BBS Board Meeting Update

Posted by Robin Gluck

August 28, 2017 at 11:17 AM

On Friday I drove up to Sacramento to attend the BBS board meeting. My goal was twofold: to gather information on matters of importance to MFTs and Social Workers, and to ask a few questions specific to the concerns we’ve heard regarding the MFT Clinical exam. Thankfully, both goals were achieved and I want to share with you what I learned and discuss how this information impacts you.

 

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First, some positive developments:

1. The BBS passed legislation that will allow English as a Second Language (ESL) test-takers to request accommodations for time-and-a-half. This process will begin in October. To qualify for this accommodation, the BBS will require you to show proof of one of the following:

a. A Test of English as a Foreign Language, Internet Based Test (TOEFL-iBT) certification score of 85 or below; or

b. Documentation from a qualifying Master’s degree program showing they granted additional examination time or other allowance due to English as a second language; or

c. Documentation of a foreign qualifying Master’s degree that was presented primarily in a language other than English

Retrieved from: http://www.bbs.ca.gov/pdf/regulation/2016/1805_isr.pdf

2. The BBS, alongside licensing agencies throughout the country, recognize the need to improve mobility and are developing processes to make interstate mobility easier for MFTs and Social Workers. The Pathway to Mobility Committee will take charge of this and develop standards. Among the big changes for MFTs is the CA Clinical Exam being accepted in other states (already true for Oregon) and CA accepting the National Exam for those licensed elsewhere!

3. The BBS is hoping to launch their new and improved website in September. This site will make it easier for licensees to navigate, renew licenses, access forms, etc.

Now let’s talk about the MFT Clinical Exam. To be completely honest, I deleted a few drafts before settling on how to present what is clearly a sensitive subject that elicits many emotions. I am acutely aware, based on feedback from recent test-takers and reading threads on various social media sites, there is a lot of anxiety and anger regarding this exam. And while I do not want to minimize or dismiss people’s concerns and feelings, I am worried that some reactions may be more harmful than helpful. After sharing what was presented at the meeting, I will discuss strategies for moving from a place of feeling like a victim to feeling empowered.

The Office of Professional Examination Services (OPES) shared with the board how they develop their exams and addressed concerns regarding the significant drop in the pass rate in the first two quarters of 2017. While the pass rate in the last two quarters of 2016 was in the low 70% range, it dropped to around the low 50% range in the first two quarters this year. Several people, including me, voiced concerns about the exam, including the drop in scores and complaints we’ve heard about awkward wording and time constraints. OPES and the board listened to the feedback while affirming their belief in the integrity of the exam, acknowledging that drops like this can happen. They are paying close attention to these numbers and noted that data for the current quarter shows the pass rate is continuing to rise. Pass rates in this cycle are expected to be more on par with scores prior to the previous two quarters. While this exam will continue to be administered in California, OPES and Board members heard the concerns that were voice and stated that the conversation is not over.

When I coach people, a key goal of mine is to shift thinking away from feeling like a victim of this test to feeling strong and in control. Feeling empowered will naturally contribute to greater levels of confidence, lower levels of anxiety, and oftentimes greater cognitive functioning as you prepare for and take the exam. So, let’s talk about some strategies to move from victimization to empowerment:

1. Join a professional association and become an active participant (CAMFT, NASW, CALPCC). These agencies exist to advocate for their members and the profession as a whole. Representatives of these agencies will frequently present to the board, advocate for the positions of their members, and help advance their members’ concerns. If you are not a member already, consider joining today!

2. Attend board meetings (or write letters). The most direct way to address concerns and push for change is to communicate directly with the people in charge. When the board convenes, they usually provide an opportunity for the public to participate and ask questions. At the meeting on Friday, several people spoke up about the exam and their concerns. This is exactly how the ESL accommodation came about. Your voice matters, so make sure you are heard!

3. Help with the occupational analysis. Every 3-7 years, the board conducts an occupational analysis—and we are due for one this year. OPES develops and sends surveys to clinicians to understand trends in the field. The results of this survey are used to develop the examination outline. The most recent survey was conducted in 2012 and the response rate was a meager 10-15%. This is a fairly small sample size. If more therapists complete this survey, the examination outline will likely provide a better reflection of trends in our profession. While this survey is conducted for licensed MFTs and not interns (associates), even as interns you can encourage colleagues to complete the survey.

4. Help with exam development. Exam questions are developed by Subject Matter Experts (SMEs). The BBS is frequently recruiting individuals to participate in developing exam questions. You do not have to be licensed for long to do this and if you are not yet licensed, you can again encourage colleagues you respect and trust to participate in the process. Imagine how much better it would feel to have people you know and trust be involved in this process.

5. Focus on your studies and uplifting activities/people. When Amanda Rowan created TDC, she wanted to ensure our program was strengths-based. TDC is designed to help you build your knowledge, clinical skills, and become more confident test-takers without feeling overwhelmed. Pay attention to how you are being affected by your studies—are you studying the right amount, or too much? Do you have a healthy balance between your studies and other aspects of your life? Who do you talk with about your exam prep and how to do you feel after talking with them? Is your supervisor aware you are preparing for the exam and helping you do so? Are you on social media and if so how do you feel after reading different threads? Would stepping away from the collective anxiety on social media be healthier for you for a time? Over the next few days, ask yourself these questions. If you find that your actions are helping lift you up and feel more confident, awesome, keep doing them! If you find certain activities are causing you to feel anxious or angry, pause and consider focusing your attention elsewhere.

These exams are hard, but they are doable. Although you do have to work hard, you do not have to suffer. We have worked with thousands of successful test-takers and are here to support you! If you are struggling, please reach out to your coach. We are here to help you PASS WITH CONFIDENCE!

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Topics: MFT, Exam Prep

Answer and Rationale for MFT Question on Duty to Warn

Posted by Robin Gluck

August 26, 2017 at 11:59 AM

On Friday we posted the following question on our Tarasoff duty, and today we have the answer and rationale for you!

