What makes an MFT different?

Many people ask what the difference is between an LCMFT and a LSCSW.

LCMFT stands for Licensed Clinical Marriage and Family Therapist, while LSCSW stands for Licensed Specialist Clinical Social Worker.

Both Licensed Clinical Marriage and Family Therapists  and Licensed Clinical Social Workers are able to conduct private therapy. Both must complete a set number of hours of supervised work before being licensed. Additionally, both have a master's degree.

An MFT has a Master's Degree in Marriage and Family Therapy.  MFTs almost always have a significant amount of graduate course work that has a strong emphasis on providing therapy to individuals, couples and families. It is a myth that an MFT can only work with a family or a couple. Many MFTs work with individual clients as well.

An MSW receives a Master's Degree in social work. Although the coursework in graduate school focuses on people, families, and society, there is not always a strong emphasis on providing therapy.

Both professions must have a certain number of hours of practice before being able to take an exam to get a license. However, the requirements of these hours can be very different between MFTs and MSWs.  An MFT candidate must perform a specific number of practice hours split among several different types of experience. MFTs can only get hours by doing therapy. Some hours must be conducted doing individual therapy, and couples or family therapy. Regardless, 100% of the hours of an MFT must be practicing therapy.

In contrast, an MSW also must perform a number of supervised hours but often has more options in how those hours are completed. Although exact rules may vary depending on the location in which a student is studying, these hours do not necessarily have to be in providing therapy. In some cases, hours can be completed performing social work, administering a senior home, helping to run a foster care program, or working at an adoption agency.



An MSW who plans to privately practice therapy will generally choose work opportunities that allow him or her to gain this type of experience, but are not necessarily required to do so before he or she is able to take the exam to have a license as an LMSW.  As well, MSW programs vary significantly in orientation. Some are specifically geared toward people who wish to get their MSW to be a therapist. However, this is not always required, unlike most MFT programs.

Many MFTs find that their certification leaves them with fewer job possibilities than those for MSWs. For example, a job that requires a social worker cannot be filled by an  MFT in most cases. Some hospitals will only hire MSWs, and some government run medical centers cannot legally hire an MFT to perform social work.

The thought behind this is that the MSW has more training in considering all aspects of a patient's life, like living conditions and income. The MSW may also have specific training in negotiating requests for government assistance. Many MFTs can also perform these functions with ease, but the MFT is more therapy-based in training, and may not be aware of all government programs.

In terms of seeing an MFT or MSW for therapy, some people note differences. Some MSWs tend to be more solution-oriented in their counseling and may give their opinions more readily. In most cases, it comes down to comfort level with a therapist rather than a degree or license. Many people find themselves just as happy with either type of counselor, as long as that counselor connects with them.  Some might prefer an MFT to an MSW or vise-versa. This is not so much because of training, but because the person seems a better fit with the person's personality or ideas of what therapy should be like.

Neither an MFT nor an MSW is allowed to prescribe medications.  Both an MFT and MSW are familiar with the potential effects of most psychiatric medications, however. Thus both an MFT and MSW can assist people with a new diagnosis of a psychiatric condition, and recognize possible warning signs that a medication may not be working. With the permission of the patient, they can also maintain contact with a prescribing doctor.

MFTs in Kansas who are practicing therapy will either be an LMFT which is a Licensed Marriage and Family Therapist, or an LCMFT which is a Licensed Clinical Marriage and Family Therapist. The difference is the clinical part of an LCMFTs licenses means that they have passed a national exam, and have had a minimum of two years of post-graduate training with a supervisor in order to do therapy. An LMFT has also passed an exam, but has not had two-years of post graduate supervision in order to be a "C" and practice without supervision.

MSWs in Kansas who are practicing therapy will either be an LMSW or an LSCSW.  As with an LMFT, the LMSW is still receiving supervision. The LMSW has already taken one exam to be have a license, and is required to take another exam after supervision to be an LSCSW.

An LCMFT is not required to take an additional exam after their supervision (in Kansas) as long as when he or she took the exam, the MFT passed at a high enough level. If not, he or she must take the exam again to pass at the clinical level to be an LCMFT, even if he or she has completed supervision. 

