normalizing these conversations, the Collaborative fosters a culture where counselors can ask for help, share tools, and remind one another that self-care is foundational to client care.
A core theme was the unique challenges facing transgender clients in both civilian and military contexts job insecurity, discrimination, and gaps in organizational support. The group highlighted the necessity of:
Ongoing cultural-competency training tailored to trans experiences
Resource-sharing of best practices for affirming care
Advocacy within agencies to improve trans-inclusive policies
Through these discussions, the Collaborative advances
FMHCA’s mission to ensure all clients receive informed, compassionate support.
Participants examined troubling societal shifts and their downstream effects on the mental health of marginalized communities. By bringing these macro-level concerns into conversation, the EIC Collaborative reminds us that competent counseling demands awareness of broader cultural and political forces
Cuts to essential programs like Medicaid, school-breakfast initiatives, and public education sparked dialogue on the
widening inequality gap Counselors shared insights on:
Advocacy strategies to protect community services
Collaborative partnerships with social-service agencies
Creative interventions to buffer vulnerable clients from systemic harm
Fostering Community & Forum Engagement
Finally, the group tackled the underused FMHCA member forum, envisioning it as a dynamic hub for:
Case consultations and peer feedback
Resource libraries on equity and inclusion
Announcements for upcoming workshops and trainings
Elevating this digital space will deepen our collective expertise and reinforce connections beyond monthly meetings
Looking Ahead: Upcoming EIC Meetings
To accommodate FMHCA’s Summer Bash, the July session has been rescheduled to Friday, August 1, at 12:00 PM ET. Thereafter, the EIC Collaborative will meet on the last Friday of each month at 12:00 PM ET via Zoom
Whether you’re seeking fresh perspectives on working with marginalized groups or eager to contribute your own insights, these gatherings are your invitation to grow alongside fellow counselors dedicated to equity, inclusion, and community. Mark your calendars and join us as we continue building bridges for better mental health care.
Joining a committee is a great way to participate in FMHCA and increase your presence in our community. We have several committees that we would love you to participate in! Below is a list of all our committees and their chairperson.
We invite you to contribute your efforts as there are numerous opportunities for you to get involved and make a difference. For more information on how to participate right away, please contact the chair committee or fill out this form.
Self-care is an important aspect of being able to manage all that life throws at you. From my experience, I have learned that selfcare is unique to each individual based on their own definition and practices. When I counsel clients, I often work to impress upon them the importance of self-care as they learn how to use adaptive coping mechanisms to manage their symptoms. For many, self-care involves spending money to attain something that helps to ease whatever ills you have or to manage life’s stressors. However, it is much more than that. I have found from working with clients and interacting with individuals throughout my time in the military, my career as a teacher, and just living life, self-care can take any form.
The concept of self-care does not have to mean spending money on clothes, taking expensive vacations or trips, going out to eat, shelling out money for a manicure, pedicure, or massage, or even getting your hair done. It could also be as simple as carving out at least 10 minutes in your daily routine for yourself. What you do with that time is what you choose to do. Some options could be reading a book, going for a walk in the park, at the beach, or even for a hike. For me self-care involves listening to music, whether it be country, classical, gospel, worship songs, or good old R & B music. Sometimes it is just having a cup of tea in a coffee shop and people watching
The key thing about self-care is to be intentional about the time you carve out for yourself. As a therapist who specializes in working with trauma survivors, I have found that it is important for me to take a break and go for walks when I start feeling the strain of carrying the burdens of trauma clients I see
between every three or four sessions It gives me a chance to process and de-stress, shaking off any potential transference that might have occurred, as well as to prepare my mind for the rest of the day. I literally add time to my daily calendar and call it “Me Time.” In that time, I do whatever I want to do, except work, because it is important to have that down time to reflect and refill your cup. This practice has been very helpful for me in maintaining focus when I see the next client and staving off burnout. I often feel more relaxed and ready to tackle whatever is left on my agenda that day.
