Monday, October 8, 2012

Everyday Miracles

It has been a while since I blogged.  Let me catch you up.  Since July, I have completed my (additional) licensure hours and been granted full LMFT status by the state!  Yay.  Also, the company I was working for renewed their contract with the state, but it included some changes that were not optimal for my situation, so I made the transition to full time private practice (www.texasfamilyinstitute.org).  So, the past few months have been busy for me. 

The family has been busy, too!  The kids are all back in school and prospering.  Amelia is also back in school and juggling all of her roles: wife, mom, student, employee, volunteer.  So we are keeping busy.  One area that has kept all of us busy in the last week or two has been a fundraiser for our D.A.D. (Diabetic Alert Dog).  Some of our beloved church family intiated this event on our behalf and I think the original intent was to just have a garage sale and gift the proceeds toward our fundraising efforts.  The reality of it turned into a more detailed level of involvement on our part.

You see, garage sales are a lot of work.  As it turns out, fundraising garage sales are an order of magnitude more work.  The call went out for donations for the garage sale and, boy, was it answered.  Of course, this necessitated picking up some donations.  Then more sale items were offered and more were dropped off and more were picked up and the next thing we knew, it was a week away and we had not one, but TWO garages (ours and my in-laws') full to overflowing of items.  It was a mixed blessing, because of course, we needed items to sell, but the more we received, the more work it was to store, organize, and price them before the sale.  Of the items, Amelia said, "We got a lot of items you'd expect to find a garage sale, but we also got a lot of really nice items." 

With the date of the sale looming, we were a little discouraged at the amount of work required and our available time and energy.  Then our friends and families rallied and stepped up and we spent hours alongside some wonderful people who helped us prepare.  At about 2am on the night before the sale, we put the finishing touches on the signs for the sale and I walked the nearby streets to post them for the next morning.

The day of the sale, we expected some early aggressive garage sale-ers because of the advertising we'd done, but surprisingly, at our start time of 8am, we only had our helpers who had shown up at oh-dark-thirty to help set up.  However, lots of folk came by after we opened for business and we did great business all day long.  At 2pm, we started to allow haggling and sold off a lot of stuff that way and at 4pm, we shut it down. 

Now, I've titled this post: Miracles, but nothing I've written so far sounds particularly miraculous, does it?  The real miracle had been happening all along and I just didn't have eyes to see it until my friend Brian shared some insight with me.  He mentioned that sometimes it seemed like he prayed for miracles and in his mind, he was thinking of something big and supernatural, like when we pray for a cure to a sudden illness and we pray for a specific situation and a specific outcome to our problems.  But what he noticed was that God was blessing us with all the things, all the ingredients, all the relationships necessary for us to receive the financial blessing of the fundraiser.  The love that prompted our church family to initiate the event started years ago.  The loyalty and friendship that drove the donations and support didn't spring up overnight from nothingness.  There was some seemingly random kindness in the process, but when we think about God's mysterious movements in our lives, it is easy to conclude that the miracle of this garage sale has been in the works before we knew we would need it.  God's hard working hands manifested in the muscle requrired to move everything.  God's comforting arms appeared in the guise of hours of help with pricing and organizing items.  Our Father's feet trampled in and about our garages for eight hours on Saturday as people showed up in droves to purchase the offerings.  A miracle, supernatural in its very mundane-ness. 

But God has ever worked this way hasn't he?  I'll never put it past God to use flashy supernatural means, but it seems he likes to work through his people.  God's greatest miracle is relationship.  It has been that way from the beginning.  The pinacle of his creation was mankind, who was formed in God's own image, endowed with the ability to choose.  God initiated a relationship and has spent all of human history chasing his beloved creation and wooing us and invited us to know Him and be known by Him. 

This weekend, despite long hours and hard work, I was blessed to be able to grown in relationship with our church friends who came to help us out.  I met and got to share our situation with neighbors and strangers.  I got to share the joy of our fundraiser's fantastic success with the congregation who loves me and my wife and my children.  Miracles all around. 

And now, may you have eyes to see the blessings God has showered around you.  May you have ears to hear his invitation to get to know him by knowing his church.  May you receive the blessing of relationship with God through His people and come to know how much you are loved.

Sunday, July 15, 2012

Family Vacation

The Emery family just returned from a fantastic vacation in the beautiful mountains of New Mexico.  Amelia's family has several cabins in Cloudcroft and we took a 1,350 mile round trip through the southeastern part of NM this week.  We left on Friday, July 6th, which also happened to be our 16th anniversary.  We drove to Carlsbad and made our way to Sitting Bull Falls in the  Lincoln National Forrest.
Then we made our way to the cabins in Cloudcroft, where we helped Nana and Papa clean them out and prepare them for our week's habitation.
 
We made our way out to White Sands National Monument, south of Alamogordo and played in the dunes for a while.  Ele was leaping joy!
 We took advantage of our proximity to several hiking trails, exploring our bit of the mountain with the California Cousins.  This trail was just around the corner in Cloudcroft and took us up to a scenic lookout where we saw the remains of the famous wooden "S Trestle".
 Back at the cabins, Papa put his engineering ingenuity toward repairing/rebuilding the deck on the front cabin.  Everyone pitched in and helped.  By the end of the week, it was 90% finished. :)

 We took a drive up the mountain to the Sunspot observatory.  It is a huge telescope devoted to measuring and observing cosmic events relating to our Sun.  It was way cool!

 On our way back down the mountain, we stopped at a scenic overlook and took in the beauty of the Tularosa Basin.  What a view!

 We enjoyed all sorts of rustic cooking and camping fare, but this treat was wonderful, if a bit sticky: S'mores!  Made with huge-mongous marshmallows.

 We actually got to take two trips out to White Sands, our second was after the California Cousins arrived.  On our second trip, in addition to playing in the dunes, sliding down and drawing in the sand, we also played with "light writing" with my camera.  Below, you can see a stormcloud I drew with a flashlight.

Nene and Nana put up a hummingbird feeder and we had quite a show with several of these marvelous birds fighting for dominance and feeding rights.

 On Thursday, Amelia and I decided to treat the kids and cousin Zach to a horseback trailride.  It was magnificent, fun, and helped us understand what 'saddle sore' means.  It was my first time to do any significant horseback riding and I loved it (maybe as much as Mary Hannah did!)

 We took a second nature hike out to Bridal Veil falls, but were unlucky because part of the trail was closed and we never actually got to see the purported 45 foot falls, although we enjoyed the hike.

 On the way home on Friday, we traveled north to the Three Rivers Petroglyph site and the kids tried to count the reported 21,000 individual glyphs.  I think they only got up to around 500, but it was a commendable effort.



 After that, we drove up to Carizozo and saw the Vally of Fire, where ancient lava vents spewed molten rock up into the basin and created a huge field of what is now cooled lava.  The lava is non-porous and helps sustain a variety of desert wildlife, but is hard on shoes and will shred your footwear if you try to walk on it for long.  Still, it was fun to visit.




 All in all, it was a fantastic vacation where we got to see fun things, have some great experiences and make memories with family.