The bottom line is making sure that your needs are being met. If you have a good relationship with your therapist, it really doesn't matter if you see and LCMFT or an LSCSW. The majority of your progress will not come from the methods your therapist uses, but instead, your relationship with that therapist.

If training is important, ask. Most clinicians will not have a problem answering your questions about their training. If having a clinician that has focused training is more important to you, then ask the clinician about their experiences before you start therapy. Most likely, he or she will be happy to oblige.



Mike is an LCMFT!  Find out more about Mike at www.reachfamilytherapy.com

A New Day Means A New Perspective

Your perspective is important. “ Let’s eat, Grandma!” is very different than, “Lets eat Grandma!”. Something just as small as a little comma (,) can make a big difference in the way we look at the world around us.

Thinking about the way you think about things (called your metacognition, or self-awareness) can really impact the way you perceive your world. And, your perception of the world shapes your reality. Your reality shapes how you feel, and so, your insight and self-awareness are pretty important factors in improving your life.

Even if something isn’t true, if we believe it to be true, then it might as well be! The truth is: Don’t believe everything you think!

So how do you change your perspective? Think about these things:

1.) Be grateful for what you have: By being grateful for what you have in your life, you tend to worry less about what you do not have. This results in a change of perspective. There is always going to be someone else that has it worse off than you. Remembering what you do have will help keep your attitude in check.

2.) Turn negatives into strengths: Despite the struggles that you may experience from day to day living, rather than focusing solely on these struggles and trying to "fix" them, channel your thoughts and energy towards challenging yourself to do something new - something different. And don’t forget that if you keep doing what you’re doing, you’ll keep getting what you’re getting.

3.) Seek out opportunities to learn: Seeing an experience as a challenge will focus your attention on a positive outcome. See the difficult things in your life as opportunities to learn something new. Notice that your issues are problems to be solved instead of battles to be won.

4.) Surround yourself with positive people: People with positive attitudes can greatly influence the way you think. Break away from those who are constantly negative as all they do is bring you down. You have plenty of your own issues, so if someone is bringing you down and they are a negative influence in your life, cancel that subscription!

Find out more about Mike at www.reachfamilytherapy.com

What do I do when I don't have anything to say in therapy?

When I begin to work with a new client, one of the first questions I will ask is, "How will we know when therapy is done?" This question serves a unique purpose in that the client is able to stop and think about what it is he or she wants to get from therapy before the process even begins. It is important for a client to develop goals with her therapist and help him or her work together to create a road map of "how to get there from here". Often times, my clients report feeling much better after just one or two sessions. This makes sense. For many people, even making the decision to start therapy can produce a change in the right direction! This is usually because when someone begins therapy, he or she is at a place in which "the pot has already begun to boil over." Sometimes, that very first session can take the heat down a notch. But just because the water isn't boiling, doesn't mean it isn't hot to the touch.

What many clients don't seem to understand is that once things start to feel better, this is the time when most long-lasting change will occur. Usually when people are in a good space, and conflict is at bay, they have a much better sense of how to problem-solve. It is during these times, the times of calm, in which a client can make his most growth because he is able to successfully practice the skills needed to make good decisions and solve dilemmas. Change is hard, and just like anything that is hard to do, it takes practice to learn. The key to understanding when therapy is complete is to develop goals and talk about what things will look like when you've met them. Once you have made goals, review them often, and change them as necessary. Despite the common belief, therapists are not mind readers. We have no Jedi mind tricks to figure out what our clients are thinking. So, tell your therapist when you feel like your direction is changing. Let him or her know that you would like to review your goals and discuss what is working and not working for you. And, tell your therapist when you feel like you might be avoiding certain difficult issues. Hopefully, you'll be at a place with your therapist in which he or she will give you an honest opinion about what goals seem to make sense for you. Together, you and your therapist can piece together a road map that is just for you. It's easy to do when you're the one building all the roads from here to there. Just remember, you'll never get there if you don't know where you're going!
Find out more about Mike at www.reachfamilytherapy.com

I'm in a relationship with a therapist; It's complicated.

