Topics 8 & 9: Non-Therapy Duties & What Therapists Don’t Talk About {by 7/17}

Based on the readings due this week consider the following two discussion points: (1) What required duties beyond therapy do you find the most frustrating and/or least enjoyable? Why? (2) Based on Pope Chapters 1 and 4 , what particular “Myth” (or Taboo/Secret/Question) piques your interest the most? Explain. (3) Based on Chapter 5, what “possible clue to taboo topics” concerns you the most as a practicing therapist? Explain.

Your original post should be posted by the beginning of class 7/17. Post your two replies no later than 7/19. *Please remember to click the “reply” button when posting a reply. This makes it easier for the reader to follow the blog postings.

43 Comments (+add yours?)

Lindsey Guyton
Jul 16, 2025 @ 12:45:28

Out of all the required duties beyond therapy, I find coordinating care with a client’s external providers to be the least enjoyable. Unfortunately, I worked with an incredibly difficult and unprofessional intensive care coordinator during my internship who failed to appropriately advocate for our client’s best interests, creating much more stress and chaos for the situation as a whole than what was necessary. Aside from this negative experience, finding time to meet with external providers in general was always much more of a hassle than anticipated, especially since there would be such frequent last-minute cancellations or changes to the original plan. I understand and value the importance of touching base with clients’ external providers and ensuring that we are all on the same page, but the logistics of doing so are more often than not frustrating and stressful.

Based on the assigned readings for today, I found the myth describing how therapists are “invulnerable, immortal, and ageless” to be the most intriguing. Despite how outlandish and out-of-touch this statement is, I know that many clients come into therapy sessions expecting their issues to be automatically resolved and that their therapists will work miracles during each session. Even though this is unrealistic and not at all an accurate representation of what therapy should entail, people tend to believe that therapists should have qualities akin to what the myth describes in order to be most effective. Some therapists may feel pressured to live up to these expectations and thus overwork themselves, ignore hallmark signs of burnout, or continue to practice even if a specific clinical concern is beyond their expertise. Not only is this myth laughable and downright silly, but it also creates false and harmful expectations for how therapists should conduct themselves.

Out of all the “possible clues to taboo” topics in Chapter 5, the one that concerns me the most is the “seeking repeated reassurance from colleagues” topic. During my time as a practicing therapist, I have always been told that seeking consultation from other professionals is never a bad idea. According to this topic, however, seeking consultation for the wrong reasons or as a means for receiving reassurance can be a sign of an unacknowledged taboo. In order to be as mindful of this as possible, it is important to seek consultation with the desire for receiving guidance about how to approach a specific situation or for a second clinical opinion.

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- Paige Riendeau
  Jul 17, 2025 @ 09:57:59
  
  Hi Lindsey,
  
  I agree that coordinating care with external providers for a client can be a real pain, especially when others in the care team are not fulfilling their roles to the child’s best interest. Finding time within our own schedules to schedule time with these providers can also be difficult, as you said there are often last minute cancellations and other such mishaps that make communication feel nearly impossible some days.
  
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- William Ritacco
  Jul 17, 2025 @ 12:55:03
  
  Personally, I find it most frustrating to deal with all the documentation that is insurance driven. This is in particular when it feels like you are writing more for billing than any actual clinical use. I recognize that it is important to keep good records and meet standards ethically, but it can get quite overwhelming when you’re spending more time rephrasing things to satisfy the system than actually thinking deeply about a client’s progress. There is a noted tension between professional identity, and the demands of the system, and I feel that every time I get caught between doing some meaningful clinical work and just checking boxes to meet productivity or billing standards it really takes me out of the present moment with clients and makes the work feel more mechanical than I think it should.
  
  One of the myths about Therapists that really hit me was the one that Pope talks about when he mentions therapists should not feel anger towards clients. It was interesting to see how common this feeling actually is, but how rarely we actually talk about it. It does feel uncomfortable to admit, especially in a profession that teaches you to be calm, patient and empathetic at all times, however in reality when you’re dealing with high intensity cases, trauma, or even just someone who pushes boundaries, anger can come up. This doesn’t mean you’re a bad therapist. It just means you’re human. What matters is how you process these feelings and whether you recognize it for what it is rather than pretending, it’s not even there in the first place. I think ignoring it actually does more harm than good so we’re better off acknowledging when things like this come up.
  
  In terms of clues to taboo topics that concern me most, one that really stuck out to me was when therapists start to subtly avoid certain clients for example saying things like I’m running late or ending sessions early or feeling a dread before sessions. Pope mentions this as a red flag that there is something deeper going on. He mentioned it may be something like burn out countertransference or that the case is unresolved inside of us. I noticed there have been moments where that kind of tension has come up with certain clients and I just chalked it up to being tired or off. However, looking back, it may have been more than that. It is a reminder to stay aware of patterns and how we show up with different clients because those patterns could show us blind spots that we are not seeing or we are not naming aloud.
  
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  - Bella
    Jul 17, 2025 @ 15:02:36
    
    Hi Billy! I think you made a really great point addressing the concept of anger with clients. I think it can actually be harmful to act as though frustrations do not come up as when they are recognized and addressed then therapists can get supervision and process why they are feeling the way that they are as you mentioned. Without addressing the feelings coming up or the behaviors contributing to those feelings it can be harmful to ignore or deny those feelings and can impact rapport.
    
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  - Melanie Bonilla
    Jul 19, 2025 @ 23:20:25
    
    Hi Billy,
    
    I also found therapists not being angry as shocking and upsetting because it feeds into the expectation that therapists should always be okay, calm, composed. But like you said, we are human, and we should have the right to express ourselves, obviously in a professional and appropriate manner. Why this is important is because if we suppress it, it can just cause more harm than good. And the benefit of speaking up is self-awareness but also transparency to our clients and colleagues which can all help us grow.
    
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  - Taylor Crow
    Jul 20, 2025 @ 18:31:51
    
    Hey Billy! I totally understand and resonate with your blog post about feeling anger toward clients and some of those moments of subtle avoidance. This is definitely something I have felt with a client during my internship and it always made me feel guilty. I definitely think that it would have been beneficial to discuss this with a helpful supervisor and maybe do more work on exploring why I was mad, moving past that emotion, and looking at the client in a more neutral light. These chapters were super insightful!
    
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- Dimitr Getchevski
  Jul 21, 2025 @ 22:59:38
  
  Apologizes for the late responses, completely slipped my mind.
  
