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Episode Description
It’s 1:00 AM on a Tuesday. Someone can’t sleep, so they type “why do I shut down emotionally?” into Google. They aren’t searching for a “developmental trauma therapist.” They don’t know that term yet. So will they find you?
In this episode, hosts Ashley Charbonneau and Morgen Villegas talk with Anna Khandrueva, LCSW. She’s a trauma and relationship therapist in Broomfield, Colorado, and she also helps therapists with SEO. Anna spent more than a decade in finance, opened her private practice right out of grad school, and later learned she is autistic and has ADHD. Ask her if the therapy field is oversaturated and she’ll say no. We don’t have too many therapists. We have a matching problem.
In this episode:
Why marketing is really about fit, not sales (and how that takes the ick out of it)
Finding your ideal client, who might just be you 10 years ago
Self-disclosure as a neurodivergent therapist
“Flow clients,” and how to bring up a poor fit with a client
Interest vs. specialization vs. calling yourself an expert
Hot takes on AI therapy chatbots and credentialing platforms like Headway, Rula, and Alma
Grad school didn’t teach you what Google wants from you. This conversation fills that gap.
GUEST BIO:
Anna Khandrueva, LCSW, is a trauma and relationship therapist and the owner of Courage to Heal Therapy in Broomfield, Colorado. She works with late-diagnosed neurodivergent women and with couples navigating the beautiful complexity of neurodivergent partnership, using EMDR, parts work, and mindfulness. Anna holds a master’s in social work from Metropolitan State University of Denver and a certificate in marriage and family therapy from the Denver Family Institute. A former finance professional, she also helps other therapists with marketing and SEO. Outside of work, she knits, watches horror movies, and explores local restaurants and food trucks.
Transcript
Welcome and Guest Intro
Morgen V.: Welcome back to The Art of Being a Therapist, the space between training and real life. I'm Morgan.
Ashley C.: And I'm Ashley, and today we're talking with someone whose work at the intersection of a few things we really love talking about on this podcast. Trauma, relationships, neurodivergence, therapist development, and search engine optimization, or SEO.
So this feels a very therapist thing in 2026, right?
Trauma work, parts work, modalities, neurodivergence, and also have you optimized your website?
Morgen V.: Yeah, exactly. This is the space between training and real life, so it's, we get to really expand on this topic today with Anna.
Ashley C.: It really is. Nobody goes to grad school thinking, "I can't wait to become a therapist and learn what Google wants from me," and yet here we are.
Morgen V.: So with that, today we're joined by Anna, a trauma and relationship therapist based in Broomfield, Colorado. Anna specializes in working with late diagnosed neurodivergent women, as well as couples navigating what she describes as the beautiful complexity of neurodivergent partnership. Anna earned her master's degree in social work from Metropolitan State University of Denver, and also holds a certificate in marriage and family therapy from the Denver Family Institute.
Her clinical work integrates EMDR, parts work, and mindfulness practices to help people better understand themselves, their relationships, and the patterns that may no longer be serving them.
Ashley C.: Wow. And then there's this whole other part of Anna's professional life that I'm really excited to get into. She helps other therapists with marketing and SEO, two things that are increasingly part of our work as therapists, especially those in private practice, and approximately 0% of what most of us were taught about becoming therapists.
Morgen V.: Exactly. So outside of all of That, Anna knits, watches horror movies, and explores local restaurants and food trucks, which really feels like such a well-rounded combination. Just as a side note, I know Anna from a book club that we started for therapists, as well as someone who does my SEO, which has been a fantastic addition to my business.
So I'll just put that plug in here. So Anna, welcome to The Art of Being a Therapist. We're glad that you're here. Let's start where we love to start. Tell us about yourself. How did you become the therapist you are today? Just walk us through a little bit of your path and your trajectory.
Anna K.: Sure, absolutely.
It's great to be here, by the way. Thank you for having me here. Thank you for the wonderful
Anna's Path to Therapy
Anna K.: intro. I'll start at the very, very beginning before I became a therapist. I came to the United States from Russia when I was 18, all by myself. My family's still in Russia. Now I'm 43, so I've been here for a while.
You probably don't hear too much of an accent, but it's there. And when I first went to college for my undergrad, I was fascinated by psychology, and I already knew I wanted to work in that area, but I also double majored in business administration and with a minor in accounting. Because my parents both have PhDs in economics and finance, and they are professors, or at least were professors, now they're retired.