A 24-year-old woman is mandated to therapy by her probation officer for anger management. The therapist has been meeting with the client for 4 months and is nearing termination. Over the course of treatment, the woman slowly opened up to the therapist about her life, including her past involvement with gang violence and drug use. In session, she shares that her boyfriend has been very possessive and threatened to hurt a guy he thought she was flirting with. She confesses that he has a gun, has been in jail for assault in the past, and already researched where the man lives. What actions should the therapist take to address the legal and ethical issues presented in this situation?

a. Inform police of the threat and attempt to contact the intended victim.

b. Encourage client to report the boyfriend’s plan to the police and develop a safety plan.

c. Inform client that we must share this information with her probation officer since she is mandated to treatment and could be an accessory to a crime.

d. Inform client she must report the boyfriend’s plan to the police and assess client’s personal safety.

In this question we are provided with information that is alarming.  There is a clear risk of danger presented by the boyfriend: he has a history of violence, has a weapon, and found where the potential victim resides. And yet, our duty to protect is not triggered. In fact, we cannot notify the police or potential victim without breaching confidentiality.  Let’s look at the answer.

Answer:

The best answer to this question is B.  Answer A would be correct if the client was the potential perpetrator of violence (in fact, this is exactly what we do when our duty to protect is triggered under Tarasoff).  Answer C is incorrect as well since we are not required to report this information to the client’s probation officer and it is outside our scope of practice to determine whether this would constitute accessory to a crime.  Answer D is very similar to B, but rather than encouraging the client to make a report, it has the therapist forcing the client’s hand. Therapists cannot force clients to make reports; it is ultimately the client's decision.  Answer B best addresses how we would handle this situation both legally and ethically. Legally, we would maintain confidentiality. Ethically, we would encourage the client to report the danger to police, but would not force them to do so. Additionally, we would safety plan with the client to manage their personal safety around this situation.

In moments like these it's also a good idea to seek legal consultation to ensure you know what your legal obligations are. If you have a supervisor, this would be a situation you would want to consult with them on as well.

Which answer did you choose?  Does the rationale fit with your understanding of Tarasoff and how you would work in the clinical setting? Or did you learn something new with this scenario?  If you have any further questions feel free to check in with a TDC coach. We are here to support you all along the way. And if you came up with the same answer-great job! You are on the right track to getting licensed.

Still haven’t signed up for an exam preparation program? Our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE.

We look forward to helping you PASS your exam with confidence!

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Topics: MFT, Exam Prep

Free MFT Practice Question: Duty to Warn

Posted by Robin Gluck

August 25, 2017 at 11:30 AM

This week our practice question explores Tarasoff and our duty to protect. Oftentimes, people struggle with questions on this topic because the subject itself feels a bit abstract. Many clinicians have read case law and studied Tarasoff in graduate school, but have not encountered these situations in clinical practice. And while it is an intimidating prospect, the likelihood of our duties being triggered under Tarasoff is thankfully low. However, the BBS still wants to ensure you know what to do in the unlikely event you find yourself in this situation.

The most common question I receive regarding Tarasoff is, “What am I required to do if the potential perpetrator of violence is someone other than my client?” Many clinicians believe our duty to protect is triggered regardless of our relationship to the potential perpetrator, but that is not true. Our duty to protect is only triggered if we can reasonably determine that someone is a danger to others. To do this, a therapist must properly assess the level of risk by taking into account risk factors such as history of violence, affect, language, etc. We cannot accurately assess someone if we do not have a relationship with them and the law takes this into account. Tarasoff is only triggered when it is our client who is the potential danger.

With this in mind, let’s look at the question:

A 24-year-old woman is mandated to therapy by her probation officer for anger management. The therapist has been meeting with the client for 4 months and is nearing termination. Over the course of treatment, the woman slowly opened up to the therapist about her life, including her past involvement with gang violence and drug use. In session, she shares that her boyfriend has been very possessive and threatened to hurt a guy he thought she was flirting with. She confesses that he has a gun, has been in jail for assault in the past, and already researched where the man lives. What actions should the therapist take to address the legal and ethical issues presented in this situation?

a. Inform police of the threat and attempt to contact the intended victim.

b. Encourage client to report the boyfriend’s plan to the police and develop a safety plan.

c. Inform client that we must share this information with her probation officer since she is mandated to treatment and could be an accessory to a crime.

d. Inform client she must report the boyfriend’s plan to the police and assess client’s personal safety.

The answer and rationale will be posted at noon PST tomorrow! We encourage you to post an answer in the comments section below (you can also post your reasoning behind your answer choice!). Then check back in tomorrow for the correct answer and rationale explaining why the correct answer is correct and why the other answers are not correct.

Haven't signed up for an exam prep program yet? Our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE.

We look forward to helping you PASS your exam with confidence!

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Topics: MFT, Exam Prep, Practice Questions

Is Private Practice Right For You?: Part II

Posted by Asya Mourraille

August 23, 2017 at 2:42 PM

Welcome back to part two of our conversation about private practice. Today we are going to explore whether pursuing private practice is the right path for you at this time. Having done both agency and private practice work myself, I have identified a number of questions I will encourage you to ask yourself while considering your choices. Keep this in mind: there are no right or wrong answers here. Each element of private practice and agency work have pros and cons associated with them. It is all about your preferences and finding a work environment that best suits you. So, let yourself sit with these questions for awhile, listen to the answers that naturally emerge, and welcome whatever comes up for you with curiosity and acceptance.

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Business Ownership

One of the biggest questions I encourage you to ask yourself is whether or not you are up for owning a business. Does the idea of having such responsibility electrify you or does the thought of it create a sinking feeling? Do you have an entrepreneur in you waiting to come out or do you prefer to focus purely on clinical work while letting someone else deal with the commercial end of things?

I remember this question was a big one for me. No person in my family has ever owned a business, so it was simply not in my DNA. For generations, my family worked diligently in hospitals and schools, so I had no blueprint to follow in this realm. I really wish I knew at the time that having your own business is akin to having a garden: it will blossom if you consistently tend to it and wilt if you don’t.