  I really appreciated your comment Lindsey, and reading your post I can see how notes can be a minor inconvenience in comparison to far more tedious tasks that are outside of our control. Intensive care coordinators that fail to advocate for our client’s best interest sounds infuriating. The logistics of coordinating with different providers sounds annoying in of itself, but to then have to deal with individuals that are not doing the best that they can for our clients, especially for those in difficult and vulnerable states, sounds more than frustrating.
  
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Rachel Marsh
Jul 16, 2025 @ 21:02:05

What Therapists Don’t Talk About and Why: Understanding Taboos That Hurt Us And Our Clients

1-Out of the required duties beyond therapy, I find documentation to be the least enjoyable. Although documentation is necessary, I enjoy interacting with clients and care teams the most. I have not (yet) met a clinician who enjoys doing the documentation aspect. It can be challenging depending upon the setting. Each setting has different expectations for documentation and what should be included. I currently work in an ABA-Based Special Ed. Program and did my internship for the same company I work for – but working in residential. The documentation for educational settings is vastly different from what is expected in residential settings. Although my internship and job were with the same company, both settings had different approaches for documentation due to having differing funding sources. Learning the nuances between both has been very helpful in working to become a clinician, however it was a bit of a learning curve.

2-With the readings of Pope chapters 1-4 in mind, the myth that piqued my interest the most is “If you’re a good therapist, the money will take care of itself” (Pope at al., 2006, page 6). This myth mainly highlighted the experience of therapists in private practice, but this made me think of my experience working in a school and residential as well. Generally, the pay for the work we do doesn’t match up to the services we provide. Pope and colleagues highlight that even a great therapist working in private practice will come across clients who decline to pay for sessions and struggle with insurance companies. In private practice, there is the benefit of having more control over pay and accepting clients who are self-pay without needing to hassle with insurance companies. Areas outside of private practice are generally underpaid to a greater degree, especially in residential/inpatient and educational settings. In my experience working in both settings, I have met clinicians who were questionable, but I have also met many clinicians who do great clinical work and do not receive a pay that matches the quality of services they are providing. Additionally, working in these settings requires involvement with parties such as school districts, milieu staff, and systems such as DCF/DMH to a greater degree than private practice. With legislation that has been passed recently, these settings which are already under-funded and overwhelmed to begin with will experience greater gaps.

3- Of all the “possible clues to taboo” topics in Chapter 5, the one that concerns me the most is “The Client-Friend” (Pope et al., 2006, page 71). As a therapist it is easy to become connected to clients that we may view as more likable or more relatable. As much as we are encouraged to remain neutral and therapeutic, we are people as well. Sometimes we may not realize that they have a favorable bias toward these clients. In classes we talk a great deal about having negative biases toward clients. On the other hand, having biases toward clients that are too positive may blur the therapeutic alliance and be just as harmful. At my internship placement, I worked with clients who had an extensive history of exploitation and difficulty understanding boundaries – as they had their boundaries violated many times in the past. Supervisions regularly consisted of discussions in maintaining boundaries, ensuring self-care, and consistent reflection in the way that my clients may perceive me in sessions and on the milieu. Navigating this by setting firm boundaries with my clients while still maintaining the therapeutic alliance is one of the more prominent things that I learned in my internship. Although we are someone that our clients can trust (we hope) boundaries need to be maintained as to not cause confusion for our clients. This can be hard for clients – as they often share things with us that they likely do not disclose to other people.

Pope, K.S., Sonne, J.L., & Greene, B. (2006). What therapists don’t talk about and why: Understanding taboos that hurt us and our clients (2nd ed). American Psychological Association.

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- Paige Riendeau
  Jul 17, 2025 @ 10:00:49
  
  Hi Rachel,
  
  Girl I am so with you, documentation is such a drag. Engaging with clients or other coworkers is far more stimulating in my opinion. Documentation also takes up so much time, I feel like some organizations expect an entire novella written at the end of each session. I appreciate you sharing your experience of how even within one organization, documentation expectations can look vastly different depending on the level of care you provide.
  
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- Bella
  Jul 17, 2025 @ 15:07:28
  
  Hi Rachel, I think you made a great point regarding the balance between wanting to build a solid rapport with clients and not molding ourselves to be more “likeable” or create a friendship as opposed to a professional therapeutic relationship. I love the point you made about not confusing the client and being able to model boundaries for those that struggle with that, I think in a lot of ways that can be protective for clients if done correctly.
  
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Paige Riendeau
Jul 17, 2025 @ 09:51:15

Discussion for 7/17

Beyond the actual therapy component of this profession, I quite dislike the duty of completing paperwork and documentation. I understand the many reasons for why documentation is important and necessary, however sitting down to complete it provides the same feeling as sitting down to work on a homework assignment. Sitting in front of computer screen typing away feels tedious at best and is not stimulating enough to keep me engaged or motivated to complete the assigned work, therefor I often find that it takes me an extended period of time to complete said notes when in reality if I was able to focus, they would likely take me little time at all.

After reading through the assigned chapters for this week’s class, I found that many of them had me rolling my eyes, especially the comment “If you’re a good therapist, your money will take care of itself”. I feel like it’s common knowledge regarding how vastly underpaid many occupations within this field are. Community based mental health organizations as well as behavioral health services often require lots of work that leads to significant rates of burnout, however the rate of pay is laughable compared to what many of these organizations request of their employees. In a setting like Devereux, clinicians are not only expected to provide their typical therapeutic services but are also asked to engage in crisis management and physical intervention of unsafe students. I can personally recall many incidents in which I witnessed clinicians placed in situations that threatened their safety as well as their relationship with their clients.

After reading through chapter five and the listed “possible taboos”, one that caught my attention was “seeking reassurance from colleagues”. Throughout this program and through my time at internship, it was always emphasized that checking in with colleagues during times of uncertainty was encouraged. I have always been told that it is better to consult first, rather than jump the gun and make a mistake, so I was a bit surprised to see this listed, though it does make sense. If an individual is constantly seeking reassurance rather than consultation, that paints a different picture. Consultation of a colleague is important to helping us grow, especially as fresh graduates just beginning in the field, where in contrast, constant reassurance seeking can be seen as needy and proof of one’s own insecurities in their abilities to complete what is expected of them.

