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Episode Description
She picked her college to study with one French horn teacher. Then came nursing, pre-med, two near-misses at medical school, and 10 years in research. Today, Allison Harvey runs a therapy group practice with 11 clinicians and keeps spots open for student therapists.
Allison is the founder and clinical director of Benediction Counseling. She joins Ashley Charbonneau and Morgen Villegas to talk about the winding, very human road to private practice. She opened her practice while five months pregnant. A few weeks after her daughter was born, her mom died. In her words, the practice “was founded with a lot of grief.”
IN THIS EPISODE:
Growing a group practice naturally instead of chasing numbers
Why supervising new therapists is her most rewarding work
Medicaid cuts, insurance pressure and fewer new clients coming in
Where AI fits (and doesn’t) in an ethical therapy practice
Making room for clients’ spiritual and religious lives
Holding on to an abundance mindset when your caseload isn’t full
GUEST BIO:
Allison Harvey founded Benediction Counseling in 2014 and serves as its Clinical Director while still seeing clients. She holds a B.S. in Biomedical Sciences from the University of Northern Colorado and an M.A. in Counseling from Denver Seminary.
Allison is passionate about mentoring and supervising early-career therapists. She believes therapists grow stronger and healthier when they befriend and support each other. She trains therapists to serve clients with knowledge, sensitivity, cultural awareness and strong ethics.
Outside of work, Allison is a wife, an adoptive and biological mom, a daughter, a sister and a friend. She loves long walks, quiet music, good coffee and slowing down with a book of poetry.
Transcript
Meet the Guest
Morgen V.: Welcome to The Art of Being a Therapist. I'm Morgen. And I'm Ashley. We're therapists, supervisors, educators, and two people who have spent a lot of time talking about what it actually means to be a therapist. Because there's a lot they teach you in grad school and a whole lot that they don't. This podcast is about all of it, the clinical work, the relationships, the mistakes, the growth, the hard days, we know there's a lot sometimes, and the moments when you think, "Am I actually doing this right?"
We talk with other therapists about the things that shape us, not just as clinicians, but as people. And today we are joined by Allison. We're so excited to have you today. She founded Benediction Counseling in 2014, and now serves as the clinical director, as well as continuing work as a therapist.
Allison earned a Bachelor of Science in Biomedical Sciences from the University of Northern Colorado in 2005, and then received her Master's of Arts in Counseling from Denver Seminary in 2010. Allison is passionate about mentoring and serving as a supervisor for early career therapists. She has a strong belief that the community at large is stronger and healthier when therapists befriend and support each other.
She loves to train and empower therapists to serve clients with knowledge, sensitivity, cultural awareness, and a strong ethical conviction. Other hats Allison wears are wife, adoptive mother, biological mother, daughter, sister, and friend. She enjoys a good long walk, quiet music, a good cup of coffee, and slowing down with a good book of poetry.
Ashley C.: That is so cool. I'm so thrilled that you're here today. Just for full disclosure, I know Allison from previous group work that we've done together.
Allison's Winding Career Path
Ashley C.: Welcome, Allison. I'm so excited to dive in with you today about your career and where you're at now, but do you want to start with what led you to this work, and what has your career looked like?
Allison H.: Sure. Thank you for having me.
I'm just looking forward to chatting with you.
My career has been interesting. I've been doing this for a while now, but in other seasons of life, people knew me with identities for other things. So it's fun to think back. I started undergrad as a music major I was a French horn player, and so much of my life was wrapped up around that.
I chose my undergrad institution based on one person, like the horn instructor, and was very serious about that, dedicated hours every day practicing, and really loved it too. I think we go through that identity development in early adulthood. I was starting to see-- I was a performance major, a music performance major, so I was starting to see, okay, there was this combination of, okay, there's only two or three horn spots open in the nation a year, and am I that elite to actually make it as a horn player?
