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Episode Description
Two months before graduation, Khara Croswaite Brindle’s internship supervisor told her she wasn’t ready to be a therapist. The reason? She was “too composed.” They wanted her to cry in supervision.
Her body knew it wasn’t okay before her mind did.
That moment became Khara’s first experience of leadership trauma: being hurt by a boss or supervisor in a way that makes you question your worth. Khara is an LPC, approved clinical supervisor, certified financial therapist, TEDx speaker, and best-selling author. She joins Ashley Charbonneau and Morgen Villegas to talk about leadership trauma and the wider problem of career trauma in therapists. Her research found that about half of the therapists she surveyed had been through professional betrayal, and nearly half had thought about leaving the field.
You’ll hear:
What leadership trauma is and how it can turn into perfectionism or overwork
The 6 career traumas: client suicide, sudden client death, client violence, professional betrayal, subpoenas, and grievances
How to tell the difference between growing pains and real harm
Why “I believe you” is often where healing starts
Two tools you can use right away: the self-disclosure “short stack” and the DAP note “Reuben sandwich”
If you’ve ever wondered whether it was just you, it wasn’t.
GUEST BIO:
Khara Croswaite Brindle, MA, LPC, ACS, CFT, loves giving people aha moments that create goosebumps and spark real action. She is a TEDx speaker, Licensed Professional Counselor, Certified Financial Therapist, Approved Clinical Supervisor, and 2x Amazon #1 best-selling author based in Colorado. As a professor, consultant, and serial entrepreneur, Khara helps therapists build second income streams that protect against burnout. When she’s not writing her next book, she’s spending time with her daughter, walking near water, or enjoying gluten-free desserts with her family.
Transcript
Meet Khara Croswaite Brindle
Morgen V.: Welcome back to The Art of Being a Therapist, the space between training and real life. I'm Morgan, and I'm here with my co-host, Ashley. Today, we have the pleasure of welcoming someone whose career is as dynamic as it is inspiring. Khara Croswaite Brindle is a licensed professional counselor, certified financial therapist, certified Enneagram professional, approved clinical supervisor, TEDx speaker, journal therapist, professor, consultant, and Amazon best-selling author.
If that weren't enough, she's also a serial entrepreneur who's passionate about helping therapists build sustainable careers through consultation, supervision, courses, and developing secondary income streams to protect against burnout. I just am so thrilled that you're here with us, Khara. This has really been a full circle moment for me, as Khara has been one of my primary mentors in the field.
Khara CB.: Aw. Thanks, Morgan. So happy to be here with both of you, two of my favorite people.
Leadership Trauma Defined
Khara CB.: Let's do it.
Ashley C.: One of my favorite parts about you is talking about career trauma, and I know that might sound weird to our listeners, but there's so much that we help our clients through with their experiences of trauma and trying to help them heal, but we don't always acknowledge that our own workplaces traumatize us as well.
I don't know a single therapist who has made it in this field without experiencing some huge event or a series of smaller events, whether it's difficult supervisors, ethical dilemmas, even workplace bullying, compassion fatigue, unsafe environments, high acuity settings, betrayal, impossible expectations.
We've seen some of these in our conversations with past guests, and we know that these experiences don't just stay at work when we leave for the day. So Khara, with all of that, I'm so excited to dive into your thoughtful perspective on this topic, and welcome. We are so glad you're here.
Khara CB.: Thank you. Yeah, I know heavier topic, but I think everyone is starting to realize your podcast will go in all spaces.
I love that you wanna talk about this. Let's do it.
Ashley C.: We'd love to start with more about your career and
Morgen V.: what brought you to where you are today.
Khara CB.: Yeah, that was a lovely introduction, although I will tell listeners I hate having my bio read and all the things said about me, 'cause it's just a lot. I think serial entrepreneur would've been self-explanatory for all the things listeners already heard.
But I started my career in community mental health, and of course, I'm a champion of you get so much experience there, but that's where a lot of the career trauma can happen as well. And a lot of the things I talk about, I've had to do my own work around, and I think that's a, a precursor or requirement of therapists, not that we have to have the exact journey of our clients, but I work with therapists, and I want to tell them I've done the work and show them I've done the work before I help them do that work.
So I've had leadership trauma. I've had client suicide. I've had to work through some money avoidance and money shame, just the top three right now in this moment. I just want people to know that there is a safe space to have that conversation, and there's not a lot of spaces to have it. I feel very honored to have that opportunity with my colleagues.