And there was this familial pressure to go into business, to go basically make money, 'cause that's the good thing to do, and then in the later in your life, a- once you've made the money, to go into being the therapist as a fun thing to do. That's how it was presented to me by my family as the trajectory.
And at the time, being 20, 21, 22 years old, I was like, "Okay, that sounds good. I'm gonna trust it and do it that way." Of course, now looking back, I'm like, I wish I stood up for myself and said, "Nope, I'm gonna go into psychology straight away." But as they say, if that happened, no clue of how the rest of my life would've turned out.
I wouldn't be where I am now. So ultimately, it is what it is. For a little bit I stayed home with my son, but I did spend close to 10, 12 years working in finance, mortgage compliance, real estate, due diligence, that type of stuff. Nothing to do with therapy. The only relation I can see there is I was a manager, a team lead, and I had to manage people, and that is what made me realize just what a bad fit I am for that industry, because I wanted to manage people like probably a therapist would with lots of using emotional intelligence and actually being nice to people and treating them like humans.
And I found that my bosses and my company weren't really on board. They were just mostly worried about production units, and if this person's not producing, let's get them producing more without worrying what it is that's making them not produce as much. There was even things like workplace bullying, not towards me, but towards other people that I had to stand up for.
So ultimately, seeing all of that, I said, "This is not what I wanna do with my life. This is not where I see myself long term. It's finally time to go back to that original vision I had of being a, a therapist." At the time, I may not even have had the word for it, but I was like, I just wanna work with people.
I wanna hear people tell me about their lives, and I want to find a way to help them grow So that's where I started that journey in my mid-30s. I went to grad school at Metropolitan State University of Denver, got my degree in social work, then I opened my private practice. So as I did two things that I think most therapists sometimes frown upon, I opened my private practice right after grad school, and I started out not taking insurance.
And I understand that those can be controversial decisions, but I have my reasons for doing things this way. Now, it's almost five, six years later, and here I am loving my private practice, loving my work, and really could not ever imagine going back to the corporate world.
Ashley C.: Thank you so much for sharing all of that about your journey.
Business Skills vs Clinical Skills
Ashley C.: At what point did you realize that being a good therapist and running a business were two totally different skill sets? Or do you think you always knew that based on your background?
Anna K.: I think there's, like, a part of me that always knew that, and my business background ultimately ended up being really helpful in being a therapist, running that side of therapy business.
But when you are switching careers into something that you have not been doing for 10 plus years, I think there was so much internal pressure that I put on myself to learn how to be a good therapist first and foremost. That micro part of social work that, how do you sit with a person when they telling you something really difficult?
How do you hold space for them? All the things that we need to learn, to where the business stuff was kind of on the back burner. Oh, I'll figure it out, I'll figure it out, I'll figure it out. And then you start your practice and you're like, "Oh, I actually need to know all of that now if I am to be successful."
So it was a bit of a, yes, I knew that was part of it, but the reality of it when you actually hit that road running and say, "Oh, I need to know now how to build a website and how to do my bookkeeping and how to network." Yeah, it's, it was a bit overwhelming at first, I won't lie.
Why Private Practice First
Ashley C.: I appreciate that you named it's controversial going into private practice right out of graduate school.
Can you talk a little bit more about that? I could argue both ways, so I'm curious your perspective.
Anna K.: Absolutely. And honestly, I could argue both ways myself. I am not here to say that one way is better than the other. And of course, what we're talking about is going to maybe community mental health out of grad school, maybe working for a group practice but not starting your own thing, versus just going out on your own.
And I can definitely see the benefits of going, let's say, the community mental health route. I think you learn tons of skills. I will be honest with you, if I were placed in a community mental health agency right now, I would probably be lost, and I would need support, and I would be like, "Okay, this pace is a bit overwhelming, and how do I do all the things?"
So it's just a different skill set. And I know myself, 'cause I am a neurodivergent person, I know what my nervous system can handle. And having heard stories from community mental health, I was like, "Oh, if I go there, it will be a very similar environment in a way to the corporate environment I was in," where you are expected to produce therapy hours And you are expected to produce results.
And it's very fast-paced, very intense. And I, I'll be honest with you, I didn't think that I could do it long term for any period of time and actually have my nervous system be regulated and essentially be happy with it. That was the reason I made this choice, and I would say the major reason I felt comfortable making that choice is because some of the institutions that I attended, namely Denver Family Institute, did such a great job preparing me for being a therapist on my own.
I felt pretty comfortable with it.
