Tag Archive for: Louisville therapist

Improving Posture Can improve your aging and quality of life

How to Look Decades Younger | Healthy Aging Series: Part 15

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There was a crooked man, and he walked a crooked mile,
And he found a crooked penny and he had a crooked smile,
He bought a crooked cat which caught a crooked mouse,
And they all live together in a crooked little house.

I remember the crooked man nursery rhyme. The image I got was of a man bent over shuffling along a crooked road. I saw the image of a crooked house, and the image of a crooked cat and mouse. It all seems a little nonsensical. There is a political interpretation that has to do with crookedness, as in dishonesty or “I’m not a crook” (I’m sure you get the reference.) But I’ll stick with the literal image.

When I look around in the community, much like the crooked man, I see lots of crooked people, bent over, twisted, shuffling, and often times using a cane. Or, another way of putting it is, people with poor posture. Unfortunately, poor posture is associated with being elderly.

Poor posture is a problem. One of the more obvious problems, if not superficial, is poor posture is associated with aging. 

In other words, poor posture makes you look older.

My wife and I were visiting Saint Augustine a few years back and we went to a place that they called the Fountain of Youth. “Drink the water and gain eternal youth.” I’m not one of those people who wants to deny getting older. My mother taught me that there’s no better age for you, than the age that you are right now. It’s more than just vanity to want to continue looking youthful. One of the ways that you can  accentuate your youthfulness is with good posture. 

Problems Created by Poor Posture

Beyond this somewhat superficial problem, there are other problems that poor posture creates. 

Poor posture can create mobility issues and put a person at risk for falling. When you are standing straight your body is positioned over your center of gravity.  As you become more bent over, your body leans out, forward of your center of gravity. It would be similar to you taking a 10-pound dumbbell and holding it out in front of you and maintaining uprightness as you do. It puts a lot of strain on the body and puts you at risk for falling over.  

Poor posture can cause back pain and other joint pain. It puts constant strain on your lower back muscles. And for those with more severe posture issues it can cause problems with your breathing by limiting the full range of motion that you need to inhale and exhale fully.

What Causes Posture Problems?

There are a few obvious answers to that question. These are habits that are usually out of our control.

  • Accidents

There are times that posture problems are created from accidents. I have family members that have a difficult time standing up straight because of back injuries due to car accidents. There are genetic problems that are completely out of your control that can cause posture problems. 

  •  Gravity

One of the more obvious problems that every human being deals with is gravity. Gravity is constantly pulling you downward. 

  • Aging

Another issue that we all face as we age is the lack of elasticity in our ligaments and the fragility that are bones experience as we age.

And here are the controllable, lifestyle causes for poor posture:

  • Poor Postural Habits!

Poor posture is more often than not related to two or three preventable issues that we all encounter as we age. Poor posture is often-times related to poor postural habits that we practice throughout our lifetime. This is in large part due to the fact that we sit a lot, stooped over a desk, or over a steering wheel, or just simply don’t resist the effects of gravity on our body. 

  • Loss of Muscle Mass

Throughout our lifetime, as we age, we lose muscle mass. Of course everybody is different, but beginning in our 40s and 50s, we slowly lose muscle mass due to a decrease in growth hormone and other hormones. I mentioned this condition in other blogs related to resiliency, this condition is called Sarcopenia. Our body needs muscle in order to stand straight. Muscle and ligaments hold our joints in place. Of course I’m oversimplifying this but a loss of muscle mass contributes to poor posture. 

  • Loss of Muscle Strength

This involves the muscles in our core, and those muscles that contribute to mobility and stability. It isn’t just the loss of muscle mass, it’s a loss of muscle strength and endurance.  It takes strong muscles to fight the never ending pull of gravity on our body. 

One of the muscles that rarely gets talked about is the Transverse Abdominus muscle or TVA. This is the muscle that is the innermost layer of our abdomen and it is responsible in large part for our stability. It’s the muscle that helps hold our guts in place. And therefore it makes sense that it should be the our focus when talking about posture.