There aren't very many socially-acceptable relationships I can think of when one member is expected to be open and honest, and the other member shares little or nothing personal. However, that is pretty close to how many therapists and their patients see the process of therapy.

Depending on the model of therapy the clinician is using depends on the amount of personal disclosure from the therapist. It's all about professional boundaries and what works for the client. A good question to ask as a therapist is, "How does this self-disclosure benefit my client?"

I do think at times keeping boundaries too rigid can be almost as destructive to treatment as keeping them too loose. It is difficult to promote hope within your client by taking the role of a expert, while at the same time, allowing your client enough space to believe that you are human and make your own mistakes. So basically, it seems to work like this: The more expert the therapist appears, the more helpful the client perceives him to be, but at the same time the more broken the client feels. He has more hope for change, but he takes less responsibility for it, because that is the job of his expert therapist. On the flip side, the more human the therapist is, the more normalized the client feels. Since the expert therapist isn't there to do it all, the client has more responsibility for change, but along with that comes less hope, because the client feels he doesn't know what to do.

This theory would look nice in a little graph that I might make some day. In the mean time, I would like to shatter the belief that therapists are perfect people. I have my own challenges with my behaviors and the behaviors of others, just as everyone else does. I get my feelings hurt by my friends, my family, and even my clients. So, I am a therapist, but I am a human. The journeys that I make with my clients happen together. There is no single set of foot prints in the sand here.

Michael Baker, LMFT
Learn more: www.reachfamilythearpy.com

PS- I would love to hear comments from therapists and lay people alike about how they experience this blog. Also, would you mind reposting, retweeting, sharing on facebook, or whatever? I find it much more fun to write and keep up with my blog when I know people read it!

Are you a scaredy cat?

Motiviation is one of the most misunderstood concepts in psychology. What motivates one person doesn't always motivate another. However, fear tends to be a motivating factor to most of us in some way or another.

Consider this example: I've never met anyone who enjoys paying their taxes. As tax-paying citizens, we pay our taxes out of fear. We don't want the IRS to levy our belongings, throw us in jail, or make our life more difficult. And so, it seems to make sense that for most people, fearful response is automatically programed within us. We do things we would rather not do because the annoyance of doing those things is much easier to sit with than the fear of what happens when we don't do those things.

One of my favorite books, Anyway: The Paradoxical Commandments by Kent Keith challenges the idea that fear need not be a motivating factor. As a therapist, I find myself focusing on Keith's last two commandments... 1.) People really need help but may attack you if you do help them... Help people anyway. and my very favorite... 2.) Give the world the best you can and you'll get kicked in the teeth...Give the world the best you have anyway.

Often times so many of my clients will elude to the idea that their lives would be so much easier if they didn't understand fear. I hear things like... "if only I could trust her not to cheat.." or, "if only I knew I could follow my plan.." or, "if only I knew he was going to stick around this time."

The bottom line is this: no therapist on the planet can predict your future for you. Life is difficult. Life is unpredictable. Life is scary. And, although it is always a good idea to collect information, make rational decisions, and avoid reactivity, at the same time, being a scaredy cat will bring you nothing but exactly what you are getting now. It seems that finding the balance between being a risk-taker and being a scaredy cat is most likely what we are after.

Learning to sit with our fear and the anxiety it causes us seems to be a great skill to master if we wish to meet our life-long goals. If we follow Dr. Keith's advice and we give the world what we have to offer by helping others when we can and giving the world the best we can despite the fear we feel if it all goes wrong, I am willing to bet that 9 times out of 10, things will turn out fine. And those are odds that I'm willing to take.

You can find more about Dr. Keith's book here.
Find out more about Mike at www.reachfamilytherapy.com

Don't Believe Everything You Think: The 6 Basic Mistakes We Make in Thinking

When we believe everything we think, we commonly make these mistakes:

Mistake #1: We remember the bad feelings we have about experiences, and forget the good facts.

We prefer stories to statistics. Even a bad story is preferred over great statistics, and this shouldn’t be surprising. We’re social animals, so whatever seems to connect us to others will have a bigger impact than cold, impersonal numbers. This leads us to making decisions based upon a single story which may not be representative of larger trends while ignoring the statistics that tell us about those trends.

