Interview with a high school student

Last week a good friend of mine (a high school English teacher) asked me if I would be willing to help out one of her students by allowing the young girl to interview me for a research paper assignment on a career path she is interested in pursuing (counseling, possibly in drug and alcohol addiction). Never having been interviewed before other than for job interviews, it was an interesting experience. I had much more to say than I would have thought...and I could have said even more. Here's my one hour of professional "fame:"

How long have you been in this career?

I started my first job working with heroin addicts at a methadone clinic in Chicago, IL in June 2005. I worked there until March 2008. I moved to Washington at that time and got a job working at a community mental health agency that provides counseling and case management services to low income individuals who struggle with mental health and/or chemical dependency, which is where I still currently work (I mainly do mental health counseling now, but I have several clients that struggle with addiction as well/are in recovery so I still do some addiction/recovery counseling as part of my work).

What education did you need/have to take?

Well, I'm not sure how to answer this question because it really varies depending on whether you want to pursue something very specialized (such as to specifically do chemical dependency counseling only) or if you aren't sure yet and want to see what's out there. If you are wanting to do work in chemical dependency, more than likely you will need at least a BA degree in social services and most places will require a MA in Substance Abuse/Chemical Dependency. In the state of WA you may be able to complete a certificate program to be a chemical dependency counselor without having to obtain a master's degree. Regardless of whether you decide to pursue a master's degree or a certificate program, you will need to study and pass a licensing exam so that you can do that kind of counseling/apply for jobs in the chemical dependency field. It's important to note too that the requirements can vary depending on the state. Unfortunately, the requirements to practice (nor the educational requirements) are not exactly the same in every state....so if you think you'd like to move out of state one day, keep this in mind for your career choices.

What college did you go to?

I got my BA in Psychology at Texas State University for undergrad and got my MA degree in Marriage and Family Therapy at the Adler School of Professional Psychology in Chicago, IL.

Why did you pick this profession?

I was always a "helper" when I was younger, but there were a few experiences that started steering me more in that direction when I reached high school and then college. I took a psychology class my senior year of high school and was intrigued by the subject matter...what makes people tick, why they do what they do...and how it's tied into how they make sense (or not) of their experience in the world. Then in college I took a sociology class (I think it was called "Love, Romance, and Marriage" or something like that). We had a marriage and family counselor come to the class one day as a speaker to talk to us about her job as a therapist. That's when I started thinking it sounded like something I could see myself doing. I was always trying to figure out the relationship dynamics in my family and if it was possible for people to be happy and healthier in relationships. After I graduated college, I searched online for graduate schools and came across the Adler School. I saw they offered an MFT program and I made my decision. Although I don't do marriage and family counseling with that degree, I love being a therapist. I love being a part of people's journey...helping them with their struggles and being a part of their healing process/personal growth.

What are your hours?

As I work in an agency setting, I work 9am-5pm Monday through Friday.

What would you recommend to another future therapist for their hours to be?

It really just depends on whether you plan on working for yourself (in a private practice) or if you'll be working for someone else (agency/company). There's more flexibility if you have your own private practice, although you may not be guaranteed financial security/stability if you have to find clients on your own.

Do you have vacation time? If so, how much vacation time do you take throughout the year and how do you separate the vacation time?

Yes. I try to space out my vacation time evenly throughout the year, typically every 2-3 months. I try to take some vacation time with holiday time that way I can give myself a longer vacation without using all my 'vacation' days, especially during the winter months. The longer I've been in the profession, the more I'm aware of how long I can go before reaching "burn out" phase...which is why I like to take time off for myself every 2-3 months, usually 4-5 days (including weekends that I already have off).

What is your salary range?

$30,000-40,000

Has your salary increased or decreased through the years?

Increased, although not enough. Good thing I'm not in it for the money. :)

Do you have any physical/emotional stress? If so, how do you deal with the stress so that you don't take none of your patients' problems?

Physical/emotional stress from the job or my own stress? There's always a fluctuating level of both personal and work related stress that I constantly have to be aware of and keep in check. It was very hard when I first started my career as I had to learn how to manage stress and wasn't very balanced about it. I've definitely cultivated a much more balanced approach now that I've been a therapist for over 8 years now. It depends on whether the stress is physical or emotional. If it's physical, I make sure to eat healthy, exercise, consistently get enough sleep, and if I don't feel well most times I will not go to work because I notice I'm not able to be an effective therapist if I'm not well/can't focus on my client due to my own pain/ailments. For awhile I also used to get regular massages (covered by my insurance, so I only had a $20 copay, which was great!) and that helped with both physical and emotional/mental stress. For emotional stress, I ask for help and support if I need it...whether it's talking to or spending time with family or friends or getting extra support with my own therapist. I also remind myself that as much as I enjoy helping people, I cannot make changes for them and can only guide them, give suggestions, feedback,etc. I leave work at work. Rarely do I spend time thinking about work stuff outside of work and rarely do any work paperwork at home. Keeps me sane!