Morgen V.: So you're saying that you scaffolded yourself, right? You sought extra training, extra support. You didn't just go completely into a silo without supervision or oversight, and I think that's probably a key piece to where I would say it's totally great to go into private practice if you have the support, right, which I don't know if I would be able to handle a community mental health center at this juncture of my life.
So it's like you probably avoided another deeply traumatic kind of experience that it has been a theme throughout all of our episodes, is that going into that kind of system of mental health centers or even other kind of institutional, systemically based places is highly traumatic. And so anyway, I just, I love that.
I love hearing about this experience that you were able to figure out a system that worked for you, and you understood yourself so much that you created something that is essentially sustainable for you. Which leads me to maybe some other questions here of the lived experience of a therapist, which I believe really
Neurodivergence and Disclosure
Morgen V.: informs your practice.
Would you be able to speak to that a little bit, lived experience in terms of neurodivergence and other intersecting pieces?
Anna K.: Sure. Absolutely. I'm very open about being neurodivergent. I have ADHD. I recently realized I'm autistic. Don't know how I didn't know that my whole life, but now that I do, I'm like, oh, things make a lot of sense looking back, and some of the things in my childhood and adolescence that never made sense up until that point, I was like, oh, that's why, that's why, that's why.
So I'm very open about being neurodivergent. If it's appropriate to disclose that to my clients, if they are neurodivergent themselves, they're going through that late diagnosed journey, I will disclose if I feel that would be productive to our work. I also talk about being neurodivergent in my blog and on my podcast, so again, I believe in being open about that.
It is- Both very nice to have this kind of similarity with my clients where I have the same lived experience, but we also know that it's not gonna be exactly the same, of course, right? If you know one neurodivergent person, you know one neurodivergent person. It's not necessarily going to be the same for everybody.
I do find it to be really helpful with the population I work with, and it also brings its own challenges, because there are things like sensory overwhelm that I sometimes have to deal with. All kinds of other nuances that a neurodivergent person might go through. So, there are benefits to it, and there are definitely drawbacks to it.
I'm not going to be the person who says, "ADHD is a superpower," 'cause it can be a debilitating disability that brings a lot of shame. If people see it as a superpower, more power to them, but I'm not here to present that view because I think it's not very relatable to a lot of people.
Ashley C.: I just had this light bulb moment of how well my ADHD served me in systems, because I didn't have to focus on one thing for very long.
And we talked on this podcast about the multiple hats, the multiple roles that we carry at hospitals or in jails or psych facilities, community mental health centers, and I think I was able to do really well because I didn't need sustained attention. Of course, the flip side of that is my executive functioning was taxed for years, and then there was this fatigue that came later, and then it was a cycle of over-functioning and then inability to function.
And I can't believe that just hit me right now while you were saying all of that. But this is part of what I love about this podcast, is sometimes live you realize something very important about your identity and functioning. Thank you for that, Anna. What would you say is off the table in terms of self-disclosure, if anything?
Anna K.: Honestly, so this is a tough one because I think like many therapists in grad school, they start out telling you to be a blank slate. And things might be changing now, right, but that was still kind of the general approach, is don't self-disclose unless it's really beneficial to the client. And it's like, how do you judge that, right?
Of course, I'm not gonna sit there and talk about my life at length, but if somebody's talking about an experience that they're experiencing for the first time that I've had many times, and I can tell them, "Look, I've been there, too." Doesn't mean you have to do things my way, but I just want you to know that I've experienced that pain, I've experienced that discomfort.
I think that's helpful. But it really is an art knowing when to self-disclose and when not to, and I think therapeutic intuition is such a big part of it, and we don't talk about that in grad school enough. We may talk about the basics, the modalities, those common factors, just the basics of being a therapist, but we don't talk about therapeutic intuition.
And then that's a big part of our job, just sitting there and listening to your gut and saying, "Okay, this is a moment for self-disclosure," versus, "Nope, that is not something that I would talk to." So I don't think there's a particular topic or topics that I wouldn't talk about. It's more to do with the appropriateness of whatever I would want to self-disclose, and whether it is going to serve the client or if it's just me talking for the sake of hearing
Finding Your Niche Online
Anna K.: myself talk.
Morgen V.: The therapist's lived experience, what you specialize in, who you are, you know, also your other life experiences. How does this now inform your private practice? I'm gonna kind of shift into that marketing question.
Anna K.: I started out, I think like a lot of people going, "Ah, I don't know what my specialty is."