But the wonderful people pictured above were not the only ones who came on our vacation.  We had an uninvited guest: Diabetes.  I know I have talked about living with Type 1 in our family before, but during our vacation, as much as we tried to just enjoy a normal time, we had to make accommodations for our implacable foe.  On Sunday, Ethan went low in the morning while we were at church in Cloudcroft.  Over the course of the day, he had to check his BG 20 times and was low 17 of them.  We were constantly trying to stuff sugars in him and it got so bad that we almost had to use his glucagon shot.  The nearest medical facility was down the mountain 16 miles away (the trip takes 30-40 minutes because of the steep grade to get down the mountain).  We had to call the emergency pager system from our Pediatric Endocrinology team at OU children's medical center.  They were a big help and at about 4 am on Monday morning, we finally were able to rest and get back to 'normal'.  I remember when we were packing for our trip, a friend who was visiting commented to Amelia when she was packing the first couple bags about getting everything packed up.  Amelia told her that the first few bags were just the medical supplies we have to take.  With two Type 1 Diabetics, we had to have supplies for the entire week, as well as backups for everything.  Extra insulin pods for their pumps, extra Novalog, extra Lantus, extra syringes, extra juice boxes, extra sugar treats, extra alcohol wipes, extra test strips, extra ketone sticks... extra everything.  Enough for two kids for one week.  We don't get a break, even on vacation.  Most of the week, the kids' BG were okay, but everything we did required extra vigilance on our part... hiking?  Check BG before we leave, restock juice and skittles in case we have a low due to more exertion.  White sands?  Great fun, but we have to interrupt every so often and check to make sure we're in range.  I don't know whether it was the extra exertion or the altitude or what factors contributed, but it seemed that the kids were either too high or going low whenever we checked them.  I'm not complaining so much as explaining.  As you can see from the pictures above, we don't let it stop us, but it sure does slow us down.  Cousin Zach was sleeping in our cabin, but on Sunday night, when Ethan was fighting his lows and feeling pretty emotional (due to his BG and the situation), Zach got so freaked out at the scene, he ended up sleeping in another cabin because it scared him to see his cousin Ethan screaming and crying about hating diabetes and not wanting to have to get a shot of glucagon or have to do injections because we took his pump off him while he was going low, to try and bring his BG back up.  I can't help thinking that if we had our D.A.D already, it would have tipped us off to the lows and helped us combat them before they got critical and sent us on a roller-coaster ride of BGs that lasted almost 20 hours.  We continue to hope and pray for a cure so that maybe someday, our family vacation will not include that dastardly diabetes.

-jeff

Thursday, July 5, 2012

XVI

Sixteen is a special number to me.  My birthday is on the 16th of November and I remember thinking that turning 16 on the 16th was pretty cool.  Lots of cool stuff happens when you turn 16, what with the whole getting to drive thing that happens, if you plan things right.  I got a job right after my 16th birthday, too... working at the Wolfforth, TX Dairy Queen.  Looking back, and adding my considerable experience working as a counselor to many 16 year olds, I would like to note that 16 looks very different depending on whether you are looking toward it, or back on it.  What my 16 year old self DID'T know would fill libraries.  Of course, I'll probably feel that way about my 35 year old self at some point in the future, but that is the subject of another blog.

The subject of this blog is 16.  16 years of marriage, to be specific.  According to Wikipedia, the proper gift is something made of Bronze.  I think it is interesting to note that the proper gift for the 90th wedding anniversary is STONE, probably headstones.

Yes, Amelia and I have been married for 16 years today!  Yay us!  I remember not very long ago, I was completing a pre-marital counseling session with a youngish couple and I came home that evening and saw that my father in law, Robert, was at our house.  I asked him, "What were you thinking?!?"  We were only 19 and 21, Jeff and Amelia, respectively and I can't fathom 19 year olds being ready for marriage.  Yet somehow, we have persevered.  Traditional martial research looks at two axis of data: longevity and satisfaction.  That is, it is possible to be married for a long time and to be very satisfied and happy.  However, the data shows that many people end up being married for a long time (longevity), but aren't very happy (satisfaction).  I knew  a guy who used to joke about his marriage: "I've been married 12 fantastic years!  Out of twenty... that ain't bad!"

In 16 years, we've lived in:
Abilene (apartment)
Coleman (Garage apartment)
Abilene (house sitting)
Plainview (Duplex)
Plainview (bought a house)
Enid (Rent house for a week)
Enid (Rent house for 1.5 years)
Enid (Traded to another rent house for 1.5 years)
Abilene (In-law's house for 4 years)
Abilene (renting)

In 16 years, we've traveled together:
Texas, New Mexico, Nebraska, Kansas, Tennessee, Colorado, Germany, Holland, Italy, England, Austria.

In 16 years together, we've laughed, we've loved, we've disagreed, we've struggled, we have faced adversity and we have lived with diabetes.  We like to talk to each other, we like to be together.  We like to have our own space and fill up each other's space.  I've shot her and she's scrapped me.  I can remember not being married, but I can't imagine not being married to her.

In 16 years, we've learned a lot about each other, but we have also each changed.  We've grown up.  Our children have taught us what it means to be parents.  They are the best gifts we have given to each other and they give us so much each day.  Our children have helped us (and continue to) grow up.

In 16 years, I'd like to be blogging (or whatever the trend is) about my new favorite number: 32.

Amelia,
Happy 16th, baby.  You complete me and make me want to be a better man.  To be esteemed by you is enough to carry me through each day.  I love you more today than I did yesterday and I'll say the same tomorrow.  Thank you for being my friend, my partner, my love, my life.  Thank you for our children and for your example to them.  Being a family with you means more to me than anything and I love you.

Saturday, May 19, 2012

Contentment

A friend directed me toward another blog that spoke about contentment and it spurred some thoughts.  The blog is a neat one that I have seen before: ZenHabits.  It was interesting to read, from the author's perspective, what has brought him contentment in his life.  One thought that jumped out at me was, "Instead, learn to be content with the person you love, just as they are. This isn’t always easy, as we are usually trained (by our well-intentioned but never-satisfied parents, and others around us) to do just the opposite — to try to change people"  This caught my attention, because I have noted, in many therapy sessions, that one contributing factor to client's issues is unresolved issues from their family of origin.  In other words, I've seen plenty of adults and teens struggle with their self-worth because they felt like what they did was never good enough for their parents... or believing that it was their responsibility to make someone else happy... or trying to manage another person's feelings because they didn't want to be a disappointment to that other person... or.... you get the picture.

It made me ask myself if, as a parent, I encourage my children to embrace the changes that are happening to them naturally as they grow and develop while pushing and stretching them enough to help them learn to balance being content with who they are and trying to improve and better themselves.

I thought to myself, 'I'll work on trying to encourage my kids to acknowledge the changes that come their way every day; their body and brain development, school events and issues... etc and be accepting of who they are on the inside, which doesn't change.'  But that isn't true, is it?  Everything about us, inside and out, changes every day.  Every moment, really... but we aren't attuned to changes at that level.  The reality is that just as our outer self changes, so does our inner self.  Personality, core beliefs, values... they are all subject to change.  I am not the same person I was several years ago. 

So I am left with one of life's great mysteries: how do we walk the fine line of acknowledging and accepting personal change while reconciling accepting ourselves as we are and finding contentment?