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- Lindsey Guyton
  Jul 20, 2025 @ 17:03:11
  
  Hi Paige,
  
  Although I personally enjoy writing session notes and doing other types of documentation, I can totally understand your perspective about it being monotonous and tedious. I’ve always enjoyed writing and am glad that there is such an emphasis of it in this particular field, although I won’t be surprised if I come to find it cumbersome further along in my career. Session notes are one thing, but the other types of documentation (i.e., consents, ROIs, referrals) can get old very quickly, especially if multiple clients need different types of documentation by a certain time.
  
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Alyson Langhorst
Jul 17, 2025 @ 11:15:21
1. I would say that coordinating care can be frustrating, especially when it’s difficult to get in contact with these individuals. There were times during my internship placement where I had to essentially play phone tag with other providers because they were very difficult to get in touch with. Additionally, interns were required to help clients and those in the community with filling out government assistance forms and applying for various programs. That in itself was totally fine, however it became frustrating when individuals consistently no showed these appointments, were difficult to contact, or show up to a follow up appointment and wouldn’t bring any of the required documentation that we spoke about previously. As these assistance programs were time sensitive, it was especially frustrating when individuals would no show because we had very limited time that we could provide help with these applications, and it sometimes meant having to schedule someone out multiple weeks or not being able to see them at all.
1. The myth “learning ethical standards, principles, and guidelines, along with examples of how they have been applied, translates into ethical practice” was the most interesting. The chapter explains that what we learn about ethics is just the starting point of ethical consideration in practice. While some aspects of ethics can be very obvious (at least to most people, I’m still shocked when I hear of stories regarding therapists who have committed serious ethical violations, like how did you think that was okay??), other aspects can be quite difficult to discern. Clients giving a therapist a gift, for example, can be kind of a gray area depending on the type of gift. Understanding the ethical codes and practicing them has a lot to do with setting and respecting boundaries for both yourself and the client and doing so in a way to not accidentally hurt the client’s feelings.
1. I would say that the “seeking repeated reassurance from colleagues” concerns me the most. Consulting with other colleagues and your supervisor is a very important part of being a therapist. However, this part of the chapter highlighted that leaning too much into consulting with others could lead to needing reassurance and becoming insecure in your own abilities. Like everything, there should be a balance between knowing what to consult others with and when you should consult with colleagues and your supervisor and differentiating those instances from ones that wouldn’t be useful or helpful to share.
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Ashleigh Keller
Jul 17, 2025 @ 11:35:36
1. A required duty beyond therapy that I find least enjoyable is paperwork and documentation. As it is essential to be paid and to cover ourselves, i understand the importance, however actually doing it is insufferable. I have had to instill a habit of doing notes as soon as possible because I know this is important once i begin full-time paid clinical work. I also find it difficult to parse out what should be included in documentation and what can be left out or remain vague, especially when I had a difficult client and wanted to make sure that if parents requested documentation that it would maintain his privacy while also providing rationale for treatment.
2. I found the myth that “If you’re a good therapist, the money will take care of itself” most interesting. I have found that a lot of people believe that since we have master’s degrees, we will be paid a good amount. It is usually jarring to someone when I tell them the average starting salary after graduating. Being a good therapist does not dictate your level of compensation, as there are so many different factors that come into play. Truly, insurance companies dictate our pay as they decide how much our sessions are worth reimbursing, so even the best therapist in private practice could struggle. Those working in community mental health face the difficulty of taking on a large case load with lower pay due to the population they serve; however, this is a population that desperately needs our services.
3. The taboo “seeking repeated reassurance from colleagues” concerns me most. As others have stated, we are continually encouraged to seek supervision and guidance when we are unsure. To know this could be taboo is disheartening, as I find this to be a lonely field sometimes, where we are in our offices with our clients, then leave. As a new clinician, I find myself running ideas past the senior clinicians at my job and especially my supervisor. I do know that I have to trust my clinical judgement and be able to make choices for treatment on my own. Reassurance is different from guidance, and I feel that it makes sense that you don’t want to seem as though you are insecure in your position.
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Han Dao
Jul 17, 2025 @ 11:41:06
- 1. With respect to required duties beyond therapy, I feel that extensive documentation and paperwork are the most enjoyable. I believe that notes, treatment plans, progress notes, billing documentation for insurance, etc., are very important in the therapy process, which help us to keep track of clients’ progress and insurance requirements. I, nevertheless, sometimes feel repetitive and time-consuming. Additionally, it takes our time away from direct client care and our personal responsibilities, leading to increased pressure and burnout.
- 2. Based on Pope’s Chapters 1 and 4, the Myth “With their extensive education and training, therapists have a firm grasp of logic and, whatever the limits of their knowledge, do not fall prey to basic logical fallacies” stood out to me. On the one hand, it seems reasonable because therapists receive years of training in their field. On the other hand, this myth ignores the simple truth that therapists are human, and like all humans in the world. Despite their best attention, they still have flawed logic and emotional reasoning. For example, there may be instances where therapists use incorrect research studies to inform their practice or misinterpret the studies. This reveals that good therapists are more than just knowledgeable; they also incorporate self-awareness and self-reflection, which are essential.
- 3. Based on Chapter 5, the “possible clue to taboo topics” that I am most concerned about as a practicing therapist is “the client-friend”. In other words, a client becomes more of a friend than a client. This blurring of roles may begin subtly, when the clinician and the client first share laughter and obtain information, but it raises ethical concerns. At first glance, it seems harmless. However, the danger lies in confusing therapeutic rapport with personal friendship. When this boundary begins to erode, it becomes increasingly difficult for the therapist to maintain professional objectivity. Thus, building rapport and trust with clients is very important, but setting boundaries is also significant. Therefore, supervision, self-awareness, and consultation are necessary supports and safeguards against turning into inappropriate dual relationships
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- William Ritacco
  Jul 19, 2025 @ 13:25:16
  
  Hey Han,
  
  You made a great point about how documentation which I know is crucial but also can also drain time and energy that we’d rather be putting into direct client care. I’ve definitely felt that same pressure as you brought you here. It’s like we are trying to stay clinically sharp and emotionally present, but the admin side sometimes pulls us into autopilot and away from thinking of our client. I also appreciated what you said about therapists being vulnerable to logical fallacies despite all the training. This really hit me because sometimes we forget that knowledge doesn’t immunize us from bias it just gives us better tools to notice it if we stay self-aware.
  
