The Modern Therapist's Survival Guide with Curt Widhalm and Katie Vernoy

Good Enough, Safe Enough: Affirming LGBTQ+ Clients When You're Not a Specialist

Affirming LGBTQ+ clients when you are not a specialist: Curt Widhalm, LMFT, and Katie Vernoy, LMFT on being a good enough, safe enough therapist when you cannot refer out.

Curt and Katie take on a question therapists often avoid: what do you do when an LGBTQ+ client needs care, you are not a specialist, and referring out is not possible, not safe, or not honest? In this Pride Month episode, they make the case that you can be a good enough, safe enough therapist for LGBTQ+ clients even when affirming care is not your declared specialty.

Mental health deserts, narrow insurance panels, long specialist wait lists, and unsafe home environments mean referral is not always available, and sometimes referring out is closer to abandonment than care. Curt and Katie argue that scope of competence is too often used as polite cover for therapist discomfort, and that most clinical work with LGBTQ+ clients is the same work you already do well. Affirming care is the container, not a separate specialty.

They also get practical about being a safe enough stopgap therapist: building a just in time consultation kit, doing the cultural humility work, and reckoning with the invisible labor and consultation tax of allyship, including why you should never bill a client to research their own identity. And they name the specific moments when referring an LGBTQ+ client out is still the right and ethical call.

This is a useful conversation for generalist therapists, rural and solo clinicians, insurance-based practices, and anyone doing the ongoing work of affirming, culturally humble care.

In this episode, we discuss:

- Why "refer out" can be avoidance dressed as ethics, and when it is genuinely the right call

- How to tell a true scope of competence limit from your own discomfort

- What it means to be a good enough, safe enough therapist for LGBTQ+ clients

- How to build a just in time kit so an LGBTQ+ client never lands on you cold

- Why the invisible labor and consultation tax of allyship is yours to carry, not your client's to fund

- The specific signs that mean you should refer out anyway

Timestamps:

00:15 - Why a Pride Month episode on being good enough, not a specialist

02:56 - "Just refer out": sound advice or avoidance?

05:05 - Scope of competence versus therapist discomfort

13:08 - The good enough therapist, and when referral becomes abandonment

16:55 - Meeting clients where they are until specialist care opens up

19:03 - Building a just in time kit for your practice

24:44 - The invisible labor and consultation tax of allyship

32:10 - When you should refer out anyway

Full show notes and transcript: mtsgpodcast.com

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Allyship Is Awkward: How Therapists Can Keep Showing Up Anyway

What if the awkwardness of ally work is not a sign you are doing it wrong, but the actual work?

Curt Widhalm, LMFT, and Katie Vernoy, LMFT explore what it looks like to do ally work as a therapist when you hold majority identities the people around you do not share. They move across three zones where this shows up: with clients in the therapy room, with colleagues and consultants in professional spaces, and in broader community and advocacy work.

Drawing on their own missteps and on the work of creators like Ashani Mfuko of Anti-Racism School Is In Session and Dr. Raquel Martin of Mind Ya Mental, Curt and Katie make a direct case to white, cis, straight, and other majority-identity therapists: cultural humility is not a credential, fragility shifts the labor onto the people around you, and the strong feelings that come with ally work belong with other allies, not with clients or colleagues of color. This is an episode about staying in the room, decentering yourself, and learning to fail better.

In this episode, we discuss:

Why ally work is inherently awkward, and why that is not a problem to be solved

How fragility, over-apologizing, and gold-star seeking shift the emotional labor onto clients and colleagues of color

What repair actually looks like when a cross-cultural rupture happens in session

Why being called out by a client can be a sign the relationship is alive enough to repair

How to process defensiveness and hurt with other allies instead of with clients or colleagues of color

Why cultural humility is not a free pass, and what therapists owe their own continuing education

How consultation with diverse colleagues protects clients from being conscripted as your teacher

Ally work is ongoing. The goal is not to stop making mistakes. The goal is to keep failing better.

Full show notes and resources: mtsgpodcast.com

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The Seven Stages of Queer Love: Therapy with Queer Couples, Queer Sex, and the Developmental Model - An Interview with Tom Bruett, LMFT

Tom Bruett, LMFT on the seven stages of queer relationship development, the Developmental Model, queer couples therapy, and queer sex.