How to Have Better Posture

I was standing in front of one of the young men that I work with the other day and I’m not sure if he meant it as a compliment, but I took it as a compliment. He told me that I stand like someone in the military. It does seem to me that young men and women in the military are taught to stand up straight and suck in their gut, and push their chest out. I felt pretty good about his comment because I spend most of my waking hours focusing on my posture. I do this for several reasons but I also do it for a reason that may not be the most important, but I do it because I want to send a signal to others that one way that you can maintain a youthful look is by focusing on your posture.  So, what do I do, and what can you do to improve your posture? 

Note: If you have been diagnosed with Hyper-Kyphosis, consult a doctor and Physical therapist before doing any flexion exercises that cause you to bend forward. Flexion exercises can increase risk for factures to the vertebrae. Here are a list of dos and don’ts to avoid flexion stresses when exercising and activities of daily living:

  • Maintain good postural alignment during exercise 
  • Strengthen core stabilizer muscles, such as transversus abdominus, obliques, and multifidus 
  • When bending or lifting objects, keep the spine in neutral, and bend at the hips and knees (hip hinge); keep objects close to the body 
  • When getting out of bed, roll onto the side before sitting up (log roll) 
  • When coughing or sneezing, stabilize trunk in neutral by hugging a pillow, or placing hands on knees while hip hinging, or place hand in small of back to help keep back in neutral 
  • Maintain the natural curves in your neck and back while sitting and standing. Imagine that you are lengthening through the crown of your head 
  • Adjust height of the walker and walk within the frame when ambulating
  • Avoid seated rowing machines or upper body ergometers 
  • Avoid crunches, curl-ups, or flexed position (traditional sit-ups) 
  • Don’t twist or bend your spine when lifting objects 
  • Don’t sit straight up from a horizontal position
    Avoid forceful trunk flexion while coughing or sneezing 
  • Avoid leaning over towards your work, or standing in a pelvic tilt 

Ok, for the rest of us, here is what you can do to insure you maintain good posture as you age.

Exercise! You need strong muscles in order to maintain good posture. I do this by resistance training and I focus on muscle strength and muscle endurance. I focus on my back muscles and my core muscles. Strengthening your back muscles, helps to pull your shoulders back and help you stand upright. 

Current best-practices suggest that spine-strengthening exercises and posture training help correct posture problems with older adults. 

I have pointed out in other blogs, that as you age, you need to incorporate instability into your workouts. This means narrowing your center of gravity as you do your workouts and alternating left and right plains of your body as you exercise. 

Stretch! Often times our body is out of balance and that can cause posture problems. For example overly tight hamstrings, the three large muscles at the back of your thighs, and hip flexors, the muscles at the top front of your thigh, can hamper basic movements like walking and running. When muscles are tight, a common result from too much sitting, you’re not able to fully extend your legs and straighten your knees. Inflexible hamstrings have also been seen as one of the causes of lower back pain. Another common problem that stretching can address is having tight chest muscles. These muscles pull your shoulders forward giving you a hunched silhouette instead of a longer, slimmer, youthful looking you. Stretching can also address the issues of joint inflexibility. Joint inflexibility can undermine your balance which can cause life altering falls. Stretching helps with all of these problems.

Practice Good Posture! One of the exercises that I do often is activating my TVA. I stand up, and then pull my belly button in toward my backbone. This is what some call “sucking in your gut.” Practicing good posture also means sitting up straight. It means limiting the amount of time that you sit. 

One of the things that has affected my posture over the years is my drive out to Colorado to visit family. I love those long road trips, but sitting that long, 17 or 18 hours straight, wreaks havoc on my lower back and on my posture.

There is no Fountain of Youth! But there are ways of maintaining your youthful appearance. And ways of avoiding the negative consequences of poor posture. Start working on them now!

This is part fifteen in the Healthy Aging Series, written by Mark Neese, LCSW, BCBA. To see more entries in this series, click here.