Being Your Own Boss

YES!!! No more agency politics. No more unreasonable expectations around paperwork. No more demanding directors and unresponsive managers. You get to set your own schedule, pick your own office, and determine the course of your career. You are the one who gets to decide whether or not you want to work with a particular client. You are the one who determines which conferences and trainings you will invest your time and money in. And you are the one who sets the framework around the paperwork you will complete. It sounds tremendously exciting at first. And if you are a motivated self-starter who likes to make decisions, it can be. If you are someone who feels more comfortable with externally pre-set structures or a person who is indecisive in nature, though, this aspect of private practice may be tough for you.

While it is a pain to get all your notes and assessments done for a monthly file review at your agency, at least you know that all your files will be in order at the end of each month. Can you guarantee the same thing if no one is looking over your shoulder making sure you get them done? And although it often feels like too much is deducted for taxes out of your wages each pay period, you know that taxes are being taken care of with minimal effort on your end. Will you be as diligent as a human resource department when it comes to paying your quarterly taxes and tracking all of the business expenses yourself? Being your own boss can be both liberating and daunting depending on your personality and work style.

Policy Structure

You know what else comes with being your own boss? Setting your own office policies. Some practitioners decide they want to a have a weeklong cancellation policy while others set a 24-hour cancellation policy. Some practitioners charge for phone calls that are over 10 minutes long. Guess what? That is their prerogative, and it will be yours too should you go this route. The kicker, though, is that you are the one who has to enforce each of the policies you set. If you find it difficult to confront clients when they are consistently late- let alone charge them for missing a session- you may decide that you want to stick with working in a setting that does this for you.

Fluctuating Income

Having a private practice can be very lucrative, but it can also take some time to get there. In the meantime, you will not have the consistent check you are used to getting every couple weeks or every month. Instead, your income will have a wave-like quality to it, with some months being more profitable than others. In addition to client cancellations, you will need to account for your own sick and vacation time and put some money aside as a cushion. Some people do not do well with such financial instability; it is either too anxiety provoking or their current financial situation does not allow for it. Others are better able to deal with these fluctuations- they either have another source of stable income or faith that what goes down will eventually come up (or both). How will you weather the ups and the downs? Do you feel like your wallet and your nervous system can take it?

Networking

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You know how the organization you worked for used to supply you with a steady stream of clients? Well, you can kiss such set ups good-bye once you start your own private practice. You alone have to get out there and bring in your own business (unless, of course, you work with an insurance company. In that case, though, you need to make peace with having lower rates). Either way, establishing a web presence and effective methods of advertising will help keep your business afloat. Most therapists I know absolutely despise having to network. Most ofus do not have the skills or the drive to invest our time and energy into regular marketing activities. We idealistically hope that once our doors are open, the clients will flock in on their own. Ask yourself this: how comfortable are you with talking about yourself? Can you clearly summarize the work you do in under a minute? Do you see yourself getting out there on a regular basis and asking for referrals? These are important questions to consider, especially if you want to stay busy (and even have a bit of a waiting list!).

Coworkers

Do you like to be surrounded by people and consult with coworkers during your lunch break? Or do you prefer to work alone, finding yourself annoyed each time someone asks you a question while you are trying to catch up on notes? Even though agency politics can get dramatic at times, if you are the type of person who thrives in a collective environment, private practice may be a challenging adjustment for you. Even in a group practice setting, you will find that your fellow practitioners are busy and you will likely not see them as often as in an agency setting. While establishing a support network for yourself is recommended for anyone pursuing private practice, it is important to recognize that private practice work is substantially more isolating than working at an agency.

As you can see, having a private practice can be a gratifying and profitable endeavor, but it is certainly not for everyone. I have attached a free worksheet here for you to explore these topics further. Take your time to ponder each question and write down some of your thoughts. Next month, I invite those of you who have decided to take the leap and start your own practice to join me here as we discuss the initial steps of starting a business.

 

 

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Private Practice Worksheet

 

Does the idea of owning a business electrify you or does it create a sinking feeling? Do you have an entrepreneur in you waiting to come out or do you prefer to focus purely on clinical work while letting someone else deal with the commercial end of things? __________________________________________________________________________________________________

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Are you a motivated self-starter? Can you set and meet your own goals and deadlines or do you feel more comfortable with externally pre-set structures? __________________________________________________________________________________________________

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Do you like to be in charge of making decisions or is decision making difficult for you? __________________________________________________________________________________________________

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How do you feel about enforcing rules with clients? Do you find it easy to confront your clients or do you struggle in this area? __________________________________________________________________________________________________

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How do you feel about having a fluctuating income? Will you have another job to offset the instability? What will it feel like when a client cancels when your income depends on it? __________________________________________________________________________________________________

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How comfortable are you with talking about yourself? Can you clearly summarize the work you do in under a minute? Do you see yourself making time for networking and asking for referrals? __________________________________________________________________________________________________

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Do you like to be surrounded by people or do you prefer to work alone? Can you see yourself building a support structure for yourself or would you prefer to work in a setting where such structures already exists? __________________________________________________________________________________________________

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Topics: Professional Development, Private Practice

Imposter Syndrome: Surviving Feeling Like a Fraud

Posted by Heidi Tobe

August 21, 2017 at 3:38 PM

 

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You recently finished grad school and got hired on at your very first job doing clinical work (or, if you’re like me, you might be on your second or third job feeling this way!). You face your client as they begin to share with you the issues that brought them to therapy. You try to focus on their words and stay present in the moment, but there is a battle going on. Your anxious mind is throwing constant attacks your way: You don’t know what you’re doing. You aren’t competent to help this person. You’ve never worked with this issue before. You don’t have the skills you need to be an effective clinician. No one should be paying you for your services. In a multitude of ways, your anxious mind is yelling at you, “You’re a fraud! And just wait- it’s only a matter of time before your client finds you out.”