Engaging in self-care is as important for you as it is for your clients As therapists, sometimes we forget that we need to take care of ourselves because we are so intent on helping others heal. Our heart for helping should not diminish our own needs, though. It is important for us to keep our cups full to overflowing, so the excess can be used to help others with whom we cross paths. Self-care is foundational to our ability to reflect and meet our own needs, so we are not depleted. I often use the analogy of putting on your mask first in an airplane emergency as an example of how critical self-care is to survival with friends, family, and clients. It is also something I tell myself often because I need to be 100% secure in myself and in my ability to help others, so I do not try to find that security in success and other people.
By incorporating self-care in my routine, I feel more energized and ready to face any challenges that might arise in counseling sessions and in my own personal life. No matter what form engaging in self-care takes, it is an important tool to use in your daily lives to stave off feeling overwhelmed and stressed, as well as any potential imposter syndrome one might feel. Self-care is critical in improving your mindset and your mental well-being. So, take the time to add this practice to your calendar. For me, it has been an essential implement in my counseling toolkit, maybe it can be for you as well.
Written By: Paula Robinson EdD, LMHC, LPC, NCC, BC-TMH, C-DBT, CCTP
Dr. Paula Robinson is an Army veteran.
She is a nationally board-certified LMHC (FL) and LPC (AZ) who uses CBT, DBT, and person-centered therapy in her work with trauma survivors Dr Robinson holds a bachelor’s in psychology, master’s in Clinical Mental Health Counseling, and Doctorate in Education: Traumatology. She is also a certified trauma professional. She is active in the American Counseling Association, National Board for Certified Counselors, and American Association of Christian Counselors.
FMHCA Member Questions Answered by President and Managing Partner of The Health Law Firm, George F. Indest, J.D., M.P.A., LL.M.
AQAs a Qualified Supervisor, can you bill insurance using your credentials for your supervisees / Registered Mental Health Counselor Interns?
Yes, as long as your contract with the paying insurance company does not state that it is prohibited In the case of a Medicaid managed care insurance company, this is allowed by Medicaid laws and guidelines
It is probably better to have a group provider number, and make sure the intern is signed up as a provider within the health insurance company and with the Medicaid Program, with their provider number re-assigned to the group The group should then bill for the services
AQWhen treating a minor child of divorced, separated or never married parents, what type of consent is necessary and from whom? and services.
Unless there is an order from a court providing otherwise that you are aware of, each parent of a minor child is considered the natural guardian of a minor child Either parent can sign a consent form and authorize any and all care
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.
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When I first entered the field of mental health over a decade ago, I thought the most important part of being a therapist was mastering theory learning every acronym, memorizing every treatment modality, and becoming fluent in the language of evidence-based practices I believed my effectiveness would hinge on technical expertise, and that each CEU I earned would somehow complete the puzzle of becoming a “real” therapist
But ten years in, I’ve come to understand something more profound: being a mental health counselor is just as much about growing as a person as it is about growing as a clinician.
Working with clients over time has provided me with a mirror a chance to look inward, examine my own thoughts and patterns, and develop the kind of emotional insight I once believed was only necessary for the people sitting across from me. The therapeutic space, while grounded in clinical skill, is also deeply human. We bring our full selves into that room our energy, our awareness, our blind spots and whether we like it or not, who we are shapes the work we do.
What I’ve learned is that being a person-centered, well-rounded therapist matters just as much if not more than simply being a highly trained one When you’re present and grounded in your own emotional life, you’re better able to hold space for someone else’s That doesn’t mean you need to be perfect or “healed” in every way But it does mean staying curious about your own growth process, being willing to confront discomfort, and practicing the same level of compassion for yourself that you offer your clients.
Early in my career, I was drawn to the idea of choosing a niche; Many therapists are Specialization offers a clear identity, a target population, and a sense of mastery It’s incredibly valuable, and for many clinicians, it becomes a calling But for me, the idea of narrowing my practice felt restrictive I worried that doing the same type of clinical work over and over could become monotonous, or worse... emotionally exhausting. Burnout, I realized, isn’t always about too much work. Sometimes it’s about too little variety.
Instead, I found that I thrive when working with a diverse range of clients I enjoy the challenge of adapting my approach to fit each person’s unique experience Some days, I’m using CBT to help a teenager manage panic attacks Other days, I’m drawing on narrative therapy to support a trauma survivor in reframing their story. Having an eclectic toolkit bolstered by ongoing CEUs and professional development which allows me to stay flexible, creative, and open-minded in session.
