Therapy or Clinical Supervision: Two Different Takes

Therapy or Clinical Supervision: Two Different Takes

Lorain Moorehead, LCSW, PMH-C, EMDR Certified Consultant & Clinical Supervisor, sits down with Dr. Laurie Bruce, clinical psychologist (25+ years), mindfulness coach, host of "From Both Sides of the Couch," in a cross-show conversation recorded for both podcasts. They unpack the gap between CEUs and real clinical consultation, what happens when a client triggers something personal in session, and the barriers that keep therapists from finding their own therapist. If you found our episode on EMDR consultation requirements useful, this conversation goes further into the blurry territory between supervision, consultation, and personal therapy. Timestamps:  0:00 — The problem with supervision ending at licensure  1:14 — How other countries require ongoing consultation and the US doesn't  2:16 — Why CEUs should partially be replaced with consultation hours  3:16 — Learning a new modality means starting over, and why that demands supervision  11:04 — Lorain's experience with EMDR consultation requirements  12:47 — Dr. Bruce on DBT consultation teams, RO-DBT, and DART training  17:26 — The deep self-exploration required in IFS training  18:29 — The blurry line between therapy, supervision, and consultation  22:00 — Naming it as a form of informed consent and emotional regulation  23:39 — Administrative vs. clinical supervision: why they're not the same  27:10 — Barriers to therapists seeking their own therapy  34:06 — Structured vs. organic supervision: two different philosophies  42:01 — Why the intake process is the clinical work, not just a formality  43:23 — Individual vs. peer consultation: the role of trust and vulnerability  45:09 — How to find a therapist when you're a therapist yourself  49:32 — Dr. Bruce's upcoming virtual community for therapists and caregivers  52:05 — Where to find Lorain's work on perfectionism, burnout, and anxiety Episode Highlights:  Supervision is treated as a finish line tied to licensure instead of an ongoing clinical need.  Several countries require monthly consultation to maintain licensure, while the US relies on CEU hours alone.  Specializing in a new modality puts a clinician back at square one, requiring the same level of supervision as early training.  Administrative supervision and clinical supervision serve different functions and should not be conflated.  Naming what is happening in the room functions as both informed consent and a regulation tool.  The biggest barriers to therapists seeking their own therapy are financial, the conditioning to be the expert, and the difficulty of finding someone outside their professional circle.  A strong intake is not a formality. It is where the clinical work and the supervisee's core skills are actually built. Host: Lorain Moorehead, LCSW, PMH-C, EMDR Certified Consultant & Clinical Supervisor. Private practice supporting high-achieving adults and therapists with perfectionism, burnout, anxiety, and irritability. This episode covers topics relevant to CE/CEU for LCSW, LMHC, LPC, LMFT, NCC. Free CEU available for Arizona licensure through the Board of Behavioral Health Examiners. Subscribe for weekly clinical training you can use in your next session. Website: https://lorainmoorehead.com [https://lorainmoorehead.com] Instagram: @selfcareapist Podcast: https://feeds.buzzsprout.com/2512198 [https://feeds.buzzsprout.com/2512198] #therapist #mentalhealth #continuingeducation #CEU #LCSW #LPC #LMFT #clinicalsupervision #EMDR #DBT The Self Careapist Therapist Podcast is a biweekly conversation with Lorain Moorehead, LCSW a therapist in private practice.  With guests ranging from expert psychologists, therapists, researchers and authors, each episode offers a deep dive and keeps listeners from intern to advanced supervisor  in mind while dropping gems and aha moments for everyone who loves to learn! If you love learning and want to keep track of some future learning opportunities, grab your personal curriculum [https://lorainmoorehead.com/podcast] here! If you liked this episode, feel free to subscribe and leave a review! Your support helps us be a top mental health podcast and resource.  See you next week!