Healthy Aging Series Part 12

Do These Five Things And I Will Predict Your Future! | Healthy Aging Series: Part 14

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I’m sick and tired of watching the weather. I have a backpacking trip planed to the Great Smoky Mountains National Park this weekend and they’re predicting rain. An 80% chance of rain. I’m tempted to cancel but I’ve canceled backpacking trips before, when the local meteorologist predicted rain, and I regretted it. 

Predicting the weather is one thing, but what about predicting the future? I remember the beginning of the pandemic. I told the clinicians in our agency to do what they could to attend to the needs of their clients, and then I predicted that it would be over in two months. LOL. I missed that prediction by about two years.

What if we could predict your future? I mean really predict your future. What if we could predict whether you aged successfully? There was a study that was completed a few years ago that looked at the possibility of predicting your future. It was called the HUNT study. It was performed in Norway with about 4500 participants, ages 45 to 59, and it lasted over 20 years. Here is the question that the researchers asked: 

Are there behaviors that you can do, beginning around mid- life, that can predict whether you age successfully? 

Their answer: Yes!

What is “Successful” Aging?

What exactly did they mean by successful aging? They were three criteria:

First, successful aging was defined by the absence of disease. The list of this orders was short. It included serious diseases like heart failure, cancer, stroke, and depression.

Second, it was defined by high cognitive and physical functioning.
The physical criteria generally meant that you could take care of yourself and perform most activities of daily living, to include, showering, dressing, cooking, laundry, shopping, and household task. It was also defined as being able to remember what happened a few days ago.

The third criteria for successful aging was engagement with life. You were engaged with Live if you worked or volunteered in a job or got out of the house at least once a month to do something like going to church, or to a concert, or to a museum.

Notice what’s not mentioned in the definition of successful aging. You can have diabetes, have high blood pressure, use a cane, be a little overweight, be fully retired and not work or volunteer, living solely on Social Security, sitting around the house watching and binging series on Hulu in the evenings, with a vodka martini or just popcorn. The bar is low for successful aging. No general fitness criteria like 18% body fat or being able to bench press your bodyweight. If you are aging successfully, you’re generally healthy, generally able to take care of yourself and you remember what you had for dinner the day before, and generally connected with people in the community. Not a bad prospect for getting older.

What Are the Lifestyle Predictors?

What are the lifestyle predictors for successful aging? Spoiler alert: there are no surprises here.

1. Being a former-smokers or non-smoker.
Notice that if you stopped smoking by middle-age we can predict that you will age successfully. No surprises here. During the height of the pandemic, we were shocked by the number of people that were dying from COVID-19. It was heartbreaking. But before, during, and after the pandemic there were approximately 1300 deaths related to smoking cigarettes every day. Tobacco use accounts for 30% of the incidence of cancer. Smoking cigarettes is one of the major causes of COPD and emphysema. Being a non-smoker or a former smoker is high predictor that you will successfully age.

2. The second predictor is high physical activity. This was defined as exercising one or more times per week and on at least one of these occasions sweating or being out of breath. Again, not a high bar: work out at least two times per week and one of these workouts needs to be more intense. This behavior, along with being a former smoker or non-smoker,  were the highest overall predictors for successful aging. Notice, you don’t have to run half marathon‘s, join a spin class, climb 14,000-foot peaks in Colorado, ride your bike across the state of Indiana, be a bodybuilder, or participate in any extreme sport. Just work up a sweat or breathe hard at least one of the two times you exercise each week.

3. The third lifestyle predictor is having a BMI under 30, which put you under the obese criteria. Notice, there is no mention of any particular type of diet. The lifestyle predictor is, manager your weight anyway you can, using whatever diet strategy that suits your personality. My good friend Sam swears by the zone diet. Some people prefer the whole 30 diet or Atkins diet or Paleo or Mediterranean diet or Dash diet. Some people are vegetarian or vegan‘s. I tend to follow what is referred to as time-restricted eating or what some have called intermittent fasting.  This lifestyle predictor didn’t monitor for any supplements, or the percentage of macronutrients that you’re taking, or calorie intake. It didn’t even stipulate that you can’t be overweight. Just having a BMI below 30 or below being obese.