THEN, my thoughts turned spiritual and I reflected that my journey with God has been one of constant change.  God loves me as I am, but is not content with keeping me as I am.  Instead, He works daily on shaping me and molding me and sometimes dragging me kicking and yelling to be more like Jesus.  It made me think that maybe contentedness, like happiness, is not a goal but a by product of godliness.  I thought of 1 Timothy 5:6, which says, "...godliness with contentment is great gain."  The passage there is referring more to money and possessions, but I think also speaks to our general sense of self-worth.

So, here is a letter of encouragement:

Dear child,
          I have loved you since before you were born.  Your arrival in my life marks a time of great joy for me.  I delight in you every day as I watch you and love you.  I want you to know that I understand that your life journey is going to include times of difficulty and struggle, but your struggling with difficult events, situations and people does not diminish my love for you.  In fact, a person's ability to adapt and change should be encouraged.  Different situations will call for different responses and thinking that there is only one way to do something will only lead to frustration when that 'one way' does not generate the results you want.  As a loving parent, so often, I just want to tell you how to do things my way... the way that seems right to me, from my perspective.  Truthfully, I've figured out a lot of situations and I wish that sometimes you would ask me for help, but I want to respect your ability to learn and grow for yourself, so I try to guide you in less intrusive ways.  I believe that a good parent should spend a lot of time teaching and guiding, and I've tried... but sometimes our viewpoints have clashed and you don't see things my way... at first.  As you grow and develop, I know that one area you'll have to figure out is how to be your own person while remaining connected to your first identity, which was as a member of a family.
I hope you'll be able to love how you look, knowing that beauty is more than just your body's appearance.
I hope you'll be able to be confident that you are worth having as a friend and not take others' inability to see it bring you down.
I hope you'll learn sooner, rather than later, that it is okay to want a thing but when you convince yourself that you need a thing, that 'need' gains power over you.
I hope that you will strive for godliness and, in doing so, will come to discover that happiness and contentment will follow when you seek to deepen your relationship with me.

love eternally,
your Heavenly Father.

Thursday, April 19, 2012

The Blame Game: there is no winner

So often it is the case that when a person feels the emotion ANGER and exhibits angry behaviors (aggression, yelling, blaming), what is really happening is that they are experiencing some other uncomfortable emotion (by this, I mean a feeling that they do not enjoy having such as embarrassment, fear, shame, guilt, hurt, abandonment, etc).  Being unable to handle the uncomfortable feeling, a person is likely to COVER IT UP by choosing to feel ANGRY.  Anger is much easier to handle and usually results in distracting from the real emotion by escalating a situation to where it is necessary to address the angry behavior and the uncomfortable feeling can be overlooked by others OR allowing the individual to feel more powerful and capable by bullying others with angry behaviors so that others don't hold the individual accountable.

When I teach ANGER MANAGEMENT classes, one of the points I stress is that when a person is emotionally competent, he/she can verbalize and deal with uncomfortable emotions without using ANGER to cover up his/her real feelings.

Unfortunately, we are so accustomed to blaming others or situations for our angry feelings, it is difficult for people to see the truth: we are each responsible for our own feelings and behaviors.

I want to focus the rest of this post on one aspect of the ANGER issue: BLAME.  Blame is especially toxic because it pulls participants in and traps them, preventing healing or recovery.

The BLAME CYCLE:

Person A chooses to feel hurt, but being unable to express/deal with it ----> Person A tells Person B, "You hurt me." (a blaming statement)

Person B, not at all wanting to be responsible for Person A's feelings, gets defensive and either denies complicity or chooses to be angry and responds with angry behavior, thereby justifying Person A's feelings.  Either way, Person B, through words or actions, exhibits blame back on Person A.

One other possible outcome is that Person B has weak ego strength and accepts blame, but far from being able to handle it, wallows in self pity, which is equally unhelpful.

Neither outcome invites Person B (or Person A for that matter) to accept responsibility and change the outcome.  Rather, BLAME invites Defensiveness which escalates to ANGER and feeds into more BLAME.

So, how do you get out of the BLAME CYCLE?  It is straightforward, but difficult.
1) Accept your own complicity / collusion in the cycle and resolve to do something different.
2) Get rid of blaming language and behavior
3) Only state how you are feeling about a situation without commenting on the other's motives or beliefs.  Don't be a mind reader.  You don't KNOW what someone else is thinking or feeling.
4) Recognize that it is a process that takes time to re-program a communication pattern.
5) Learn to recognize the underlying emotions behind your anger and learn to express your feelings without blaming.

Here is a sample of a session with an adolescent who is hurt because his/her father did not follow through on a promise to attend an event.  Note that the Youth has been pre-trained by experience and society to fall back on Blaming behavior to explain what he/she is feeling.

Youth: Here is something we can talk about: I'm mad at my father.
Therapist: You feel angry at your father?
Youth: Yes, he promised to come to my event, which I told him about a month ago and he said he would come.  Yesterday, he told me that he couldn't come, and it is tomorrow.
Therapist: You feel like he is breaking a promise to you.
Youth: Yeah.  He's done it before, but I know he could come if he wanted to.  I mean, he is the manager and when I've been visiting with him, he sometimes takes off in the afternoons when he wants to.
Therapist: It has been my experience that when people think that they are angry about something, that there is usually a deeper emotion underneath that anger.  What feeling word or words would you say are behind the anger?
Youth: I don't know.  Sad.  Mad.
Therapist: How about... hurt?
Youth: Yeah!  It hurts that he doesn't want to see me.  Dads should want to come and be proud of their kids and stuff.
Therapist: It hurts because...
Youth: Because... because it feels like other things are more important to him than I am.
Therapist: You feel devalued.
Youth: Yeah.

**At this point, the therapist has helped the Youth to identify and express the underlying emotion that is covered up by being angry.  Now, the therapist will coach the Youth on how to express it in a healthy way**

Therapist: I think it is good that you are able to express how you are really feeling.  Some people just get angry and do hurtful things, like punch walls and say ugly things that they can't take back.  What do you think would be a good way to share how you feel with your Dad?
Youth: I don't think I could say any of that stuff to him.  Maybe I could write him a letter and tell him that I'm disappointed that he lied to me about coming to my event.
Therapist: If you were a parent and you got a letter from your child like that, how would you feel?
Youth: ... bad, I guess, but he should feel bad for lying to me.
Therapist: I don't disagree with you, but I have found that if we can share our feelings without blaming others for them, the other person is more likely to respond without getting angry back at us.
Youth: What do you mean?  I don't get it.
Therapist: I think it is a good idea to express how you are feeling, but think about this, if you are basically going to tell him, "I'm mad at you because you lied to me", do you think he is more likely or less likely to try and defend himself and come up with some excuse for his behavior?
Youth: More likely
Therapist: Okay, so I've usually experienced that when someone gets defensive, the best defense is a good offense and they usually get angry back.  So, I'm just saying that if we can stick to talking about how YOU feel, instead of blaming him for making you feel that way, he is less likely to get defensive about it and remain open to hearing what you have to say.
Youth: Okay.  How do I say it then?
Therapist: How about something like: "I was excited when you told me you could come to my event and I was disappointed when I found out that you weren't going to be able to make it.  Part of me feels like if you really wanted to, you would find a way to make it.  I know you are busy, but when you chose other things before me, it feels like I am less important to you.  I would like to feel like I am important to you."
Youth: But isn't that still blaming him?
Therapist: I know it sounds similar, but by only stating the situation and how YOU feel about it, you lessen the chance that he will get defensive and by using gracious language like, "I know you are busy" and "it feels like" instead of accusing him of doing something to purposely hurt you, it doesn't make him responsible for how you are feeling.  Stating what you want from him allows him to accept responsibility for his actions and choose to start behaving differently.