DBT for LGBTQ+ Mental Health: Self-Love, Emotional Resilience & Queer Joy With Dr. Kiki Fehling

What does DBT look like when it is truly LGBTQ+ affirming? In this episode of The Self Careapist Therapist, I sit down with Dr. Kiki Fehling to talk about DBT for LGBTQ+ mental health, minority stress, queer joy, self-love, emotional resilience, and what it means to apply skills in a way that actually honors context. We talk about why being queer is not the source of mental health harm, how anti-queer environments shape emotion dysregulation, and why DBT can be especially helpful when clinicians understand the transaction between identity, biology, environment, invalidation, and safety. If you are a therapist working with LGBTQ+ clients, or if you are trying to deepen your affirming practice beyond good intentions, this conversation offers a thoughtful clinical lens. Listen to the full episode of DBT for LGBTQ+ Mental Health: Self-Love, Emotional Resilience & Queer Joy With Dr. Kiki Fehling. Dr. Kiki Fehling, Ph.D., is a licensed psychologist and Linehan-Board-certified Dialectical Behavior Therapy (DBT) expert therapist. She specializes in emotional sensitivity, borderline personality disorder, self-harm and suicide, trauma, and LGBTQ+ mental health. She is the co-author of Self-Directed DBT Skills: A 3-Month DBT Workbook and regularly shares mental health tips and DBT-related posts through her @dbtkiki social media accounts. Her work focuses on making DBT skills more accessible and affirming for LGBTQ+ people, especially around self-love, emotional resilience, minority stress, and queer joy. Website: https://www.kikifehling.com/   [https://www.kikifehling.com/] Instagram: https://www.instagram.com/dbtkiki/  [https://www.instagram.com/dbtkiki/] Li: https://www.linkedin.com/in/drkikifehling/ [https://www.linkedin.com/in/drkikifehling/] FB: https://www.facebook.com/drkikifehling/  [https://www.facebook.com/drkikifehling/] Tiktok: https://www.tiktok.com/@dbtkiki [http://www.tiktok.com/@dbtkiki] Lorain Moorehead is a therapist, consultant, and EMDR Certified, EMDRIA‑approved consultant specializing in trauma‑informed care and EMDR integration. She works with high‑achieving adults navigating anxiety, perfectionism, identity loss, and relational stress through depth‑oriented, evidence‑based approaches. Lorain brings advanced training in DBT and certification in Perinatal Mental Health, grounding her work in safety, attunement, and nervous‑system awareness. She also supports clinicians through supervision, consultation, and training, with a strong focus on ethical practice and clinical decisionmaking. In 2025, she launched The Self Care‑apist Therapist Podcast, creating space for therapists to explore innovative, research‑backed modalities—including emerging conversations around KAP and trauma treatment. Website: https://lorainmoorehead.com/ [https://lorainmoorehead.com/]    LinkedIn: https://www.linkedin.com/in/lorainmoorehead/ [https://www.linkedin.com/in/lorainmoorehead/]   Instagram: https://www.instagram.com/theselfcareapist/ [https://www.instagram.com/theselfcareapist/]   TikTok: https://www.tiktok.com/@theselfcareapist [https://www.tiktok.com/@theselfcareapist]    YouTube: https://www.youtube.com/playlist?list=PLjS1AkQopGeVq6eP-1j7Y4i-oloOPSJmw [https://www.youtube.com/playlist?list=PLjS1AkQopGeVq6eP-1j7Y4i-oloOPSJmw]   The Self Careapist Therapist Podcast is a biweekly conversation with Lorain Moorehead, LCSW a therapist in private practice.  With guests ranging from expert psychologists, therapists, researchers and authors, each episode offers a deep dive and keeps listeners from intern to advanced supervisor  in mind while dropping gems and aha moments for everyone who loves to learn! If you love learning and want to keep track of some future learning opportunities, grab your personal curriculum [https://lorainmoorehead.com/podcast] here! If you liked this episode, feel free to subscribe and leave a review! Your support helps us be a top mental health podcast and resource.  See you next week!