Like, I knew I wanted to work with people who went through trauma, but I wasn't sure exactly any specific flavor of trauma, right? And I eventually realized I wanted to work with me 10, 15 years ago, if that makes sense, right? That's my ideal client is me 10, 15 years ago before I became a therapist, before I became more self-aware, did all this work on myself.
That's who I wanna work with. And that took, I don't know, two, three years for me to realize that that's my ideal client. And I think you don't always have the luxury at first. You're trying to get your hours. You're trying to make money. So you will take clients that may not be your ideal clients. And it's a privilege to get to a point where you get to work with your ideal clients.
So at first I didn't know what my ideal client would be. It took me, like I said, several years to get there. And knowing that, hey, I have this- The thing about me, I'm neurodivergent, and I can work with people who are neurodivergent and kind of do trauma work with them as well, because as you all know, neurodivergent people are going to have trauma related to being neurodivergent, to hearing all of those comments.
I can't remember what the statistic is, but kids with ADHD get thousands more negative comments by the time they are teenagers compared to kids who don't have ADHD, right? So all of that leaves an impact. So yeah, just combining kind of all of that and saying, "Okay, this is what I wanna do." In order to do that, to find those ideal clients, well, you have to have some kind of presence online, right?
'Cause everything's online now, so you kind of have to know who you're going for and then connect yourself to those people Because that's the big issue I see when it comes to, like, marketing yourself as a therapist, is a therapist might know what their ideal client is, but they don't have the matching online presence where those clients can go and actually find that therapist.
Because if you look on social media, especially on Reddit, you will find some themes. On the therapist subreddit, people will talk about how their field is oversaturated and it's hard to find clients. On the Denver subreddit, you will often see posts about people looking for therapists and being desperate to find one, and saying how they called so many people and emailed so many people, and nobody got back to them, and they can't find what they need.
So when I see those two types of posts, I'm like, okay, so we don't have an oversaturation problem. We have a problem of matching people, because there are therapists out there desperate for clients, and there are clients out there desperate for the right therapist. How do we bring them together? So that was the big missing piece of the puzzle for me.
First was to realize who my ideal client is, and then to realize how do I actually create an online presence that matches that ideal client.
Ashley C.: You're talking about target market, right? Like-
Anna K.: Yes.
Ashley C.: Mm-hmm ... who is your pool of clients, and how do you market towards that pool? And then how do you not just market, but get the first call, and then get- Mm-hmm
the client to walk in your door? And it sounds very salesy when I put it that way, but as you've spoken to, part of running a business is sales.
Anna K.: Absolutely. I don't see it as salesy. I see it as finding a good fit. I remind myself of that research that says that the good fit the quality of the relationship and the bond between therapist and client is seven times more important to their outcomes than the modality used.
Constantly remind myself of that. I'm like, okay, is it salesy, or are we actually serving people out there well by trying to match them with the best fit therapist for them? For which you do need to do that marketing and to know, like, who you are as a therapist, and to be able to communicate that in your consultation or in the first session and have the person truly go, "Yes, this is a good fit," or, "No, that's not a good fit."
So if you change your perspective to that, to being like you're actually serving people better if you know how to, quote unquote, "sell yourself" in the right way, I think that takes some of that ick out of it.
Morgen V.: I totally agree with you, and that's where you were saying something earlier where I was like, "Holy shit, this really does transcend just this SEO thing," right?
It's actually matching people to the right person, which could then lead to more sustained kind of healing because there's a sense of safety, a sense of connection, and a sense of kind of common values in a way, right? With the, between the client and the therapist, which you just named, right? Like statistically, it, there is a greater probability of healing and of positive outcomes.
So I don't know, my mind just feels blown by that.
Anna K.: Yeah. No, you're absolutely right. It's definitely a great reframe, and I think it's true. It's not me lying to myself here. It's really true. If we can match people with the right therapist, because, okay, this is a pet peeve of mine. I'm sure you've heard that where a person will go and try therapy for the first time and it doesn't go well, usually because it's not a good fit, and then the person goes, "Oh, well I guess therapy didn't work for me.
I'm not gonna do it anymore." And I understand where they're coming from. I'm not trying to blame them here. But it's kind of like going to one restaurant, not liking their food, and going, "Oh, guess I don't like food. Never gonna go to another restaurant again." Like, no. There are so many different therapists out there who have a different approach, completely different modality, different personalities, different everything, to where you can definitely find a good fit.