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Dimitr Getchevski
Jul 17, 2025 @ 14:26:21
1. Notes. I hate notes. They’re boring and tedious. Does anybody find notes and documentation enjoyable? Those who find notes enjoyable need to go to therapy. Was I straw manning there or just being insensitive? Hard to tell, but I doubt anyone’s going to come in here defending the enjoyability of documentation. Tomfoolery aside, what I find most tedious about documentation is that because I do take it seriously and because I am still fresh and unexperienced, I struggle with being concise and efficient in documenting progress notes. With practice and feedback I’m sure the most frustrating part of the job will become ever so slightly less frustrating and dare I say, enjoyable? Probably not, but hopefully less frustrating.
2. I found a lot of the myths and taboo questions quite interesting! You could map my interests on a tachycardic ECG, piques for days. Seeing as how chapter 2 was not part of the readings, I’ll avoid the sexual attraction, arousal, and fantasies questions in Chapter 4 as my pique interests, although that potential avoidance is all the more reason to address this taboo topic. I think starting with – “What, if anything, has a client said or done, or what could a client say or do, that you would experience as sexually arousing?” and “Have you ever worked with a client whom you experienced as sexually arousing? If so, could you work effectively with that client?” and the remaining questions of the same theme in Chapter 4 piqued my interest the most. Are we surprised? No. Out of all the topics as taboo, I find this one to offer the most discomfort in discussing with supervisors, colleagues, and classmates. The fact that it’s sexual in nature triggers some sort of societal alarm that we must tread carefully and avoid if possible? It’s not like other topics, such as not being paid by a client or managing a private practice. That’s just business. This is sex. Well, sexual. How do we go about talking about it? To we take a clinical and detached approach? Do we cover our ears like Smeagol in Lord of The Rings, and pretended like we don’t hear? Do we take an honest a vulnerable approach? What about the potential repercussions and potential social alienation? I like this topic because it is hard to talk about it, and because it’s far more of an occurrence than the conversations that are had around it.
3. I’m not sure which topic concerns me the most, but I found the “client-friend” particularly intriguing and potentially something for me to be extra-aware of. I don’t see myself going into the extremes listed in the chapter, such as meeting clients for sessions at restaurants, tennis courts, or anywhere outside the office. However, I did notice that during my internship at the college counseling center, towards the end of my sessions, I felt like the dynamic between myself and the student, was starting to hint at being of two “friends” talking, rather an a therapist and client. This was always a good indicator to reevaluate treatment goals, and discuss termination when treatment goals had been met. I feel like I, as most people in our profession, have a predisposition to getting a long with folks, and that can lead to the “client-friend” dilemma when our goodwilled intentions lead to an overly favorable and positive bias towards certain clients. I do try to stay mindful of what our dynamic is supposed to be and to not cross that boundary, and I have brought it up once in session, clarifying that we are meeting to work towards a therapeutic goal, not to just “shoot the shit” as buddies.
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- Han Dao
  Jul 19, 2025 @ 14:54:56
  
  Hi Dimitr,
  
  Thank you so much for your humorous and great post! Notably, your reflection on the “client-friend” issue is very appreciated. The tendency to want to connect and relate can be both a strength and a vulnerability in the mental health counseling field. I appreciate how you handled the shift in dynamic during your internship by recognizing it, addressing it, and using it as a cue to revisit your goals. The way you framed the distinction, “we are here for a therapeutic goal, not just to shoot the shit,” was very kind, clear, and essential! Thank you!
  
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- Lindsey Guyton
  Jul 20, 2025 @ 17:11:42
  
  Hi Dimitr,
  
  As someone who enjoys writing session notes (yes, really!), I chuckled when I read your post. Although there have certainly been times where it took everything in me to bring myself to write my session notes at the end of the day, I enjoy reflecting on what happened during my sessions and describing how I assisted a client in generating insight, processing their emotions, engaging in cognitive restructuring, etc. They serve as a tangible reminder of the progress my clients are making in session, which often provides me with a sense of fulfillment after a long day. Writing notes in accordance to what insurance companies require can be tedious and that aspect of it absolutely plays a role in dulling the experience, but I still view them as a positive in that they provide me with a chance to “debrief” with myself and process each session.
  
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Mariana Valera
Jul 17, 2025 @ 14:39:11
1. There are a few required duties that I consider most frustrating and/or least enjoyable and many of them are crucial parts of my job. One is documentation and progress notes, I definitely have accepted them and understand they are an important part of our job, but I still don’t find them enjoyable. If I’m being honest, the last thing I want to do during or event after sitting in a session is write a note on the session. Another area that I don’t find enjoyable would be filing 51A or any mandated reporting. Again, I understand the importance and reason these mandates are in place but it’s still a difficult thing to have to go through as a therapist especially considering the impact it may have on the therapeutic relationship.
2. A specific question that stood out to me or piqued my interest was the “What if anything, could a patient say or do to you that you’d be uncomfortable or embarrassing to you during a session?”. I really never thought about this before but towards the end of my internship I had one experience with a patient where I felt very awkward and uncomfortable. I had never previously considered what type of scenarios would make me feel uncomfortable or awkward until I was in the predicament. In general, I can be a very awkward person when “the spotlight” is on me and that’s why I like being the therapist because this has nothing to do with me. I have had patients ask me personal questions before like my culture which does not bother me and I think can be valuable for my patients to know if they find it important such as my Hispanic patients. This specific patient had commented on my image and the way he went about it and what he was saying made me feel awkward and uncomfortable that I just awkwardly chuckled and then transitioned back on to the topic. It was a patient that was not assigned to me luckily, but I was surprised after the encounter and consulted with a supervisor to discuss what had happened and how it made me feel. I wish it was something I had considered more in the beginning to better prepare myself.
3. It was hard to which clue to taboo topics concerned me most as several of them concern me. One of the many includes the avoidance one. Essentially doing everything to decrease sessions including canceling, not rescheduling appropriately, or booking them far out. It’s the therapist putting their feelings before the clients. Even when explain the discomfort I felt with a patient in question 2 the resolution to that uncomfortable isn’t to cancel future sessions and sabotage the potential to have a session. The right thing would be to consult with a supervisor or colleagues and if you as the therapist can’t handle putting your emotions to the side then its most appropriate to support the patient by transitioning them.
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- William Ritacco
  Jul 19, 2025 @ 13:21:39
  
  Hey Mariana,
  
  I really appreciated your post. What you said when you mentioned documentation totally hit. As we all know it’s important and part of the job, but that doesn’t make it any less draining, especially right after you just have an intense session with a client. Sometimes it feels like the clinical work keeps you emotionally engaged, but the paperwork just end up pulling you back into your own head. I also liked that you brought up 51As. They’re so necessary, but yeah I get that it would never be easy. There’s always that tension between doing the right thing legally and ethically, and worrying about how it’ll affect trust with the client. I think a lot of us wrestle with that more than we let on.
  