I was combining that with learning more about who I am, who I was, and how I'm wired. I wanted to actually help people more directly than that. I think music can help people, for sure, but more one-on-one. I took the second semester of my sophomore year off and traveled abroad, and that always just really increases global awareness and gives you a lot of opportunity to learn about yourself and your skills and what you really want when you're, like, that far out of your comfort zone.
So coming back, I switched my major to music education, and I think I did that and I was still able to play in all the ensembles and everything. I did that for probably just a semester, and then I switched to nursing And I learned that I love the sciences when I started the nursing program. I did not know that from high school.
That was new information for me, but I really did. I love the sciences so much that, like, you do two years of, like, pre-clinical work and then two years of clinical work in your undergrad nursing program. So when I got to that point of starting clinical work, I actually switched to be, like, a pre-med biology major, and just truly loved the sciences and wanted to become a doctor.
That was the goal, and graduated with that pre-med biology degree. I haven't talked about this in a while, so maybe I needed to just, like, offload a little bit. So I pursued medical school for a few years. I got a job at Kaiser Permanente first just as, like, a pharmacy clerk with a line of people in front of me all day.
I took opportunities to, like, shadow doctors who were kind when I could. Then I transferred to the research department at Kaiser and did 10 years of research at Kaiser. So in the middle of that 10 years, I applied to medical school a couple times. I was invited for interviews both of those times, which means I was in the, like, top 10%, but only the top 5% get accepted, really, and I never made that cut.
So I tried some, like, grad school programs for public health just to see if that could be a path that I wanted to do, and it never really stuck. And then continued to get to know myself. I'm getting into, like, my mid-20s at this point, and I applied to grad school and really found my place in grad school.
It was a really tumultuous time in my life though, too, I think. So I started grad school at 28. I was still working at Kaiser, and I worked at Kaiser for too long after I graduated as well. My parents got divorced right before I started grad school, which was a huge-- I was still single at that time, and losing my family unit was a huge loss for me.
So started grad school broken and had some important people tell me that's okay. It's okay to, to learn as you heal and learn as you grow and put pieces back together, and I agree with that at this point. That didn't always make sense, but having humility and really not feeling like I had it all together at that time in life helped me learn with a different posture, I think.
Graduated grad school and stayed at Kaiser for four more years. They promoted me because I had a master's degree, and that was really tempting. It wasn't until I got pregnant and became a mom that I was really motivated to like, I wanted to be a working mom, and what really motivated me to do the work that I really wanted to do.
I couldn't be a working mom and kinda just slog through my work. I wanted to do work that felt meaningful and well-aligned at that point.
Launching a Practice Through Grief
Allison H.: So I founded my private practice in the fall, and we just turned 12, in the fall of 2014. And when I was five months pregnant, I saw a couple of clients that fall. I was done at Kaiser the moment I gave birth, which turned into, like, a traumatic transition actually.
It was huge. The financial pressure to make a new practice work while becoming a new parent was a lot, and it worked out. But yeah, that first year was, it was, it became even more intense because my mother died just, like, four, eight weeks after my daughter was born. I, I continued, and I was just a solo practitioner then, pre-licensed, so I treated my practice as a growing thing, and I treated closing my mom's estate as a part-time job that first year as well, and had a baby in tow most of the time also, and did several side jobs because I feel like, felt like I needed to.
I wish I would've given myself more space and time, but I think the stress and pressure of starting a new practice in that season just felt like I needed to have wheels turning all the time. So where are we at, 2015? 2015. Did you expect this to take so long? Do you want me to keep-
Morgen V.: No, this is so good.
Ashley C.: No, I love it.
I love it.
Morgen V.: I'm just so interested,
Ashley C.: I just- And it just speaks to so many of us Have had so many variations of life by the time we're the age we are at now and by the time we're at the point of our career where we're at now. And I think we often forget, you mentioned, I haven't thought about this in a while, and we often forget how much we've done, how we made big decisions in our early 20s, how we went to school with a lot of other stressors and influences.
It's so important to talk about how we got to where we are today and what made us who we are today. So please, keep going.