Have you been there? I know I have. It's one thing to learn CBT in grad school. It's another to try and take that knowledge and apply it to a real-life situation with an actual person. In school, we often learn a little bit about a lot of things, but come out lacking the knowledge and experience in any one area to feel competent in our practice. I was incredibly lucky in grad school- I had an amazing practicum that provided me both experience and excellent supervision in DBT. Even so, the Imposter Syndrome I had both during and post grad school were overwhelming and downright debilitating at times.

Nearly every social worker and MFT I’ve spoken with has experienced Imposter Syndrome at some point during their careers. While some clinicians are very open about this experience, others bury these anxieties and fears deep beneath the surface, afraid they are the only ones feeling this way. These feelings can shake us to the core. Genuine human interaction is foundational to our experience as clinicians, and feeling like you are performing the role of a therapist instead of actually being one is counter to all that we hope to be in our clinical work. It can make any and every client interaction exhausting and overwhelming. And ultimately, being caught up in our own minds rather than fully present in the room makes us less effective clinicians, thereby reinforcing our Imposter Syndrome.

So how do we get out of this? How can we make it go away?

Unfortunately, there is no quick, easy fix to make it disappear. Overcoming Imposter Syndrome is something that takes time, acceptance, and experience to get through. There’s no fast-forward button. While there’s not a way to entirely bypass these feelings of inadequacy, we have found some helpful strategies to make this uncomfortable experience more tolerable and fruitful:

1. Sit with the anxiety.

So often we try to fight against our feelings of fear. We try to push them away, bury them, or act like they don’t exist. Instead, try accepting these feelings as part of your present, lived experience. The feelings of anxiety that you are experiencing mean that you care about the quality of your work. If you didn’t care about being an excellent clinician, you wouldn’t feel anxiety. Make it a regular practice to validate yourself. Continually remind yourself that you are at the beginning of your career and that’s where everyone starts. No matter how skilled and experienced a clinician is, we have all been at a minimal place of competence. Rest assured, you're improving and growing every day. This is the beginning and it’s okay to be where you are, not having all the answers (and even experienced clinicians will tell you, you’ll never have all the answers!). It’s okay to not know what to do sometimes. That’s exactly why your supervisor is there!

If you have a supervisor that challenges you (which I hope is the case for each of you!), remind yourself that it is helpful to be challenged. A supervisor who is able to highlight what you could have done differently or what you can do differently going forward will help to make you a better clinician. While this may not feel good in the moment, and can certainly heighten that sense of feeling like an imposter, it is a key element in growing into a more confident and competent clinician.

2. Be vulnerable.

The more I talked about my feelings of fraudulence with others, the more I realized I was not alone. I was so ashamed of the fear I felt, but found comfort in knowing so many of my peers were going through the same thing. As I spoke with supervisors and mentors further along in their careers, I realized that the people I looked up to the most had spent years feeling the same way I was feeling. In her book Daring Greatly Brene Brown states, “Shame derives its power from being unspeakable…If we can share our story with someone who responds with empathy and understanding, shame can't survive.” While opening up about my own experience didn’t remove the feelings completely (even now, I still have moments where I feel like the only real fraud out there who just happens to do a really good job of appearing competent), it helped remove some of the power those feelings had over me. It reminded me that this is all a part of the process. It doesn’t have to be shame inducing, it won’t last forever, and none of us are immune from or alone in it.

3. Remind yourself of what you do know.

It’s easy for me to mentally spiral. One stroke of incompetence can lead to a slippery slope that lands me at a place where I convince myself I know nothing. It’s important that we remind ourselves what we do know. In my work with individuals preparing for their social work exams, I encounter a lot of people days (or hours) before their exams who feel like they don’t know anything. I remind them of how far they’ve come from their first pretest to their final mock exam, as well as the intangible ways I’ve personally seen them progress in their reasoning skills. It doesn’t erase their anxiety, but this dose of encouraging reality is often a soothing balm to the sting of unyielding fear.

When I get to a place where I feel like I know nothing, possess zero rapport building skills, and lack the basic personality traits to be an effective clinician, I remind myself that my feelings are not facts and that in reality there is a lot I am very good at. I remind myself of where I started back in 2012 and where I am now. When you find yourself at a really insecure place, it may be helpful to ask others for feedback on your skills and strengths. If you do this, write their responses down and use them in the future when you need a kick starter for self-validation. And don’t wait until you’ve crashed to the bottom of the pit of self-criticism. Start now practicing self-validation on a daily (or multiple times daily) basis. When your anxious mind feeds you lies about your incompetence, combat them with encouragement and truth. While it’s easier in the moment to let your mind run wild with insecurity, each time you choose to fight back with truth you come one step closer on your path from incompetent imposter to confident clinician.

4. Engage in this quick activity:

Think of something you are really good at now, but that was at one point new and difficult. Maybe it’s a sport, musical instrument, second language, or a challenging hobby. What did it take to move you from a place of ineptitude to a place of proficiency? For me, I think about my first time driving a car. I remember feeling as though driving would never feel natural-that it would always be scary and take immense amounts of mental energy. Now, it feels completely natural and takes minimal effort. I remind myself that in many ways, I am still like a new driver as a clinician, but it won’t always be that way. When I want to run far, far away from the clinical world, I think about the fact that if I gave up on driving when I was 16, it wouldn’t have become second nature like it is today. It took a lot of practice and a lot of uncomfortable moments (if my memory serves me correctly, I was at a complete loss as to how to pump gas the first time. Pre cell phone days and in the middle of a Michigan winter, I stood out in the snow red faced and confused for a good ten minutes before finally asking a kind stranger for help), but over time I moved to a place of competence. What would it have been like if you gave up on the very things that were once hard and are now second nature? What would you have missed out on in life?

It’s a long journey, fellow clinicians, but know that you are not alone. Seek out peers going through the same things you are and individuals further along their career paths who can empathize with you and encourage you along the way. I’ll leave you with the wise words Christopher Robin shared with his best friend Winnie-the-Pooh: “There is something you must always remember: You are braver than you believe, stronger than you seem, and smarter than you think.”