Six Career Traumas
Ashley C.: We rarely talk about trauma that happens to therapists while they are acting as a therapist. What have you seen that has really harmed therapists?
Khara CB.: Yeah, so I think in doing some of my own work, I was looking for language. I'm a writer, and that's why I have so many books. Embrace that identity more than ever before, and writing is a healing aspect for me, and that's why I became a journal therapist, is I could see that bridge, and people were showing with the data that it works.
And so from that, I realized that there are six career traumas. There's probably more than that, and Ashley is my co-author on a book on this topic. But the six career traumas as we've written about include client suicide, client sudden death, client violence directed towards the clinician, professional betrayal, subpoena, and grievance.
Originally it was five, and then we added in that professional betrayal because that was showing up so much in our field. I have a little research going and have an anonymous survey, and so we've asked our colleagues, "Hey, I don't wanna assume anything. Tell us what's happened. Tell us the impact." And that's been a huge eye-opener for me as a clinician and mental health leader.
Okay, this is happening way more than I thought it ever was.
Morgen V.: Can you give an anecdote or just more of a detailed experience about a career trauma that you had to go through and how that- Yeah ... called you into this, into these difficult
Leadership Trauma Origin
Morgen V.: topics?
Khara CB.: The one that really stands out as an origin story is in graduate school.
So a lot's happening, a lot of stress is happening in graduate school. Loved my program. I'm now an adjunct faculty at that program, so it's not the program that's the problem. But I had some leadership trauma happen in my internship, and it was two months before graduation. I had a supervisor say, "Hey, you're not ready to go into the field."
That felt bewildering to me. I was there three days a week. I was doing all the work. You both know I'm very Type A, so I was just completely floored by them saying, "You're not ready." And when we finally got to the root of it with my mentor's help, they were like, you're too composed. You need to cry."
And I was like, "Is this supervision or therapy?" As a early 20-something, having someone say, "Hey, you're too composed, we want you to cry in supervision," my body told me before my mind that wasn't okay. I didn't consent to that. So luckily for listeners, happy ending. I was able to graduate on time, but that really rocked the foundation of am I a good therapist?
Because I had two, what I thought were leaders, telling me I'm not ready. I'm not ready to do this. I worked with a supervisor who was lovely and healthy, and now is my business partner, Christina Murphy. And so as I moved into supervision with Christina, she was the first person in my world who said, "Cara, what do you look for in a supervisor?"
Now mind you, this is two months after this leadership trauma. And I looked at Christina and I was like, "I don't know what I need, but I can tell you what I don't want." And she's like, "Yes, tell me that." And so that felt very healing to have someone else who was in a leadership role say, "Tell me what you want in a supervisor, or in this case, what you don't want."
And I told her exactly what I didn't want. So that happened, and then she came back to me a couple years later and we wrote a book on empowered supervision. And all of that to say there is no counselor role or therapist role in our model. So that's just the beginning of my leadership trauma. I started talking about it more in trainings, and then people were coming out of the woodwork saying, "Me too.
I've had that happen, too." That's where I think all of my writing was like a practice for this hardest book I've ever written. I've written about my client suicide in 2021, and the impact of that has been really significant, even though it's very quiet, right? People aren't willing to come out into the public saying, "Hey, I've had this happen."
But they're sliding into my inbox to tell me it's happened or to have a conversation about that. So there's the two that really stand out as part of my journey and what I wanna talk to people about.
Ashley C.: I know you coined the term leadership trauma, but can you define it real quick for us?
Khara CB.: Yeah. So gosh, what did I say back then?
I know you, you screen capture it and share it with people. I said something like, when you've been burned or made to question your self-worth by a leader, whether that's a boss, a manager, a supervisor, someone in that leadership position, but it leads to this core belief of we're not good enough. And so perfectionism or workaholism might show up out of that.
But leadership trauma by definition is something around being burned or made to question ourselves. And so it's very psychological, and then it has impact on our working relationship and even our personal relationships.
Ashley C.: Yeah, I like how you phrase that too, and I wanna name, even in my work with students or pre-licensed therapists, or even those who are more experienced than me, sometimes it's not an event at work that is the most painful, it's leadership's response to that event at work that's very painful.
Whether it's invalidation, blame, shame, boundary violations, not holding space, kind of that neglect piece from-
Morgen V.: ...