So it's important not to give up, and even more important for us to present ourselves in that way, again, quote-unquote, selling ourselves so that the client knows what exactly they're getting.
Ashley C.: You mentioned networking as well, and I think that is a big piece of this, is networking with colleagues in our communities so that when we are not a good fit, we have specific referrals to give clients so that we give them the best chance that they have of finding a therapist who is a good fit.
And then in return, those same colleagues know our specific ideal client, and they refer people who are not a good fit for them to us.
Anna K.: That would be the ideal situation, right? To where we all feel that our practices are sustainable enough to where we can refer out if it's not a good fit, and we don't have that desperation of, "Oh my God, I need to take this client even though it's not a good fit because I need the income."
Ashley C.: Speaking of sustainable practices, I hear frequently with people who are just starting a private practice the question, how long does it take to fill my caseload? What would your answer to that be?
Anna K.: Oh my gosh. That can be so varied. Of course, it's going to depend on whether or not you take insurance.
If you take insurance, it's going to fill much faster. That is definitely true. For example, if we take a bit of an SEO here, if your hours of your business are later than, let's say, you work past 5:00 PM, which a lot of us do, you're going to get more clients. Because people usually work 9:00 to 5:00 and they need those evening hours or maybe early morning hours.
So it really depends on what you are willing to do to get more clients. And of course, it depends too on your specialty, what's needed in, in the area. So there's lots and lots of factors. But I do see a lot of therapists who are starting out make the mistake of basically going, "I wanna work with X, Y, Z," without doing research on things like keywords in their area to see are people actually searching for X, Y, Z help?
'Cause if they're not, you're not going to fill your caseload quickly. Could be like niching down too far, or it could just be choosing a specialty that doesn't have a lot of interest in your area. Like I can think, for example, I was just working with an SEO client who does sports counseling and works a lot with athletes, and he just happens to be in an area where there's also physical therapists that specialize in athletes, other businesses that kind of work with athletes.
So he's very well positioned to be in that area. But like, I don't know, I haven't looked into it, but maybe sports counseling here wouldn't be as good, right? So there is, there are nuances to doing that research first and finding the intersection of what you wanna do, what you're good at, and what actually has demand out there.
Morgen V.: And not using too highly of a clinical language, right? Like-
...
Morgen V.: But using language that translates into just regular vernacular, right?
Anna K.: Yes. Oh, absolutely.
Yeah. Yeah, that, that's another big one.
Morgen V.: Like I work with developmental-- Yeah. Like I work with women who experience developmental trauma between the years of zero to three or something like that.
It's just like- Right. Like
what does that mean, right? ... big, but.
Anna K.: Nobody's sitting there going like, "I'm looking for a developmental trauma therapist," 'cause they may not know that term. The rule I always use is what is their ideal client thinking on Tuesday at 1:00 AM? What is running through their head when they can't sleep?
Those are going to be the words they're going to be searching for- Right ... when they search for a therapist. Right? They might even not know they're looking for a therapist, and they might just type into their Google search engine, "Why do I shut down emotionally?" And that's when they find my blog on why do I shut down emotionally, and read it and go, "Hey, maybe I wanna work with this person."
So you kinda do have to do that chain of taking it back to what words will they actually be using to search for me, and using those words in your website and in your marketing.
Ashley C.: You're talking about the power of language, and I think a lot of therapists are so used to talking in our own language, right?
Whether it's trauma specifically, or fight or flight, or neurodivergence, or a specific type of trauma. And it's so easy to forget that's not how people talk in their everyday lives. And when people ask me about, like, "How do I get more clients, like supervisees?" I ask them, "Who's your ideal client? Who are you marketing to?"
And the most common answer is, "I see trauma." And I'm like, "Okay, what does that mean?" And a lot of people can't answer that question. And if you can't answer that question, potential clients are not gonna enjoy having an initial conversation with you.
Anna K.: Absolutely, yeah. And I just wanna say that starting out, I also was the whole, "I wanna work with trauma."
Well, what does that mean? I don't know.
Ashley C.: Oh, same.
Anna K.: But I just wanna... Yeah. And so it comes with experience to know how to talk about it in a way that your clients can relate to, absolutely.
Morgen V.: I love
Fit Ethics and Referrals
Morgen V.: this conversation. There was, like, this other part of me was like, but we learned in school that we have to see everybody, Anna.
Like, how do we reconcile that? We're all three social workers, right?