Allison H.: Yes. And isn't that the truth? Real life continues even while we start to show up for other people in really significant ways, and I guess that is a, a major theme in my experience becoming a therapist, too.
Morgen V.: You had a child and then it's almost like you birthed a private practice and a child. Then you also were saying goodbye to your mom. Mm-hmm. And you said goodbye to Kaiser, th- I know that's not the same, but it's like there was just this huge metamorphosis happening in 2015. Whew, just getting some chills over here as you're sharing.
Allison H.: Yep, yep. It was a whole lot. And sometimes I think back and think, "Wow, this practice was founded with a lot of grief, actually." And I wonder what the impact of that is and has been, too. My husband was working... I think I started, when I was healthy and well and ready to work, I was working two days a week, and one of those days was Saturday.
And my husband was working the other four days of the work week. And as my practice grew, he was able to lose a day here and then lose another day, and then he got to the point of, it made, just made more sense for him to stay home full time, and that, that was our ultimate goal, too, for him to be our primary care- caregiver for our kids and for my work to support us.
This was a part of my kind of life goal. I've, I've always wanted to do foster parenting. And so we were certified as foster parents somewhere, probably 2016, and we welcomed our first foster kiddo. It was a Friday night and we got a, a call at 3:00, and they dropped a newborn off at our house at 5:30, like straight from the hospital.
And he's old enough now that he's asking us not to share h- his story without him, so I'm not gonna share too much. But he was our first and only foster kiddo, and he's still in our family today. So we birthed a second child in that way. His schedule ran our world for that first year definitely, and then it got a little bit less intense the years following.
And we adopted him when he was two and a half. So two kids in the beginning of 2017, and the
Growing a Group Practice and Mentoring
Allison H.: practice kept growing. So when I started the practice, I was a play therapist. I worked with children primarily. Once my daughter got old enough to want to play at home, felt like I was playing around the clock, and I was, like, starting to see burnout on the horizon.
And this is one of the cool things about private practice is you can shift. So I slowly transitioned out of play therapy, and I started offering DBT as a new and different service at that point in time. So started leading DBT groups alongside seeing still teens and adult clients. And I welcomed my first interns, I think somewhere 2018, 2019, and was able to hire my first hire in 2020.
The practice has been growing. It's had some ebbs and flows as society changes. That's really the biggest impact on what our practice looks like. Growing through COVID, really having a boom in the post-COVID years, and needing to shore up a little bit here more recently. Our practice has had, at the most, 15 therapists, and we're down to 11 right now, and I try to hold spots for four students at a time in our practice.
A lot of what I do, like what my passion is right now, is supporting brand new therapists as they start to see their very first clients and really learn who they are or start to learn who they are as therapists and get to try some of the things that they've collected in their toolbox and learn along the way.
So I had one more kid. I'll let me inter- like insert that real quick. I had a, my third child, my daughter, and I birthed her biologically in August of 2020, so another COVID baby. So family growth alongside practice growth has been my experience.
Ashley C.: Did you plan to build a group or did this happen more organically?
Allison H.: It has been very organic. I was talking to part of my team last week and I'm not motivated by like goals of numbers. Like I don't have a si- a ideal size of practice in mind at all. So- If we were able to bring more people on and we had people interested in coming on, we interviewed them, talked to them about that, and brought some on.
And if we're not able to, I just don't hold open spots in slower times. But that has felt very organic, and it still does, just that ebb and flow feels very what we can do at any given time.
Morgen V.: Feel really passionate about working with new therapists. I'm wondering, like, is there some aspect of what you experienced there somehow driving that desire to support newbies?
Allison H.: Let me think about that. I like that question. It's probably just what I'm passionate about this work. I think I just love, I love what we can do in supporting clients, and either helping them heal and overcome barriers to have a life that they might not have been able to have otherwise. It's the experience of one removed, like helping somebody else have that experience in the therapist's chair is really exciting to me, too.
And working with students, there's new stuff that's come out since we've graduated. There's new stuff, so working with students is my route and exposure to the new conversations in our field, too.