Ashley C.: the worker's perspective.
Healing Through Validation
Ashley C.: How do you help people who have been traumatized by a leader or d- more generally by someone in power at work?
Khara CB.: Yeah. There's probably lots of layers to this, but one thought I'm having is how can we show them the contrast?
It's what if this is all they've ever known? When I was a graduate student, this is the only supervision I'd ever had up until that moment. If I didn't have something to compare it against, I would've thought this is just how supervision goes. So it took having a healthy supervisor after the fact to say, "Oh, that's what was wrong.
That was so different. That's why my body was recoiling from this interaction they wanted me to have with them." And so I would hope that everyone can have a diverse experience with supervision in this example, or with leadership to say, "Hey, most of us are gonna move around. We're not gonna stay in the same position for the rest of our lives."
If you're in private practice, maybe it's more of a mentor or colleague role, but if you're working under someone else or with someone else, can you have some diverse examples of what it looks like to be led by that person? So I would hope that would give illumination to what this looks like. Of course, the other piece is normalizing how often this happens.
Recently, I had someone come into a call and she goes, "Yeah, I had a really horrible experience with a training facility." And I looked at her in the eye on our Zoom call and I said, "I believe that. I'm not surprised." She started to tear up and she's "Cara, I feel so seen. All you said to me was, 'That makes sense.
I believe you.'" But no one had done that for her. She thought, "Oh, this is a me problem. This is not an them problem." But I knew the training institute, so I was like, "No, I've heard that before." Unfortunately, as a confidant to therapists, I hear lots of things, and so that really seemed to help her. And so oftentimes I'm having these conversations and people go, "No, you're actually helping me, even just with the validation or normalization that this is happening, even if that doesn't make it any less painful that it's happening."
And so leadership trauma falls under that professional betrayal career trauma lens that we've been talking about. And so we have about 50% of our folks who have anonymously said, "Yep, these things are happening." 50% of them have had a professional betrayal, and that might be colleague to colleague rather than leader to subordinate.
But the fact that's so prevalent, like 50% is not what I expected when I went on this journey in 2023.
Ashley C.: I love how you said the power of, "I believe you," or, "That makes sense." I've seen so much messed up shit in my career from when I worked at a jail, escapes, weapons, overdoses on that campus. Any time someone comes to me and says, "This is what happened," I'm like, "Oh yeah, I believe you," because I've seen so much.
Also, from the other perspective, people don't speak up because they think it's happening to only them. They think that they are alone. They think, "This is my fault. This is my workplace," and they're very hesitant to step into the light, and then to have someone like you say, "No, I see you, and I hear you, and I believe you."
We know that is a huge part of healing from trauma, is to be able to verbalize it and have someone else believe us.
Khara CB.: Very much. And so I think a lot of people just want to then engage in narratives from there, like they just want to tell their story. And because I position myself as a confidential grief specialist, we can define confidential grief here in a second, but because I create that space, I ask them, "What would best serve you?
I'm a stranger to you. I've never met you before. I'm coming in completely cold. What would you need to make this feel worthwhile, useful," dare I say, for their time? And almost 80% of them say, "I just want to-- I just want you to witness. I just want to tell you what happened. I want your genuine reactions, and then I might have a question for you at the end."
I'm like, "Okay, here's the hour that we have together." But there is something that's healing for me, too, so this feels bidirectional for me because the more I hear other people's stories, the more I can tell that hurt part of me that's, "Wow, did I really mess something up in grad school and beyond?" The more I can tell her, "You're okay.
You are helping other people. You didn't do anything wrong." I'm a little teary-eyed there as I said that out loud, actually. Because we all need that. That's part of the healing, right? Witnessing their story is so powerful, and I feel honored, truly honored that people want to tell me what happened. And I would say more often than not, there's nothing they did wrong.
It just happened. When it's client suicide, that's such a complex topic to go into. But sometimes it just happens. This person made a choice to die, and this clinician was along for the ride or didn't see it coming. For leadership trauma, none of us are raising our hands saying, "Yes, hurt me. Abuse me, leader."
So sometimes it's just that witnessing that is really part of the healing. There's so much more that can come from that, but I think that's a starting place for a lot of humans.
Morgen V.: Thank you so much for sharing this, Khara. I'm just really wanting to share about my own experience with you as my approved clinical supervisor.