Interracial Marriage: Love, Identity, and Navigating Differences with Geoffrey Greif and Victoria D. Stubbs

What can interracial couples teach therapists about race, family systems, and the conversations many clients are still learning how to have? In this episode of The Self Careapist Therapist, I sit down with Dr. Geoffrey Greif and Victoria D. Stubbs, LCSW, co-authors of Interracial Marriage: How Diverse Couples Navigate Relationships. We talk about what hundreds of interviews with interracial and interethnic couples revealed about communication, family approval, identity, power, children, language, safety, and the daily accommodations many couples learn to make. We also explore how therapists can approach these conversations with more humility, curiosity, and clinical nuance. Victoria shares how the six pillars of a brave space framework can support conversations about race, power, privilege, oppression, and identity, while Geoffrey highlights what research interviews can reveal that surveys often miss. Listen to this episode of Interracial Marriage: Love, Identity, and Navigating Differences with Geoffrey Greif and Victoria D. Stubbs Dr. Geoffrey Greif is a professor at the University of Maryland School of Social Work, researcher, author, and co-author of Interracial Marriage: How Diverse Couples Navigate Relationships. His work spans family relationships, fathers, adult sibling relationships, group work, and interracial marriage research. Website: https://geoffreygreifbooks.com [https://geoffreygreifbooks.com] Victoria D. Stubbs is the founder of Inner Truth Psychotherapy and Wellness, co-author of Interracial Marriage: How Diverse Couples Navigate Relationships and was previously a full-time clinical instructor at the University of Maryland School of Social Work.  Website: https://www.innertruthllc.com/ [https://www.innertruthllc.com/] Instagram: https://www.instagram.com/innertruthllc/ [https://www.instagram.com/innertruthllc/] Discover how love transcends boundaries — click the link to grab your copy of Interracial Marriage: How Diverse Couples Navigate Relationships in a Divided Time and explore the powerful, real stories that remind us that connection is stronger than division!  Buy the Book Here: https://www.amazon.com/Interracial-Marriage-Diverse-Navigate-Relationships/dp/0231218192 [https://www.amazon.com/Interracial-Marriage-Diverse-Navigate-Relationships/dp/0231218192] Lorain Moorehead is a therapist, consultant, and EMDR Certified, EMDRIA‑approved consultant specializing in trauma‑informed care and EMDR integration. She works with high‑achieving adults navigating anxiety, perfectionism, identity loss, and relational stress through depth‑oriented, evidence‑based approaches. Lorain brings advanced training in DBT and certification in Perinatal Mental Health, grounding her work in safety, attunement, and nervous‑system awareness. She also supports clinicians through supervision, consultation, and training, with a strong focus on ethical practice and clinical decisionmaking. In 2025, she launched The Self Care‑apist Therapist Podcast, creating space for therapists to explore innovative, research‑backed modalities—including emerging conversations around KAP and trauma treatment. Website: https://lorainmoorehead.com/ [https://lorainmoorehead.com/]    LinkedIn: https://www.linkedin.com/in/lorainmoorehead/ [https://www.linkedin.com/in/lorainmoorehead/]   Instagram: https://www.instagram.com/theselfcareapist/ [https://www.instagram.com/theselfcareapist/]   TikTok: https://www.tiktok.com/@theselfcareapist [https://www.tiktok.com/@theselfcareapist]    YouTube: https://www.youtube.com/playlist?list=PLjS1AkQopGeVq6eP-1j7Y4i-oloOPSJmw [https://www.youtube.com/playlist?list=PLjS1AkQopGeVq6eP-1j7Y4i-oloOPSJmw]   The Self Careapist Therapist Podcast is a biweekly conversation with Lorain Moorehead, LCSW a therapist in private practice.  With guests ranging from expert psychologists, therapists, researchers and authors, each episode offers a deep dive and keeps listeners from intern to advanced supervisor  in mind while dropping gems and aha moments for everyone who loves to learn! If you love learning and want to keep track of some future learning opportunities, grab your personal curriculum [https://lorainmoorehead.com/podcast] here! If you liked this episode, feel free to subscribe and leave a review! Your support helps us be a top mental health podcast and resource.  See you next week!