Morgen V.: Tell us more if there's more that you can share about that. What has maybe been something that's maybe felt like, oh, okay, this is a pivot in a really positive direction, or I could see us in five years really benefiting from that?
Allison H.: Okay, so I'm probably gonna date myself for the newer therapists listening here, but so yeah, Morgen, you and I have connected over IFS and really love that as a modality. Two of the students I've got right now just started doing what I would call a softer version of IFS. It's more of leaning into the somatic sense of different emotions in the body, and they just started doing this work with clients and they've seen very big shifts early in the process with their clients.
And then, so as a group, we read one or two books together a year and just have a book discussion sometimes, and I asked the team, "What have you read that's really great that we could read together?" And one of those students recommended a book on the felt sense, and I don't remember the title right now.
And I got into that book discussion, leading, facilitating the discussion, and I'm like, "This is new to me." And then these two students are like, "This is what we've been doing. This is what we're trained to do. That's what it's called." And I was like, "Oh my gosh, okay." In Allison's terms it's like a softer IFS.
It's like parts work, but as they show up in the felt sense in the body and in learning to sit with them and learning to listen until they, they soften and loosen and release. It's really cool to see this work in progress.
Hope and Angst in Today's Field
Morgen V.: Do you feel hopeful about our field? When it comes to therapists, like humans doing the work- Just-
Allison H.: absolutely. I have a lot of existential angst about being a practice that takes insurance
currently. I have two minds about that question, Morgen. Um-
Morgen V.: Feel free to answer both.
Allison H.: Yeah, for the existential and the hope. Yeah, bo- both can n- be true, right? Yeah. Both are very much true in my mind, in my world right now.
The humans showing up to do this work, I see a lot of dedication, a lot of maturity, a lot of self-awareness. People who are actually doing the work as they lead clients to do the work. That's just so encouraging. I think they're increasing the standard. The business side is getting harder and harder, and we are a practice that takes Medicaid and most of the major commercial insurance panels, and holy cow.
We all know that Medicaid funding has been cut. Our state level- Medicaid folks are making decisions right now about where that money's gonna get cut, what that looks like.
Ashley C.: And I saw Colorado has a $443 million deficit for Medicaid specifically.
Allison H.: I just heard that last week. There have been some really hard impacts.
There are areas I wish they wouldn't, or ways I wish they wouldn't cut. And I don't, I still don't know what that's gonna look like, and I think most of the impact is scheduled to hit next year. As a small business owner with very small margins, it's tough. I think, so this is Allison's perspective on the world, but I don't see people at large reaching, starting new services as much as we've seen in the past, and I think what I'm reading into that is there's just a lot more uncertainty in our world.
People aren't sure coverage is gonna last. People might be paying more out of pocket even at, even though they're, they are covered. It's, it feels like- As a business owner as well, it feels like a really tough time. What about AI? Oh gosh. Okay, two minds again, I think. Some of the newer therapists, the student therapists are really challenging me to consider ways to incorporate AI in our practice.
I'm pretty old school about that, but I'm open to learning as well. We have Colorado state laws that say we may not use AI for client care, direct client care or diagnosis, and so there's laws around that. We don't do that. There's ethics around disclosing whether or not we use AI to transcribe, and we don't do that in our practice right now.
We could, and I think the ethical thing to do would just be to get consent for it, and to disclose that and allow our clients to decide yes or no in each case, and we're not leaning in that direction right now either. Part of that's I'm super old school about learning how to write clinical notes. I think that's a skill that, the writing is a skill, but the summary is a skill that serves therapists as well too.
It helps us like- I don't know, integrate and also get it out and close the file and be done and all of that. There's like a psychological benefit, I think, to therapists there too. But I think it can be a tool to learn from as well. Like, to collect resources, I think is my favorite way to kind of coalesce resources.
There's the ethics behind the environmental impact that really matter to me too, so I still feel a lot of tension even in leaning in, into AI in those ways as well.