That's a credential that we can get as professionals to deepen our work as supervisors. And when I reached out to you, it's probably been about six years ago now, I remember you witnessed my own leadership trauma that I had experienced. And I'm also getting teary-eyed because I feel that when you're sharing about how you witness other clinicians, that heals pieces of me as well, because I know that what we do has a ripple effect on this field.
And I'm just having just such deep gratitude for the work that you do and how you've been able to shift and change my own perspective of how to be an ethically driven consultant and supervisor for clinicians in this field.
Khara CB.: Thank you, Morgan.
Morgen V.: Yeah.
Growth Versus Harm
Ashley C.: I'm curious, how do we distinguish between, "I need to grow as a therapist," and, "This is actually extremely painful, and this might not have anything to do with my skill as a therapist"?
Khara CB.: That's a very loaded question.
Ashley C.: Yeah. I'll put you on the spot, Khara.
Khara CB.: Yeah. listeners, I did not know that one was coming. I didn't know any of these questions were coming. So what's popping in my head, though, is short-term, long-term impact. Short-term impact might be, okay, this is an opportunity to lean into discomfort, an opportunity to discover my own resilience, my own grit, my ability to overcome adversity, all the buzzwords.
And so short-term, I think of Gay Hendricks coming up against your zone of excellence to zone of genius. It's not always comfortable when you move into that zone of genius, and we can validate that. But when there's a long-lasting or long-term psychological impact of how I see myself as a human, as a helper, as a therapist, that to me is when I want someone to have a conversation and have that gentle mirror saying, "Here's what I'm noticing for you, and is this sustainable?
Can you stay in this job if you're continuing to be abused? Can you stay in this job if you're continuing to be assaulted by a client?" So I'm not saying, "Yeah, let's jump out of it quickly," but I think I want people to slow down enough to say, "Okay, is this sustainable? Could I do this for another year, two years, five years?
Do I need a trusted person in my life to hold up the metaphorical mirror and say, 'This is what you look like. You're burning out?'" Which is a gift other colleagues have given me. I couldn't hear it from my spouse, but I could hear it from them of, "Khara, you're burning out." For some reason, their voice got through the stubbornness, but his won't, which...
And so I want everyone to have that colleague, whether they're in a mentorship role or just colleague to colleague. Can we have someone say, "You're not okay"? And not in a rude way, just like a way that we can hear it. So that's the first thought I had to this question, Ashley, is like short-term versus long-term impact.
Like short-term, maybe I can get through all sorts of horrible things. But long-term, the body's gonna start breaking down, and psychologically I might not be the same human, and that's maybe something I don't want to risk.
Ashley C.: And I, w-- something that just came up t- for me is we shouldn't have to get through trauma at work.
We should be psychologically safe, physically safe. It is mind-boggling to me still, even though we've been having these conversations for years, how often someone says, "I'm not safe," or, "I'm still not safe at work or in this role." And it's interesting to me, too, that your spouse doesn't get through to you when it was only my spouse who was like, "You're done.
You're resigning today. You're not doing this anymore." And of course, underneath all of that is, "You deserve more. You deserve safety. You're worth more than this, and you get the choice to leave a very abusive supervisor and a very toxic and traumatic workplace environment." But I think what was really hard for me is I had a lot of colleagues, and we were in it together, and we didn't realize how bad it was until we were out of it, and not even out of it a day.
There's still stuff I'm looking back on five years later and I'm like, "That is so fucked up. I cannot believe that happened at my place of work." And I think this, this idea of long-term impacts, that's where we see post-traumatic stress, secondary traumatic s- stress, burnout for sure. I'm curious, how do you see kind of this arc of therapists finding themselves again or finding their confidence or finding strength, being empowered to heal?
What are you seeing?
Khara CB.: Yeah, I wish I could say that there was, like, a timeline, and I know you didn't ask it this way, but just for listeners who are like, "I desperately need to hear this takes a year or five years or two years or whatever, six months." But just like grief, there is no timeline. And so I think the formula, though, is you need spaces to pull back and zoom out like you had to do.
Maybe it's a couple years later. But I think that's one of the reasons I love doing retreats is because it's a chance to little zoom out in the moment, even if I just stepped away from work for a couple days or half a week, and I'm doing this work, this intentional healing work. But oftentimes it's perspective-taking, and they can't do that if they're in it every single day, going to work every single day.