Mistake #2: We seek to confirm what we know is wrong about ourselves, find the conformation and believe it, and ignore the good things.

We seek to confirm, not to question, our ideas. Everyone wants to be right and no one wants to be wrong. This may be the primary driving force behind the fact that when people look at neutral evidence before them, they almost invariably focus on what seems to confirm what they already believe while ignoring what might count against their beliefs.

Mistake #3: We struggle to believe the impossible to be possible.

We rarely appreciate the role of chance and coincidence in shaping events. Odds are that any randomly chosen person has no idea how odds, chance, and randomness affect their lives. People think that unlikely events are very likely while likely events are very unlikely. For example, people forget how large the numbers around them are — an event with a million to one odds against it will happen given a million tries. In New York City alone, this means that several such events could happen every day.

Mistake #4: We don't have an accurate view of the good work we do.

We sometimes misperceive the world around us. We simply don’t perceive things happening in our vicinity as accurately as we think or might like. We see things that aren’t really there and we fail to see things that are. Even worse, our level of confidence in what we have perceived is no indication of just how likely we are to be right.

Mistake #5: Although it is important to accept responsibility for self, it is important to not take responsibility for things that are not ours to own.

We tend to oversimplify our thinking. Reality is a whole lot more complicated than we realize. Indeed, it’s more complicated than we can deal with — every analysis we make of what goes on must eliminate lots of factors. If we don’t simplify, we’d never get anywhere in our thinking; unfortunately, we often simplify too much and thus miss things we need to take into account.

Mistake #6: We believe what we think!

Our memories are often inaccurate. To be fair, this isn’t a mistake because we can’t help the fact that our memories are unreliable. The real mistake is in not realizing this, not understanding the ways in which our memories can go wrong, and then failing to do what we can to make up for this fact.

Mike's lesson today is.... don't believe everything you think!

Find out more about Mike at http://www.reachfamilytherapy.com/

Encopresis and Enuresis in Stress Disordered Children

This is an excellent article. Mike

Encopresis and Enuresis in Stress Disordered Children

Find out more about Mike at www.reachfamilytherapy.com

The Appendix Monologues

Anxiety is a lot like your appendix. It's not really good for anything, but it can cause a lot of trouble. If only chronic anxiety were as easy to remove as going under the knife!

Most of the time, we find our anxiety nothing more than a waste of time. Problems have a way of working themselves out. Many of my clients already know what it is they want to do to solve a problem; they just need a little push in that direction. Often times, when anxiety is very great, we seem to draw the conclusion that we simply can not cope. However, no matter how anxious we become, the anxiety that fosters in us will never be strong enough to stop the clock. The show does go on, whether you are ready or not.

When you find yourself in a position of feeling like you just can't "go on", just remind yourself that at that very moment you are, well, "going on". Right now, at this very moment, as you read this blog, your problems, worries, and fears are managing themselves. They are going on without you, and you are coping.

This isn't to say, however, that problems solve themselves. Rewriting the story of a difficult past, or developing new patterns of behavior for the future isn't easy. Just like anything else that's worth having, you have to work a bit to get it. However, it is important to understand that Nike got it wrong when they wrote the slogan, "Just do it". As a matter of fact, when anxiety it at it's worst, you don't have "to do" anything. Instead, "just be". Wait. Rest. Slow down. Give yourself permission to take a vacation from your problems, even if it is just a few short hours.

If you still have that useless appendix, well, it's probably not going anywhere. But you can do something about your anxiety. You can start by seeing your therapist. Life is way too short to allow anxious feelings to keep you from what the world has to offer.... even if exploring does leave an appendix scar or two.

Find out more about Mike at www.reachfamilytherapy.com Like my blog? Please comment and let me know... or better yet, follow me using the link at the right. It much more fun to blog when I know I have people who read it! Cheers!

You Say The Most By Not Saying Anything

No matter what the relationship, be it spouse, sibling, co-worker, or friend.... conflict will happen. Unfortunately, we often attempt to measure the health of our relationship by the amount of conflict that it has in it. However, since conflict is going to happen, measuring our relationship health by the level of conflict makes about as much sense as deciding how smart someone is by the color of his or her eyes. People are just going to fight sometimes. It happens.

