A couple of months ago I decided to apply to grad school - yet again - in what was mostly an effort to find a more well trodden path to getting clients than the rugged little footpath I was trying to machete into existence “marketing” (ugh) myself as a coach. Several things fed into this decision: what I was learning and loving in the sessions with my one client (more of this please!); a dear therapist friend’s accounts of what he learns about himself through his work and his sincere encouragement and desire for me to have more of what I loved and what he felt I would be good at; the cold hard fact that after more than a year of machete-ing (or trying to get myself to) I still just have one client. Just one. And inklings from others, as well as my own experience with a coaching referral platform, that there are way more life/relationship coaches out there than there are people seeking our services (not so for career/business/professional development coaches - they’re in high demand; thank you capitalism). And we certainly need more queerish therapists who are sex-positive and experienced with alternative relationship structures (not many of those in SC). But the bottom line was that I’m way better at doing school than I am at marketing myself.
So, when I became aware of some online programs - one of which has a new focus area in sexuality (sweet!) - I talked to admissions counselors, applied, and was feeling excited and relieved, very similar to the relief I felt when I signed up for that coach referral site a year ago (please, universe, anything but marketing myself!).
Then the universe hit me with an awareness that pulled the rug right out from under pursuing this well-worn pathway to practice: perhaps licensure is not the benign, protective structure we are taught all through graduate school that it is - protecting people seeking mental health services from predatory charlatans and legitimizing the profession in general. Maybe it’s not even just an annoying set of hoops to jump through in order to bill insurance. Maybe it binds us to a set of ethical standards that can actually cause harm, particularly to groups of people who already experience more harm than safety at the hands of state sanctioned “protectors” (think police, but maybe also prosecutors, educators, healthcare professionals…).
In a panel discussion on racial inequity in "healthcare" that I attended in April, two BIPOC mental health professionals brought up how they felt the ethics codes of licensing boards, particularly mandated reporting, were not just at odds with what their clients really need, but potentially harmful; how personal information necessary for insurance coverage (e.g. diagnoses, progress reports) can be weaponized against clients, further disadvantaging them. One had already decided not to renew their license for these reasons and the other was seriously considering it. Whoa. Then my daughter shared an IG post from @ismatu.gwendolyn where I found this article. Licensed therapists can actually be participating in the carceral system. Whoa again.
As Ismatu points out, this is not to say that licensure is categorically bad. I know plenty of therapists, mainly in private practice, who choose to take their chances with the ethical boards of their profession and just go ahead and do what they think their clients need. That is one way to resist from inside the system and they risk losing their license by doing so. I suspect that in larger organizations and public healthcare, that might be harder to get away with.
I already have a healthy fear of the seemingly unstoppable machine that mandated reporting can set in motion, both from personal experience and previous graduate coursework, but these two pieces of information stopped me in my tracks. Much food for thought. My admissions interview for the online graduate program was at the end of May. I had many new questions. I’ll let you know how it went in the next post.
By the way, that panel discussion was part of the Building Bridges program in Asheville, NC. Highly recommend if you're in Western NC/Upstate SC.
Thanks for sharing this perspective…so insightful. I wouldn’t not have thought of these challenges with licensure. Much food for thought, indeed!