4. The fourth lifestyle predictor was low to moderate alcohol consumption. The definition of this predictor was drinking five times or less during the past 14-day period, without excess. Moderate/high consumption meant drinking five or more times in a 14-day period with periods of access during that time. Here is an interesting caveat to this predictor. Regardless of high or low alcohol consumption this behavior played almost no role in predicting successful aging. This is partly because most subjects were moderate to mild drinkers. Having said that, the low drinking status did not predict, by itself, successful aging.

5. Social supports. The definition of social supports in the study meant being connected with others and having significant relationships in your life. The criteria included two factors: Do you feel lonely? And do you have a person in your life that would help support you during an extended illness? The less lonely you felt and feeling that you would receive help when ill were predictors for successful aging.

What are Your Odds of Aging Successfully?

Look at your life and count the predictors.

1. Are you a former smoker or non-smoker?
2. Do you exercise intensely at least one of the two times that you exercise each week?
3. Is your BMI under 30?
4. Are you a mild or moderate drinker?
5. Are you connected to people in the community?

Of these five predictors the one that is most important to have in your life is being a former smoker or non-smoker. This means: if you smoke stop now! All bets are off if you smoke!

In other words, if you are a former smoker or non-smoker, you greatly increase your odds for successful aging. Having all five predictors dramatically improves your chances of successful aging.

If I were a betting man and you had the first predictor (former non-smoker) and at least two or three of the other predictors, my forecast would be clear skies ahead for you! 

You cannot predict everything about your future. Will you experience an accident, or exposure to an unexpected virus, or exposure to environmental toxins? No one knows. Those things are out of you control! What things are in your control are the lifestyle predictors that can and will predict your future.

BTW: I postponed my backpacking trip to the next weekend because of the rain chances. I watched my weather app closely that weekend. Not a drop ☺

This is part fourteen in the Healthy Aging Series, written by Mark Neese, LCSW, BCBA. To see more entries in this series, click here.

Trust Based Relational Intervention, TBRI, explains an alternative way to handle siblings in a conflict.

A Way to Manage Sibling Conflict

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Trust Based Relational Intervention (TBRI) explains an alternative way to handle siblings in a conflict. The main goal of this intervention is to have your child:

1) stop telling on their sibling to promote healthy relationships, 

2) teach your child accountability, and 

3) manage conflict healthily.  

Now how do we get there?

  1. The caregiver says, “I want to know what you did” or “What did you do?”
  2. Repeat that phrase as many times as it takes until the child tells you what they did, not their sibling.
  3. After the siblings have both shared what they did, the caregiver responds with, “Thank you for telling me what you did; now, how can we do this better? Can we try again?”
  4. Have your children “redo” the situation.
  5. Move on.

There is no “punishment” or “consequence” – we prompt children to redo situations in a healthier way.

Additional options and concepts: 

  • You may need to remove the children from the space to a neutral or different setting. 
  • You may try prompting everyone to take a deep breath before the conversation. 
  • You may separate children and go from one sibling to the next, then bring the sibling unit together for a redo. This ideally is immediately after a fight, argument, or incident. 
  • Prompt with choices if necessary. “You can ____, or you can _____”. 

Siblings have conflict, and this cannot be avoided. But how your children learn, grow, and respond to these experiences matters. Stay connected to both children when using this intervention. Try speaking calmly and maintaining eye contact. If you need help managing sibling conflict, additional ideas could be looking into family therapy! 

This blog was written by Meredith Edelen, Marriage and Family Therapy Associate, LSW. Learn more about Meredith and her work here. 

Personal Relationships Virtual Class Session at True North Therapy of Louisville

New Adult Personal Relationships Group Therapy Session Starting September 13, 2022

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We’re excited to announce another virtual group therapy series here at True North Counseling: Personal Relationships!