Morgen V.: I was just curious if you thought maybe that would be a reason, another reason for decrease in folks accessing services, 'cause they're consulting a chatbot.
Allison H.: That's a great question. Probably, yeah. I think that's, that feels very accessible to people. I think there's risks that we need to be talking about, that chatbots don't support people in crisis in a reliable way. So one of our Medicaid management companies in Colorado sends out monthly newsletters, and there's this, this box at the bottom that says, "Our members can now access AI-driven mental health care."
And I'm like, "What?" So our insurance companies are trying to further AI-driven care because it's-
Morgen V.: Yeah. Oh my gosh. I just appreciate you being willing to name some of this, and also thinking about the new generation of therapists that you're bringing into your practice, right? Thinking about ways to be with AI, right?
'Cause it is kind of like a, I don't know, if wanna call it a necessary evil that we might have to just figure out ways in which to integrate it with which, whatever way makes sense ethically, right? But there's just so many things that we don't know about it. Your main purpose is to teach folks how to be ethical, how to be a therapist, how to be good therapists, right?
So I appreciate you having these hard conversations with them, and also thinking really critically before just being like, "Yes, let's bring in whatever that simple practice AI tool is." I can't think of the name right now, but I know it's a lot of hard conversations you must be having, but it sounds like there's parts of you that feel hopeful and parts of you that feel existential just about the future of our field in general, and it's like your practice is sitting in the middle of that.
And I'm imagining as you're holding space for clinicians, the need to also speak truth, but also maintain that sense of connection to the profession in a hopeful way.
Allison H.: Yeah. I've learned to just speak my decision-making process out loud to, so people can learn and give me input too. "Well, what about this?"
Or, "Can you think about this?" I'm such an internal processor, I've had to learn to choose to do that.
Ashley C.: And I- It's such a great teaching tool. I think a lot of students and pre-licensed clinicians really enjoy seeing and hearing us talk out loud, not just to them, but amongst other experienced clinicians too, to just witness What goes into clinical decision-making or business decision-making.
Allison H.: Totally. I need to share more business decision-making too. I try to be transparent when making those choices, but sometimes they surprise the people on my team too. And I've had to learn to say, "Okay, I'm putting on my business owner hat to answer this in a fin- you're asking a financial question, so I'm gonna be pretty blunt about giving you a financial answer, and it is my job to keep us afloat."
Yeah, those are different hats and sometimes that can surprise people too.
Spirituality, Supervision, and Final Takeaways
Ashley C.: I'm gonna go back just a little bit. I would love to know how you decided on Denver Seminary.
Allison H.: I was just stumbling through different career decisions, and I had tried several different things. And applying to a master's in counseling program, I didn't have a lot of personal experience in mental health care prior to that.
I was just starting to hear stories from people in my world. Denver Seminary was the only counseling school I knew about. I should have researched more.
Ashley C.: Yeah.
Allison H.: Yeah, so that, that worked out, uh, very well, and I consider it a very solid education. And they are CACREP accredited, so they get all of the counseling training in, and also do some theological integration with- alongside that.
And I don't practice fully from a Christian perspective. I love to incorporate any kind of spirituality in the work that I do, and I think that's how integrated education has supported me as well. Most of my student therapists come from Naropa University. A lot of people have a history in Christianity, but have had different spiritual paths.
I'm still trying to decide what we should be called. 12 years in, I don't know if Benediction fits us well anymore. But I do consider us a spiritually minded, spiritually welcoming group, and we're interfaith now. Lots of different spiritual bents in the group. But really love to support that when it's on the client's mind.
We don't have an agenda around spirituality at all, but if it supports their mental health care, we really love to work to understand the client's framework and to integrate that when we can, too.
Ashley C.: I've never operated from any religious background, either educational or personal either when it comes to my therapeutic practice, but I had a professor my freshman year of college tell me, "If you wanna understand human behavior, you need to take a religion class, because religion is one of the number one drivers of human behavior in the world."