And so whether that's zooming out by taking a break, zooming out by going to a different job, zooming out by taking a sabbatical, zooming out by going to a retreat. I know all those things have privilege because they require dollars to actually financially make that possible. But if that is possibility, I see a lot of people have aha moments when they're removed from a situation, even if it's just for a few hours or a few days.
And that's not the same as I'm in it fully immersed, and I can't see it for what it is because I'm right up close, right? It's the image of your hand over your face, which is what I'm doing for both of you right now for people listening. Hand over your face, I gotta zoom it out so I can actually see it for what it is.
Morgen V.: I really appreciate you sharing about this because honestly, it sounds like you're doing a type of crisis work at times, where people might reach out to you in a critical moment in their career. And so what I'm hearing and having glimpses of and also remembering my own reach out to you is like how you formulate your responses, how you formulate your care for clinicians, right?
Just like the way that you frame things and then the empowered supervision model, which I think also lends itself well to consultation. Just like how you frame questions, how you elicit information from folks. I'm curious if you can comment a little bit more on that too, because there's a difference, right?
You de-center yourself as an expert in your work. I know that from my own experience with you, and you really support people in coming to their own conclusions about what they need.
Khara CB.: Yeah. Thank you for that. I always lead with a lot of curiosity. I feel like that's the one thing that in my leadership trauma at the beginning of my career was not happening.
There was no curiosity of, "Cara, why are you stoic? Why are you so composed?" It was just, "You are too composed. Do something different." And I think curiosity serves so many of us in all the roles that we hold, whether it's my professor hat, my supervisor hat, my consultant hat, and even just some intentional questions.
What are you hoping to gain from our time together? That really anchors people versus I'm gonna word vomit all over you, but I don't need you to fix it, right? It's like the couples question of do you want me to be heard or do you want me to help you fix it? Life-changing question in couples world, right?
So I think that still applies here of like in a crisis it might be, are you looking for solutions or are you looking for a place to talk about something you have no other place to talk about it? Which is truly the definition of confidential grief that I didn't come back to until just now, which is Dr.
Lena Salpeter's work, which is specific to client suicide. It's confidential and it's grief, but it's confidential because the client's stuff is still protected and private and confidential after they die. But it's also confidential because of the stigma attached to those of us who are clinician survivors.
What if we mess up? What did we miss? What did we do wrong to have this happen? I think having somebody slow us down and ask us, "What do you really need in this moment?" is helpful because moment to moment's different. One minute I need you to give me a hug. Not saying this to the listeners, but someone in my life might need to give me a hug.
Next minute I might need to have tacos to feel better, and I think that still applies to career trauma. So what do I need in this moment will evolve moment to moment. But if someone could just ask us that, it might actually help us anchor down a little bit versus the, "Oh my gosh, I'm everywhere and I'm in crisis for valid reasons."
Ashley C.: How many people either on your survey or that you've met with would you guess have either left the field or seriously contemplate leaving the field because of career trauma?
Khara CB.: I think we were almost up to 48%, I think, or something like that. So not all of them had left. It was a lot of consideration. I think we had coded it as, "I'm thinking about leaving the field, but I haven't yet."
Something like that was the phrase. And I was like, I'm not a professional researcher, so I probably could have done that better in how I framed the question. But even just that normalizes for folks that hear a presentation on career traumas from us, this is what we're hearing from the community. I know another shocking stat that listeners have heard from me in other spaces is that the average LPC, I know you're both social workers, so I'm just gonna say counselor for a moment.
The counselors on average stay in the field seven years, and that's it. And so all of us who have doubled that now, 14, 15, 16 years are like, "Pat on the back, we're still here." But the burnout potential is so high no matter what stage we are in. But I think that's adding to the, "I think about leaving, but I haven't yet.
I wanted to make it better," kind of language that showed up there. And I have way more questions, but I guess it's anonymous, so I can't ask the people, "Tell me, did you take a sabbatical? Did you come back?" But it was a much smaller portion of people who'd left because this is so much about our identity.
This is who we are. We are helpers. We're clinicians. Most of us are like, "This is who I've been for years and years," so it'd be really hard to just walk away
Ashley C.: I remember the first time I thought about leaving the field, and I just felt like a failure. I have this degree, I have this experience, I have this expertise, and I must be a failure if I cannot continue because this is the job.
And who am I if I can't do the work that I've gone to school for, that I've gone to trainings for, that I've built my career on? And then even more deeply questioning, like, how do you leave your expertise? Do you say goodbye when you're on top? Do you try to get through burnout and overcome burnout and start fresh and set new boundaries and try something new in your career?
