The Practice of Therapy

Gordon Brewer:
Well hello over one and welcome again to the practice of therapy, podcast and lumps. I'm happy to have with me today, Rebecca toner and Rebecca is another one of those great people that reached out to me and we started chatting. And I'm glad to have you on the podcast, Rebecca,
Rebecca Toner:
Glad to be here. Thanks for having me.
Gordon Brewer:
Yes. And I know that this topic is going to be one that I'm, I know I'm interested in and I think it just kind of we'll have all have a lot of interest for people. And just thinking about support in that sort of thing during, during the whole COVID pandemic, even though, you know, it just kinda seems like old hat to say that anymore. It's because it's, it's just kind of sticking with us, but as I start with everyone, Rebecca, why don't you tell folks about your private practice journey and just kind of how you've landed, where you've landed?
Rebecca Toner:
So I have been in private practice for probably going on six years now. I started out as an independent contractor in other private practices and kind of just cut my teeth and got used to working in private practice that way. And then I caught the bug and decided it was time to go off on my own, rented my own office. I got super lucky. The area that I'm in my family was actually pretty well known. So I guess people trusted me and kind of started reaching out to me and it got so crazy. So fast. I had to open up a group practice within like probably four months of opening my doors and it just took off. So now have a group practice owner for about five years in change. And I also offer clinical supervision. I, I supervise in EMDR and just general people getting their hours or people just wanting to touch base about trauma and association. Cause that's kinda been the focus of my continuing education and I run a podcast.
Gordon Brewer:
Yes. Yeah. So tell, tell, tell, tell folks a little bit about your podcast as well.
Rebecca Toner:
Sure. so my podcast is called the supportive supervision podcast and it's basically geared towards supervision. Anything that I would have wanted to know in grad school or early on in my career and that I make sure I try to pass on to people. It's so it's kinda my way of extending that reach while also broadening horizons for people, especially new clinicians who might not be aware of all the cool ways we can be in this field and all the different creative things we can consult on and projects we can take on. And you know, it's not just in the therapy room,
Gordon Brewer:
Right? Yeah. I love that. I love that. And I think one of you know, as you were saying that I was reminded of when I was back in the day when I was going through my supervision process with one of my, my favorite professors from, from grad school, it just happened that he was also doing supervision for licensure. And I remember just all the conversations we had about going into private practice and, you know, if that would be a good fit for me or should I just continue working for an agency and all of that. And I think that's just a real important conversation for, for everyone to have, particularly in those early stages and just having that vision. But, you know, I think one of the things too, just about supervision is, is the support it gifts. And I think, you know, that's one of the things that is a theme that I think at least I picked up for you is just the importance of that support. You want to say more about that? Just you know,
Rebecca Toner:
Totally. So I think it's wonderful for clinicians to be connecting in general as long as it's authentic. And I think supervision is a really kind of homed way of developing as a clinician because you're teaming up with this person almost in a parallel way to therapy, to maybe work on a few goals and to just really hone in on that and drive your own career, however it's going to go. So folks often come to me to focus on I do a lot of ifs related supervision and a lot of trauma informed supervision because they haven't had that in general. They've had maybe more administrative supervision where it's, you know, let's get all our notes done and what's your percentages. And how can we retain clients who are clearly indicating they don't want to be there versus actually digging deep and doing trauma work and realizing this is what I, my self energy as the therapist is sitting with, and I don't know what to do with that and helping to kind of compartmentalize and use that to build rapport. That's a huge benefit.
Gordon Brewer:
Right? Right. Yeah. So what, I'm what I'm curious. I think I've shared, I shared with Rebecca, but also I think a lot of the folks in the audience know that one of the other hats I wear is I'm also a, an AAM ft approved supervisor. And so I love doing supervision with people and that sort of thing. And I'm curious from you, Rebecca, what, what do you find as kind of some common struggles that newer therapists run into in terms of just doing their clinical work and really learning how to hone their, hone their craft, so to speak?
Rebecca Toner:
Oh, that is a great question. I like that one. I think the thing I'm noticing the most is that so many clinicians are focused on doing it perfectly or doing it exactly by the book and that strips the human element a little bit for me because they're they're second guessing themselves rather than staying in the moment. And they're also trying to mold themselves to be maybe a little bit more like their supervisor rather than more like themselves with the information the supervisor has offered as tools. And I think clinical supervisors don't necessarily consciously do that, but it can definitely come across as like you're seeking me out for this service, so you should want to do it. Like I do it and that's not the case.