And that has stuck with me 18, 20 years, and now we are seeing a lot more deconstruction, a lot more clients wanting to talk about how they were raised, and how some religions are pretty high control, and how that shaped their development and view of the world and their mental health. And it truly is fascinating to me, just really intellectually stimulating to continue to learn about people's religious or spiritual beliefs and traditions.
Allison H.: I agree. I know I, I feel, I, my mind just goes in so many different directions when you, when you make statements like that. We've got an excellent therapist on our team, and she has tailored her language around this. She's a practicing Christian, very strong, deep faith, and what she advertises now is offering emotionally healthy Christian care.
And isn't that interesting? This isn't just Christianity, but religion can often be used as, like, a way to bypass emotions and ignore our natural body cues that we need to learn to listen to. I think both can be very present, healthy, and I don't know if that's taught very consistently in our society either.
Morgen V.: Your business, I believe, could be considered maybe like a thought leader in our community. The way that you're delineating how you hold space for clients in terms of their religious and spiritual experiences or identity, it's different than what would be, like, more of a fundamentalist perspective, right?
Or one that would be, like, a faith-based agency that we only do this kind of therapy, right? So it's that delineation I think is so important, and it has such an educational component, not just for therapists, but for clients, too. Oh, I wanna talk about faith, but I wanna do it in a way that has integrity for me and for my identity and my path, rather than, like, another kind of experience.
I just wanna hear how did you carve that little niche there?
Allison H.: Goodness. I think it's, it's just been carved by the unique groups of people that we've had, each of our paths and deconstruction or personal development around spirituality, too. I appreciate you mirroring that back to me a little bit. I'm still learning how to talk about it.
I was just talking with a couple people in the group, and I feel the need to clarify around our spiritual positioning, and I was like, well, we need to do that even if benediction wasn't in our name, or could we just be ourselves and invite individual clients to share in their context? Any person coming from any religious background, it takes time to understand what that means to them, and it looks different for every person, too.
We want to hold all of that information with respect, of course, and likely we can increase the mental health within as well.
Ashley C.: I'm just sitting here thinking how- I know amazing isn't a clinical word, but amazing that your group has background in understanding how religion or spirituality influences development, trauma, understanding of us versus other, understanding the world, ability to engage in healthy relationship patterns or not.
And I don't think that is talked about a lot. To echo what you said, it's not taught in schools, it's not focused on in supervision unless there's a specific client that's trying to navigate their own religious or spiritual beliefs or practices. I'm just in awe of what you're able to do and how you're training the people within your group to navigate people's relationships with religion or the divine or God or fill in the blank, honestly.
Allison H.: I just give a lot of credit to the team. I think this is one of the areas that I've learned from others as well. We do get calls from people looking for Christian-directed therapy, and we can support that with some of the therapists on our team. What's on my mind as I, I hear you reflect that back, Ashley, is some of our non-Christian therapists have provided the most skillful, sensitive, thoughtful care to Christian clients.
It's, that's been really, has struck me with awe too. And I think it's a process of trust, and that's always the case in therapy, where the client is going, can you, therapist, hold this very precious, important part-" And can, even if you don't have context for what this means, can I tell you about it and can you hold it with care?
We've seen that happen really beautifully several times and probably me coming from a Christian background, I've got more triggers in some of those areas. So somebody who doesn't have that, that context at all can enter it with a lot more neutrality and support actually.
Morgen V.: That's so cool. Yes. And I don't know, i, I hear you giving a lot of credit to your team, which I think is amazing, and I also think that a team is a reflection of their leader who has an openness to feedback and to growing and to changing or shifting.
So I just wanna name that. I think you're amazing, and it just seems like, again, what you're speaking to is being client centered, de-centering the therapist, de-centering our own agenda, being with a client the way that they need. Also, yes, it is like a team approach to figuring out what would be supportive in terms of a healing process.
That's ultimately the goal is to scaffold therapists until they're ready to go out on their own, whether that's on your team or on, on their own, right? I'm wondering if you wanna speak a little bit more about the supervision piece, like what that's been like for you and your development in that role.
Allison H.: I don't know where to start.