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Topics: Professional Development

Veterans Service Scholarship Winners

Posted by Heidi Tobe

August 18, 2017 at 2:07 PM

On Monday we announced our five winners for Therapist Development Center's 2017 Veterans Service Scholarship. Today, we share a bit of each of their stories. We hope you are as inspired by each of them as we are!

Fernando Chavarria

Michigan State University

After receiving his undergraduate degree in communications, Fernando Chavarria had no plans to pursue education in a different field. It wasn't until Mr. Chavarria was offered a career as a Peer Specialist that he began considering the social work profession. On a daily basis, Mr. Chavarria collaborated with clinicians and it was during this time that he discovered that the field of social work was one comprised of complex communication, relationship building, and collaborative efforts-something not so far off from his original field of communication.

During his time in the military, Mr. Chavarria saw what it looked like to push his mind and body to new limits, increased his confidence and determination, and learned that "impossible is just the body operating without the mind." Mr. Chavarria worked on the short-term inpatient medical floor of the VA Hospital for his first-year internship, assisting with discharge planning and high risk screenings. This experience provided him greater insight into the types of support and interventions provided through the field of social work. Mr. Chavarria has an innate desire to help his fellow comrades and wants to do everything he can to help fellow veterans stay alive in both mind and body when they return home. He plans to become a clinical social worker with the VA upon graduation and to move into positions of leadership that will allow him to advocate for organizational changes that will lead to more effective delivery of recovery-oriented care.

Dr. Brady is a psychologist at the agency where Mr. Chavarria is a Peer Support Specialist. Dr. Brady was so impressed by his clinical skills that she has had him assist in sessions with veterans. She describes Mr. Chavarria as "extraordinary in his authentic depth, ability to connect with others, and ability to convey understanding and accurate empathy” and goes on to state that she has “never seen anyone better.” Dr. Brady has seen Mr. Chavarria “able to offer even difficult feedback in a way which meets with acceptance. He has this essential clinical skill honed, yet keeps striving to encompass more of the human experience." Mr. Chavarria is someone Dr. Brady states has a great deal of life experience and wisdom and is able to use these to lead humbly and authentically. She expects that Mr. Chavarria's clinical social work career will "deeply touch many lives, and help bring about advances.

 

Jonathan Gill

The Ohio State University

As a United States Marine Corps service member who decided to 'come out' after witnessing the repeal of Don't Ask, Don't Tell, Jonathan Gill discovered a community of hidden LGBT service members who created their own support networks due to the stigma of reaching out for help. He encountered many individuals who silently struggled with issues of substance use and mental health issues, failing to get the services they needed. It was during that time that he learned about his own identity, what trauma is like, and how one needs to seek healing once they are removed from the trauma.

During his first-year internship, Mr. Gill met veterans and non-veterans experiencing chronic homelessness. He witnessed and heard stories of trauma and chronic homelessness that he was surprised to find were in his own back yard. Mr. Gill is currently pursuing his Masters degree in Social Work at The Ohio State University, with an internship at the Chalmers P. Wylie VA Ambulatory Care Center in Columbus, Ohio. Mr. Gill’s goal is to work with veterans as a clinical social worker for the VA to address the needs of those transitioning into the civilian world, with an emphasis on homeless reduction, vocational rehab, trauma-informed care, and substance use disorders after graduation. Mr. Gill is interested in using his shared identity as a veteran to build strong therapeutic alliances in his clinical work.

Anna Stewart is one of Mr. Gill’s instructors at The Ohio State University and has worked with Mr. Gill over the last year in three very unique settings, which include a student run free health clinic, a field seminar course, and overseeing his field placement experience. Ms. Stewart describes Mr. Gill as "one of the most motivated students I have ever worked with" and someone who is "humble in his approach to his work and education.” She goes on to share that “he asks for help when needed and never assumes he knows it all. His humble nature allows him to quickly build rapport with patients/clients allowing them to feel at ease." She describes his involvement and commitment to the service of others through his time in the Marine Corps and other campus and community volunteer activities as "commendable" and shares that Mr. Gill is someone who is already "an agent of change for vulnerable and oppressed populations” and that she "can't wait to see where his career takes him.

 

Kelli Hatzenbuehler

University of Nebraska Omaha

Kelli Hatzenbuehler has worked for the United States army for 20 years. Through both her and her husband’s military service, Ms. Hatzenbuehler has learned first-hand about the sacrifices service members make, including being away from their children and spouses for extended periods of time. Through her service, Ms. Hatzenbuehler has developed a great deal of empathy that she will take with her into her career as a clinical social worker.

Ms. Hatzenbuehler recognizes that there is often a language barrier between veterans/service members and the civilian population and believes she is able to understand that language and the unique problems that veterans face. Ms. Hatzenbuehler was first deployed in 2003. During her first year of deployment, she lost three members of her unit. In the thirteen years that this unit has been home, 3 additional members were lost to suicide. Ms. Hatzenbuehler wants to assist service members and veterans when they are feeling hopeless and hopes to do so by working at the VA or a similar entity as a clinical social worker. 

William Buettner has worked with Ms. Hatzenbuehler for over 5 years in the Resilience and Suicide Prevention Office of the Nebraska National Guard and has served in the same units with her on occasion for the past 10 years. Mr. Buettner describes her as someone who "uses her empathy to relate to people in crises and or distress...her empathy helps make the persons at risk talk more freely." He describes Ms. Hatzenbuehler as a person of integrity who "takes the ethical road and helps others along that path." He shares that Ms. Hatzenbuehler is "an expert in her field and looked at by her peers as a subject matter expert” and is someone who continually strives to become better at her duties, consistently rising to the top.

 

Kevin Rumley

Western Carolina University

As a United States Marine Corps combat wounded veteran who has undergone 32 surgeries, Kevin Rumley is someone who has witnessed first-hand the devastation and chaos of war. Mr. Rumley received world class psychotherapeutic and physiological rehabilitative care, including services from clinical social workers at the Walter Reed Medical Center. This along with his early maternal introduction to serving others were catalysts for his passion to become a clinical social worker. It was through his military service that Mr. Rumley's belief in the critical importance of building relationships and active-listening were solidified. He learned that “only through listening can we begin to understand.” Mr. Rumley describes himself as “a veteran for peace” and strongly believes that clinical social workers have the capacity to change lives. He is passionate about recovery, resiliency, and fighting for social justice and is someone who strives to be a positive agent of change within his community.