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- Han Dao
  Jul 19, 2025 @ 15:17:35
  
  Hi Mariana,
  
  Thank you for your thoughtful and great post! I appreciate your insight on the “avoidance” taboo. You have subtle ways that help clinicians pull back from discomfort rather than leaning into it. It really stood out to me with your point that not putting the therapist’s discomfort ahead of the client’s needs. The way you tied it back to your example by consulting with a supervisor instead of avoiding the situation demonstrated a great deal of maturity and clinical integrity. Thank you!
  
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Heken Bugaev
Jul 17, 2025 @ 14:47:13

I honestly find the documentation process really frustrating—especially when it feels like it’s more about meeting insurance and billing requirements than actually being useful from a clinical standpoint. I get that keeping accurate records is important and ethically necessary, but sometimes I feel like I’m spending more time rewording things just to check the right boxes instead of focusing on what really matters: my clients’ progress.Paperwork in general feels tedious to me. It reminds me of homework—just sitting at a screen typing for hours—and it’s hard to stay engaged or motivated. I’ve noticed that when I start falling behind on my notes, it snowballs fast. Then I feel even more overwhelmed, and that stress just adds to burnout. With more focus, I know the notes wouldn’t take that long, but getting into that headspace is easier said than done.

One myth that really stuck with me, especially from reading Pope’s chapters, is the idea that “If you’re a good therapist, the money will take care of itself.” I think a lot of people believe that once you get your master’s degree and have the skills, the paycheck just follows. But honestly, it’s not that simple. Being a great therapist doesn’t automatically mean you’ll earn a good income. A big part of how much therapists get paid comes down to insurance companies and how much they decide to reimburse for sessions. Even the best therapists in private practice can struggle because insurance rates are often low. And for those working in community mental health, it’s even tougher—they often have big caseloads, lower pay, and are serving people who really need help. This myth really highlights a hidden challenge in the field—money and financial realities don’t get talked about enough, but they have a huge impact on how therapists feel about their work and how long they stay in the profession. It also shows how important it is for therapists to understand the system and maybe get involved in advocating for better pay and funding.

The “seeking repeated reassurance from colleagues” topic in Chapter 5 really stood out to me—and honestly, it made me pause and think. I’ve always heard that consulting with supervisors or colleagues is a good thing (and it definitely is), but this chapter pointed out something I hadn’t considered: when we rely too much on others for reassurance, it might be a sign of self-doubt. I’ve caught myself second-guessing decisions before and wanting someone to tell me I did the right thing. While it can feel comforting in the moment, I can see how doing that too often might hold me back from building confidence in my own clinical judgment.

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Helen Bugaev
Jul 17, 2025 @ 14:50:22

I honestly find the documentation process really frustrating—especially when it feels like it’s more about meeting insurance and billing requirements than actually being useful from a clinical standpoint. I get that keeping accurate records is important and ethically necessary, but sometimes I feel like I’m spending more time rewording things just to check the right boxes instead of focusing on what really matters: my clients’ progress. Paperwork in general feels tedious to me. It reminds me of homework—just sitting at a screen typing for hours—and it’s hard to stay engaged or motivated. I’ve noticed that when I start falling behind on my notes, it snowballs fast. Then I feel even more overwhelmed, and that stress just adds to burnout. With more focus, I know the notes wouldn’t take that long, but getting into that headspace is easier said than done.

One myth that really stuck with me, especially from reading Pope’s chapters, is the idea that “If you’re a good therapist, the money will take care of itself.” I think a lot of people believe that once you get your master’s degree and have the skills, the paycheck just follows. But honestly, it’s not that simple. Being a great therapist doesn’t automatically mean you’ll earn a good income. A big part of how much therapists get paid comes down to insurance companies and how much they decide to reimburse for sessions. Even the best therapists in private practice can struggle because insurance rates are often low. And for those working in community mental health, it’s even tougher—they often have big caseloads, lower pay, and are serving people who really need help. This myth really highlights a hidden challenge in the field—money and financial realities don’t get talked about enough, but they have a huge impact on how therapists feel about their work and how long they stay in the profession. It also shows how important it is for therapists to understand the system and maybe get involved in advocating for better pay and funding.

The “seeking repeated reassurance from colleagues” topic in Chapter 5 really stood out to me—and honestly, it made me pause and think. I’ve always heard that consulting with supervisors or colleagues is a good thing (and it definitely is), but this chapter pointed out something I hadn’t considered: when we rely too much on others for reassurance, it might be a sign of self-doubt. I’ve caught myself second-guessing decisions before and wanting someone to tell me I did the right thing. While it can feel comforting in the moment, I can see how doing that too often might hold me back from building confidence in my own clinical judgment.

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Bella
Jul 17, 2025 @ 14:51:28
1. One of the most frustrating duties for me that isn’t inherently a part of therapy is in coordinating schedules and managing appointments with clients as well as with other providers. This can be incredibly frustrating especially when managing no-shows or cancellations and the inevitable phone tag that occurs as a result. Working in my agency we had a receptionist however they were trained and would often enter in appointments incorrectly, or add clients that were not mine into my schedule on days that I was not in office leading to a few “surprises” in my schedule. Reaching out to clients or other providers to reschedule can be time-consuming and sometimes feels inefficient, as multiple attempts may be needed just to connect. This can be furthered by needing to correct appointments or fix errors in scheduling day or that add a layer of scrambling and stress that takes away from the flow of the day.
2. The myth or secret that sticks out to me is the idea that therapists are always calm, objective or unaffected by their work. I think this point especially struck me with all of the conversations we have had centered around the reality of burnout and the importance of maintaining self care. This myth creates a harmful expectation that therapists are emotionally neutral or remain calm and unaffected by their cases and their complex content. This is not the reality as therapists are human beings with their own emotions, and a large part of our role is being able to switch and compartmentalize our feelings to maintain professional boundaries, but that does not mean that we do not experience emotion or take feelings and ideas home with us from the clients we work with. Despite training in emotional regulation and boundaries, they still face risks of vicarious trauma, compassion fatigue, and burnout especially when working with high-intensity cases.
3. I like many others, was struck by the idea of seeking reassurance being considered taboo. Given the nature of internships, where we rely on colleagues, supervision, and support to find our footing in the field, there is a real risk of becoming too dependent on that feedback to feel confident that we are managing clients correctly. It’s important to find a balance between seeking proper, informed guidance and developing trust in our own skills, so we can build confidence and comfort in making sound, independent decisions. All of this being said, I also do believe that building connections with colleagues and being able to offer second opinions and collaborate is a really powerful strategy and tool to stay informed and to continue to learn in this field as well.
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- meghanguittar
  Jul 19, 2025 @ 15:37:42
  