Gordon Brewer:
Right. Yeah. And that, that reflects, I think a lot of what I see as well. I mean, I had somebody asked me one time it was another podcast interview I was doing for someone else. And they asked me, you know, what, you know, if somebody were just starting out and to this whole realm of doing therapy and becoming a therapist looking back at your own career, how would you have done things differently? And I think it, it really just kind of echoes what you said, and that is learning how to be genuine with people and being yourself and developing your own style of doing, doing clinical work. Because I think ultimately it's, as we know, and, and the research backs this up, the, the number one predictor of the efficacy of therapy is the relationship between the therapist and the, and the client. And so being able to know how to hone that and create those relationships. Absolutely.
Rebecca Toner:
Absolutely. And I think folks today, like this particular generation of clinicians who are being, I say initiated by fire because of COVID-19 and, you know, they may be maybe internships were kind of taken out from under them. And now they're starting with like the extra layer of fraud syndrome or, you know, they used to have their supervisor directly available in an office and they could just turn around and be at their desk. And now they're doing tele-health and everything's by phone, and it's harder to reach that person. You know, these are folks who are also trying to get their chops diagnosing and creating treatment plans and doing the, in the moment work and manage crises and they're kind of getting it all
Gordon Brewer:
Right, right. Yeah. Yeah. So I know that, that, that would be a great segue into thinking about what, what, what sort of advice, or, or, you know, whatever would you offer to those that are just getting started. And like you said, I've gone through this, we're going, or we're still in the midst of it is the whole COVID thing and just really having to do therapy and practice differently. Yeah.
Rebecca Toner:
Definitely suggest for folks to invest in their own supervision slash I to say supervision slash consultation. So consultation is maybe like a one off. I have a couple questions on this one topic. This person can answer them. I'm going to pay them for their time. And we're going to do that. Supervision is more of a paid, ongoing relationship where, okay, if I'm a young clinician and I'm working at a community mental health agency, I'm probably getting supervision. And a lot of it's going to be administrative. And a lot of it's going to be very geared towards making money for the program very often. Versus if you're paying for somebody who provides clinical supervision, they're offering a different perspective, which is never going to hurt. They probably have multiple resources and you are their main concern. Your clients are their main concern. That's the program that they're working for, not okay, let's get your documentation under control, you're behind whatever. Like it's going to be more about the clinical process and what skills you can kind of.
Gordon Brewer:
Right, right. Yeah. So in your work with, with therapists what do you find has been most helpful to them in terms of supervision and, and what they, what seems to resonate with people? Because one of the things I'm thinking about is there are probably a lot of people listening to the podcast that might be in that phase of, okay, they're, they're in the process of getting licensed. There are there even, it may be even trying to figure out a niche for themselves of just kind of, okay, what, how do I want to focus my clinical work? What are some ways that people can figure that out for themselves?
Rebecca Toner:
I would definitely recommend, first of all, being part of online therapist groups, if possible. So getting on list serves Facebook groups are great because then you can expose yourself to people who specialize in so many different things. So somebody has probably already worked pretty hard to develop at least a niche close to yours. If you have an ideal client, if not your exact niche and you click, there's no need to reinvent the wheel, pay that person for their time and ask for their advice and see how can I get from where I am now to where you are, because that's what I want. And kind of gear the supervision towards that, where it's building a business, it's building up your own competence and it's also working on your clinical skills to help your clients, which is the foundation of good supervision.
Gordon Brewer:
Right, right. Yeah. And so what, what do you see as the stuck places for a lot of people? I mean, where do they, what do you notice with people in there as they're trying to do through their work, through their clinical stuff and work with clients in different areas, how do you see them getting stuck the most?
Rebecca Toner:
I think definitely confidence in diagnostics. So confidence in being able to assess a client document accordingly and decide between one diagnosis or similar diagnosis and why one or the other is more appropriate. Because often supervisors aren't in there to process that with clients or with clinicians who are brand new. So they're just kind of going with their gut. So, you know, people don't realize how good those gut feelings can be and they start second guessing themselves and they're overthinking it. And I also think the biggest thing that I noticed as a private supervisor is that people are made to believe that they're more dependent on their agency jobs than they are. And it's, it's almost like a really abusive marriage where like one partner is, is not allowing the other to get a hair cut or wear makeup, or do things for themselves to give themselves that confidence to leave. It's the same thing just on an agency's systemic level. Right,
Gordon Brewer:
Right, right. Yeah. Say more about that because I think that's again, just thinking about people that listen to the podcast, they're obviously, they're probably listening to this podcast because they're thinking about private practice in some way. And, and just really, maybe feeling a little bit scared about giving up the, what seems like the stability of an agency job to maybe move out on their own.