During his first-year internship serving at the Buncombe County Veterans Treatment Court, he found that non-punitive treatment-based programs are effective modalities for reducing recidivism. He discovered the importance of self-care and boundaries in this difficult work. Mr. Rumley learned that it is through open dialogue and ongoing advocacy that change can occur and that to be the most effective clinician possible, he must remain open and receptive to his environment. Mr. Rumley has worked at NC Brookhaven Behavioral Health, a Service Disabled Veteran-Owned Small Business, for the last five years on the ACT Team (assertive community treatment). He plans to become an LCSW, LCAS, and EMDR practitioner, promoting change on an interpersonal level through EMDR and on a policy level with the goal of instituting harm reduction clinics in rural parts of Western North Carolina. Mr. Rumley additionally hopes to pursue his DSW in the future.

Susanne J. Loar served as Mr. Rumley’s supervisor for the North Carolina Substance Abuse Professional Practice Board for the past two years. Ms. Loar shared that Mr. Rumley is dedicated to assisting people-especially veterans-in their recovery from substance use and mental health disorders. She describes him as "an advocate for veterans living in the community." Ms. Loar reports that Mr. Rumley has been unofficially running the team while he pursues his graduate degree and shares that his "innate intelligence, ethical integrity and vast experience have added value to the individuals and to the wider community.” She describes Mr. Rumley as "a great advocate for people on medication assisted programs” and that he “brings empathy and expertise in the field." Further, Mr. Rumley “has been instrumental in setting up and following veteran's through the veteran's court system" and has been a "driving force in the local and state judicial system." Ms. Loar states that Mr. Rumley is "a tremendous addition to the field of social work" and that she "cannot think of a person more deserving" of this scholarship.

 

Shayne Wiggins

Western New Mexico University

Shayne Wiggins was drawn to the field of clinical social work after returning from his deployment with the United States Marines. He had a difficult time finding a military social worker who was also a veteran. It was through this experience that Mr. Wiggins realized 1. there is shortage of master's level social workers who can provide services through a veteran's lens and 2. many veterans who have experienced combat trauma may feel more comfortable opening up to a professional who can relate to their military experiences.

Mr. Wiggin’s military experience taught him how to fight through adversity and serve with honor. During his deployment, he developed integrity, dedication, commitment, and honor to both his country and his shipmates. His first-year internship taught him that he is a culturally competent social worker in training and that becoming a competent social worker takes commitment and dedication-two things that Mr. Wiggins has. Mr. Wiggins plans to practice clinical social work with veterans who have experienced combat trauma, homeless veterans living with substance use disorders, and veterans who are survivors of military sexual trauma and assault. He recognizes that these are underserved populations that deserve well-trained and competent clinicians that understand their trauma and can help them resolve and manage their traumatic experiences through empirical translational science.

According to Kendrick Lockett, who Mr. Wiggins met through his internship at the Atlanta Mission organization, Mr. Wiggins is someone who "has a gift for working with those who have been subjugated and marginalized within our society." Mr. Lockett stated that "our veteran services have improved significantly since his internship began here” and that “he has excelled in his internship above and beyond the agency's expectations." Mr. Lockett describes Mr. Wiggins as someone who "exemplifies strong attributes and abilities in becoming a clinical social worker.

 

We at the Therapist Development Center believe that more can and should be done by every civilian American to support our troops and veterans, so we are now offering our programs FREE for any veteran or active duty military, including each of our scholarship applicants. To learn more about how to obtain this offer, click HERE. To learn more about our social work exam preparation programs, click HERE.

Haven't signed up for an exam prep program yet? Our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE.

We look forward to helping you PASS your exam with confidence!

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Topics: Exam Prep, Social Justice, Social Work Exam Prep, Professional Development

2017 Veterans Service Scholarship Winners

Posted by Bethany Vanderbilt

August 16, 2017 at 1:47 PM

Congratulations to the 5 winners of the 2017 Veterans Service Scholarship:

1. Fernando Chavarria of Michigan

2. Jonathan Gill of Ohio

3. Kelli Hatzenbuehler of Nebraska

4. Kevin Rumley of North Carolina

5. Shayne Wiggins of New Mexico

We would like to thank everyone who participated in our 1st annual Veterans Service Scholarship for 2nd year MSW students. We had more than 50 applicants from 21 states and 29 schools! Our entire scholarship committee was impressed by the service and quality of our applicants and it was extremely difficult to select our winners. We are inspired by each of your stories and hopeful for the positive impact you will have on this field and the world. Stay tuned for a piece featuring each of our scholarship winners.

We at the Therapist Development Center believe that more can and should be done by every civilian American to support our troops and veterans, so we are now offering our programs FREE for any veteran or active duty military, including each of our scholarship applicants. To learn more about how to obtain this offer, click HERE. To learn more about our social work exam preparation programs, click HERE.

On behalf of the Therapist Development Center team, we wish you the best in your careers as clinical social workers and we know the world will be a better place with your contributions to the field.

Sincerely,

Bethany Vanderbilt, LCSW

Executive Director

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Topics: Exam Prep, Social Justice, LCSW Exam Prep, Social Work Exam Prep

Pathways To Success

Posted by Heidi Tobe

August 16, 2017 at 10:01 AM

So often when I see a successful clinical social worker who is a leader in their area of expertise, I find myself wondering how they got there and what their first few years out of grad school were like. I’m excited to announce that once a month we will be interviewing and sharing the story of a clinical social worker’s or MFT’s “pathway to success” and have an opportunity to explore these questions. It will share insights, hard earned wisdom, and tips that we hope will encourage and inspire you no matter where you are on your own pathway to success.

Our first “Pathways to Success” social worker is Sharon Greene, LCSW.