***********
Now, I know that it is highly possible and even probable that the Youth's father will feel bad or ashamed or even guilty and that he will not respond to the Youth's invitation to step up and behave differently.  That would be unfortunate, but it would not be because the Youth didn't do her best.  Of course relationships are complex and it helps if both parties are interested in becoming emotionally healthy individuals.  The bottom line is that when even when it is justified, BLAME doesn't help.  It only encourages defensiveness and reciprocal anger.  Note also, that BLAMING is different from helping a person to accept responsibility.  They sound like the same thing, but they carry different connotations.

Feedback?  Questions?  email or comment!

-jeff

Wednesday, April 11, 2012

Listen and learn

There is an old saying, "God gave us two ears and only one mouth so that we will listen twice as much as we talk."  I don't know who originally came up with that, but in my experience, it is good advice.

I frequently get to observe the communication process between individuals in a relationship and I am almost always intrigued to discover what their interactions reveal about their relationship.  It doesn't matter what the nature of the relationship is, marriage partners, parent-child, friend, boss-employee... all behavior is communication and it is very revealing if you know what to look for.


When a relationship is in conflict, research indicates that having conflict itself is not an indicator of the health of the relationship, but how each individual conducts themselves in the midst of conflict is a strong predictor of the stability and health of the relationship.  People who have a high positive regard for each other tend to be able to have conflict and still like each other because they aren't cruel to each other during the conflict.  They can disagree without being disagreeable.

Too often, the communication patterns I witness are locked in a pattern where the same arguments are made over and over and the conversation never goes anywhere, except to reinforce the hurt that each individual feels.  I try to coach individuals who are stuck in a situation where there is no traction that they need to spend less attention on what is being said and more attention listening to how it is being said.

Being attentive to the emotions of the other person is a miracle communication tool.  When a person feels like they are being heard and understood, they feel valued.  Conversely, when in an argument and we are more focused on making sure that the other person sees how right our viewpoint is... it is easy for the other person to feel less valued because they don't feel heard or understood.

Daughter: I feel like I have to always walk on eggshells at home because I never know how Mom is going to react.
Mom: She says that I overreact and don't talk to her for weeks, but she ignores the fact that I still do her laundry, I still cook for her, I still work to pay the bills for her computer and her cell phone.  How is that ignoring her?  I give her plenty of opportunities for her to come and talk, but she is always walking away.

 In the above snippet, the daughter is expressing how she feels, putting the mom on the defensive.  Because Mom is more attuned to her hurt feelings, she is unable to acknowledge and validate her daughter's viewpoint.  To be fair, the daughter is doing the same thing (thus the traction-less cycle they are in), but I don't expect the child to be more capable than the adult of being able to control her emotions, it is something I try to teach the parent before I work on the child.  So, I challenge the mom: "Right now, don't focus on whether you agree or disagree with what your daughter is saying, just try to reflect what you think she is feeling.  You may not agree with her, but right now it is more important that she feels that you understand her."  I ask the daughter to restate her last statement

Daughter: Sometimes it feels like no matter what I say or do, you overreact.  I feel like I can't tell you anything because nothing is ever good enough for you.
Mom: (bristling) What do you want me to say to that?  She is just attacking me again!
Jeff: What do you think she is feeling?
Mom: (sighing) She feels like she can't talk to me because I overreact.
Jeff: That is what is happening.  What do you think she might be feeling?
Mom: I don't know?  Hurt?  Frustrated?  Lonely?
Jeff: Okay, how about asking her if she feels those things because of the situation...
Mom: (thinking about the phrasing...) Okay... so... You feel hurt because when you tell me stuff, I blow it out of proportion.  I can see how that could be frustrating.
Daughter: Yeah, it is.  I mean, I used to be able to talk to you about lots of stuff, but lately it seems like you are just looking for something to yell at me about.

And the mom is stunned that her daughter hasn't completely shut down again.  The previous exchange shows how reflecting a person's feelings can help to break the blame and defensiveness cycle and gain some traction in the conversation.  It allows the conversation to move forward. 

It sounds pretty easy, but in practice it is a difficult thing to do, to ignore the gut reaction to respond and tell the person why they are wrong.  Instead, if we can push that instinct back and instead, try to reflect what the other person is feeling, it breaks the cycle of devaluing language and behavior and invites the other person to feel like they are being heard and understood, giving the communication process traction to move forward.

Give it a try and let me know how it goes!

-jeff

Sunday, March 4, 2012

A little consideration, please...

Few things are more satisfying than seeing your children have teenagers of their own.
Doug Larson

I spend a good deal of my professional time interacting with parents and their teens.  One issue that has popped up recently is the struggle between parents and teens: Teens say they want more independence, freedom and to be seen as adults and parents say that they want their kids to show responsibility, respect and evidence that they can handle more independence.  

From the parents' perspective, all the signs are evident that the kid just isn't ready: 
Comes home late - check
Spends more time with friends than with family - check
Refuses to open up to parents about details of the day - check
Most often heard words include: whatever, fine!, just leave me alone, ...but I....
Says they will help out more around the house, but needs constant nagging/supervision. - check

From the teen's perspective, all the signs are there to show the world that they are ready to be adults: 
Holding down a job AND a decent GPA at school - check
Picks up his/her own room without being told - check
Has a checking/savings account - check
Pays for own cell phone - check

The complaint I hear coming from parents usually has something to do with what I call parental anxiety.  Parental anxiety is activated when our children display their lack of consideration for their families (especially their parents).  For instance, the teen is supposed to be either at school, at work, or home at specified times.  When the teen fails to show up, or check in, or even text, parental anxiety is activated.  Parental thinking may include any one of (or mixture of) the following: 
*I'm worried... my child could be hurt or in danger
*I'm annoyed... this is just the latest example of a lack of respect for my time and abusing the privilege of having a car/job
*My child is too lazy/inconsiderate/disrespectful  to follow the rules and call 
*My child ALWAYS does this... he/she knows it will make me upset and he/she is doing it on purpose.

Many parents have valid and legitimate issues with their teen... it is rude and inconsiderate.  If it is an ongoing problem that has been addressed before, it may be seen as disrespectful even.  However, it is helpful to keep in mind that if a parent approaches their teen with that perspective, they will invite defensiveness, possible withdrawal and even angry behavior in return.  Even when they are accurate and justifiable, blaming attitudes rarely help resolve issues.  

It may be helpful for parents to remember that, as adults, we have had years to learn to be considerate of others.  It probably started for us in our late teens or early twenties... the romantic relationships that were so important that we had to start taking into account what the other person liked and disliked.  In those exclusive relationships, we suddenly had to learn to take another person's preferences into account when planning our weekends.  You remember that phase of courtship, right?  Our sense of being considerate of another only got stronger when we actually married someone... now there was another human being who has emotional, social and legal claim to our time and attention and property.  We either learned to be more considerate or had lousy relationships.  When our kids came along, now there was another human being who depended on us thinking about their needs juxtaposed to our own needs... and the 'being considerate of others' training goes on as we grow...