Do you pivot completely? Do you leave completely? And I think even those conversations, having them with people who have experienced career trauma, there's almost a lightness after you have that conversation for the first time. Everyone else around me has considered leaving the field, and you're like, "Dang, I'm not alone."
And that is just so powerful.
Khara CB.: Very much. Yeah, I think that's the theme of our conversation is like, how do we just like not feel alone in any of these experiences, whether we call them career traumas or something else. In my research, I call them adverse psychological events, and that was very specific to sound like ACEs or adverse childhood experiences of like there is a long-term impact and a short-term impact to all of them.
But yeah, how do we just not be alone? And maybe there's like a mantra or something we say to ourselves to help us through that if it's not surrounding ourselves with community can help us. Because I'm hearing in my head that there are mantras that helped me get through those dark times of, "Do I wanna leave?
Am I burnt out?" I've been burnt out one and a half times so far, and I say so far because I'm also not gonna have the delusion that it's not gonna happen again because of how I'm built and how the field is built.
Pivots And Preparation
Morgen V.: And you've had a couple of pivots yourself, right? Do you wanna share a little bit about what that's looked like?
Khara CB.: To my students, I say, "I'm the queen of pivots, and I will never judge you if you wanna pivot." And they're like, "Okay." These are folks coming straight into the field, right? they're new, they're bright and shiny, and I'm already normalizing for them career traumas and client suicide and, "Hey, you can pivot," as they're like, "I don't even know who I like to work with, Khara.
Slow your roll." But I say, "I will always help you if you decide you wanna pivot." And so for me, my population pivots every two and a half to three years. When I actually mapped it out, I was like, "Oh, that's interesting." And I have a theory as to why it's every two to three years, so that's more personal as to why that's happening.
But also conditioned of, I come from a quarter system in a master's program that every 10 weeks were different, so I was like, "Yeah, let's have change." And I'm a control freak, and I like that control. But I pivoted populations, and then I pivoted to a consultant role, and then I discovered the term confidential grief in my own healing from client suicide, and then I put that label on some of the work that I do now.
But as you all heard from my intro that you so nicely put together, I don't like to be bored, and so partly that means I'm always building something or supporting people building something, 'cause I get the same joy out of helping other people rise versus doing my own thing. And even as I say that, I'm also in my year of slowing down, which sounds like that's not even possible with everything I'm doing.
But I promise listeners, it's very true that I've slowed down. You'll have to get to know me better to see how that really looks. But I craft now, I take days off. It's a thing. Yeah.
Ashley C.: We want to prepare those who have come after us for the realities of the field in a gentle and compassionate and empathetic and empowering way.
You're creating the foundation for having important conversations when difficult things happen. No one had those conversations with me. No one showed me how to get help. I was blamed for having a trauma response when I was with my first client, who was a very dangerous, abusive client. Looking back, I wish I had someone who was like, "I want you to have hope and fulfill your dreams and create meaning in your life personally and professionally, and this field is hard."
And we should hold both of those things. I appreciate that you are trying to show that very early on because those students are gonna remember, "Oh yeah, my professor said a lot of us are gonna experience a client death, be grieved to our regulatory board. We're experiencing trauma from the leaders that have power over us."
Khara CB.: Beautifully said. Yeah, I don't wanna scare them. I just want them to be prepared for a reality that's not hearts and flowers. that's how I always describe it to students is, "Please don't take this as me being jaded and grumpy and just ugly thoughts with the world." It's more just, I just want you to feel prepared because none of us were taught this in school.
Sorry, I feel like I'm changing the rhythm. But let's just normalize it happens. It might be one lecture and that's it. I don't have to scare you, but I'm gonna at least name it and we'll move on. And I love, Ashley, how you said maybe they'll just remember that when two, five, 10 years from now they go, "Oh, I'm in it.
What can I do? Where can I go? Where can I find my community?" And I always tell students, "You can always reach back out to me. Reach out to someone. If it's not me, it could be anyone else that they trust." But yeah, I think my job as a professor is pull off the wool over our eyes that says this profession is all easy.
It's not easy. It's very fulfilling, but that doesn't mean it's easy
Morgen V.: You're speaking to the dichotomy of our profession and just the, in the truth telling, right? It's, yes, there's some really wonderful, beautiful things, and there's some really deeply difficult, horrific things that happen. And so I'm just-- I love the authenticity.