Do you have any coworkers? If so, are they also drug and alcohol counselors too?

Yes, I do have coworkers. There are three other therapists in my office that are part of the counseling "team," but they only do mental health counseling.

How are you evaluated on your job and how you do with your patients?

I have a supervisor that I meet with regularly for 30-60 minutes twice a month. Once a year (around the time of year that I was hired) she completes an evaluation based on my performance for that year, which is largely based on what she observes that I'm doing and/or what I share (about my clients, my workload, issues that come up,etc) during our supervision meetings. I'm evaluated on various aspects of the job....my strengths as well as areas for improvement. As part of the evaluation, goals set for the year are reviewed to see if I've accomplished/completed the listed goals as well as coming up with goals for the new year ahead.

What are the advantages and disadvantages of this job?

This is a great and also hard question to answer. There are alot of complexities to being a therapist, which can be both an advantage and disadvantage....an advantage in that it pushes you out of your comfort zone and can motivate you to always try something new, be creative, and really be present with each unique client that comes to you for help. This can be both scary, anxiety producing, and also interesting. If you like people and like being the person they turn to for help, it can be very rewarding. The cool thing about being a therapist is that I sometimes learn things from my clients and am also constantly pushing myself to grow too.

The disadvantages can be numerous, so you really must have a passion for this kind of work in order for the advantages to outweigh the disadvantages. Disadvantages: Not everyone that comes to you wants help nor is always necessarily ready to be helped/make changes (patience and compassion is essential for the therapist). You can't expect to be appreciated/thanked. The pay isn't great. There's a high risk for burn out and health problems if you don't find balance with self-care and separation between work and personal life. Sometimes you will have things going on in your own life that may make it very hard at times to "give"/help effectively at work and you still have to go to work/do your job even when you have your own problems (again, this is why self-care is a must!). You will see the best in people as well as the worst/dark sides (advantage and disadvantage, depending on what's going on and your perspective on humanity).

What options or other job opportunities has this job opened up for you?

My current job has allowed me to learn and gain significant experience in trauma work as most of my clients have an extensive history of trauma (physical, sexual, and or emotional abuse). I knew almost nothing about mental health disorders (especially PTSD) prior to my current job. My first job working in addictions actually opened up doors as far as helping me get the job I have now as there is an increasing need/demand for chemical dependency counselors. It's easier to find a job if you have experience working in addictions as there aren't enough people trained to do it as there are mental health counselors (at least that was the case when I was looking for a job back in 2008 when I moved to WA).

What are the skills required for this job?

You must be compassionate/have empathy for people, be a great listener, have a thick skin (learn not to take things personally), have healthy professional boundaries, and have a reasonable knowledge/understanding of addiction/mental health (with the help of what you learn in school and doing a clinical internship before you start your first professional job). I'm sure there are more skills but that's all that immediately comes to my mind.

What training did you have to take for job in high school, college, and any other extra thing?

High school and college I took psychology courses to get a basic understanding of psychology and the human mind. Graduate school focused specifically on courses that would help me learn "how to be a therapist." After I got my master's degree I studied and took an exam to get my counseling license. I currently have a license as a mental health counselor ("LMHC) and as part of maintaining my license, I have to complete 34 or 36 credits of continuing education (by attending seminars, workshops,etc) every two years. Chemical dependency counselors have their own licensing requirements. I'm not sure what their requirements are, but you can find them listed on the Washington Department of Health website for details.

Sexual compulsion and the internet

As a mental health therapist working in the community mental health system, I'm constantly challenged by a myriad of presenting problems clients would like to work on in therapy. While I've been working in the field of co-occurring disorders (ie, addiction and mental health) since 2005, there are certain disorders I'm very skilled in and others I have very little knowledge or experience to draw from.