Teenagers, on the other hand, are developmentally predisposed to be selfish and lack consideration.  After all, they haven't had 14-18 years of learning to take the thoughts and feelings of others into account.  The prime directive for teens is to differentiate and individualize and yet somehow remain connected to their family of origin.  They face enormous social pressure to be both unique and conformed.  They walk a fine line of being responsible and yet impulsive.  

The bottom line is that being considerate of others is a skill that is underdeveloped in most teens and if parents will work at helping them develop the skill instead of chastising them for not already having a 30-40 year old's sense of consideration, both parties would be happier and emotionally healthier.

Cheers!
-Jeff

Friday, February 24, 2012

Transcript from Licensing Board Meeting in Jan 2012

I promised it a while back, but have just now gotten around to typing up the audio file from my appeal to the licensing standards committee of the Texas State Board of Examiners of Marriage and Family Therapists in January.

I spent a good part of this afternoon trying to decipher the letter I was sent detailing what I have to resubmit and how many hours I have yet to accumulate.  I had in my mind that the board had essentially said they would accept half of the hours that they had originally declined from my non-profit agency job.  If that was the case, by my reckoning, I would only have to finish 514 hours, which, by my estimate, I would finish by March!  Woo hoo!  

...
...

Then I sat down and transcribed the audio file of the actual recording of the meeting and that is NOT what was decided by the committee.  Instead of counting all the hours I'd accumulated from September 2011 through Dec 2011 and adding them to HALF of the hours they'd denied.... the actual ruling was that from Jan 13th on, I would have to get ANOTHER 1000 hours... 500 of which have to be direct clinical hours and 250 of those have to be hours to couples and families. 

The practical difference between my recollection of the event and the actual recording of what happens amounts to about 3 months or more of my life before I can upgrade my license.  *sigh*  Instead of being able to finish and upgrade in March, I will be lucky to finish by the end of May or June.

Just yesterday, I learned that another friend from the MFT program at ACU found herself in the same pickle with the board.  They denied her 2000 hours (presumably half of those are direct clinical hours and the rest are paperwork and such).  Learning about her situation incensed me again about the whole situation. 

They board has blatantly admitted that the rule about submitting paperwork for additional sites was unclear, as evidenced by the fact that THEY HAVE CLARIFIED THE RULE and changed the form to include a HUGE paragraph in BOLD print explaining it.  And yet, if a licensee doesn't submit the correct form, it is somehow the licensee's fault and apparently, we deserve to be punished.  The board doesn't say that the hours accumulated that are not board-approved are somehow invalid.  In fact, by accepting a portion of my 'uncontracted' hours, they are essentially admitting that they are perfectly valid and that it is within the purview of the board to approve and accept them if they were so inclined.  Instead, the board feels that it must force the licensee to admit that they 'had a lack of clarity about the rules.'  

Anyhow, here is a copy of the transcript in .PDF form if you want to download it.  I obtained it using the open records law and received a CD with the entire 1.5 hour session on it, but only transcribed the portion pertaining to my appeal. : CLICK HERE

For others who would rather just read it here, scroll on.
 
Transcript from my portion of the Licensing Standards Committee meeting on 1-13-12.
Carol Miller, Executive Officer from the Licensing office, Sandra DeSobe presiding.  Beverly Womack, Sean Stokes, George Francis attending.

(about 10:32 from the start of the recording)
Sandra: Next we will hear from Jeff Emery.  And there is a little more information available here…

Carol: There is.  We have received three emails of support for approval of Mr. Emery’s appeal.  (distributes copies of the email to committee members)

Jeff: I also printed some… I wanted to make sure they had some… if you need extras…There are several that weren’t emailed, but were handed to me…

(sounds of papers being handed out and looked over)

George: If you don’t mind, I’ll take a copy of those, please.

Jeff: Sure.

George: Thank you, sir.

Jeff: Anybody else?

(long pause while committee members ostensibly read over the support letters)

Sandra: Are there any questions from committee members for Mr. Emery?

(pause, with no questions)

Carol: Okay, I just wanted to be sure everyone had time to read.  Um… Mr. Emery is an LMFT-Associate.  He gained LMFT-A status on 9-17 of 2009.  He submitted an application for LMFT upgrade to licensure which was received by the board office on 9-20-11.  But the application was denied because Mr. Emery did not meet minimum requirements for supervised experience under a board-approved plan.  Mr. Emery had previously been approved to begin supervision at Texas Family Institute with John McLen on 9-17-09 for part-time work.  Mr. Emery has credit for supervision and supervised experience at this location for the time period submitted.  Um.. and for a specified number of hours.  According to the Licensed Supervision Experience Verification Form submitted with the application for upgrade, Mr. Emery also, apparently practiced with the same supervisor at New Horizons Ranch and Center with a start date of 12-1 of 09.  And that was for the number of hours that were there on the form… um… these hours at New Horizons Ranch and Center were denied by staff.  Mr. Emery says in his appeal letter that he had, quote “missed a step two years ago and all of the hours at the agency are being denied” unquote, and requests that you count the hours at New Horizons Ranch and Center towards fulfilling the requirements for licensure as an LMFT.  He has submitted new Supervisory Agreement Forms to work at both locations with a board approved start date of 9-17-11 for New Horizons and 10-16-11 for Texas Family Institute.  He listed the Texas Administrative code for requirements related to .. um.. ah.. submission of… um… Supervisory (indistinct word ) to the board… at 801402(?) and 801202.  And that is the information.

Sandra: …To clarify, Mr. Emery, You filed a supervisory agreement form with your first supervisor…

Jeff: With my only supervisor, yes, ma’am.

Sandra: So he supervised your work at both sites.

Jeff: Yes.  The step that was missed was when I started a month later at New Horizons, um, they didn’t have an LMFT supervisor there and I asked John (Rusty), if he would agree to do both and he said that was fine.  And because it was with the same supervisor, it didn’t click that I needed to do a new Supervisory Agreement.  But both locations were aware that the hours I was getting at New Horizons were being supervised by Rusty.  They gave me time off for professional development so I could attend supervision. 

Sandra: And are you still working there?

Jeff: Yes, Ma’am.  I am still currently employed there. 

George: And that was my question, Mr. Emery.  So, you knew to file for the Supervisory… for the first position…

Jeff: Yes, sir.

George: … But not for the second one?

Jeff: Well, um, when I filed for the upgrade, and I was filling out the paperwork, in the upgrade packet, it has the verification of supervisory experience where you list every location that you have provided services at.  And I did, because that is where I knew I’d provided services at two locations.  But on the original Supervisory Agreement Form, there is a spot for the licensee, where you’ll be providing services and the supervisor.  And so there wasn’t anything intuitive there that said, “hey, if you’re going to have it at another location…” to fill out another one for the SAME supervisor. And that…

George: For another location or for another position, because this was another position, correct? 

Jeff: Yeah.  Um.. ah… That was the step that I missed … that because I was utilizing the same supervisor, I didn’t understand that I needed a new Supervisory Agreement.  I didn’t realize that it was per location…

George: So you thought that it was tied to supervisor and not to job?  Or to job AND supervisor?