  Hey Bella,
  
  I had similar thoughts on the seeking reassurance topic. I feel like it’s about finding a balance. There’s a big difference between struggling on a case and getting feedback/suggestions and asking colleagues frequently if you’re doing the right thing. I think either extreme can be harmful, either never consulting colleagues or asking their opinion too much. I think it’s different when you’re just starting out too. We need more supervision than someone who has been in the field longer.
  
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- Melanie Bonilla
  Jul 19, 2025 @ 23:31:27
  
  Hey Bella,
  
  I cannot only relate but feel your frustration regarding scheduling and coordination. Scheduling and coordinating with not only clients but also external provides was not only overwhelming but often times difficult for me. I thrive off of routine and structure, and at my internship we were expected to not only be flexible at all times but also responsive to last minute cancellations, phone tags, errors in scheduling, multiple feedback of external providers not agreeing, which all made it very challenging and draining. Now I do understand that sometimes that is apart of the job, but it can be a stressor if one is not aware or utilize grounding techniques to help navigate this.
  
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Taylor Crow
Jul 17, 2025 @ 14:59:12

(1) There are actually two required duties beyond therapy that I find pretty annoying. The first being having to deal with other providers that may be involved in the care of the particular client. *cough cough* psychiatrists and prescribers. In my experience, these individuals see so many clients and for only about 15 minutes tops. They are too busy to respond to emails and their notes do not always reflect the current state of the client. It was often quite frustrating because I would try to be a helpful advocate for my client after they have tried to reach out to their prescriber with no luck. Secondly, I also think dealing with insurance is super frustrating. In some instances, you have to document an inaccurate primary diagnosis in a client’s chart in order for insurance to cover sessions. I learned this the hard way when I met with a client whose primary diagnosis was clearly BPD, so that is what I documented. My supervisor then informed me that my client’s insurance would likely not cover treatment with a primary diagnosis of BPD because they believe personality disorders are basically “incurable.” Frankly, everyone else seems to make this job harder when they are not willing to cooperate and work together for the good of the client.

(2) The myth that piques my interest the most is the one that discusses understanding ethical principles means they translate well into ethical practice. I feel like reviewing the ethics, taking a course in ethical considerations, and doing your own research can be great; however, there are sometimes where “gray areas” make me question what is correct and what is not. I feel like context really matters and everything is not as black-and-white as some of the ethics books make it out to be. For instance, if your client who is terminally ill expresses they want to go to another country to get physician assisted suicide, should you report that as a client who intends to harm themselves? They have expressed a plan, a method, and intention, but they express they are suffering due to an incurable terminal illness. What would you do?

(3) I think the “fantasies, dreams, daydreams, and other imaginings” is most concerning to me, especially the sexual fantasies regarding a client. I understand that it is very human to be attracted to other people, and I’m not here to kink shame; however, if you are thinking about your client in a sexual matter, that seems a bit weird. It makes me feel a bit icky and I feel like it could lead to potential dangerous behavior depending on how the individual handles their “urges.”

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- Rachel Marsh
  Jul 20, 2025 @ 09:29:27
  
  Hello Taylor,
  
  I enjoyed reading your post! I especially found your point around ethics and the question you asked around physician-assisted suicide to be quite thought-provoking. Ethics when we first start learning about it seems very straightforward- but there are also a lot of areas as you mentioned such as physician-assisted suicide that could be viewed as both ethical and unethical depending on what aspect you are looking at. There are even some states that are passing legislation to allow it (including some New England states). Some countries in addition to terminal illness, have begun to discuss legislation to allow physician assisted suicide for individuals with psychiatric diagnoses such as Borderline Personality Disorder as well. Although different countries have different ethics – would you approach the situation of a client under your care for a personality disorder who verbalizes going to another country for this treatment the same as someone who is terminally ill?
  
  Overall, great post! Keep up the great work!
  
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- Dimitr Getchevski
  Jul 21, 2025 @ 23:11:01
  
  Hey there brother,
  
  My second thought was that I think some people might think you’re kink shaming if you call them weird for having sexual thoughts about their clients. I am not one of those people, however. My first thought was that I really liked your topic of interest for the myths. As someone who enjoys exploring the varying shades of grey, whether intellectually or at Kohl’s clearance rack, I appreciate what you are bringing attention to. I like to think about the functional purpose of ethics in practice, and what the goal of having a code of ethics is for. Blind obedience, even towards a code of ethics, does not inherently lead to fulfillment of the codes purpose. I think the example you gave is one that represents that, and there are many other circumstances like that, that can occur. It’s important that we think and develop our understanding beyond what’s written, and to have the discussions that we have, whether on here or in class, in order better understand ethical principles and their purpose.
  
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Ashley Calore
Jul 17, 2025 @ 15:09:47
1. In my opinion, the least enjoyable duty beyond therapy is completing documentation. I do understand the importance of completing this task, however it is often time-consuming and very repetitive. I’ve made a habit of doing notes promptly, but I still struggle with providing the right amount of detail and getting the motivation to do the best job possible on notes. I also find collaborative care with other members of clients teams can be challenging and frustrating. In my experience, it can be challenging to reach people via phone and get the information you need.
2. A myth that really stood out to me was the idea that therapists should never feel anger toward their clients. While being a therapist does mean you need to be calm, patient, and empathetic, it is still normal to feel other emotions. For instance, intense cases or cases that evolve trauma can naturally evoke anger for therapists. However, I do this it is important that therapists remain aware of these emotions and not act upon them to clients.
3. The taboo of “seeking reassurance from colleagues” stood out to me because it contrasts with what I’ve consistently been taught during this program and my internship. Furthermore, I have always been told that it was the right thing to do to check in with others when I need assistance. I think that this helps prevent mistakes and make the best possible decisions for my clients. However, I do see how there is a different between seeking consultation for growth and learning versus constantly seeking reassurance for every situation.
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- Katie Aiken
  Jul 19, 2025 @ 22:03:52
  
  Hi Ashley!
  