I'd venture to guess that an individual presenting to therapy is confident that their therapist can help them tackle any and all presenting clinical problems. Unfortunately, this is not always realistically possible. Sometimes the problem is totally out of the scope of a clinician's educational or professional competence. In these instances, referral to a more appropriate professional specialist is warranted. In a majority of cases, however, it is important for clinicians to take the initiative to seek either (or both) supervision, case consultation with trusted colleagues, and self-motivated professional development via continuing education classes/workshops or reading professional literature on the particular subject.

With that said, I was recently presented with a case involving compulsive masturbation and addictive online sexual behavior. I found myself (internally) floundering within this extremely sexually revelatory session with my client....not out of discomfort of the subject matter being discussed, but out of not knowing how to specifically help someone with this particular issue. Especially given how vulnerable my client felt telling me and wanting the client to continue feeling confident or courageous enough to proceed with treatment.

I found myself both intimidated and intrigued by this newfound clinical challenge, that of sex/cybersex addiction. Immediately and somewhat ironically, I searched various sites online for well-written and highly rated professional books on the topic. Much to my surprise, it was a disappointing and difficult search. While there are a plethora of books promoting "healthy" sexuality and how to explore one's sexuality in healthy/safe ways, books on sexual addiction are few and far between. The book I ended up getting wasn't even one I thought would be very helpful, but it ended up being decent.

"In the Shadows of the Net" by Carnes, Delmonico, and Griffin explores and analyzes the dangerous allure of the Internet on one's sexual proclivities, especially given the technologically dependent society we live in. Although certainly not to be used by any means as an excuse to act out compulsive sexual behaviors, the availability of sexual content and ease of anonymity online makes it that much easier for an individual to get sucked into a downward spiral of unhealthy and unmanageable sexual behavior. Chapters in this book include identifying problematic behavior ("Do I Have a Problem with Cybersex? and "Understanding Problematic Sexual Behavior on the Internet"), analyzing sexual arousal and intimacy ("What Turns You On? The Arousal Template" and "Courtship Gone Awry"), and how to change/recover from sexually addictive behaviors ("Boundaries," "Taking That First Step," "Changing the Way You Live," "Preventing Relapse: Maintaining the Changes You've Made," and "Family Dynamics and Cybersex"). I found "Understanding Problematic Sexual Behaviors on the Internet," "What Turns You On?," "Courtship Gone Awry," and "Boundaries" to be most helpful.

Upon reading the second half of the book, I realized recovery for sex addiction is very similar to alcohol and drug addiction. The author posits that there is a stronger propensity for relapse with sexual addiction than other addictions. Not sure I agree with that, though the relapse prevention model is very much akin to those used in alcohol/drug recovery programs and seeing that made me feel more confident in my professional capabilities to help a client seeking recovery for sexual addiction. I might even take it one step further and pursue a training to become a Certified Sex Addiction Therapist.

Who can say their work is never boring or that they're always learning more about the human condition?

Therapists.

Working with issues: my own and others

Last week, you may recall I mentioned that I would be posting a short paper I have to write for my Chemical Dependency and the Family class. I basically had to write one page about a distressing quality (aka, personal issue) about myself that could impact or interfere with working effectively with a chemically dependent family. It was difficult to write only one page, seeing as I'm so verbose and all....but here it is.....

Setting high standards for myself has typically worked out favorably for me, at least as far as reaching my goals. Growing up the daughter of a cop and a teacher, a love of learning and a strong work ethic were instilled within me at a young age. I always went the extra scholastic mile, and it showed. I graduated from undergraduate college with honors and went on to get my master's degree in counseling. While this worked well for me in academia, it was a whole different ballgame in the counseling arena of chemical dependency.

It wasn't until I started my first official counseling job working as a substance abuse counselor at a methadone maintainence clinic that I realized how much this quality about myself caused me distress. It also made me ineffective in my work with addicts. My perfectionistic, overachieving standards many times left me feeling like I was working harder than them. I was tired, stressed out, and miserable. I think it also made me less relateable as a person. If I couldn't go with the flow and make mistakes, how could they feel they could do the same in their recovery? I had to release my need for control. I also had to give up thinking that if I worked real hard to help a client, it automatically meant they would magically become sober and make positive changes. If only it were that easy for addicts!

Interestingly, I noticed my work became more effective as I worked on modifying this quality within myself. Sessions with clients became more relaxed, sometimes taking on a life its own. What started off as a distressing quality in the past has morphed into something valuable in the present. Working with a chemically dependent population has impacted my ability to be more patient (with both myself and the client) and more effectively meet clients 'where they're at.'