Radically Open DBT (RO-DBT): A Clinical Approach to Emotional Overcontrol With Ellen Astrachan-Fletcher

Your most contained, rule-following, hardest-working clients may be the ones standard DBT is least equipped to help. In this episode of Self Careapist Therapist, I sit down with Dr. Ellen Astrachan-Fletcher, lecturer at Northwestern University's Feinberg School of Medicine, Associate Professor of Psychiatry at UIC, and owner of EAF ReCenter. With over 30 years of clinical and teaching experience, Dr. Astrachan-Fletcher is a nationally recognized expert in both DBT and Radically Open DBT (RO-DBT). She is the co-author of two clinical workbooks used in eating disorder treatment programs across the country, and her third book, RO-DBT for Anxiety, is set for release in August 2026. We cover what RO-DBT is, who it's designed for, how it differs from standard DBT, and what a training path looks like for clinicians who want to learn it. What You'll Learn in This Episode: Radically Open DBT was developed by Dr. Tom Lynch after observing that many clients, particularly those with chronic depression, restrictive eating disorders, and anxiety, were not responding to standard DBT. Standard DBT targets emotional dysregulation, helping clients learn to contain and control. RO-DBT does the opposite: it targets emotional overcontrol, the pattern of holding emotions in, appearing fine, and disconnecting from authentic social signaling. Dr. Astrachan-Fletcher explains the concept of emotional leakage, the moments when a tightly controlled client expresses emotion in unexpected, often indirect ways. She walks through the three core treatment targets in RO-DBT: flexibility, receptivity and openness, and true connection. True connection, she is careful to clarify, is not having a large social network. It is the felt experience of being known and loved even in your most uncomfortable truths. We also discuss emotional loneliness, what Tom Lynch identifies as the core suffering of overcontrolled clients: feeling utterly alone in a room full of people. Dr. Astrachan-Fletcher explains how this loneliness develops from the overcontrolled pattern of masking inner experience and what RO-DBT teaches clients to do differently. Other topics from this conversation: The temperament and developmental origins of overcontrol, including the role of threat sensitivity and detail focus in shaping coping early in life. The three mind states in RO-DBT: fixed mind, fatalistic mind, and flexible mind, and how each shows up in session. The clinical presentation differences between emotionally undercontrolled and overcontrolled clients, and how easy it is to misread a controlled client as doing well. Why RO-DBT calls its group component a "class" rather than a group, and what that distinction signals about how overcontrolled clients experience social environments. How RO-DBT is transdiagnostic, reaching across depression, OCPD, restrictive eating disorders, anxiety, and several personality disorders.  Resources Mentioned: Official RO-DBT Training Site: radicallyopendbt.net EAF ReCenter (Dr. Astrachan-Fletcher's practice): eaf-recenter.com RO-DBT for Eating Disorders workbook by Dr. Astrachan-Fletcher RO-DBT for Anxiety (forthcoming, August 2026) by Dr. Astrachan-Fletcher Key Points: 00:00 Introduction 03:19 Emotional overcontrol defined 06:51 Overcontrol as the “high road” 09:03 DBT and RO-DBT as dialectics 12:50 Leakage in real life 15:05 Flexibility, openness, true connection 19:49 Social signaling 23:57 Frozen and masked expressions 25:28 Mirror neurons and Botox 28:02 The eyebrow wag 31:29 Self-inquiry and Malamati Sufism 35:38 Self-inquiry meets EMDR 39:14 Mindfulness differences 43:36 Playfulness and teasing 45:35 Screening and self-reporting 50:00 Skills class structure 53:28 Diagnoses that respond to RO-DBT 58:02 Self-care recommendation Ellen Astrachan-Fletcher is a licensed clinical psychologist, Founder of EAF reCenter, and expert in eating disorders, DBT, and Radically Open DBT (RO-DBT). With nearly three decades of experience spanning academia, clinical leadership, supervision, and training, she specializes in helping individuals cultivate authentic connection and emotional resilience.  Website: https://www.eaf-recenter.com/ [https://www.eaf-recenter.com/]   LI: https://www.linkedin.com/in/ellen-astrachan-fletcher-ph-d-ceds-s-faed-a2aa8151/?isSelfProfile=false [https://www.linkedin.com/in/ellen-astrachan-fletcher-ph-d-ceds-s-faed-a2aa8151/?isSelfProfile=false]    Lorain Moorehead is a therapist, consultant, and EMDR Certified, EMDRIA‑approved consultant specializing in trauma‑informed care and EMDR integration. She works with high‑achieving adults navigating anxiety, perfectionism, identity loss, and relational stress through depth‑oriented, evidence‑based approaches. Lorain brings advanced training in DBT and certification in Perinatal Mental Health, grounding her work in safety, attunement, and nervous‑system awareness. She also supports clinicians through supervision, consultation, and training, with a strong focus on ethical practice and clinical decision making.  Website: https://lorainmoorehead.com/ [https://lorainmoorehead.com/]    LinkedIn: https://www.linkedin.com/in/lorainmoorehead/ [https://www.linkedin.com/in/lorainmoorehead/]   Instagram: https://www.instagram.com/theselfcareapist/ [https://www.instagram.com/theselfcareapist/]   TikTok: https://www.tiktok.com/@theselfcareapist [https://www.tiktok.com/@theselfcareapist]    YouTube: https://www.youtube.com/playlist?list=PLjS1AkQopGeVq6eP-1j7Y4i-oloOPSJmw [https://www.youtube.com/playlist?list=PLjS1AkQopGeVq6eP-1j7Y4i-oloOPSJmw]   The Self Careapist Therapist Podcast is a biweekly conversation with Lorain Moorehead, LCSW a therapist in private practice.  With guests ranging from expert psychologists, therapists, researchers and authors, each episode offers a deep dive and keeps listeners from intern to advanced supervisor  in mind while dropping gems and aha moments for everyone who loves to learn! If you love learning and want to keep track of some future learning opportunities, grab your personal curriculum [https://lorainmoorehead.com/podcast] here! If you liked this episode, feel free to subscribe and leave a review! Your support helps us be a top mental health podcast and resource.  See you next week!