  I liked that you wrote about the myth regarding feeling anger toward clients. This is definitely something I experienced in internship while working with families. Reflecting on why I might be feeling angry at a parent or client is important, and helped me to remain objective and in the moment.
  
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Angela Connors
Jul 17, 2025 @ 15:27:37

A required duty beyond therapy that I personally find the lease enjoyable/frustrating revolves around paperwork and documentation. Although I strongly believe that this is a valuable and important part of the therapeutic process, sometimes I find myself feeling an extra layer of pressure to complete notes as soon as possible. For example, sometimes clients have reported that they feel uncomfortable when the therapist starts documenting during session. I find this to be very understandable and when putting myself in the shoes of the client, I can see why this may cause discomfort and perhaps even come across as cold at times. Further, I find that documentation can easily take the therapist out of the present moment with the client if they are consumed with documenting throughout the session as a whole.

The myth that I found piquing my interest the most was the myth about “good therapists” not having to worry about money. There is so much here! First, one would hope that being a competent therapist equates to making more money; however, that is not always the case in reality. Additionally, there are plenty of therapists in the field who make a sizable amount of money and are not as competent/professional as others who may be making less. Additionally, there is a lot more that goes on behind the scenes that dictates the salary of a therapist (i.e., insurance, licensure, population, agency, and etc.). All in all, being a competent therapist does not always guarantee adequate compensation.

The taboo statement revolving around seeking reassurance from colleagues concerns me the most as a future practicing therapist. I found this statement kind of contradictory to what we have been taught throughout our education, as we oftentimes were encouraged to seek reassurance and feedback from coworkers and supervisors. I also find this statement to be a bit rigid and cold, as it can be really refreshing to talk with colleagues as these individuals have a different level of understanding and can potentially relate to our own experiences. Be that as it may, I do agree that seeking “repeated reassurance” from coworkers can be problematic to colleagues, as needing constant reassurance can create issues and leave some room for the other colleagues to feel mentally drained/burnt out.

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- meghanguittar
  Jul 19, 2025 @ 15:27:40
  
  Hey Angela,
  
  I hear you on the documentation issues! I know lots of clients feel concerned about what their therapist is writing down and I personally feel it takes me out of the moment. On the flip side, if I don’t write something down, I forget it. I end up just jotting down a mess of notes and then have to decipher my scribbles at the end of the day when I have a chance to write progress notes. It’s very much as painful as it sounds. Even still, I prefer it to doing concurrent documentation and typing on my laptop while the client speaks. I always think of how frustrating it is when you’re at the doctor’s office and it feels like they’re spending most of the time in the room with you just doing documentation.
  
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meghanguittar
Jul 17, 2025 @ 20:45:09

(1) Like many people have said, I find documentation to be the least enjoyable duty outside of therapy. It felt like half my day was just doing documentation sometimes. I found myself getting really frustrated by the many different individual consent forms I had to have clients fill out. I had to keep lists of all my required documentation for intakes because it was so easy to lose track. Part of my dislike of documentation is the fact that I usually save it for the end of my days because I had back to back clients. After a long day, the last thing I wanted to do was write progress notes.

(2) The myth I found the most interesting was “if you’re a good therapist, the money will take care of itself”. It’s interesting to me to see this myth when I feel we so often hear the opposite, that therapists don’t make good money. I feel that’s something a lot of clinicians wear with pride, the idea that they are suffering for their work. I’ve found it’s especially common in community health settings. I’ve never really liked the idea that I can’t love what I do AND make money from it. Asides from that, I think it’s just odd to measure our worth based on how much money we make. I’ve met really bad therapists who make a lot of money and really good therapists who make little. I’ve met the opposite as well. A lot of it comes down to how you market yourself, where you live, if you have an uncommon specialty, and sometimes luck.

(3) The “possible clue to taboo topics” that concerns me the most is repetitive therapy. During my internship, I often had clients who my supervisor (unfairly) called “lifers”, implying they’ll be in therapy for life and that they only come to see us to have someone to talk to. I read their notes from previous therapists and found they were working on the same things every week with no progress, or even worse, not working on anything at all. When I met with the clients, my results were split. I think with half of my caseload, their previous therapists assumed they would be “lifers” and didn’t put the effort in, resulting in the clients not making progress. Most of those clients finished treatment during my time at my internship once they actually had the chance to do some interventions. With the other half of my caseload I found myself getting stuck in repetitive therapy. Each time we would try new interventions, they would either not attempt them or have a new crisis occur which they wished to address in session instead. It took extra effort to help some of these clients adjust to doing interventions and homework instead of talk therapy. These sessions were really draining as it felt like I was fighting to get a word in sometimes. I worry that down the line I’ll get burnt out and start doing repetitive therapy like many of my clients previous therapists.

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- Rachel Marsh
  Jul 20, 2025 @ 08:50:19
  
  Hello Meghan,
  
    I enjoyed reading your post! I completely agree with your statement regarding documentation. I appreciate what you mentioned about keeping a list of required documentation. In my internship I had what felt like a lot of documentation required. As unenjoyable as documentation was, this was helpful to stay organized.
  
    Additionally, I liked the taboo you chose for part 3. I especially appreciate what you brought up regarding clients who have been in therapy for a long time. Often times, clients who have been in therapy for a long time may not have found a good therapist match or interventions that motivate them. It is unfortunate that your supervisor also viewed the clients in your caseload in this way. It is extremely commendable that you put in the extra effort to see what the underlying pattern for this was to support your clients in achieving their goals, regardless of how long they have been receiving services. The fact that many of these clients completed treatment while working with you is a testament to your work as a clinician and will be a valuable asset for you to have in the future.
  
    Overall, great post! Keep up the great work!
  