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Sharon received her Masters in Social Welfare from UCLA in 2000 and immediately started working in the mental health. She has coordinated school mental health programs and is currently the social work training director at Providence Saint John’s Child and Family Development Center, a nonprofit Department of Mental Health contracted center that provides mental health services including therapy, psychiatric treatment and psychological testing to disenfranchised youth and their families from diverse backgrounds. Sharon is part of the executive management team and oversees the intern training program for master's level students in Social Work and is responsible for the training and professional development of their licensed staff. She has trained hundreds of social workers, MFTs, and psychologists. In addition, Sharon is a certified trainer in Managing Adaptive Practices, Crisis Oriented Recovery Services, Interpersonal Psychotherapy (IPT) along with being certified as a therapist in Seeking Safety, Cognitive Behavioral Therapy, and Positive Parenting Program. She is a consultant for the Interpersonal Psychotherapy Institute and provides training calls to clinicians being certified in IPT. Sharon has received intensive training in Structural Family Therapy at the Minuchin Center in New York and teaches the Advanced Clinical Practice graduate course for UCLA’s Social Welfare Department. She has been a field liaison and guest lecturer at California State University, Northridge in their graduate social work department and has been an adjunct professor in the graduate Social Work Department at University of Southern California. 

TDC: When you entered graduate school, what did you imagine your life would be like now? How have things turned out similarly or different?

Sharon: When I entered graduate school, I was in the PHD program at UCLA's social welfare program. I thought I would end up as a professor teaching and doing research. A year into the PhD program, I realized I wanted to get my Masters and do more clinical work. Luckily, as I have built my career, I have had the opportunity to teach in the graduate school social work programs at UCLA, USC and CSUN which incorporates some of my original thoughts of what my career would look like. What I did not imagine at the time is that I would also have the opportunity to provide therapy in private practice and be a training director touching many lives for the better.

TDC: What was it that drew you to the field of social work?

Sharon: Originally what drew me to the field of social work was my desire to help the underprivileged and disenfranchised. I was initially more interested in policy and programming than clinical work. As I studied, though, I realized how important it was to do direct services to truly understand what different populations need. As I immersed myself in the clinical world, I found that I love providing therapy and was hungry to learn more and more as to how to help individuals and families in a clinical setting. My thirst for knowledge drove me to seek out trainings in different types of therapy. I was lucky enough to have some amazing trainers, challenging but supportive supervisors and inspiring mentors who continued to encourage me to grow professionally. Because of these great experiences, I wanted to give back and now have focused the next stage of my career in being a clinical supervisor, trainer and teacher in the mental health field.

TDC: So what was your first job out of grad school?

Sharon: My first job out of graduate school was at a residential facility for girls with mental illness- many of whom were either part of the DCFS system or were on probation. This experience was so valuable and career changing because it was what made me so interested in pursuing training in Structural Family Therapy. The clients whose families where willing to participate in family therapy fared so much better than the clients whose families were disengaged. I found myself enjoying conducting family therapy with all the complex dynamics occurring in the therapy room and I also was so impressed by the outcomes of the work. I sought out more training and supervision. It was the first time in supervision that I was truly challenged. I had to submit video tapes of my session and despite it being initially anxiety provoking, I grew immensely as a clinician. Although it was a difficult first job, unbeknownst to me, it launched the direction of my career so I am so thankful for it. I always tell my supervisees you never know where the road with take you. If you allow your experiences to teach you, the road will take you to the right destination for you.

TDC: How did you get from that job to where you are now?

Sharon: When I got offered my first job it was not my dream job, but I took it because I needed to start working immediately due to finances. As I mentioned, my first job ignited my passion for doing family therapy. Because of my experience working with youth who were on probation, I was offered a job at Saint John's Child and Family Development Center working with youth who were at a transition school, transitioning from the Youth Authority back to mainstream public schools. The majority of my work was doing group and family therapy on the school site. During this time, I was being supervised by the outpatient director who saw something in me. She encouraged me to pursue more training and to take on more administrative responsibilities. After getting licensed, I became coordinator of the school based mental health programs at the clinic. I was able to enhance the services we were providing to incorporate family therapy. Many school based programs see the students individually on the school sites but do not involve the families so this made our program stand out. I received the Dorothy Kirby Administrator of the Year Award from NASW in 2007 due to my work in this program. I found myself enjoying providing supervision and training my staff and soon moved into an executive position at the agency as the Social Work Training Director. I continue to be in this position where I train and provide clinical supervision to social work interns and unlicensed staff. I am also certified as a trainer in several evidenced based practices. This launched me into teaching at local universities. I maintain a small private practice which I enjoy. I feel it is crucial to have your hands in the work in order to be an effective clinical supervisor and trainer. All of this started from taking a job that was not a dream job. Had I never worked with the youth at the residential facility who were on probation I would not be where I am today. I feel so lucky to have the career I have with my hands in so many different things from private practice, training, providing clinical supervision, and doing consultant work.

TDC: Who has influenced your work? Do you have any social work/mental health mentors?

Sharon: Jacquie Wilcoxen, LCSW, my first supervisor at Saint John's, has greatly influenced my work and I am so grateful that she gave me the confidence that I could achieve what I wanted in this field. Clinically, Salvador Minuchin has greatly influenced my work. I have always been interested in the working of systems and structural family therapy provided me with a framework as to how to do systems work with families to enhance their functioning.

TDC: What do you think has made you so successful?

Sharon: I think that my passion for the work, my passion for learning, and my passion for sharing my knowledge has made me so successful.

TDC: What drives you to do your day to day work?

Sharon: I love helping clinicians grow through training and supervision. Those light bulb moments that I help facilitate for clinicians make my day. In addition, I enjoy my work with clients. I recently was trained in mindfulness and have been incorporating that into my practice. Seeing my clients develop more self regulation and self compassion is so gratifying.

TDC: What’s next on the horizon for you?

Sharon: I want to reach more clinicians and contribute to expanding the amount of quality mental health services out there. By doing continuing education courses live and online, I hope to reach this goal.

TDC: If your current self could give your younger self a piece of advice as she was finishing up her MSW program, what would it be?