There's that mentality of whoever comes in my door, I have to see. Can you speak to that? Like, how did you reconcile that piece as well with the ideal client conversation?
Ashley C.: I was gonna say, the example I give to supervisees all the time is a car accident is very different than spiritual abuse or leaving a cult, which is very different than sexual trauma.
Mm-hmm. And sexual trauma in and of itself is a huge umbrella, right? Certain types of trauma versus trafficking, for example. I can see most of those certain types of trauma. I do not specialize, and I would likely not be competent working with someone who's experienced trafficking.
Anna K.: No, you're totally right.
And I think, yes, there is that like, oh, you have to take everybody. And, you know, to go back to that conversation about fit, if you take everybody, including people who you're not a good fit with, you are not serving them well. You're not serving yourself well either. But if you just wanna focus on their benefit, you're not serving them well by taking everybody in.
And I think it's totally fine to start out that way because, again, how are you supposed to know what you're good at and what particular flavor of ideal client is going to be just right for you? You don't. So I definitely worked with clients where I was like, "Okay, that doesn't seem like a good fit," and that's a lesson to learn, right?
There's the issue of fit, and then there's the issue of values, and I think that's where that conversation starts to get interesting because fit you can easily say, "Okay, if it's not a good fit for whatever reason, I'm not serving that client well by taking them on." But if it's just difference in values, some therapists I think are totally justified in saying, "No, I cannot see somebody who has such diametrically opposite values from me, that if it comes up in therapy, I'm going to be not okay with it," right?
And that's something to work with. And again, I'm not here to say one way is more right than the other way, but those are two different reasons not to work with people, is, one, you truly don't think you can serve them well because of a poor fit. The other is your values are so opposite that you're like, "I don't know if I want to work with that person," right?
With political division today, that's a good example. Like, how do you work with somebody who is on the completely different end of the aisle, but they need the help? And I think that's a very personal question that every therapist just has to sit with and answer for themselves.
Ashley C.: This conversation is coming up more and more between me and colleagues, but also in supervision and consultation.
And I think the answer I've landed on is, if you have so much countertransference towards a client that you cannot do good therapy, we are ethically bound to find someone else who can serve them better than we can. And that is a very, like, vague but also specific statement at the same time. And it's so hard to have these conversations about values when things are so polarized.
And then even if you have a colleague who you feel safe enough having that conversation with, how do you have that conversation with a client, or do you?
Anna K.: Those are excellent questions that I don't necessarily have the answer to, right? Is how do you have that conversation with a client if it's appropriate?
How do you decide who to work with, who not to work with? But yeah, that idea that we have to take everybody coming in the door, I just don't think it serves anybody well. Because even as a therapist, if you work with just anybody, you're gonna burn out. The word I love to use to describe the ideal client is flow, a flow client.
When you're in that state of flow during the session where it's just naturally going and you're working together, you're in it, you're engaged, you feel renewed and invigorated after the session. You're like, "Yeah, this is awesome. This is why I became a therapist," that's your ideal client. If you don't feel that way, then of course you have to start looking at countertransference, what's happening with that, right?
And ultimately, if you decide, "No matter what I do, the work that I do with myself, I cannot get into a flow state with that client," then that's a reason for me to start questioning is this a good fit.
Ashley C.: I love that word, and sometimes I talk about maybe the word fun or even chemistry, right? Mm-hmm. Like professional chemistry with boundaries of course.
But like you said, there's this excitement, this ease, this fun, this we're doing it together, and then the session flies by and you're like, "Oh my God, we got to so much and the session's already over. Can't wait to see you next time."
Anna K.: Absolutely.
Morgen V.: I think about it also as like a depletion versus something that feels really uplifting, but if I check in with parts after a session and they feel really like there's some kind of energy, there's some kind of flow, then that means, yes, there's likely some kind of co-creation happening in the room.
But if they're feeling really depleted or just angsty, and this is not, this has nothing to do with diagnosis, this has nothing to do with client progress, it just has to do where you're right, like with some kind of fit issue, some kind of dynamic that can either be concrete or not, and I really have to check in with myself about that kind of thing.
Like, is there something happening where maybe it would be appropriate to refer out? And I'm like, what do I say?
Okay, so if you're already working with somebody and then you realize it may not be a good fit, how do you have that conversation?
Anna K.: That's a tough one. I had to have that a couple of times only, so I can only speak to those times.