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- Taylor Crow
  Jul 20, 2025 @ 18:43:17
  
  Hey Meghan! I really appreciate and applaud you for your honesty in that very last sentence of your blog post. This is also something that I fear, and it comes up in the back of my mind, but I try to push it down because even just the thought makes me feel guilty. This is why I think self-care is so important! I get everyone talks about it and stresses the importance; however, how often do agencies allow for clinicians to practice self-care to avoid burnout and repetitive therapy? I think there are some great places that give self-care days and prioritize the care of their therapists so that they can help the actual clients get better and make progress. Unfortunately, some places do not really care about short-term therapy and this definitely adds to the stressful caseloads of therapists at these places. It is hard to balance work and a social life when you are expected to do repetitive therapy with “lifers” while also taking on more and more clients to meet your productivity goals. The whole thing is exhausting!
  
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Katie Aiken
Jul 17, 2025 @ 21:53:10
1. One required duty beyond therapy that I find frustrating at times is coordination with other agencies or resources the client might have. In particular, I have worked with families with DCF involvement and that struggle with behavior at school, in which I had weekly meetings with teachers, school counselors, and DCF workers. I have also filed some 51As which require contact to DCF. Being new to the field and having to contact these agencies can be daunting, and collaborating with them was challenging at times.
2. One myth from Chapter 1 that particularly piques my interest is the “myth of therapist invulnerability”; the idea that therapists don’t struggle with the same mental health challenges as their clients. This myth could contribute to isolation, or reluctance to seek treatment as a therapist. We encourage vulnerability and help-seeking in clients, but often feel compelled to conceal our own struggles. This disconnect can perpetuate stigma of mental health struggles in the field.
3. In Chapter 5, one clue that concerns me the most is “the absence of conversation or consultation around emotionally charged experiences”, particularly when therapists avoid discussing moments of doubt, confusion, or discomfort with colleagues or clients. This silence can indicate a taboo area, whether it relates to feelings of incompetence, or countertransference for example. Avoiding these discussions can lead to burnout, ethical blind spots, or diminished effectiveness. Individual and group supervisions should be places where these “unspeakable” experiences can be named, explored, and understood without fear of judgment or professional repercussions.
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- Ashleigh Keller
  Jul 18, 2025 @ 14:20:33
  
  Hi katie! That is an interesting myth to think about! Clients and others may believe that since we are trained in counseling that we can apply it to ourselves. While that may be true sometimes, we also need an unbiased take on our lives and are just as susceptible to mental health struggles.
  
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Melanie Bonilla
Jul 18, 2025 @ 00:09:03
1. There are a few required duties in therapy that I do not like doing even though I know it is so important to do. First is documentation, second, progress notes, and third, reaching out to external providers. I just personally enjoy more of the sessions, and providing the care, then needed to write everything we did down . And that in itself requires another set of thinking cap because it can not be gibberish but professional and vague but informative enough to be billable. As the external providers, at my internship, there was so many people I had to speak to for just one client, and if I wanted a certain plan to be accomplished/approved, then it would have to go through every single person. Waiting on emails, writing numbers of emails, setting up meetings, it was all so tedious. Again, I know the importance of all of these, but sometimes it can be a lot.
2. The myth that pope mentions that I find most interesting is how therapists are always okay. This myth feeds into how therapists should be calm, regulated, and insightful at all times. It excuses that therapists are human and can have personal struggles. Which only reinforces isolation of not wanting to be vulnerable with your clients or staff, but also feeling burnout due to not seeking support when needed. I believe that this important in our field to know and debunked because once we put on the role of therapists, there are unsaid exceptions from even our supervisors and colleges to have ourselves be collected at all times, but that in itself is not healthy and can cause more harm than good to not only our clients but to others around us (in the work environment).
3. A possible clue to taboo topic that concerns me the most as a practicing therapist is the “client friend”. As therapists it is our goal to build a therapeutic relationship, and that comes with trust. But sometimes the therapeutic relationship can start becoming a “friendship”. This is a problem because now roles are being blurred and it can make it difficult for the therapist to maintain professional boundaries. Personally, I think there was moments where I caught myself with one client that I had in my internship that the way I was speaking was becoming more friend like instead of client like. Of course, I was able to readjust and reflect to do better. But it is always important to go over boundaries, and treatment goals, and have an awareness check on yourself and of the client and seeing the direction of session.
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- Ashleigh Keller
  Jul 18, 2025 @ 14:17:39
  
  Hi Melanie!
  
  I wrote something similar about the process of writing notes. Clinical writing is its own skill that can be difficult to learn. i still second guess how I need to word notes sometimes and deciphering what is important to include. Making sure to cover yourself to be reimbursed and also in case notes are requested by the client can be difficult.
  
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- Katie Aiken
  Jul 19, 2025 @ 22:01:50
  
  Hi Melanie!
  
  I found it hard especially while working with adolescents or young adults similar in age to establish clear boundaries when it comes to the topic of the “client friend”. I definitely have had moments where I want to talk to the clients like a friend, however it is important to stick to your boundaries!
  
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Maura Sneed
Jul 31, 2025 @ 15:18:10

One of the most frustrating duties beyond therapy for me is the administrative workload—especially the constant documentation and scheduling demands. Progress notes, treatment plans, and managing client communication outside of sessions can be mentally exhausting. While I understand the necessity of thorough documentation for ethical and clinical reasons, it can feel like this work pulls energy away from the therapeutic process itself. It’s especially challenging when paperwork starts to pile up, making it harder to stay present and focused with clients during sessions.

From Pope’s Chapters 1 and 4, the myth that piques my interest the most is the idea that “good therapists don’t have personal problems.” This myth is harmful because it promotes the false idea that therapists must be emotionally perfect or completely resolved in order to help others. In truth, self-awareness and the willingness to engage in our own growth can actually strengthen our work. Denying our humanity can lead to isolation and burnout, and this myth contributes to a culture where therapists might feel ashamed to seek support or supervision.

In Chapter 5, one “possible clue to taboo topics” that concerns me the most is when certain subjects—like therapist vulnerability, mistakes, or ethical uncertainties—are consistently avoided in supervision or peer discussions. I have seen this at times in my own office and in other locations within my agency. I have a coworker currently in another location who has confided in me about experience of countertransference where she has been vulnerable and open, and this has not been met with knowledgeable support. This kind of silence can create a professional environment where people feel unsafe to be honest or ask for help. I believe these unspoken topics can build pressure and lead to greater risk of harm or burnout, which I currently worry about for my peer. As a practicing therapist, I want to be part of a culture that normalizes open dialogue and reflection, even around difficult issues.

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