I think this, this is my most rewarding work, I think, is being a supervisor now. Really seeing people work through the courage of seeing their first few clients and navigating those unknown moments and trusting the skills that they do have, getting to witness them show up with courage in those moments, and then start to gather enough experience to be like, "Oh, this is where I bring that in," or, "This is how I can introduce that," or, "I've been waiting until I get a client who would really be supported by this thing that I care about a lot."
Those are rewarding moments for me secondarily. New therapists have those experiences is really rewarding to me.
Morgen V.: What feels like the opposite of that? When you're holding space for supervisees, what are the struggles that you feel like come up frequently with that? We're talking about clinical supervision, just to clarify.
Allison H.: This is what comes to mind. I don't know if this is exactly what you're asking for, but we're in a time where everybody could use a few more clients.
Morgen V.: Feeling worried about getting folks their hours and their clinical goals met. Yeah, for sure.
Allison H.: So this is more of less clinical w- work with clients and more internal work.
It's finding that abundance mindset in the midst of actually needing more hours or actually needing more income or, and I have not found a way to put this into words, and it's not something I would hold anybody directly responsible for, but what's our posture gonna be? What are we gonna do with the anxiety that we feel as we have more openings that we want?
And how does that ener- how does the energetics of that affect our openness to receive new clients and our, I don't know, ability to welcome new clients as well? I'm still trying to find verbiage for that. I don't feel like that's something I can hold somebody personally responsible for either, but I think it matters too.
Morgen V.: Sure. If we're in a scarcity mindset, would that preclude us from welcoming in new clients in some way, shape, or form? Not in a conscious way, but in a more subconscious, energetic way, right? That's such a great reminder. Not only am I being reminded of the power of really great clinical supervision with what you just described, but the power that it, and also the fortitude I feel like in this profession to maintain a, an attitude of abundance, right, and not get stuck in, like, that whirlpool and that toxic sludge of corporate mindset or numbers mindset, fill in the blank.
But so yeah, you're naming again the complexity of this work greatly. Not only are you teaching people how to be therapists, you also are naming just the overarching energetic kind of things that impact us.
Allison H.: Yes. I agree with you more. Yep. We're on the same page here. It didn't feel this way two years ago, I would say.
There was just an energy that existed in the field. There was just a lot more client flow, people really ready to do the work, and therapists had as much or more than they wanted on their caseload. And I don't wanna minimize people who actually need to make more money to support themselves, too. That's so important.
You want this field to be sustainable in that way, too. It's all of this, and it ebbs and flows, as we've seen.
Ashley C.: It does ebb and flow, and I don't think that's something I really realized until I was full-time private practice. Because when I had either half a foot into agency or I was full-time in agency setting, there isn't this...
Wonder, concern, thought about client flow and funding because all of that is given to you from an agency. And I've heard more and more very well-established clinicians either scaling back or considering going back to agency. And of course, that's a very complex decision for a lot of different reasons.
But this is the first time in 10 years that I've heard people actually say that out loud of, "I'm thinking about applying to a job."
Allison H.: I'm hearing that too.
Ashley C.: I think there's a lot of fear, self-judgment, but also leaning towards what is gonna be financially stable for me and my family through this ebb and flow of what we're experiencing right now, and it's hard.
I don't know what else to say except it's so hard when you're in it and you're trying to figure out, can I even plan for the next six months, 12 months, five years, 10 years? It's tough right now
Allison H.: Isn't that the truth? I've heard probably three or four people that I respect with practices that are more mature than mine say those words in the last month or two.
Morgen V.: In the last month you said?
Allison H.: Yeah.
Morgen V.: We do say some controversial things on here. If we wanna think about what happened two years ago in our country, thinking specifically about presidential elections and just the uncertainty that gave us, I don't know, I just wonder if a lot of what we're feeling is just a reflection in general of that trickle-down effect of small businesses maybe not maintaining sustainability based on the systemic impact that the, a lot of the political situation has had on the bigger systems.