But I usually started by going, "How do you think this is going?" Right? It, it's that curiosity that, what do you think? 'Cause what if the client is like, "This is amazing. You're the best therapist I've ever had. I'm making so much progress." Well, maybe that, that is something that I need to dig deeper within myself.
If they think it's going so well, what is the countertransference telling me? So that might give me a pause and not have that conversation straight away, and that's, that's what happened with one client. They were like, "Oh, I think it's going great," and ultimately we ended up parting ways, but it was for a different reason.
It wasn't because of fit. I realized that was something that I had to work on in myself. The other one, they said, "Yeah, I kind of, I'm not feeling it." I was like, "Thank you for saying that. I really appreciate it. And how do you think it's serving you that you're not feeling it? Like, do you think it's productive and useful for you to keep coming here if y- that's how you feel?"
'Cause maybe it is, right? Some people might find that productive. And that client said, "I don't know." And it turned out that they felt the same way and didn't know how to bring it up, and that's where that therapeutic intuition comes in handy, right? If your gut is telling you something's not quite right here, probably something's not quite right here.
But it is a difficult conversation to have. Yes.
Morgen V.: I can tell you what it's like on the client end. Like, the other question I'm having is why would a client continue with a therapist that doesn't seem that it's a good fit, right? And the therapist, the onus is on them to bring it up, and I can just speak for myself on a client end.
It is so hard to find a therapist, and so if it's just, quote unquote, good enough, it's like, ugh, I just don't wanna have to try to find someone. I don't wanna have to try to go through that. But honestly, if a therapist brought it up to me, that might be like, oh shit, maybe I should be doing something different here.
Anyway, I just appreciate- Yeah, yeah ... that you're open to having that conversation with folks if you're noticing that something feels off.
Anna K.: Absolutely. In general, I think it's a good idea to check in to see, like, how do you think therapy's going once in a while. You may not have to do it every single session.
I know when I first started out, I did have a habit of asking the client at the end of almost every session, "So how do you think this went? What's your takeaway?" So it's not so much as like they're giving me a grade for how I did, it's more of like, what's your takeaway and how did you feel during this session so we can use that later to work on.
Like, it's all gristle for the mill, as they say.
Ashley C.: That's feedback informed treatment. That's, there's a formal term for that, and there's a whole slew of formal steps and evidence-based practices that go along with feedback informed treatment. But there's the less formal piece that you're talking about, too, and that's where the art is, right?
Like, that's where the art of therapy is. How do I ask this client how our connection is? How do I ask this client how this session went? And I have to be prepared for whatever the answer is, right?
Anna K.: Right. It's that combination of we need to have the curiosity about it, because that just makes it so much more open.
Like, if you're curious, it's okay if the answer is not what you, quote unquote, expect it to be. And then having the kinda like inner strength and self-knowledge about, oh, okay, they might say something that I'm not expecting, and it's okay, and this is how I'm gonna deal with it. And that all comes with experience.
I think at first, like in my first year as a therapist, if somebody said, "No, you're a horrible therapist, I don't wanna work with you," it would cause a lot of distress for me, and I would have to do a lot of work on it. Now I just see it as if it's not a good fit, it's not a good fit. It's not serving them well trying to do therapy despite it not being a good fit.
Morgen V.: I love that. And then just to bring in the neurodivergent piece, right? If somebody asked that to me at the end of a session, I'd say, "I need to get back to you at the next session how I feel at this session." Yeah. 'Cause it takes me a week to really synthesize and feel into what happened. So that would be like another art, right?
It's oh, this client maybe needs some time to really synthesize everything that happened. But we are racing toward the end of our episode today. So I'm not sure if there's other questions that you wanted to ask, Ashley, before we start to wrap up?
Marketing Credibility and Field Hot Takes
Ashley C.: One question I have is, can you explain to listeners the difference between an interest, a specialization, experience, and being an expert in something?
Anna K.: Oh gosh, that's a good question. Well, okay.
Ashley C.: And how do you market all of those things?
Anna K.: Mm-hmm.
Ashley C.: And all of those things differently, 'cause they mean different things.
Anna K.: If you start to think of yourself as an expert, you start getting in the weeds a little bit, right? Because it's like, I don't know, who's to say who is an expert?
Do you have to write a book? Do you have to have your own training? Do you have to be, like, certified in some kind of modality? So that part I would just caution against. If you start feeling like an expert in an area, I would start questioning, what don't you know? When you go to undergrad, you're like, "Oh, okay, so there's a lot I don't know, but I'm competent."