Jeff: Well, it seemed to be pretty conclusive that if there was going to be a new supervisor, that I would need a new supervisory agreement.  And I did have friends in my cohort that were getting hours at different locations where a supervisor was provided, so if there is a new supervisor, it would make sense that you would need a new supervisory agreement.  But intuitively, because I was using the same supervisor, it didn’t click that I would need a new supervisory agreement. 

George: Ah, thank you.

(long pause)

Sandra: Any other questions for Mr. Emery?

Womack: Did you file for a new supervisory agreement in a different location now?

Jeff: Yes!  Yeah, as soon as I discovered from the board that that was the step that I missed, they recommended that I go ahead and extend my LMFT-A, which I did.  I filed it as soon as possible for that, and managed to get all the forms signed to get that sent in.  Which has allowed me to continue practicing at both locations and gain hours and I counted up through my billing at both locations that I’ve garnered almost another 200 hours since then.  But I have continued, as recommended by the staff. 

Sandra: Okay, so how many hours are you gonna be short? Of the face to face time?

Jeff:  Lacking all of the New Horizons hours?

Sandra: Yes.

Jeff: 2410.

Sandra: That’s not face to face time…

Jeff: I’m sorry… the face to face time… um…

Sandra: Counting the hours you have accumulated since September… when you discovered this… problem.  That would give you what you need?  If you accumulated about 700 more hours?  Is that correct?

Carol: What is currently approved is 730 practice hours, 365 of which were direct clinical and of those 156 were to couples and families.  So there ….

Sandra: But that was before… September?

Carol: Correct.

Sandra: So… we’ve got that.  So far. 
Carol: So, of 3000, he has 730.  Of the 1500 that have to be direct clinical he has 365.  And of the 750 that have to be to couples and families, he has 156. 

Sandra: Now, can you give us that run down of hours that you’ve completed since September?  How many total hours have you accumulated since September?  Clock hours?

Jeff: Um… as of September.. face to face clock hours?

Sandra: Not Face to face… total.

Jeff: Um… I only kept track of the face to face hours.

Sandra: Okay, so how many face to face hours have you accumulated since September? 

Jeff: Um… Through my December billing, not counting January, 199 face to face hours. 

Sandra: And how many of those are for couples and families?

Jeff: Well, I’d have to … I … didn’t delineate those when I was counting them up. 

Sandra: (long pause while she does math on a scratch paper)  So you are about 936 just to pick a number… ah… hours short of what you need to get your license.  (pause) But we don’t know that for sure because we don’t know how many are client, couple and family hours. 

Jeff: Ah… the work that I do at New Horizons… I provide prevention counseling for at risk families.  Part of our program is that we have to meet with primary caregivers as well as the target youth, so a lot of the hours I get at New Horizons are, ah… count as family hours.

Sandra: Yes.  I can see that.  Okay. 

Beverly: And you are a full time employee there now, yes?

Jeff: Yes.

Sandra: And about how many clients are you seeing a week? 

Jeff: I generally carry a caseload of 15-20 clients a month at New Horizons…

Sandra: A month?  Or a week?

Jeff: Oh, well, on my caseload, it rotates out.  On a weekly basis, I generally meet with about 14-15 hours. 

Sandra: So you’re not really going to have any trouble at all accumulating the ah… non face to face hours. 

Jeff: As far as paperwork and …

Sandra: Right.

Jeff: That’s not a problem at all.

Sandra: No one really has trouble accumulating that!  Well, Mr. Emery.  This may be your lucky day.  Not as lucky as you think, but I’m going to make a recommendation that because we have had this problem and this precedent, the board has taken action to correct this so it will not be a problem in the future, that we will accept part of those hours that were done without the contract.  And, so, committee… He’s about a third of the way there.  If we accept another third from the uncontracted and let him get one more third accumulated under supervision… Essentially cut his mistake in half…

George: Is that a motion?

Beverly: But can we do that?  Because everyone is going to be saying that we’ve got to waiver the plan. 

Sean: Well, we *have*.

Carol: We … have inconsistently … waived or not waived

Jeff: Um… before a motion is made I just wanted to offer some information, or at least a perspective…

Sandra:  Yeah.   (clears throat) Dig yourself a grave here….

Jeff: Well, I hope I won’t be digging a grave… necessarily.  I appreciate the policies and procedures that are in place and I understand that this is not a … I’ve very diligently tried not to strike a tone that I’m deserving in some way because I know that I missed a step on this and that any action taken by the board is an action of grace.  And I do appreciate all the consideration you’ve given it.  However, I’ve talked to several of my colleagues and I’ve heard that this is something that has come up in the past… one of my cohort actually told me that she had the same problem when she applied, but in her case it was a secondary site and she said it was about 100 hours and she said “I was upset about it and I cried about it and then I just earned the hours back again.”  But in this case, it represents about two years of accumulating hours.  In that time, in addition to the work that I’ve done with New Horizons, a non-profit agency, and TFI, doing private counseling there, I’ve had the opportunity to be a part of the community and utilize my talents and services in ways that have benefited the community.  I serve on several coalitions… one of them provides training for child care providers so that they can continue to provide that service to our community.  Another one works with Teen Drug prevention and we offer a support group for teens who are involved in drug or alcohol abuse.  And I understand that any motion that’s made or decision that is made that extends the time that I will remain an associate in some was impacts not only my professional development but also the ability to further any opportunities to help the community.  So… I can see this as a win-win, since it is in the purview of the committee to accept all the hours or some portion of them, obviously it would be personally beneficial to me but I think also, in addition to professionally, I think it would be good for our community.  And since the board has already taken action to make sure that it doesn’t happen for future folks, ….

George: Mr. Emery, what were you looking for?

Jeff: Um… as I mentioned , I was looking for some grace. 

George: I’m just asking, what are you looking for from the board?

Jeff: Best case scenario?  Since it was something that was on the last agenda and it has been handled before, I was hoping that it would be something like, “Hey, we’ve already fixed it.  We’re sorry that it has caused some confusion for you….”  Next level down, I was looking for: “We’ll take the hours you’ve accumulated over the past three months and say that that is the number of hours you needed to get, so we’ll call it even since you have…. like I said, I’ve tried to be compliant with everything the board staff have asked me to do as far as extending things and continuing to work on those hours…. BUT, I was prepared that if there was a need to go ahead and continue to get some hours, that that is something I would go ahead and have to do.  Because I love what I do.  I’m intending to pursue this and this is what I want to be my career… so… whatever it takes in order to make it happen is what I’m going to do.  In order, that was kind of my preference of how I’d like to see this happen. 

Sandra: I’m suggesting that we split the difference.  And because we are acknowledging that we had some problems with a lack of clarity about our form, we would like for you to acknowledge that you had a lack of clarity about the rules.  And part of our job here, in protecting the public is making sure our… our therapists are competent.  And one of the ways we evaluate that is whether or not they can follow the rules … and… (crackling of a food wrapper near the mic) .  I am chairing this committee, so can someone make that motion?

George: I make the motion that we split the difference and go for one third of the hours that still need to be accumulated by Mr. Emery.

Sandra: So, what would mean is that you would still have 500 hours.  Face to face hours to show to the committee.  Do I have a second?

Sean: I second.

Sandra: Any discussion?  Yes, George?