Why Clients Skip Their Second EMDR Session (And What It's Telling You)

Moments of hesitation after a first EMDR session often signal that meaningful work has already begun.   In this episode of The Self Careapist Therapist, I break down what’s really happening when clients feel unsure about continuing EMDR after their first session. I walk through common reactions like exhaustion, vivid dreams, confusion, and the sense that something shifted without fully understanding why.  I also talk about how to respond clinically. Sometimes it’s about better debriefing and helping clients understand what their brain is doing. In some cases, hesitation points to something deeper. Slowing down, strengthening safety, and meeting the client where they are can make the difference between dropout and meaningful progress. Let this episode sharpen how you interpret hesitation in your clients. Watch now Why Clients Skip Their Second EMDR Session (And What It's Telling You). Lorain Moorehead is a therapist, consultant, and EMDR Certified, EMDRIA‑approved consultant specializing in trauma‑informed care and EMDR integration. She works with high‑achieving adults navigating anxiety, perfectionism, identity loss, and relational stress through depth‑oriented, evidence‑based approaches. Lorain brings advanced training in DBT and certification in Perinatal Mental Health, grounding her work in safety, attunement, and nervous‑system awareness. She also supports clinicians through supervision, consultation, and training, with a strong focus on ethical practice and clinical decisionmaking. In 2025, she launched The Self Care‑apist Therapist Podcast, creating space for therapists to explore innovative, research‑backed modalities—including emerging conversations around KAP and trauma treatment. Website: https://lorainmoorehead.com/ [https://lorainmoorehead.com/]    LinkedIn: https://www.linkedin.com/in/lorainmoorehead/ [https://www.linkedin.com/in/lorainmoorehead/]   Instagram: https://www.instagram.com/theselfcareapist/ [https://www.instagram.com/theselfcareapist/]   TikTok: https://www.tiktok.com/@theselfcareapist [https://www.tiktok.com/@theselfcareapist]    YouTube: https://www.youtube.com/playlist?list=PLjS1AkQopGeVq6eP-1j7Y4i-oloOPSJmw [https://www.youtube.com/playlist?list=PLjS1AkQopGeVq6eP-1j7Y4i-oloOPSJmw]   The Self Careapist Therapist Podcast is a biweekly conversation with Lorain Moorehead, LCSW a therapist in private practice.  With guests ranging from expert psychologists, therapists, researchers and authors, each episode offers a deep dive and keeps listeners from intern to advanced supervisor  in mind while dropping gems and aha moments for everyone who loves to learn! If you love learning and want to keep track of some future learning opportunities, grab your personal curriculum [https://lorainmoorehead.com/podcast] here! If you liked this episode, feel free to subscribe and leave a review! Your support helps us be a top mental health podcast and resource.  See you next week!