Curt and Katie talk with Tom Bruett, LMFT, founder of the Queer Relationship Institute, about what therapists most often get wrong when working with queer couples, why queer sex is still treated as an asterisk in most sex therapy training, and how the Developmental Model of Relationship Therapy can be expanded to better reflect queer experience.

Trained under Drs. Ellyn Bader and Peter Pearson, Tom adds two stages to the five-stage Developmental Model: Second Queer Adolescence and Agreement. The expanded seven-stage model gives therapists a clearer way to track differentiation, autonomy, and connection in queer relationships that do not fit the standard "relationship escalator." Tom is the author of The Go-To Relationship Guide for Gay Men: From Honeymoon to Lasting Commitment (Jessica Kingsley Publishers).

This is a useful conversation for therapists working with queer couples, sex therapists, couples therapists trained in heteronormative models, and queer therapists looking for better tools and community for this work.

In this episode, we discuss:

- What therapists most often get wrong with queer couples and queer sex

- The Seven Stages of Queer Relationship Development, including Tom's two additions

- Why a "second queer adolescence" matters clinically

- Mutual interdependence versus codependence in gay male relationships

- Minority stress, the relationship escalator, and queer identity formation

- How the current political moment is showing up in queer couples therapy

- Trauma activation, nervous-system regulation, and slowing the work down

- Support for queer therapists working through a difficult cultural moment

Timestamps:

02:28 - What therapists get wrong with queer couples and queer sex

04:43 - Sex therapy training and the asterisk problem

08:20 - The Seven Stages of Queer Relationship Development

13:00 - Mutual interdependence versus codependence

17:39 - The relationship escalator and minority stress

21:14 - The current political moment in queer couples therapy

25:18 - Trauma, regulation, and slowing down the work

27:08 - Writing The Go-To Relationship Guide for Gay Men

33:21 - Doing the work on the back end, not asking clients to educate you

34:13 - Where to find Tom and the Queer Relationship Institute

Guest Bio:

Tom Bruett, LMFT is a therapist, trainer, consultant, and author who works extensively with the queer community. He is the founder of the Queer Relationship Institute, which provides therapy for queer folx and training for therapists who work with queer relationships. Tom has trained under Drs. Ellyn Bader and Peter Pearson in the Developmental Model of Relationship Therapy, which he now trains other therapists in. His book The Go-To Relationship Guide for Gay Men: From Honeymoon to Lasting Commitment is published by JKP. Tom has spoken at national conferences including AASECT. Learn more at www.QueerRelationshipInstitute.com.

Full show notes and transcript: mtsgpodcast.com

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Modern Therapist's Consumer Guide: Paubox. HIPAA Compliant Email, Secure Communication, and Practice Privacy. An Interview with Hoala Greevy, Founder and CEO of Paubox

Curt and Katie talk with Hoala Greevy, Founder and CEO of Paubox, about what HIPAA compliant email actually requires, where standard Google Workspace and Microsoft 365 Business Associate Agreements leave gaps, and why most secure-portal solutions fail at the inbox. Paubox is a HIPAA compliant email security platform built to deliver encrypted messages straight to the recipient's inbox, without portals, plugins, or extra clicks.

Hoala explains how Paubox wraps around the email systems therapists already use, why domain ownership and TLS encryption matter, and how inbound threats like display-name spoofing affect small practices. The conversation also covers HITRUST certification, AI scraping, the Paubox Foundations, the Paubox Kahikina Scholarship supporting Native Hawaiian students in STEM, and how to evaluate a HIPAA compliant email vendor on security, reliability, and ease of use.

This episode is part of our Modern Therapist's Consumer Guide series. While this interview is a paid partnership, our discussion and opinions are our own.



In this episode, we discuss:

- Where standard Google and Microsoft BAAs leave HIPAA compliant email gaps

- Why most secure-portal solutions never get read on mobile

- How TLS encryption and secure email delivery actually work

- What domain ownership has to do with HIPAA compliance

- How Paubox integrates with Google Workspace and Microsoft 365

- Inbound threats, display-name spoofing, and ExecProtect

- HITRUST certification and how to evaluate a HIPAA compliant email vendor



Timestamps:

- 02:18 – What Paubox does and why it was created

- 05:19 – Mission, vision, and the Paubox Foundations

- 08:38 – What HIPAA compliant email actually requires

- 10:26 – The Google and Microsoft BAA gray area

- 14:48 – What the client experience looks like

- 21:09 – Inbound email security and display-name spoofing

- 24:32 – Data access, HITRUST certification, and trust

- 34:05 – Pricing, value, and the referral program

- 38:43 – Curt and Katie Chat: Our Review of Paubox



Guest Bio:

Hoala Greevy is the Founder and CEO of Paubox, a leading provider of HIPAA compliant email solutions for healthcare organizations. Born and raised in Honolulu, he founded Paubox after a meeting with the CEO of the Make-A-Wish Foundation of Hawai'i revealed a critical need for secure healthcare communication. Greevy supports Native Hawaiian students entering STEM and technology careers through the Paubox Kahikina Scholarship. Learn more at paubox.com.