George: Is that consistent with our … inconsistencies previously?  (laughter)

Carol: It has been an evolving process.  In the beginning, all were denied, that have done this.  But then this is consistent in that it is partial credit.  And that is consistent …

Sandra: That is a precedent that this committee set in July of last year.  So… we’re kind of stuck with that right now.

George: I’m comfortable with it.

Sandra: Okay.  All in favor?

George, Sean and Beverly: Aye.

Sandra: So… keep practicing. (more crackling from food wrappings obscure the sound)

Jeff: So, 500 beyond the three months I’ve already done… the 200 I’ve already gathered?

Sandra: Starting from now.

Jeff: Starting from now… about 500.  And when it gets to that point as far as…. do I just submit for upgrade again?  As I’ve done, or…

Carol: Your application, um…yeah, I don’t think that it is going to be realistic for you… the application will expire 9/20 of 2012.  So I don’t think it is going to be realistic to get those hours…

Jeff: I think it is.

Sandra: Yep.  He’s gotten 200 in the last three months.

Carol: Yeah.  Oh.  So.  I’ll send you a letter outlining the details, okay?

Jeff: Thank you very much.

(ending at about 30:12 from the beginning of the recording

Thursday, January 26, 2012

I know everything I need to succeed in life...

Occasionally, I run across family systems that are heartbreaking.  Consider the following: my client: a middle-school aged kid.  His mom requested I work with him because of his behavior at home and at school.  Seems that all he wanted to do was play his Xbox.  He is very smart and schoolwork holds no interest for him, so he sometimes refuses to go to school.  His mom says that he often throws tantrums when he doesn't get his way.  He is close to neither parent and his siblings are old enough that he may as well be an only child. 
Using open ended questions, I discovered that he considers himself to be decently happy and content with himself, but has few friends.  Asking about the presenting issue as described by his mom, he admitted that he is spoiled.  I asked him to finish the following statement, "The most important thing in life is..."  his answer: to not be bored.  Though he is not a child of the 1990's, my brain sparked and connected to the grunge band, Nirvana and their hit, "Smells Like Teen Spirit."  Part of the chorus pleads, "here we are now, entertain us!", helping the song to be hailed as the anthem of an apathetic generation who only wanted to be entertained.  As I continued to dialog with the kid, I learned that he described his relationship with both his mother and father as distant and faint.  Developmentally, it is my understanding that most children find their identity and sense of self through their connection with their family.  At his age, he should be starting to develop his identity apart from his family, but it seems like his family identity was never really formed, as he feels no attachment or connection, only entitlement.  Trying again to get a sense of his value system, I asked him to evaluate the following quote: "Show me the person you emulate and I shall know by this measure, better than any other, who you are yourself."  The young man was quick to analyze the sentence and reflected to me that he understood its meaning.  But when I followed up with, "So, who do you admire?  Who in your life is someone that you can see yourself growing up to be?"  He thought for a few minutes and then shrugged and said, "No one, really.  I think I know everything I need to succeed in life."
At first, I had to stifle an urge to laugh at the seemingly preposterous statement I'd heard.  My bemusement quickly turned to pity when I realized that far from being cocky or feeling entitled, this young man's problem was not a character flaw in himself, but a failure in his family system.  I felt sad for him because his parents don't know enough to challenge him or help him have a healthy sense of self. 
I have come to understand, as I work with various families, that kids' behaviors and beliefs are generally a response to their environment.  So, as I am presented with a kid whose troubled behavior or attitude is labeled by their parent as the presenting issue, I am always careful to examine the family system and try to work with the parent to depathologize the kid and help the parent to accept some responsibility for the resulting behavior which they say they don't want.
Anyhow, I am saddened because my role in working with this boy is limited and in order to really address the core issues, the needed work is with the family system, something that is unlikely to happen.  I think the best I can hope for in this situation is relationship triage, not relationship repair (as it relates to helping this young man to have a healthy connection to his family).

The situation invites me to reflect on my own family functioning.  How would my children be affected if I viewed their behavior as a function of their response to the environment that I create for them in our home?  Now, I don't want to take absolute responsibility for their actions, but do I really recognize and honor the influence I have on my children, or do I discount it?  If I have generally happy children, how am I influencing their happiness?  If I have generally anxious children, how is our home environment encouraging them to be anxious?  If my children are generally angry and hateful, what kind of environment am I providing for them?

Nietzsche wrote, "When you look into the Abyss, the Abyss looks into you," reminding me that I do not remain unaffected by the families that I encounter in treatment.  Even as I hope to influence them, I recognize that I am influenced in return.  Hopefully, I will embrace the opposite philosophy that my young friend espoused and will find freedom to grow by knowing that far from having everything I need to succeed in life, I recognize that I know nothing.  And that is the beginning of wisdom.

 



Monday, January 16, 2012

Obstacles, Barriers and Hoops to Jump Through: Bureaucracy at work

I started on my journey to become a therapist several years ago, when I decided to go back to school and get my Master's in Marriage and Family Therapy.  Just getting a degree isn't the end of the process, though.  Once one has one's diploma in hand, one must obtain a license from the state to practice as a therapist.  Licensing and regulation are as old as government and serve to protect the public from any old person labeling themselves a therapist and setting up shop.  However, whenever you have government regulating things, you will inevitably experience red tape and bureaucracy.  Here is a narrative of my troubles so far: Jeff's Licensing Journey.

So, I requested to have my situation brought before the Licensing Standards Committee of the Texas State Board of Examiners of Marriage and Family Therapy and was added to the agenda for the meeting on Friday, January 13th, 2012.  The outcome of the meeting was that the Committee is requiring me to accrue an additional 700 hours of client contact before I can be awarded my license.  That is the short story.  If  you want to know details and my opinion of the situation, read on.

Here are the facts to keep in mind:
1) The critical step that I missed was that the Board requires a Supervisory Agreement Form (Form III) to be on file and approved by the board for each location that a LMFT-A will be providing services.  I had one on file for my hours at TFI, but not for New Horizons.
2) Over the past year or so, the Licensing Standards Committee has had so many LMFT-As  appear before them for a waiver of that rule, they have changed the wording of the rule to be more clear and added a block of text on the FORM III at the top of the form, in all caps and in bold, so it can't be missed. See a copy of the revised form HERE.  Here is the previous form, for comparison: HERE.

The problem is that the rule that was violated was unclear in the first place, as evidenced by the fact that so many people have missed it and by the fact that the board apparently felt the need to change it for clarity.  Here is the wording of the rule as it appears in the Texas Code:
Texas Administrative Code, Title 22, Part 35, Chapter 801, Subchapter G, Rule 801.142(D) “Supervision must be conducted under a supervision contract, which must be submitted to the board on the official form within 60 days of the initiation of supervision. The supervision contract submitted to the board must be approved by the board. Fees charged by a supervisor during the course of supervision, which occurred without a board-approved supervision contract in place and subsequently resulted in the supervised experience hours of the supervisee being denied by the board solely on the basis that there was no board approved supervision contract in place within 60 days of the initiation of supervision, must be reimbursed to the supervisee.” 