Rebecca Toner:
I think I've, I think every therapist I know in private practice has wrestled with that for a little while and something that I really work with, my supervisees, who are interested in private practice on, is realizing many of these folks are up for agency jobs. Who's, you know, maybe they're grant funded and those grants have to be renewed every year and they're biting their nails about not having a stable job anyway. So the stability is a story. Yes, there are other jobs out there, but also it doesn't need to be from zero to a hundred with something like private practice. It could be, can I build up slowly on evenings and weekends if that's, when I'm not working and, you know, can I start shaving off maybe using my PTO to shave off a couple hours from the shifts each week and take more clients, can I move from full time to part time, it kind of bridge the gap a little bit.
Rebecca Toner:
Right. And I think confident clinicians who do those things are ultimately people who want to be able to have that solid safety net. So they go out things that will help them form a niche. Like somebody like EMDR training, you could do EMDR and a million things, substance abuse you know, pregnancy loss, general trauma car accidents, things like that. And really honing in as specialty by getting a couple of different trainings that way will cause people to seek you out for that. Now you're like a beacon for your ideal clients because you're putting it all out there that you've just done me.
Gordon Brewer:
Right. Right. Yeah. Yeah. I like that, that way of thinking about that. And I think you know, like we had maybe mentioned a little bit earlier, just the importance of forming a niche and a specialty. Yeah. So I think what sort of guidance do you give along those along those lines with people?
Rebecca Toner:
I usually start with what they're just kind of naturally doing as an interest. So I've worked with some supervisees who are really interested in trauma and neuro diverse clients. So people with OCD ADHD, maybe some sort of traumatic brain injury, something like that autism type diagnoses. So I worked with a supervisee who specialized in that and we really worked on, how can we make you feel super confident in doing this? She knew a lot of this stuff already, but going to the trainings, getting certifications in what she already knew really doubled down at validated. Yeah. You'd know your stuff.
Gordon Brewer:
Right, right. Yeah. Yeah. I think that you know, and you had mentioned earlier, just, I think one of the things that happens is people can get caught up in that whole imposter syndrome of just not really recognizing what they do know. You know, that was a, it's interesting because I had a conversation with my staff earlier, and I've got one particular staff or member who's a newly minted therapist and that she's, she's working towards licensure and just graduated. And, you know, I think it's important to remember the, you know, those of us that are therapists are, are, you know, we're, we're in a category kind of our, on our own and that we've gone through the training and we have the knowledge and, and we've put the time in, in terms of graduate school and, you know, doing your, your practicums and your internships and all of those, all of those kinds of things are you, you shouldn't discount those things. And so I think somehow or another, one of the things that not to get on too much of a soap box, that's kind of broken in our training system in our academics is that there's this, this kind of, this pretense has put out there's that, unless you've done so many put in all this time, or you put in all these have all these credentials or whatever, then you're not a value. And I think that's one of the big things. That's hard for a lot of people to overcome.
Rebecca Toner:
Totally, totally, completely agree. I lived my life on that soap box, I think because there's, there's a lot of systems within our educational system internships, practicums, and beyond that really undermine confidence and undermine that individuality. So honestly, one of the first things I really focus on in order to build a solid foundational relationship with my supervisees is to let them realize, like, you don't have to be a full time expert in everything, but you are an expert in how you do therapy. So what tools can we give you to help you really believe that you're there.
Gordon Brewer:
Right, right. Yeah. Yeah. I think that's, that's so important. So, yeah. So, so to switch gears a little bit, I know one of the things that you've you've done is really kind of branched out not only from private practice and doing supervision in that context, but really you've kind of developed kind of a whole kind of business kind of separate from just doing traditional therapy around supervision. You want to talk to some little bit, a little bit more about how that developed for you and yeah, just how you've done that.
Rebecca Toner:
Sure. so I've really spent a lot of time noticing what I felt was missing or not clear from some of my training and wanting to be the person who is holding herself responsible for answering those questions and staying on top of that information because no one gave it to me, even things like starting a private practice, I was not given any clue of that. And really, it didn't seem like a possibility at all when I was in grad school or beyond. I think there were folks who had vested interests in new clinicians, not knowing that information. So I wanted to really hold myself accountable to putting that information out there, making it easy for other people to come by because I had to learn everything the hard way. And I did it by myself and I don't want anyone to have to feel like that because so much easier in so many ways.
