Hey Ethan: What is an LCSW?

An LCSW or Licensed Clinical Social Worker is someone who has a Masters Degree in Social Work, has completed at least two years of direct, supervised, clinical practice as a Registered Social Work Intern, and has passed the Clinical Social Work Licensure Exam.

Social Workers like to think in “systems”. That means that social workers always think about how a person fits in with the world around them. Other mental health professionals definitely think about this stuff too, but it’s a core part of social work: you can’t take the person out of the environment and you can’t take the environment out of the person—real change happens when you think about the System as the client.

Social Work was also founded on principles of justice, human rights, advocacy, and equity. It hasn’t always lived up to those standards, but it is a social worker’s job to keep learning and challenging themselves to become a better advocate for their clients.

Hey Ethan: What is psychotherapy?

You know how in physical therapy, a physical therapist uses special exercises and techniques to help a client decrease pain, discomfort, or increase the freedom or efficiency of movement? Psychotherapy is the same thing, just for all the stuff you can’t stretch!

Psychotherapy uses many different techniques to help people build awareness, gain insight into themselves, change unproductive behaviors, build new helpful habits, set and reach goals, and sometimes even heal the invisible hurt of worry, loneliness, or heartbreak.

Often therapy is about looking for patterns: When I think (X), I feel (Y), and I do (Z). Once you see patterns, you have the ability to think about them differently, which changes the way you feel, and gives you the energy to act in ways that help you reach your goals. Sometime starting at the other end helps: change what you do, which changes how you feel, which changes the way you think. No matter what, the goal is the same: to improve your self-esteem and your quality of life.

And just so we’re clear: most therapists don’t ask you to lie down on a couch. There’s probably a couch and you’re probably welcome to lie down on it, but it’s generally not required anymore.

Hey Ethan: Does it work? Like for real. Does it?

It really does. Different techniques work for different people and sometimes the client and the therapist aren’t the right fit (we’re people, it happens.) However, research has shown over and over again that the with the right tools and a supportive, trusting alliance or relationship between the client and the therapist, positive change is not just possible—it’s probable.

Sometimes, though, there are things that need to happen before that change feels like enough. Back to the person-in-environment thing again: if a person’s environment isn’t stable, safe, and predictable, real positive change can take longer and be harder to achieve.

Hey Ethan: Do you tell other people what I say in therapy?

Confidentiality means that what a person says to a therapist stays in that room. It can’t be shared. If it is, a therapist gets in real trouble. With anyone under 18, a parent or legal guardian does have the right to know what was said in session. However, without trust, therapy doesn’t work and a client is a client no matter how young, so I ask that families allow space for minors to speak their minds freely. I often find that many of the private conversations become productive collaborative discussions with the whole family when the client is ready.

There are a few situations where a therapist is mandated (meaning they HAVE to) break confidentiality or share what was said in session. Those circumstances are when a client says that they are suicidal (meaning they are thinking about killing themselves), they are thinking about killing someone else, or they are being abused. I have deep respect for any client who shares their pain at this level and I do everything in my power to make sure that I am disclosing the information in a way that is kind, without judgement, and focused entirely on safety.

Hey Ethan: Do you prescribe medicine?

I don’t prescribe medicine. Psychiatrists are medical doctors, which means they are the ones who prescribe medication, such as stimulants for ADHD and SSRI’s for anxiety or depression. Psychologists can be doctors of psychology, which means they are trained to test and evaluate clients, but they do not have the medical training to prescribe medication. I am an LCSW, which means I am licensed to provide direct psychotherapy to humans. This is fortunate because humans are my speciality.

Hey Ethan: What can I expect from my first session?

Good question! The first session in therapy is usually called the “intake." The goal of the intake is for the therapist to take in as much as they can about the client and for the client to take in as much as they can about the therapist. We’ll use the first session to discuss the issue that brought you in, the change you’d like to see, your expectations for me as your therapist, and our shared expectations for each other as a team. I’ll probably ask lots of questions and make a few hilarious (but extremely tasteful) jokes. Clients generally find that just talking through the issue and putting their goals into words can be a positive experience that leaves them with a little more hope than they had before the session. However, I like to make sure that I end each session with a strategy or technique for a client to experiment with before our next meeting. While the therapy is far more about the process than any one strategy, I find that it often helps to have something specific to try or work on between sessions. I’ll also make sure I have your “informed consent” for treatment.

Hey Ethan: You just said “Informed Consent"—what is that?

Informed Consent means that the client has a clear understanding of what they are getting into with therapy and are agreeing to participate in the process. Informed consent isn’t just a one-time thing, either. It (like everything in therapy) is an ongoing process. As things change, new topics or goals introduced, and the therapy because deeper and more complex, it becomes even more important that clients feel that they still have a solid understanding of the process, their rights as a client, the potential risks of the work, and any alternative treatments that might be available to them. I will get your informed consent during the first session, but I will continue to refresh that consent as we move along to make sure you always know your voice—supportive, questioning, or critical—is always encouraged.

Hey Ethan: Can we talk by phone or online?

Yes and our Simple Practice software offers an easy, user-friendly, and HIPPA-compliant teletherapy platform right from your portal!

Hey Ethan: How high can you jump?

Pretty high. If you saw me jump you’d be like: “Whoa—I didn’t expect him to jump that high." I did and you would be right in saying this.