I love just what you offer people. I know that you also have created a lot of projects and classes and things that, and written books and really deepened around your own desire to contribute to our profession. I think your private practice class could be one of those places where you've been able to, I think, shine a flashlight on some of the cobwebs.
Khara CB.: Private practice and financial therapy are two areas that feel a little bit lighter, but also still feel like they're missing in the curriculum of master's programs. And so my big, hairy, audacious goal is to have private practice be normalized as course curriculum, but also a financial therapy class, as in how do we approach the emotions that come with money?
Because that's gonna come into our client work, whether we acknowledge it or not. It could be a couple saying they're fighting about money. It could be a person saying, "I have no money." It could be a person saying, "I just got inherited wealth and I'm in grief and I feel like this is gross money." There's lots of things that are gonna come out of that.
I would like us to have at least a bare minimum to not cause harm when it comes to the topic of money. As for the private practice class, I've now been teaching it for I think four years. It feels like longer, but four years feels like a win. It's now a regularly scheduled part of the electives in my alum, and I'd love to see it in other places.
But yeah, we talk about contingency plans in that. We talk about marketing. We talk about career traumas just briefly as part of a full circle, "Hey, private practice could be hard, but also what happens to your practice if something happens to you?" Which might be a career trauma or something even more catastrophic in your personal life.
So yeah, I always tell students, it doesn't mean you have to like this part of the curriculum, but it is important to name that it does happen.
Morgen V.: This is an example of you bringing in something to solve a problem in our field, right? But just that there's a lot of pieces that we didn't learn in school, and you literally created a class to help people learn about private practice.
Ashley C.: And I wanna also name the six adverse career altering events that you named, client death, client suicide, betrayal, violence, subpoenas and grievances. Oh my gosh, I've been talking about these for years and it's still okay, did I hit all six? Those happen in private practice. And Morgan, I love how you said Khara identifies these problems and tries to not necessarily fix them, but fill gaps in training and experience and education so that the next generation of therapists is much better off than I certainly was.
But I also think, as the three of us know, there is a sort of loneliness in private practice, and it's not until or unless one of these big things happens in private practice that we're like, "Oh, this happens here, too?" I thought that was behind me. I thought that was only in community mental health. I thought that was only in jails.
And so Khara, I again appreciate you weaving that into your class and your conversations with students, consultees, supervisees, et cetera, around stuff happens in private practice, too, and how are you going to build your community and keep yourself safe and reach out when you need help
Khara CB.: Very much. It makes me think of the, one of the favorite parts of the class if someone wanted to recreate this in their own space, is a panel, and you've both been on the panel, I believe, at some point.
Basically, I ask my community to come together and talk to my students in a panel where they ask me questions and they hear from not just me as their professor, but other community members, here's what it's like to be in private practice. And every year students love it. It's their favorite part because they hear information that's new, but then they also hear information that's reinforced by what I've already taught them.
And so for me, there's something very satisfying about the community saying, "Yes, this is still important," or, "Yes, pay attention to this." But students recently, we just did the panel a couple weeks ago, and they were like, "Wow, I just love that it, people are showing us it's not linear," right? Of there's not A to B to C on private practice.
Each of us have our stories of how we got here. Mine just happened to be burnout. But to get me here and then burnout continued, oops, sorry, private practice did not solve that. But the students really appreciated that of like the humanness behind our stories of like some of us are like, "I pivoted from a different career," or, "I did this because I was being harmed in a different system."
Ashley C.: You thought private practice would solve burnout or prevent burnout, and I think that's the opposite for a lot of us. It's not until someone else showed me, this was a couple years ago now, but I was working like 6:30 AM to 8 or 9 o'clock at night, which was 5, 10, even 15 hours more a week than I was in an agency setting.
And I'm the only one who can hold me accountable to that. I'm the only one I can blame. And sometimes that's even harder than blaming a system or placing responsibility on an agency.
Morgen V.: Totally agree with
Future Of The Field
Morgen V.: that. I guess the question that I have, it's changing a little bit of the conversation just- What, what hopes, what do you anticipate is the future of our field?
You have networked and written books and just really, I think, been in the trenches, right? You've lived it yourself. You've witnessed it in other therapists. You walk alongside a lot of us in our own journey. What are you sensing about that?