This class is open to adults ages 18+. Classes are online every Tuesday, from 12-12:50 pm. They will run for 10 weeks, beginning on September 13th. Classes are $15 per week.
These classes are for adults seeking guidance concerning friendships, romantic connections, and other personal relationships. Each session will focus on learning about new skills to use in different types of relationships. Expect to learn about boundaries, consent, and other important relationship skills.
If you’re interested in joining or have any questions, please reach out to jennifer.kendrick@truenorththerapylouisville.com.
You can also contact us by visiting our Contact Us page or calling 502-777-7525.
See the flyer for the session here:
Personal Relationships Virtual Class Session at True North Therapy of Louisville
true north therapy is now offering a teen zoom talk therapy group on july 28, 2022

New Online Teen Group Therapy Session Starting July 2022

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Does your teen struggle with their emotions? Are you a teen who wishes they could communicate better?

At True North Counseling, we are now offering a Teen Dialectical behavior therapy (DBT) Skills group! Join us weekly to practice coping strategies, emotion regulation, and communication skills.
This class is open to ages 13-17. Classes are online every Thursday, from 3-4 pm, beginning on July 28th. Classes are $15 per week.
If you know of a teen who would be interested/appropriate for the group, please reach out to admin@truenorththerapylouisville.com.
You can also contact us by visiting our Contact Us page or calling 502-777-7525.
How Can You Tell If a Therapist is the Right Fit? by Meredith edelen

How Can You Tell If a Therapist is the Right Fit?

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The goal is to feel comfortable with them.

Here are some good signs the fit is present…

  • You are able to be honest with them
  • You feel safe with them
  • You trust them
  • They do not cancel sessions on you often
  • They take and ask for feedback about how sessions are going and your preferences
  • They do not tell you what to do but instead help you discover what the best choice is for you given your current situation
  • They validate your feelings or experience
  • You don’t have to re-explain things to them over and over again

Here are some signs this therapist might not be the right fit…

  • You feel uncomfortable.
  • You feel judged.
  • You don’t see the possibility of changing comfortability level.
  • Your therapist over shares about their personal life or problems (and it feels odd).
  • They call you names or use condescending language.
  • They try to be your friend or form a relationship outside of therapy office.

For some people, they might know if the therapist is a fit after the first session. For others, it might take 2-3 sessions to see comfortability or trust. Does it take you some time to connect with others? It might be the same for your therapist.

The therapeutic relationship is sacred and important. You as the client have the right to fire your therapist if the fit isn’t right. One therapist cannot be the right fit for every client out there, so don’t give up hope! You will find a therapist right for you.

This blog was written by Meredith Edelen, Marriage and Family Therapy Associate, CSW, MFTA. Learn more about Meredith here. 

Here are self gaslighting signs you can learn about

What is Self-Gaslighting?

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1. Blaming yourself for not “handling things better” …

Without acknowledging all the difficulties or challenges you’re facing and the strength it takes to survive them.

2. Criticizing yourself for being too emotional or disregarding a strong feeling and feeling shame…

Without checking in on your feelings, the place they come from, or noticing triggers.

3. Shaming yourself for being “too needy” or a “burden” …

Without acknowledging that you have needs, like every human, that is likely unmet, and it is this that drives the behavior you’re shaming yourself for.

4. Blaming yourself in the situation without seeing another side.

Ex: “They didn’t mean that, if I didn’t ____ this wouldn’t have happened.”

5. Criticizing yourself for not “getting over” that traumatic or stressful experience.

Ex: “Well it’s been 2 years, I shouldn’t feel this way. What is wrong with me?” No room for understanding the complexity of trauma, the impact, and the patience for working through the healing process.

Does any of this sound like you?

If so that’s okay, be gentle with yourself.

Remember your feelings and experiences are valid.

You can achieve balance.

Ex: “I feel really upset about this AND I don’t know if I making this a bigger deal than it needs to be.”

“I feel hurt AND I could have handled that situation better.”

“I love this person AND I didn’t deserve what happened.”

This blog was written by Meredith Edelen, Marriage and Family Therapy Associate, LSW. Learn more about Meredith here. 