So anyway, I just wanna name that. Again, the complexity here.
Ashley C.: Yeah. What the fuck is our state doing with Medicaid dollars? I, when I saw that deficit number, I was like, how are we here? I want someone to tell me where we started and how we are here. And then you see news articles of so and so provider embezzled millions of dollars from Medicaid. And I'm like, why are the small private mental health practices the ones on the chopping block when you, the system, have allowed some entity or somebody to go on millions of dollars worth of embezzlement? That just- Yeah ... blows my mind, and Morgen has seen me get worked up about accountability, but for me, that's what it comes down to, is yes, we're in a new sociopolitical environment that I think a lot of us with private practices haven't sat in before.
Even during 2016 to 2020, I think it was a lot different, at least where I was in my career. But now I'm like, I wanna see our state budget down to the penny. What's happening?
Allison H.: I wish I could answer some of that, and I wish I had more context there too. There, I, yeah, I don't know how many feet you have in the Medicaid world, but our mental
Ashley C.: don't anymore because I was getting so worked up all the time. I had to cancel my contracts because- Yeah ... I was unwell, like so dysregulated all the time.
Allison H.: I would if I could. Our practice is located in the county of the contract that I would cancel. Get it. It's tough. It's tough. You understand that our, the mental healthcare, the Medicaid mental healthcare is managed by corporate entities.
Like Anthem manages some counties of Medicaid in Colorado. Right. United manages some other counties of Medicaid in Colorado, and they're allotted a certain amount, and they don't use it all for mental healthcare. And do they get to keep it maybe? Yeah.
Ashley C.: They're for-profit companies. Yeah. Insurance companies.
Yep.
Morgen V.: That brings us to our final questions, but before we do, what else, is there anything else that you wanna share about you and/or your practice? Yeah.
Ashley C.: Thanks for bringing us back, Morgen.
Morgen V.: You got us on a tangent.
Allison H.: I don't think so. This feels very, like, comprehensive. Thank you. Yes. Integrative to have conversations like this, for sure.
Morgen V.: Yes. Thank you so much for what you've shared today. I'm just gonna ask you our final question. What is your one thumbs up, one thumbs down, and one middle finger to the therapy field right now? So something that you love, something that you're like, "Eeh, not so loving," and then the middle finger.
Allison H.: Ooh, and that just feels like a summary of what we've been talking about anyway, doesn't it?
Morgen V.: Yeah, might as well just rename it.
Allison H.: My thumb up would be to the people, the relationships within this field. Our clients show up with so much bravery and courage and persistence to do the work. For therapists, new and old, new and mature, maturing, experienced, yeah, for what we do to continue to show up in different environments and all of that.
I'm still thumbing upping here. The way that the field is evolving, I have a lot of hope for what we're learning, and here's my, my big hope. May the next 10 or 20 years give us a brand new framework for understanding neurodivergence. I really want that. There's so much more to learn there, and may we have a whole new framework for all of it soon.
Thumbs down to corporate wealth in the mental healthcare realm and the extraction that's happening within our world, and I guess I'll just add one more. The ways that individual therapists are being, what's the word? Exploited. Ex- exploited, but also villainized. We're the ones that are, like, fingers are pointed at us for wa- fraud, waste, and abuse, and that, that's just demoralizing, I think.
So that's part of what we have to wade through. I guess I'm, I'm giving the middle finger there too, so maybe can th- those be combined? Yeah.
Morgen V.: Yeah. Yeah. You got it. Oh my gosh, thank you for being here today.
Ashley C.: Yeah, just to echo what Morgen said, thank you for being here. It has been a lovely conversation. I've enjoyed it too.
Allison H.: Thank you for having me.
Morgen V.: And thank you to everyone for listening to The Art of Being a Therapist, the Space Between Training and Real Life. If you enjoyed this conversation, please follow or subscribe, leave us a rating or review, and share the episode with someone who might appreciate it. It really does help people find the podcast.
Ashley C.: Take care of yourselves,
Morgen V.: and take care of each other.