 So, according to this rule, I had to have a supervision contract in place within 60 days of the initiation of supervision.  Check!  I did that.  I submitted the official form (Form III) and happily started seeing clients on a part-time basis at Texas Family Institute.  The form (Form III), has a spot for the licensee information (that is me) and where services will be provided (TFI).  Then it has a spot for the supervisor's information and the supervision schedule.  Then, it has spots for a notary to sign off and volia!  You are done!  Now, I will grant that the inclusion of a line on the form asking where services will be provided does indicate that the information is important to the board.  However, there is nothing explicit on the form that indicates that if you provide services at a second location, it would necessitate filling out a new form.  On the other hand, if you have a second supervisor, it makes logical sense that you would need an additional supervisory form on file.  In fact, there are other rules that state a supervisee can only have two supervisors at any given time in the process.  So, not only is it a logical thought process, but there are multiple rules that discuss how to handle having multiple supervisors, but none that specify what to do if you have more than one location that is being supervised by only one supervisor, as was my case.
A month after I started working at TFI, I was hired by another non-profit organization where my job would allow me to accrue hours toward my license, but they had no LMFT supervisor available, so I asked my original supervisor if he would supervise those hours as well.  He agreed to do so and my new job allowed me to take time each week to attend supervision sessions with him.

So, did I fail to turn in a form that was required by the board?  Yes.  Was I at fault for my negligence?  Well, kind of... you see if I was the only one who misunderstood, then it would stand to reason that it was my own lack of diligence or intelligence that was at fault.  However, by the board's own admission, this rule is unclear and confusing to people in my situation.  So they changed the rule.  They changed the form.  And it is at this point that I feel that the Supervisory Committee handled my appeal poorly.

When time came to address my appeal, the Executive Director informed the board of my situation, gave them time to look over my narrative (linked above) and some support letters from colleagues who knew my situation.  The members of the committee asked a few questions for clarification.  There was some discussion between the committee members wherein they acknowledged that my case was not the first time they had heard about this situation.  They mentioned that each time, the details were examined and that the board had made some inconsistent rulings about other's cases and they joked about needing to be consistent in their inconsistency.  Then the chair called for someone to motion that they look at the how many hours I still had remaining that weren't approved and that they split the difference with me, accepting half of them and requiring me to make up half of them.  I interrupted and asked if I might speak and give further details.  The chairperson sat back in her chair and said, "Okay... dig yourself a grave."  That comment was offensive to me, as it indicated to me that her mind was already made up and that whatever I was about to say would only serve to damage my appeal.  I spoke for a few moments about my perspective on the situation and acknowledged that the decision was in their hands, but also the power to grant my hours, all of them.  I noted my service to the community, the fact that the rule was unclear, that my supervisor knew he was supervising the hours and that I had complied with everything else that was required of me, including renewing my LMFT-A for the three months between my denial of hours and the chance to appeal.  After I spoke, the chairperson picked up where she left off, as if nothing in my statement held merit and again requested a motion for splitting the difference of my remaining hours.  The chairperson looked at me and said that the board was willing to admit that the wording of the rule was unclear, but that I had to admit that I'd done something wrong by not filing the paperwork.  So essentially, the committee was asking me to admit that I had deliberately not filed a paper that I didn't know I was supposed to file because by their own admission, it was unclear and confusing.  This seemed to make sense to her and when I protested that it was unclear, she told me that it was my responsibility to make sure I knew everything I needed to know to file things correctly.  She said it was the Board's responsibility to protect the public from incompetent therapists.  Again, I was offended by her suggestion that because I didn't file a form that was required because I didn't know I needed to because the rule was unclear and confusing in the first place... that somehow made me an incompetent therapist.  I was nonplussed and didn't reply.  The chairperson pressed forward and put pencil to paper with the numbers for the hours I had documented previously and had been accepted and calculated how many remained and told me that I would need to complete 700 hours more of face to face hours and then re-submit my application for upgrade.  Another committee member made a motion to that effect, it was voted on and I was done.

As I drove home, during my 4 hours on the road, I was able to mull over what had happened.  I feel that although I did have a chance to appeal the staff decision, that my appeal was not really considered.  I feel that due to all the previous cases they'd seen, the mindset of the committee was that I needed to be held responsible for the crime of not filing a form and that I somehow should have known I needed to file it despite it being unclear and confusing, given my circumstance.  I further feel that the mindset of the committee was driven by the chair, as the only other committee member to ask any questions about my situation was the public member, a MBA, who had never been through the licensure process himself.  The rest of the committee seemed to follow the chairperson's lead.

With just a little effort, I can think of several outcomes that would have been much better for the committee and for myself and my community.
1) Acknowledge that there is a situation where the wording is unclear and in those cases, simply require the licensee to fill out the form, have their supervisor sign it and have it notarized and applied retroactively.  After all, if the purpose of a board-approved supervisor is to monitor the supervisee in the first place and ultimately, it is the supervisor who signs off on everything anyhow, why make this more complicated than it has to be?
2) If the board felt that there needed to be some accountability on my part for not filing the form, they could have required me to continue in supervision for a set period, a fine, the denial of some of my hours ( a reasonable amount, not all of them)  In fact, because I'd renewed my LMFT-A while waiting for my appeal, they could have accepted the 200+ hours I'd accumulated in the meantime and counted that as recompense for not filing the 2nd Form III.
3) As the committee repeated bemoaned the fact that there were so many licensees who were coming before them with this problem, they could have granted my appeal and then enlisted my help in informing others who had not yet completed their hours to contact the board and rectify the potential problem before it had to turn into an appeal.  After all, I am in contact with my cohort and other licensees who are in a similar position.  I have anecdotal evidence of several others who have experienced a denial of hours, to different degrees, because of the same set of circumstances.

At any rate, I feel that the mindset of the committee led to this appeal being handled unprofessionally, and, according to their own comments and my anecdotal evidence, it was handled inconsistently.  The end result is not just a faceless licensee having to do a few more hours toward a license.  The end result of this appeal has numerous consequences for me, my family, my community and the practice of MFT in the state of Texas.  Consider these consequences:
1) My career is delayed for 5-7 months (or more) while I continue to strive toward these hours.  I am having to work several jobs at pay scales below my education level as a result of only being provisionally licensed.  I can't get on insurance panels with a LMFT-A.  I have to be fully licensed.  So, in the mean time, I can only accept private-pay clients.  Current economic conditions notwithstanding, most folk can't afford $80/session and so I am forced to accept low-paying clients.  I don't mind helping with that, but it is hard to feed my family and pay off my school loans when I can't charge a reasonable rate for my services.
2) Clients who have state insurance can't utilize my services because I can't accept their insurance.
3) The non-profits, and coalitions that I serve who may have benefited from my credentials are also forced to wait until the hours are completed.
4) As other students and provisionally licensed people hear about how the board handles situations like this, it can influence them to seek other avenues of licensure.  I know of several in my cohort from school who opted to get LPCs instead of LMFTs because of difficulties in obtaining a MFT license.  How can our profession continue to advance itself in the state if those who are trained in Systems Thinking and MFT modalities opt to practice under LPCs and LCDCs and Social Work instead of working toward MFT credentialing?

So, while I am primarily disappointed because of the effect on me, my family and my practice, I recognize that the implications go beyond me.  700 hours represents approximately 5-7 months for me and in the mean time, opportunities that require a full license, which I have already earned, pass me by.  I have already spent three months waiting, so in effect, a year of my life, livelihood and career are gone due to a confusing, unclear rule and the hard-heartedness of a panel of MFTs.


-Jeff