10 Lessons I’ve Learned in My First Year as a Licensed Therapist
Reflecting on key takeaways one year post-licensure as a therapist
June 1st, 2024 I officially got licensed as a licensed professional clinical counselor (LPCC). Which in Minnesota, is fully independently licensed. I’ve been thinking a lot about my road to get here. My road towards licensure was long and rough, filled with several tears and self-doubt. A story that would be best served on it’s own. Along with this, I’ve been reflecting on all the things I have learned through my work. There has been many things that I either found insight in or had my perspective shifted. All lessons that have been formed through my own professional development. In this article, I'll delve into the key insights I've gained one year post licensure and how they continue to shape my work as a helper. Join me as I share the wisdom that has emerged from my journey, offering valuable perspectives for aspiring clinicians and anyone interested in the world of mental health.
10 Key Takeaways
Validation is a big motivator for change.
The more I work in this field, the more I realize how much people want to be heard and seen. While someone might have supports in their lives, it doesn’t guarantee they are truly being listened to, let alone heard. I could give insightful knowledge or use an effective therapy tool, but often I see it not applied without the presence of validation. There is power in validation beyond being a motivator for change, it can help the client feel safe, seen, and decrease hypervigilance.
If we think about therapy like building a safe and durable home, I would say validation lays the foundation.
Support systems can be built.
I have often heard from my clients that I am the only person they feel they can talk to. Several clients seek therapy not having a current support system. Instead, they might come from abusive families and are estranged from them. Equally, they may be in an abusive relationship, don’t have supportive friends, or a community. It is not uncommon for people who have experienced trauma to have a severe lack of support system. Whatever the reason for their lack of support system—it can be built. A community of people who are validating, empathic, and supportive can be found.
It is hard to flourish in harmful soil.
When people are in abusive, neglectful, and toxic environments, it causes an immense amount of stress and dysregulation. Most sessions may be focused on the current crisis. I use this as an opportunity to work on psychoeducation, coping skills, and identifying things inside and outside of their control. When your body is so dysregulated, hypervigilant, and activated due to constant distress, it is incredibly hard to address past trauma or other goals.
If we think about the client like a plant, it is incredibly hard for them to grow in toxic soil. We can’t address the roots until the soil is healthy.
“You can’t grow in the same soil that poisoned you.”
Identify which stage of change the individual is in.
When I explore with clients problem solving that is met with resistance I say, “It sounds like you aren’t ready for this change” and more often than not they agree to not being ready. In these moments I show the client the cycle of change diagram. Identifying what current stage they are in and further exploring this opens a lot of doors. People who feel unsafe may not be in the action stage-mentally, physically, or environmentally. Things that would make them feel safe can be further investigated. Pulling from Internal Family Systems (IFS), different “parts” can be in different stages of change. Identifying the client’s “parts” and where those “parts” are in the stages of change offers further insight and activation in the therapeutic work.
When feeling burnt out, lean into the basics of therapeutic skills.
In graduate school, we read, On Being a Therapist by Jeffrey A. Kottler. He explained that feeling burn out isn’t an “if” but rather a “when.” He discussed how maintaining self-care and boundaries are vital, but he offered another tool. Often when we are feeling burned out, we struggle with clients to find the right modality or profound insights. He suggest going back to focusing on basic therapeutic skills. This involves honing in on skills like, empathic statements; paraphrasing; summarizing; using open ended questions; immediacy; and good sentence starters. This was the most important thing I took from that book. When feeling burned out, refining these skills and using Socratic questioning has helped both me and my clients. I definitely see a positive shift.
There is not a “gold standard” therapy modality.
A lot of therapy modalities say they are the best or the leading intervention in the field. They will say, “This is the gold standard” for x, y, or z diagnoses. As I spend more time in this profession, I notice an endless cycle of advertisements for “the new gold standard of therapy,” which often turn out to be just costly training programs. Our field is relatively young and constantly evolving, with new techniques emerging regularly, many of which are borrowed from other cultures and repackaged. I believe there are specific modalities that assist with certain diagnosis, however, to say there is only one modality that work with everyone, is unrealistic. The most important thing when it comes to a therapeutic modality, is how it impacts the client and what works for them.
My thoughts surrounding mental health has shifted over time and that is okay.
My view of mental illness and diagnoses have shifted a lot since my first abnormal psychology class in high school. I used to think mental illness was so fascinating and something to be dissected. I now see it through a lens of profound empathy and de-pathologizing mental health issues. I see several mental health issues be a direct cause or exacerbated by systemic issues. While other times, mental health issues have to be categorized as a diagnosis for insurance needs.
Getting to the core of trauma takes time.
Someone might be seeking therapy for a certain issue, unaware that what lies deeper is unresolved trauma. Getting to the meat of that trauma, takes time. Sometimes there is pressure by colleagues, supervisors, or insurance companies to get to the core of trauma. That way they can be “cured” and end services. When someone is not ready, trauma work can take time and that is okay. It does not mean you need to feel pressured and break therapeutic rapport or the flow of therapy to get there.
Processing the trauma can allow for self-reflection and awareness.
Processing trauma is incredibly hard. Although we can’t change what happened to the person, there can be some beautiful growth from reflecting on it. It can allow for awareness that can build on discerning skills. It offers self-reflection of what was inside and outside of their control at the time. Many trauma survivors tend to blame themselves for what happened to them. Processing this further can assist in taking on what is actually their actions and leaving what is not. It is possible for insight into a life lessons to be formed from this exploration.
People don’t “fake” having trauma, if anything, they minimize it.
Trauma survivors often minimize their suffering. This isn’t something I necessarily “learned,” but rather something that has been reinforced in my work. So often I hear from people that trauma survivors are “faking” their experiences or talking about it for “attention.” They aren’t recalling it to be “vindictive” or hurt someone. Instead, it is when people feel safe and ready they can finally discuss what happened to them. This can be taking a risk in order to connect with others and be provided the empathy they were not originally given.
Final Thoughts: Throughout my work, I often think about what my role is on a larger scale for my clients. In life, impossible problems and stressors don’t end. Even if I could solve all the problems or have the perfect solution, it is still their journey to be on. I think my role is to be that support for them, even if it is only for a moment in their life. I believe I get the privilege of being a part of that through an authentic and personal therapeutic relationship.
Over the last year of being a licensed therapist, these are the key lessons I have learned when working with clients. These are my own insights, while another therapist’s growth looks different and that is okay. This is just where I am currently at in my journey. There are so many more lessons to be learned in this field and I look forward to being a constant learner.
If you are a licensed mental health therapist or provider in the field, what has been a key lesson in your own work? What has shifted for you over time being in the field?