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

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

Patreon: https://www.patreon.com/c/mtsgpodcast

Facebook Group: https://www.facebook.com/groups/therapyreimagined



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/

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/

Inside the Troubled Teen Industry: Wilderness Therapy, Residential Treatment, and the Harm Done to Kids – An Interview with
Chelsea Maldonado and Dr. Will Dobud

Dr. Will Dobud and survivor advocate Chelsea Maldonado on wilderness therapy, residential treatment, institutional abuse, and what therapists need to know to support troubled teen industry survivors. 

Curt and Katie talk with Dr. Will Dobud and Chelsea Maldonado about what actually happens inside the troubled teen industry, why the marketing rarely matches the reality, and how wilderness therapy programs and residential treatment facilities continue to operate despite decades of survivor testimony, documented abuse, and youth deaths. 

The conversation covers why so many adopted youth and foster youth end up in these facilities, how restraints, isolation, and medical neglect produce lasting trauma, and why power dynamics and institutional structure undermine real therapeutic work. Will and Chelsea also discuss the silence of professional associations after youth deaths, the recent Atlantis Leadership Academy case in Jamaica, and what therapists working with troubled teen industry survivors can do to create safer therapeutic relationships. 

In this episode, we discuss: 

What therapists get wrong about wilderness therapy and residential treatment

Why "round the clock therapy" marketing rarely matches the reality inside facilities

How restraints, isolation, and medical neglect cause lasting harm

Why adopted youth and foster youth are disproportionately placed in these programs

The role of power dynamics and institutional structure in the troubled teen industry

Why survivors are highly traumatized and highly therapy resistant

How therapists can work more safely and effectively with survivors

The silence of professional associations after youth deaths in licensed, accredited facilities 

Timestamps: 

07:34 – What actually happens inside troubled teen industry facilities

13:04 – Katie reflects on her own residential treatment experience

16:28 – Common harms: restraints, medical neglect, sexual abuse

19:38 – Power, conversion-style programming, and adopted youth

24:31 – Why these facilities still exist

28:07 – Attachment, restraints, and institutional contradictions

33:00 – What actually helps youth in crisis

38:14 – The Atlantis Leadership Academy case and survivor-led advocacy 

Guests:

Dr. Will Dobud, Senior Lecturer in Social Work at Charles Sturt University and former wilderness therapy field guide whose research focuses on improving outcomes for teenagers and exposing harm in the troubled teen industry (willdobud.com).

Chelsea Maldonado, troubled teen industry survivor, lead researcher for the Trapped in Treatment podcast, and consultant to Paris Hilton's nonprofit 11:11 Media Impact (1111mediaimpact.com). 

Full show notes and transcript: mtsgpodcast.com 

Join the Modern Therapist Community 

Patreon: https://www.patreon.com/c/mtsgpodcast

Facebook Group: https://www.facebook.com/groups/therapyreimagined 

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/

Why Therapists Stop Working with Kids and What It Takes to Stay: Sustainability, Boundaries, and Pivots for the Long Haul

Curt Widhalm, LMFT, and Katie Vernoy, LMFT push back on the field's quiet stereotype that working with kids is the "starter home" of private practice, the place clinicians put in time before graduating to a cardigan and a wing-back chair. Working with kids and teens is not entry-level work. It is some of the most clinically and physically demanding work in the profession, and it has a sustainability problem that rarely gets named honestly.

Curt and Katie examine why so many therapists who work with kids and teens hit a wall around the five-year mark, and why that wall is rarely about clinical depth. They unpack the sensory toll, the parent communication load, the school and provider coordination, the cost of running a play therapy room, and the way a child caseload can quietly distort a clinician's sense of what is developmentally typical.

They also talk about how to build a long-haul career working with kids, teens, and families without becoming, in Curt's words, "a cynical, glitter-covered shell of a human being." This is a conversation for therapists in private practice, supervisors of clinicians who work with minors, and anyone weighing whether to keep working with kids, scale back, or pivot.

In this episode, we discuss:

Why working with kids is not a lesser clinical specialty

Why the work is hard to sustain, and why "burnout" alone does not fully explain it

How shifting from kid sessions to family work and parent work extends the clinical impact

The sensory, physical, and administrative load of working with kids

Why parents contact child therapists more than adult clients contact their own therapists

The financial and logistical reality of running a play therapy room

How a clinical caseload can distort a therapist's sense of typical development

When a pivot to adult, family, or parent work is healthy, and when it is avoidance

Timestamps:

00:15 — The "starter home" stereotype, and the five-year wall

06:03 — The 167-hour problem and why kid work is family work

10:08 — The sensory and physical toll

12:58 — Caseload diversification and structuring the day

19:41 — The unpaid hours: parents, schools, and the village

23:43 — The play therapy industrial complex

27:59 — Keeping up with kids' culture without losing yourself

30:19 — How a clinical caseload distorts the sense of typical development

33:09 — Expectations, moral injury, and what "fix my kid" really costs

35:01 — When a pivot is survival, and when it is avoidance

Full show notes and resources: mtsgpodcast.com

Join the Modern Therapist Community
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Facebook Group: https://www.facebook.com/groups/therapyreimagined

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/