Khara CB.: I think this is one of the many reasons you all put this podcast together, but the authenticity and the realness or the humanness behind our field is something I'm so excited to see continuing to be leaned into or grow into.
I come from a cohort of folks who were never allowed to self-disclose, and so to come on podcasts and say, "Here's my career trauma" or here's my life experiences," so opposite of what I was trained to do as an early career clinician. And so I'm just really excited to see clinicians that come after us.
What's that nice blend between the professionalism and the ethics and morals with the authenticity or vulnerability of we're human, too. I'm really excited to see people lean into a balanced, sustainable work life. If that means private practice, great. If that means community mental health, great. They have their pros, they have their cons.
But just really excited to see each cohort that comes through every year. They're a little bit different and I always pay attention to that of what do they have going on? One cohort might be like, "I don't wanna burn out." Great. They're like really leaning into work-life balance. Another cohort might be, "I want to make sure I don't cause harm to clients.
How do I do that?" And then we talk rupture and repair as just two examples. So I do really love what I do as a professor and I hope that continues forward, 'cause I think there's so much that this next generation can offer that we weren't trained to do and we're just gonna help them pivot and that's okay.
Tools And Farewell
Morgen V.: Are you okay with sharing the pancake metaphor? Yeah. Just for a takeaway tool here because- ... what you're sharing is our own capacity and kind of gauging of self-disclosure as well as the empowered consultation or supervision. Yeah. So I know that you have this great tool and I'd love for our listeners to hear it.
Khara CB.: Yeah. I have a lot of food analogies or m- images that show up in supervision even today. I have a Reuben sandwich for a DAF note. We can talk about that later. And now I have pancakes. So what Morgan's asking about is what I call the self-disclosure short stack, so three pancakes and it's just basically a quick little framework for people to recall the purpose of self-disclosure because it is still an art form or there's a skill behind it.
And that's something I had to learn the hard way, right? 'Cause again, my program said never self-disclose which is so unrealistic now. Let's just call it for what it is. So bottom pancake, what's the purpose of self-disclosure? That's the first question we wanna ask ourselves before something comes out of our mouth.
Keep it short and succinct is the second pancake and the last pancake is how did it land? And when we ask that of ourselves, we're asking it of us as the clinician but also the client or us as a supervisor and them as our supervisee. So self-disclosure's happening in both places now, both supervision and client caseloads.
But yeah, in a nutshell, what's the purpose, short and succinct if you're gonna do it, and how did it land? So asking for feedback or checking that out verbally and non-verbally with the person across from you.
Morgen V.: Do you wanna just briefly share the DAP note Reuben sandwich?
Khara CB.: Yeah. For all the clinicians I work with, they're like, "Oh my gosh, we're not here to learn how to write notes."
The running joke is we're not in this field to be good note writers, even though it's important. We're here to help people. We're in front of humans usually. So the DAP note Reuben sandwich, and this is just how I was trained as a Medicaid provider for 16 years, is that you have a slice of bread, which is really simple for the D, for data or description.
And that's just like what did the client come in with. Again, one to two sentences, really simple. And then the meat of the note, if you think of a Reuben sandwich, is a huge stack of meat. And so the meat is under A, for assessment, which includes how the client showed up in the room as evidenced by language.
But also, that's where all the clinical interventions and tools that we brought to the table come in. And then that last little piece of bread is the plan. P for plan. And so it's like, what's the next-- is there homework assigned? What's the plan for the next session in alignment with the goals? And of course, when's the next date and time of said session?
And so for some people who are very visual like I am, they just organize it from that Reuben sandwich image. But really, it's just helping people rework their internal belief about a note documentation and say, "Wow, I was going from 20 minutes writing a paragraph to organizing it in three little chunks, with the biggest chunk being the middle, and what they did."
Morgen V.: Now I'm hungry. Those are amazing, the pig cake and then the sandwich metaphors. And this is what I'm talking about and really would love listeners to just understand about this, this perspective that I have on Care of as being a thought leader, just really distilling down these ideas and topics that feel really accessible for us as clinicians and as professionals.
And so thank you for being here today, for sharing your vast experience and wisdom and knowledge, and we are just so lucky to have you in this podcast and in our community. Thank you for what you've shared.
Khara CB.: Thank you.
Morgen V.: Thank you so much for listening today. Don't forget to share this episode with someone who might enjoy it, and be sure to like, follow, or subscribe to the podcast.
Until next time, take good care of yourselves and each other.