That variety has been one of my greatest teachers. I’ve learned just as much from clients navigating grief, identity, chronic illness, or relationship struggles as I have from any textbook. Each session is a reminder that human suffering doesn’t fit neatly into diagnostic boxes and healing doesn’t either.
Of course, continuing education is still essential We owe it to our clients to stay informed, ethical, and competent But I’ve come to believe that no modality is effective unless it’s delivered with genuine empathy, presence, and self-awareness Therapy is not just something we do it’s a relationship we build And relationships, at their best, are mutual Even in our professional roles, we are shaped by those connections.
As I reflect on my path, I’m grateful for the technical skills I’ve developed but even more grateful for the personal growth that has accompanied them Being a therapist has helped me become a better listener, a more patient friend, and a more grounded human being. The work we do is sacred. And when we let it change us for the better, everyone benefits our clients, our communities, and ourselves.
Written By: Brandi Hedges
Brandi Hedges-Hubert, MS mental health counselor
in Carolina, South Carolina, a She works with individuals and couples using an integ centered approach drawin mindfulness, and solution specializes in treating ADH and sexualized behaviors. affirming care ensures eac personalized treatment pla needs and goals.
Professional Experience Article
Last year, my partner and I experienced a miscarriage at ten weeks. What had been an exciting and fun roller coaster, came to a screeching halt, leaving us heartbroken and confused. As a mental health therapist, I understood the importance of validating and normalizing the emotions, but no amount of professional experience could have prepared me for the depth of grief that followed.
When I first started to feel discomfort, like many of us, I turned to the internet for answers. What I found at the time was confusing, with some sources describing miscarriage as relatively common and others presenting it as a rare outcome. My symptoms were framed as either completely normal or very concerning. When I called my doctor’s office, I was told to go to the hospital if symptoms became “severe,” only leaving me to contemplate what “severe” may look like. Once the miscarriage was confirmed, the hospital staff compassionately explained that these experiences are, in fact, quite common. That we had done nothing to cause it and nothing we could have done would have prevented it Still, knowing the facts did not make the emotional impact any easier to navigate After nearly a year of trying and consistent disappointments, the loss felt shocking and overwhelming
In the days that followed, I shared our experience with close
friends and family To my surprise, so many people responded with their own stories of loss My mother, a close friend, colleagues, even friends of my partner empathized with him, almost like when someone finally leaves their toxic partner and everyone suddenly shares all the honest opinions they’d been too polite to say before. Nevertheless, their vulnerability helped me truly begin to heal. Hearing “I had a miscarriage, too,” was painful but comforting, because it was a clear reminder that no matter how much it may feel that way, we were not alone in our grief.
It also became a little clearer to me how rarely these experiences are discussed at all Understandably, many of us avoid thinking about the worst-case scenarios, we are told to think positively In therapeutic settings, we often encourage clients to manage their anxiety and worries by reframing their thoughts, but avoiding difficult possibilities doesn’t make them go away. It makes us unprepared and when loss does occur, that silence can deepen the sense of loneliness and despair.
I’ve wanted to write this piece since our experience, to help spread compassion and awareness Miscarriage is more common than many people realize and a greater openness and discussion might ease the burden for others going through it It’s okay to consider all possible outcomes and to prepare emotionally for uncertainty. Miscarriages can occur suddenly and inexplicably, and while they can shake your world, they do not define your worth, your future, or your ability to parent.
Today, my partner and I are preparing to welcome our first child. Though I wish no one had to go through the pain of miscarriage, I can say that our experience brought us closer together and prepared us in ways I could not have imagined at the time I know that not every journey continues the same way, but I hope our story helps others feel seen so they may also feel heard You did nothing wrong You are not alone And healing is possible
Written By: Stephanie Danilov, LMHC
Stephanie Danilov is a licensed mental health counselor with a warm, insightfu and empathy-driven approach grounde in compassion, emotional attunement, authenticity. She integrates CBT, mindfu trauma-informed techniques to suppor life transitions, trauma, and emotional Drawing from both clinical and lived ex believes in the healing power of vulnerability, connection, and honest conversations