Sharon: Don't worry so much. By being open to experience and learning and following your passion, you will create a career that you love.

TDC: What advice do you have for those just starting out in their social work career?

Sharon: Keep learning. Keep pursuing experiences whether trainings, on the job experiences or reading books that will expand your horizons. Find a therapeutic orientation or practice that resonates with you and become an expert in it. Lastly, get good supervision. Find a supervisor that supports you and challenges you to grow. I have grown the most from supervisors who challenged me to take risks and that made me show them video tapes and audios of my sessions. It is from anxiety provoking uncomfortable situations that we grow the most.

 

If you know a clinical social worker or MFT who should be highlighted in an upcoming "Pathways to Success" story, email Heidi at heidi@therapistdevelopmentcenter.com

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Topics: Counseling, Family Therapy, Professional Development

Answer and Rationale for MFT Practice Question on Suicidal Clients

Posted by Robin Gluck

August 14, 2017 at 10:22 AM

On Friday we posted the following question on suicidal clients, and today we have the answer and rationale for you!

Jill, an 18-year-old college student who is living at home, has been meeting with a therapist on a weekly basis for several months. She was referred for therapy after receiving medical treatment for alcohol poisoning. Jill reports feeling alone, lacking direction, and does not believe the future has much to offer her. She cut back on drinking after her experience with alcohol poisoning, but continues to smoke marijuana on a regular basis and has experimented with other drugs. In session, she shares that her boyfriend broke up with her over the weekend and now that she is completely alone, she wants to go to sleep and not wake up. How should the therapist manage the legal and ethical issues presented in this case?

a. Determine if she has a plan and means to commit suicide before taking other steps

b. Inform parents of risk because client lives with them and is a danger to self

c. Initiate involuntary hospitalization due to stated suicidal ideation and substance use

d. Validate client’s feelings of helplessness and help her identify healthier coping strategies

This question provides you with some information about risk factors, but the clinical picture is incomplete and until you gather more information it will be hard to determine the most appropriate intervention. The BBS is not only testing that you know when to intervene, but is also testing that you will take reasonable, measured steps based on the level of risk and not overreact. Breaking confidentiality or initiating hospitalization prematurely could rupture the therapeutic relationship and cause greater harm than help to the client. Remember, our legal and ethical responsibilities are to assess and manage our client’s safety and overall well-being. With this in mind, let’s review our answer choices.

Answer:

The best answer to this question is A. The client has expressed suicidal ideation, but has not indicated a plan or means to carry out a plan. Before we decide what level of intervention is appropriate, we would need to assess the level of risk. Based on the information provided, it’s not clear if breaking confidentiality is necessary, or if it’s even appropriate to involve the parents, so we would hold off on B. We are not required to break confidentiality, but may choose to do so only if we believe it is necessary and would be beneficial. Answer C may be tempting as well because of the risk linked to substance abuse, feelings of hopelessness and suicidal ideation. Again, this would be a jump without assessing plan and means. Answer D is not strong because validating the client’s feelings of helplessness and identifying healthier coping strategies does not directly address the suicidal ideation and potential danger to self and would fall short of fulfilling our legal and ethical obligations.

Which answer did you choose? Does the rationale fit with your understanding of danger to self and how you would work in the clinical setting? Or did you learn something new with this scenario? If you have any further questions feel free to check in with a TDC coach. We are here to support you all along the way. And if you came up with the same answer-great job! You are right on the right track to getting licensed.

Still haven’t signed up for an exam preparation program? Our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE.

We look forward to helping you PASS your exam with confidence!

 

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Topics: MFT

MFT Practice Question: Suicidal Clients

Posted by Robin Gluck

August 11, 2017 at 10:15 AM

In this week’s practice question, we explore the subject of suicide. You will likely see several questions on this subject regardless of which exam you take. This topic can be difficult to navigate whether you are working in the clinical setting or trying to determine the best answer on an exam question. However, reviewing the audio lectures that Amanda Rowan developed teaches you how best to approach these questions on the exam. You will also be able to take this knowledge with you into your clinical practice!

I am frequently asked about issues regarding our legal and ethical requirements with suicidal clients. Common questions include, “Aren’t I mandated to break confidentiality if my client is suicidal?” or “How do I know which intervention is most appropriate?” Although we are not mandated to break confidentiality, we are legally and ethically obligated to assess a client’s level of risk and take a measured approach to address their safety. What this looks like will depend on the information shared by the client and the therapist’s understanding of risk factors. With this in mind, let’s review our question of the week:

bigstock-Beautiful-mixed-race-African-A-169146785-1.jpgJill, an 18-year-old college student who is living at home, has been meeting with a therapist on a weekly basis for several months. She was referred for therapy after receiving medical treatment for alcohol poisoning. Jill reports feeling alone, lacking direction, and does not believe the future has much to offer her. She cut back on drinking after her experience with alcohol poisoning, but continues to smoke marijuana on a regular basis and has experimented with other drugs. In session, she shares that her boyfriend broke up with her over the weekend and now that she is completely alone she wants to go to sleep and not wake up. How should the therapist manage the legal and ethical issues presented in this case?

a. Determine if she has a plan and means to commit suicide before taking other steps

b. Inform parents of risk because client lives with them and is a danger to self

c. Initiate involuntary hospitalization due to stated suicidal ideation and substance use

d.Validate client’s feelings of helplessness and help her identify healthier coping strategies

This week we are doing something a little different with our practice question: we are waiting to post the answer and rationale until tomorrow! We encourage you to post an answer in the comments section below (you can also post your reasoning behind your answer choice!). Then check back in tomorrow for the correct answer and rationale explaining why the correct answer is correct and why the other answers are not correct!

Haven't signed up for an exam prep program yet? Our structured, straightforward approach to exam prep will provide you with exactly what you need to pass your social work exam or MFT exam and nothing you don’t. You can learn more about our social work licensing exam prep HERE and more about our MFT licensing exam prep HERE. If you’d like to connect directly with one of our coaches, you can do that HERE.

We look forward to helping you PASS your exam with confidence!

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