ROMMIE’S THOUGHTS ON ECKHART TOLLE’S THE POWER OF NOW

Rommie’s Thoughts on Eckhart Tolle’s The Power of Now

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Where is your mind? Right now. In this moment. What is on your mind?

Imagine picking up whatever is on your mind and setting it outside the door. It will be fine sitting there. Now, look up. What do you see? What do you hear? Notice I did not ask what you feel.

I’m outside. I hear a soft rustle of leaves. A robin’s song. A buzz. The subtleties of a distant jet.  This is the Now. There are no problems in the Now. Life just is. This is the wisdom of Eckhart Tolle (ET), author of The Power of Now. Every moment of every day is what it is, as if we had chosen it that way, good or bad—and even “good” or “bad” are just concepts of the mind. The things we judge. The things we react to. The things that we empower to literally suck the life energy out of us as if the problem shouldn’t be what it is.  As if we shouldn’t accept life as it is just now. As if we shouldn’t accept, that in large portion, we have likely created whatever “problem” we are reacting to. If we accept the “problem”, what will happen?  We will become conscious. ET’s philosophy is to become aware, conscious, awake to what is. Accept what is as if you had chosen it. Then observe the transformation. The evolution of consciousness, of acceptance, of peace.

Our egos love to react.

Our egos love to argue, to fuss, complain, and demand that life be “better” as if the ebb and flow of life should be something other than what it is. 

I’m here to challenge you to give the “Now” a chance.

It takes practice to live, speak, and enjoy the Now, which is really all anyone has.  Becoming conscious of one’s self, one’s ego, one’s identification with mind is the first step towards acceptance, towards peace. ET teaches to observe your thoughts but don’t believe them. Think about when you quarreled with someone last. If you’re honest about your role in the non-peace, it likely comes from a place of fear. A fear of being wrong. A fear of “losing”. Losing what? And even if you “lose”, what does that mean about you, if anything? Can you accept the circumstances without judging them?

Which brings me to resistance. Can you accept the circumstances without resistance?

ET teaches that suffering does not come from the circumstances but our resistance to them. Again, whatever the circumstances are, this is the way it’s supposed to be. Our response, not reactivity, is to embrace whatever “is”. Whatever the circumstances are is the way the circumstances are supposed to be…or they wouldn’t be that way.  It is our reaction or response that determine whether or not we suffer.

Surrender to what is.

ET teaches that “surrender is the simple but profound wisdom of yielding to what is rather than opposing the flow of life.” When you stop resisting what is, when you surrender, the past and future cease to have power. 

But what if someone wrongs me? Does acceptance and surrender mean I allow others to mistreat me?  Does surrender mean give up? Give in? Enable disrespect?  What if I have disrespected another person?  Do I accept that, do I surrender to that? ET teaches that “resentment and pain arise from the false sense of self we’ve created for ourselves and others.”  That our grievances are reactions to the artificial egos of others. He teaches how to bring non judgment and equanimity when others overstep our boundaries. He also teaches how to forgive our past selves and what to do when the pain of memories hijack our emotions. Holding on to old wounds is one of the surest signs that we are caught in the egotistic thinking of the false self. However, ET shows us the way to let go and embrace the liberation that living in the present moment, the Now, brings us.

Make the present moment the primary focus of your life.

Rommie OshriehRommie Oshrieh is Co-Founder/Owner of Sage Support Services and True North Counseling.

She serves as Executive Director of Sage and has served as a Case Manager/Supervisor for individuals with Developmental and Intellectual Disabilities for the past 15 years. 

#Therapy TikTok: A Substitute For Actual Therapy?

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By Rachel Eichberger, True North Counseling MSCFT Intern

I’ve been there- scrolling away and all of the sudden I find myself on an unexpected side of TikTok – that algorithm is getting a little too good. Eventually, after several likes and follows I realize that I found #Therapy TikTok. While there is some encouraging, validating, and even eye-opening content it makes me wonder- could people view this as a substitute for actual therapy? Since “#mentalhealth has 15.3 billion views and #therapistsoftiktok has 318 million” it is fair to assume that consumers are latching onto the de-stigmatization of mental health and potentially considering the content as guidance1. A study completed in 2022 gathered data on TikTok mental health content specific to ADHD and exposed some stirring evidence. Of “100 videos, 52% were classified as misleading and non-healthcare providers uploaded the majority of these videos”2.