So then, how does one measure relationship health? You see, it's not in how we fight, it's in how we make up. The repair. Just like that old clunker out in the driveway, if you can throw some duct tape on it and fill it was gas and it can still go, well, it might as well be good as new.

The time between conflict and repair is the dangerous time. That is the relationship twlight zone. You see, it is during this time that the relationship is most vulnerable, and the most damage can be done. Sometimes enough damage that even a full tank of gas and a roll of duct tape just isn't enough. Be careful during this time.

One of the most dangerous weapons people use in their relationships, one that sends the biggest message, is the silent treatment. We say the most by not saying anything.... and usually what we say isn't self-serving to get our relationship back on track. When conflict is happening, it is because we are in distress. When one member of a relationship sends a distress signal, and that distress signal is simply ignored by the other, it only fuels more distress. It is in many ways more hurtful than just spilling the beans about how one feels about the conflict at hand.

When people don't talk to each other, relationship expert John Gottman calls this "stonewalling". Renounced family therapist Murry Bowen calls this "emotional cut off". But no matter what it's called, it's generally not a good idea (unless of course, something toxic is involved, but that's just a whole other blog!).

So, when things aren't going well, talk about it. As long as one can manage his or her own reactivity, and stays true and honest to his or her feelings, it seems like it is always better to talk about what is going on. When we leave people the opportunity to guess what we are thinking, we have a better chance at winning the lottery than our partner guessing our feelings correctly. And I don't know about you, but I'm not interested in those odds determining the success of my relationships. When in doubt, talk it out.

Find out more about Mike at www.reachfamilytherapy.com

Don't Believe Everything You Think

Although cognitive-behavioral therapy is a well-respected and widely used model of therapy, it's not one of my favorites. However, there is something about it that I do like.... the idea that it doesn't seem to do any of us much good if we always believe everything that we think.

For those of us that have brains that work mostly off of intutition and feeling, and less off of logic and data, it is hard sometimes to break ourselves free from the cycle of always believing what we think.

There never really has been an answer to the age old question, "Which comes first, the chicken or the egg?". And just as this question leaves me perplexed, so does the idea of, "Which comes first, our thoughts or our feelings?". Regardless of the answer, we do know that our perceptions of interactions create our reality.... distorted or not. So, it seems to make sense, then, that finding new or different ways to create preceptions, just might breed new and creative ways to create reality. And as Martha Stewart says, that would be.... " a very good thing."




Find out more about Mike at www.reachfamilytherapy.com

What's in a Name?

So, I've been asked what the title of my blog really means.

From a little age, we have been taught we ought not to run with scissors. Why? Because it's risky. And although I do not suggest any of us run around with sharp objects anytime soon, I do suggest that sometimes it is important to learn to tolerate risk.

You see, if we live our lives too cautiously, we may never quite learn how a little bit of risk propels us into personal growth. At the same time, if we live our lives with too much risk, we find ourselves involved in unproductive, and destructive behavior.

Learning to find the balance between the two is the key. There are times in my Master's work when I thought I might never be able to actually make it as a therapist, but I find that by willing to take the risk, to run with the scissors so to speak, I'm here. And, I'm loving it.



Find out more about Mike at http://www.reachfamilytherapy.com/

Set in Your Ways? Teach An Old Dog, A New Trick.

It is easy to know when someone doesn't like you.
It is a trick to remember to like yourself, regardless.

It is easy to become angry too fast and too soon.
It is a trick to remember when to say you're sorry, and mean it.

It is easy to blame the other person when they do wrong.
It is a trick to know how to take responsibility for your part of the problem.

It is easy to feel slighted and offended when someone is rude.
It is a trick to remember that people have a lifetime of experiences to shape who they are.

It is easy to feel defeated when someone doesn't believe in you.
It is a trick to remember that you are the author to your own story.

Isn't it time to teach an old dog, a new trick?

Find out more about Mike at www.reachfamilytherapy.com