Therapist Spotlight: Tempering Your Enthusiasm as a Young Therapist with Kevan Walker

This Therapist Spotlight is a part of our interview series with experienced Mental Health Practitioners, where therapists share their experiences in Private Practice Therapy.
What was one of the biggest problems you struggled with and ultimately solved in the beginning of your private practice? What solution did you find to your (perhaps persisting) problem?
A thread that runs through my entire private practice in all these questions is found in one of the most famous quotes by philosopher Michel Foucault,
“I don’t feel that it is necessary to know exactly what I am. The main interest in life and work is to become someone else that you were not in the beginning. If you knew when you began a book what you would say at the end, do you think that you would have the courage to write it? What is true for writing and for love relationships is true also for life. The game is worthwhile insofar as we don’t know where it will end”
(Interview, 25 Oct 1982).
I am always learning, from not just professional colleagues, but from clients too, and everyone else that I meet in life, both in person and otherwise. As a reminder of this I have on the wall of my office the license plate to the car I owned in grad school; the meaning of the code is “Marriage and Family Therapist in training”. My aim is to become someone else than I was at the beginning of the day.This was a big problem as I came out of grad school in that the culture at my first job was very different from my worldview and education in Social Justice & Social Constructionism. My ethic was seeing the people I consulted with as equal experts to myself, but the mental health world I was surrounded by in large part was doing to people, rather than walking with people. Eventually I came to a point where an opportunity presented itself and I was in a position where I could start the private practice I dreamt of. In my private practice I’ve been able to work more with my clients more as experts in their own lives, as people. This independence & relational way has been extremely freeing, and what a friend of mine has called “Genuine Human-Being Therapy”.So a major hurdle for me that I continue to struggle with has been learning to be a businessman. This is not something they teach you in grad school, and I wish they to some extent. I’m not naturally well-organized. I’ve gotten better at managing my practice, but a persistent issue for me is learning how to market my services. I seem to have gotten down passive advertising fairly well, via my website, a blog, referral sites, newspaper & telephone book ads; but more active marketing is coming slower and still eludes me to a great extent. I did well when I first started the practice, carrying business cards in my hand wherever I went, making appointments with doctors, chiropractic clinics, alternative medicine businesses, church leaders, etc.; but after getting my first few clients I slipped into laziness and wasn’t networking so much.Now that I’m low on clients, I’m getting nervous because I don’t have the flow of revenue used to, or having the great conversations I love so much. This is been a great motivator for me, that & my sweet wife! Now I’m writing out simple lists with goals, especially pertaining to marketing, that’s helping me get organized. This is now a less persistent problem.
What advice would you give to a budding mental health practitioner just getting licensed? What advice would you have given yourself early in your career?
I think the number one advice for those just coming out of school and working towards licensure, as well as if I were able to benevolently haunt my younger self, would be to get to know the inner workings of the agencies they will eventually work at, & either start planning for your private practice/ group practice now or learn to be a change agent from within. So often, we young, inexperienced therapists have a great idealism that can be contagious, that people can see in our eyes, but that first experience can also be very disheartening when we deal with the power dynamics that run through the culture of mental health & is evident in most agencies.
Most states in the U.S. require that you start out in an agency setting where there’s guaranteed supervision of the green therapist, but that same agency setting has been indoctrinated often in the great panopticon of mental health & can easily put the light out in our eyes. My advice would be to keep that youthful vision, but also to be aware that the Culture of Money, the Culture of Hubris, the Culture of Insurance, the Culture of the DSM, & others, are all influencing the thinking & doing in an agency. From individual to organization, all have limited agency & possible responses to such cultural influences, which for me, after a time, also fostered compassion for some that I saw making questionable ethical decisions.You will have to temper your enthusiasm for activism, with wisdom well-earned over time. Attempt change where you can, be tactful, but stand your ground in behalf of the people you consult with. As I said earlier, have compassion for those who may hold a position of authority over you, & may use their power to keep you in line through threats of termination or other censure to keep you walking the party line- if you look closely, you’ll find admirable things about them that contradict the story of abuse of power, which if cultivated in your conversations, might influence their decisions to keep truer to their better selves.If by through your efforts as a change agent you find yourself more in despair & the light going out in your eyes, start looking for options in private practice or better yet a group practice with like-minded & like-hearted therapists. As you exit the agency towards a higher calling, look back on what went well in that first experience. Your recognition of supervisors & others who did some good, but found their homage to the “gods of this is the way it’s always been” to strong, will go a long way as you say your sweet-sour goodbyes in favor of your preferred way of being professionally.
Do you see any persisting or upcoming problems in the private practice industry. If so, how do you handle them?

For me this comes down to two hallmarks in both large & small organizations in the U.S., as a heritage of the mental health culture: Hubris & Pathologizing. This was best pointed out by a teenage friend of mine that remarked of his long relationship with mental health organizations that “they trade kids like trading cards”, & further saying “I’d rather see the baseball bat coming”. Having spent many years in varying tiers of the house of mental health I’ve felt the invitations & even well played along with in hierarchy above those we’ve termed as “clients”, “consumers”, or “patients”. Being invited to be an “expert” in position over people seeking our services can be intoxicating & feed the hubris; again, this I can attest to from personal experience.

From my experience within the position of expert, I’ve seen folks in & outside that culture pathologized when they fit criteria in the Bible of this culture, the DSM. I’ve also seen people equally pathologized for questioning the culture. This Pathologizing as far as I can tell, acts in service to the mental health hubris, the adage “if you are less, I am more” seeming to hold sway.