Special Offer for Modern Therapist Listeners:

Get $250 off an annual Paubox plan. Visit paubox.com and use promo code MODERN.



Full show notes and transcript: mtsgpodcast.com



Join the Modern Therapist Community

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Music by Crystal Grooms Mangano: https://groomsymusic.com/

Before You Refer to the Hospital: De-Escalation, Safety Planning, and Wraparound Care for Teens in Crisis

When a suicidal teen is in crisis, is the hospital really the safest call? What outpatient therapists need to know.

Curt Widhalm, LMFT, leads this episode from his work running a comprehensive DBT private practice in Los Angeles that specializes in higher-acuity adolescent cases, including teens with serious suicidality, self-harm, and emotional dysregulation. These are exactly the clients most often routed toward psychiatric hospitalization or platform-based care, and Curt argues the default-to-hospital reflex frequently makes things worse, not better.

Drawing on recent research and his clinical experience, Curt walks through the iatrogenic harms of adolescent psychiatric inpatient care, why post-discharge is the highest-risk window for completed suicide, and how clinician anxiety can drive premature 5150 holds and crisis referrals. Katie Vernoy, LMFT, joins with years of LPS-designated assessment experience from community mental health, naming what really happens when a teen gets sent in, including the relational rupture that often starts the moment a crisis evaluation is requested.



Together they show outpatient therapists, including solo practitioners, how to build the clinical infrastructure that makes hospital diversion a real option: standardized risk assessment, collaborative safety planning that starts at intake, verbal de-escalation, family-integrated care, and wraparound treatment teams that include both formal providers and informal natural supports.



This is a continuing education podcourse. Therapists can earn 1 CE credit through the Modern Therapist Learning Community at moderntherapistcommunity.com.



What you'll take away:

- How to recognize when a teen client really needs inpatient care, and when escalation will cause more harm than help

- How to use standardized risk assessment tools (C-SSRS, LRAMP) without losing the therapeutic relationship

- How to build a safety plan that actually works, and what to leave out (hint: no-suicide contracts)

- What to teach parents about verbal de-escalation and environmental modifications at home

- How to construct a mini Intensive Outpatient Program inside a solo or small-group practice

- Who belongs on a wraparound treatment team, and how to find informal supports that families often forget to mention

- How systemic barriers and health disparities shape access and outcomes for Black, Hispanic, and lower-SES adolescents



Timestamps:

00:15 - CE intro and how to earn 1 CE credit

05:17 - Why outpatient therapists need real de-escalation protocols

11:23 - What actually happens during a crisis evaluation, with Katie's LPS-designated insights

18:46 - Iatrogenic harm and post-discharge suicide risk in adolescents

26:27 - Distant admissions, capped beds, and reentry into school and community

30:43 - Building safety plans from the first session, not the first crisis

34:32 - What belongs in a comprehensive adolescent safety plan

41:05 - When a teen says "I want to die," and why language matters

47:27 - Family-integrated care in solo private practice

48:56 - Building a mini IOP without the institutional overhead

55:29 - Wraparound teams and the role of informal natural supports

59:51 - ROIs, HIPAA-compliant communication, and minor consent

1:01:00 - Health disparities and access for marginalized adolescents



Earn 1 CE credit:

Therapists can earn 1 CE credit for this episode through the Modern Therapist Learning Community. Register, purchase the course, pass the post-test, and complete the evaluation to receive your certificate. Therapy Reimagined is approved by the California Association of Marriage and Family Therapists (CAMFT CEPA #132270). Please check with your licensing board to confirm eligibility.



Full show notes, references, and transcript: mtsgpodcast.com

CE enrollment: moderntherapistcommunity.com



Join the Modern Therapist Community:

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Modern Therapist's Survival Guide Creative Credits:

Voice Over by DW McCann: https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano: https://groomsymusic.com/