Gordon Brewer:
Right, right. The same as exactly true for me, because I know when I started thinking about private practice, you know, fortunately now we've got lots of resources available and lots of information about that, but there was little or none. And so, yeah. And I think that's, you know, and I think that that's one of the things that I think for people thinking about private practices that there's, you know, now more than ever, there's just a great opportunity to be able to do that. Rebecca and I were talking before we started about just how busy we've gotten, you know, here lately. And I know that was I'm in the process at my old practice or trying to hire some more therapists because we can't with the volume of calls that we're getting. We don't have a place to put people. And so that's a, it's a nice problem to have, but again, you know, just learning all those things around how do you start a group practice and, and that sort of thing, you know, fortunately I've been able to learn those things, but yeah. So you want to say more about that just about yeah. Just about the helping people learn, the stuff that they need to learn about going into private parts.
Rebecca Toner:
Yeah. I feel like everybody's view of private practice and what that would be like is different everyone's goals around it are different. And so many capable clinicians end up staying in jobs they hate or leaving the field entirely rather than going into something like private practice that would really be such a good fit for their lives. And it's because of that fraud syndrome. So to me, consulting about opening a private practice and clinical supervision, if that's a goal for someone they go hand in hand because so much personal stuff comes up when you're opening a private practice that no one warned me about like, even something like the setting is like, wait a minute, I get to decide how much I'm worth. And no one has ever given me that kind of validation before it's very Stockholm syndrome. And so helping overcome that process before any steps are even taken with the value of hindsight is a huge value for me.
Rebecca Toner:
And especially now because I really, I firmly believe we're going to spend the rest of our careers, helping people come through COVID and all of its implications and all the fallout. And I hope that more grants will be given to private practices like ours, to be able to hire pre-licensed and provisionally, licensed staff or laws will change, or because we're going to have a clinician shortage very soon, very soon. And I think we're really going to need these folks who are interns that we maybe haven't been able to hire or because of, you know, just the way laws and insurance are kind of structured right now.
Gordon Brewer:
Right, right. Yeah. And that's why, yeah. And that's exactly one of the problems I'm running into now and that I need to hire somebody that's already licensed because of the insurance demand for that. And if, if the laws were to change some around that, and there were some loosening around that, I think there would be that would be huge because I'm really, you know, there, there's a, there's a shortage, like you said, of mental health providers and, and I think being able to find ways to work around that in creative ways. Yeah. So, yeah, that's a such an important thing. And, and like I've said before now more than ever is a great time to go into these careers, particularly if you, you feel compelled or feel called to do that because it's it's a, it's a wonderful growing time for this, this profession. Yeah,
Rebecca Toner:
Absolutely. And it's totally okay to learn on the way down. Right. You can learn to fly on the way down. Right. Ample, like every therapist I know is so, and, and social workers and counselors too, are just so passionate about what we do. It's, it's impossible to talk to one of us and not be reignited, and this is why we need each other. We have to be able to borrow energy.
Gordon Brewer:
Yes. Yeah. Yeah. It's so important to draw and supports. And, and I would say if you're, if you're going into private practice, don't try to do it too much alone. I think that's one of the things I learned along the way, and that, you know, as we, we talked about just a minute ago is you know, there wasn't that much information when you, and I probably started thinking about going into private practice, but I would definitely say that would be, get a mentor, get a supervisor and get a, get a coach, whatever you want to label that, to help you go through that process because it'll make it so much easier for you along the way.
Rebecca Toner:
Yeah. And you'll feel more confident right out the gate. If you hire someone who helps you get really clear on your vision, what you want to do, how you want to package it and who you're talking to and where to, because that's something every single one of us has had to do. So, and I didn't know anything about that. I knew how to make a treatment plan and trauma really well, but I didn't know how to translate that back out into the world. Right,
Gordon Brewer:
Right. Yeah. Wow. Well, Rebecca, I know this is something that we could talk about probably four hours and that's usually how it goes, but but anyway, I'm so grateful for you for being on the podcast and I want to be respectful of your time, tell folks how they can get in touch with you and a little bit more about your website and your practice and, and that sort of thing.
Rebecca Toner:
Sure. so my website is supportive supervision.com and that's where you can also find links for all the show notes for the supportive supervision podcast. You can follow me on Instagram at supervision underscore podcast. And you can also find me if you just email me rebecca@supportivesupervision.com.
Gordon Brewer:
Okay. Awesome. And we'll have links in the show notes and show summary for all those things. And so while Rebecca hope where we can have a conversation again, this was great.
Rebecca Toner:
Absolutely. I enjoyed it. Thank you so much. Thanks for being on the podcast. Thanks for having me.