One way in which I’ve actively opposed the hubris & Pathologizing, & encouraged co-expertise in relationship with the folks I work with, has been through the use of documentation. I noticed early on in my career, long before becoming a therapist how documentation was used as a means of perpetuating the practices of hubris & pathologizing. After years of reviewing assessments, treatment plans, professional notes, discharge summaries, court documents, & the like, I was introduced to the Narrative tradition of critiquing such paperwork & writing counter-documents. Narrative practitioner Steven Madsen aptly summarized such practices by asking “who has the storytelling rights to the story being told?” (Vancouver Narrative Training, 2011).

Increasingly I’ve authored & co-authored counter-documents to assist in dissolving iatrogenic practices & enliven the expertise of people I consult with. Most often this comes in the form of the process notes I keep. I start from the first session by asking the person or persons permission to take notes, painting myself as a Therapeutic Biographer, who takes their words down & not my own interpretation, & together we as Co-investigators “warning the [problem]: ‘Put on your nut-cup, we’re going to ask some tough questions!’ ” (Reporter David Carr, NPR interview). I then inform them that at any time they can tell me to “hand it over”, as it’s their property rightly, & I’ll do so. I will at the end of the sessions hand off the said notes to the rightful owner to keep & continue. I also treasure the position of persons through Narrative Letter-Writing, wherein I summarize our conversations from my position as guest, forward some points I find admirable in my opinion, & pose some questions that, as narrative poet David Epston puts it, “takes both the person asking the question & the person being asking the question just beyond were the busses run” (original time & place unknown, but confirmed to me personally by David).

These and other collaborative practices, I’ve found, equalizes the balance of power & turns on all the lights in the panopticon, Reversing the Gaze.

Please let us know about you: where are you located, any specialties, credentials, and educational background. How should someone get in touch with you?
I am located in Fairbanks, Alaska, the Golden Heart City. After working about 9 years in varying mental health settings as either floor staff in residential treatment or a Coordinator (Case Manager), I decided to move towards my dream to become a therapist. I started out in a program that was more oriented towards individual therapy, linear, but it felt fairly flat to me. I reflected on conversations with folks with relational, systemic, mindsets. This relational stance seemed to fit better with my own worldview based upon my life experiences. In 2008 I transferred to the Marriage & Family Therapy Masters program at Antioch University New England (ANE) in Keene, New Hampshire.
The MFT program at ANE has a Social Justice focus, with very small class sizes (10 in my cohort), & starts students in the second semester in internships to get real-world experience. Probably the two hallmarks of my experience that I’ve brought forward into my relational practice were In-Home Therapy & Narrative Therapy. My internship, which lasted virtually both years, was out of a county-run in-home therapy program. Through it I gained valuable insight with the people who sought services. I also took a Postmodern Therapies course as part of the curriculum, of which most was in Narrative Therapy. That introduction to Narrative practice by my continued friend & mentor Ken Potter, was like coming home again. I’ve continued to immerse myself more & more over the years in Narrative practice, using that as my GPS while tweaking some of the modernist tools I’ve collected along the way.
My private practice, Golden Heart Family Therapy LLC (GHFT), is unique in three distinct ways: 1) it is foremost Brief-Narrative in practice, 2) it’s in the client’s home, & 3) it’s insurance-free. As mentioned already I consider myself a Narrative Therapist, & I’ve detailed already some of the ways I practice that, but over time I’ve seen practitioners of the Narrative & other traditions find that change can happen in a very short time. I limit our sessions to 10 & more often I notice that people feel they don’t need that many. I eventually look to start a day of the week where I only see walk-in clients. I really loved the experience of seeing folks in their homes, I find people enjoy the convenience, & I just can’t afford the overhead of renting office space at Fairbanks prices right now. I meet with people in the evenings in their homes after my full-time job as a subcontracting counselor with the military, as well as in outlying communities like Delta Junction, Salcha, Nenana, & Denali on Saturdays. Lastly, with all the recent revelations with the NSA’s big brother tactics, along with a number of year’s dealings with insurance sticking its nose into folks’ treatment, I decided to start out insurance-free in my practice. About ¼ pay out of pocket (some getting reimbursed later by their insurance) & the rest come through Fast Offering Funds of the Church of Jesus Christ of Latter Day Saints (LDS Church) to which I belong, as well as most of my clients. All these practices have been much more confidential than previous dealings.
As mentioned I deal with a lot of LDS people & being one of that crowd I tend to at least understand the culture & speak the language. I deal with couples more often than not & am really enjoying it. I’m a certified facilitator with the Prepare/ Enrich program for engaged couples, as well as healthy couples that want to enrich their marriage- this fits well with my focus on Brief Therapy. I’ve also over the years, due to my family heritage, as well as by circumstance, worked with a lot of teens, & therefore become very interested in what our profession terms oppositional-defiant behavior. I knew as a lover of the Narrative arts, that there had to be another side, & there was. The result is a growing project I’ve called with others Dignified Defiance. I’m also enamored with bullying & intimidation from the work of Marie Nathalie-Beaudoin & Jodee Blanco. Lastly, I’m looking into Narrative Mediation & in the near future want to market that through GHFT.
If you’re interested in learning more about GHFT & what folks & I explore together, check out one (or all) of the resources below:
www.goldenheartfamilytherapy.com
narrativewalker.blogspot.com (my blog/ vlog The Thick of Thin Things)
Facebook page- Golden Heart Family Therapy LLC

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