While educational and inspirational content can leave consumers feeling supported, it is clear that TikTok is not an appropriate or effective substitute for therapy. A USA Today article highlighting the benefits and downside of #Therapy TikTok quoted therapist Jamie Mahler stating “TikTok can’t be therapy because therapy involves individualized care. The therapist creates the entire treatment plan around the client as an individual. It also is held to ethical standards and confidentiality in an interpersonal exchange”1.

So, should I even spend time on #Therapy TikTok? I would say, yes! The upside of this content is that users can find a welcoming environment to explore concepts and consider trying therapy. Ideally, this would provide connections to qualified providers and open doors to users who truly need the individualized care that psychotherapy provides. As with all of social media- consider the source before believing content as truth and enjoy those daily validations!

1. Dastagir, A. E. (2021, September 3). Mental health TikTok is powerful. But is it therapy?. USA TODAY. https://www.usatoday.com/story/life/health-wellness/2021/09/03/tiktok-mental-health-content-has-exploded-but-therapy/5694716001/

2. Yeung, A., Ng, E., & Abi-Jaoude, E. (2022). Tiktok and attention-deficit/hyperactivity disorder: a cross-sectional study of social media content quality. Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie, 7067437221082854, 7067437221082854–7067437221082854. https://doi.org/10.1177/07067437221082854

how therapists are trained

How Therapists Are Trained

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Jennifer Kendrick here! Not only am I the clinical director at True North, but I’m also a supervisor for people seeking licensure in social work and marriage & family therapy. Many people don’t understand the differences between professions, or how the professions are trained. While the steps and regulations vary between jurisdictions, here is a basic overview.

Clinical Social Work

To become a clinical social worker, you have to first get a master’s degree in social work. This can take anywhere from two to three years, depending on the program. After graduating, you have to take a Social Work Master’s Exam, which has 170 questions (including 20 unscored pretest questions). After you pass that exam, you can practice as a clinical social worker. You’re not licensed yet, however, so you have to be supervised for a minimum of two years (in Kentucky and Indiana). Supervision is one hour per week (or two hours every two weeks), and is sometimes provided (read: paid for) by the social worker’s employer, but if it’s not, they have to pay out of pocket.

After accruing two years (or 150 hours) of supervision and 1,000 hours of client contact, the social worker is then eligible to take the Social Work Clinical Exam, which is another 170 questions (same deal with the 20 unscored pretest questions). At a minimum, by that point, your clinical social worker has spent 4 years training to serve you.

Fun fact! In Kentucky, “social worker” has title protection, which means that you can’t call yourself a social worker unless you have the required training and license.

Marriage and Family Therapy

To become a marriage and family therapist, the path is similar. You have to get a master’s degree, either in family sciences or couples & family therapy or in social work with specialized training in couples & family therapy. The path verges a bit after that. After graduation, marriage and family therapists in Kentucky and Indiana can apply for an associate’s permit, which means that they are practicing under the supervision of a fully-licensed marriage and family therapist. Like social workers, they have to be supervised for a minimum of two years (in Kentucky and Indiana). Supervision is one hour per week (or two hours every two weeks) and is sometimes provided (read: paid for) by the marriage & family therapist’s employer, but if it’s not, they have to pay out of pocket. (In Kentucky, there aren’t as many supervisors, so people often have to pay out of pocket for supervision.)

Fun fact two! Marriage and family therapists don’t just see people who are married! We see family constellations of all kinds—married, engaged, coupled, co-parenting, you name it!

Both clinical social workers and marriage and family therapists are therapists, which means that regardless of the letters after our names, we are here to help you address your mental health, relationships, and all of life’s seasons.

(Bonus fun fact! “Marriage and family therapist” also has title protection!)