You go to a master's program and you're like, "Oh, there's still a lot I don't know." You go to PhD and then I don't know anything except this one very specific narrow thing. So the more you learn, the more you realize all the gaps you have. So yeah, if you truly feel like you're an expert on something, I would just start questioning your own attitude towards it.
But interest, like interest versus specialization, I would say interest is something you feel internally. Like, what are you interested in working with? What particularly gets your brain to start having those thoughts of, "Oh, I wonder how it would work with that, and how does this work? Ooh, I've heard about this book or podcast on this topic. Let me search more." You feel maybe in that flow state when you are talking or researching about that thing that you're interested in. Specialization, that's the result of that interest, is you actually saying externally, "This is what I am good at," right? Not necessarily an expert, but good at.
It's the intersection of my interest, my training, and the demand in the area. That's your specialization essentially.
Ashley C.: I love how you answered that question, especially about being an expert. And now I'm having this dialectic conversation in my own head about my expertise. And you're right. The more I learn, and the more I testify, and the more I do the work that I do, the more I'm like, how does anyone defend against this?
Because we can't know absolute-
Anna K.: Mm-hmm
Ashley C.: And there's so many experts who would say, "I'm not an expert." And then there's other experts who would say, "Oh, you absolutely are an expert." And so again, that nuance of language and word choice and who gets to decide, that's such a cool conversation to have.
Anna K.: Agree.
And again, it's the difference between saying, "Oh, I have a lot of training." It's okay to say, "I have a lot of expertise on something," right? That's a true statement. But calling yourself an expert, that's where I start going, "Okay, what's going on here?" Because to me, saying I'm an expert implies I don't need to learn any more on this topic.
Maybe that's just my own interpretation of the word, but that's how I view it. So that, to me, is a problematic statement. But saying, "I have expertise in this," that's different.
Ashley C.: And when we talk about marketing, someone might search for expert in, and really want that or need that, and then some people might see my website, for example, and think, "Oh, I don't want an expert."
And so it's interesting that you're naming... Again, we need to put ourselves in our client's shoes to think about what they might be drawn to and what they're looking for, and it's often not an expert. I agree with you.
Anna K.: Yeah. Yeah. I think about yourself. Would you, if you go looking for a new therapist, are you going to gravitate more towards somebody who's like, "I'm an expert in treating childhood trauma," versus somebody who's like, "I've worked a lot with childhood trauma.
It's something I feel really passionate about." I know which one I would go for.
Morgen V.: Okay, well before we let you go today, what is one thumbs up, one thumbs down, and one middle finger to the therapy field right now?
Anna K.: Ooh, oh, good question. Okay, middle finger, I'm gonna start with that, AI. Come on. And I'm totally cool with people, like, using AI to help them in their own work, but the fact that these AI companies are coming in and saying that talking to a chatbot is just as good as talking to a therapist.
I've heard that UnitedHealthcare, they're now saying you're gonna have to go to a life coach before they can refer you to therapy, right? Like, I'm not cool with that. I don't like all of those developments 'cause I do see that as devaluing our field.
Thumbs up I would say to all of the young people who are still coming into this field.
I think we know, yes, you can make a good income here, but for a lot of us it's not about money, it's about helping people. It's about seeing our clients grow and succeed, and that feels so good. So big thumbs up to anybody who, despite seeing these challenges with AI taking over the field and maybe some perceived oversaturation maybe in some areas, still going into the field.
Big thumbs up.
Thumbs down. Okay, I'm gonna give thumbs down to all of those companies like Headway, Rula, Alma, that help you get credentialed, which I do think they do good work there, but ultimately they, I think, are not doing a good thing for our field. So I'm not quite giving them the middle finger, but I'm gonna give them a thumbs down.
Again, I understand starting out therapists might wanna use them, but long term I would just caution against it. I've heard tons of not-so-great stories, some horror stories about clients being told one thing by, let's say, Headway, and then finding out the reality's totally different.
Morgen V.: Okay, well that is the perfect way to leave it, Anna.
Thank you so much for being here and for talking with us about what it actually looks like to build a practice that reflects who you are, not just as a therapist, but as a human and as a business owner.
Ashley C.: And thank you all for listening to The Art of Being a Therapist, the Space Between Training and Real Life.
If you're enjoying these conversations, give us a like, follow, listen, or subscribe wherever you find us. It really does help more people find the podcast and helps us keep having these awesome conversations. Take care of yourselves, take care of each other, and we'll see you next time on The Art of Being a Therapist.
