Will the COVID-19 situation finally convince the MA LMHC board to update guidelines for online CEUs?

Since I became licensed in 2005, the policy of the Massachusetts Board of Allied Mental Health and Human Services Professionals has always been that no more than 50% of LMHC CEUs can be earned "on line or via home study." (Interestingly, this is stated in various documents of theirs such as this one, but the actual law regulating the continuing education requirements, 262 CMR 7.00, doesn't specify anything about online vs. in-person.)

When I was first licensed, the only type of online education available was largely text-based and did not generally occur in real time. Most people were using dialup internet at this time. Streaming media existed, but wasn't something most people's home setups could handle. College courses taught online from about 1995-2010 or so were generally something like a text-based discussion forum with papers submitted by e-mail or upload. There were maybe a few pre-recorded YouTube videos of lectures if the instructor was savvy. Similarly, the only "online" professional continuing education available at the time they made this regulation was the type (still widely in use today) in which the learner reads through some array of articles or slides, maybe a few short video clips, then takes a multiple-choice quiz, with no interaction with the instructor at any point. There were also home study courses that could be purchased that were similar –– read some stuff, take a quiz, get some credits.

For the past five years or so, I have been thinking the "no more than 50% online" regulation seemed a bit outdated. So many organizations are now offering trainings and conferences online using interactive Zoom sessions limited to a classroom-sized group. Actually, if we want to get into whether interaction is a necessary component of a training worthy of credits, a number of conferences I've attended do give one CEU for attending a keynote speech with hundreds of people present and no discussion or interaction. How is that any different from watching a video at home?

We should also be considering that best practices in the field mean we have plenty of providers of all different socioeconomic backgrounds and those living with disabilities, among other folks who make our field look more like the folks we serve. Many of the people we should be encouraging to work in our field are more comfortable with courses that can be taken at home, as these are generally less expensive and are often much more accessible to people with psychiatric or other disabilities who may have a hard time with travel and/or being in a conference setting all day.

This year, a number of well-established conferences that typically meet in person (thus usually awarding what would be considered in-person CEUs by the licensing board) have moved their conferences online. Sessions are taking place over Zoom or similar. Attendees are able to have discussions with presenters and break into small groups to do activities, just like at in-person conferences.

Based on what is still listed on the licensing board web site, these conferences will no longer count as in-person CEUs, despite being the same conference as the one that usually occurs in person, and despite having a similar level of face-to-face interaction. Many conferences for early 2021 have already made the decision to cancel the in-person event. I am surmising that a large percentage of LMHCs renewing licenses in December of 2021 will be in the position in which more than 50% of our CEUs were taken online, despite being high-quality offerings through universities, medical centers, established conferences, and so forth. My hope is that rather than just issuing an emergency waiver allowing for 100% online CEUs, the board will actually take this as an opportunity to review what constitutes an acceptable course. I hope that they will move into modern times and recognize that the "distance learning" of pre-2005 is not the distance learning of 2020, and change the policy to reflect the high-quality interactive offerings that now take place online.

Online trans/queer/LGBTQ+ youth support groups offered free or at a steep discount

E-mail me for details.

Black-owned yoga website offering free online classes until April 11

From an e-mail I received and wanted to pass along:

To support the community during these times, the 11 online classes below are free to everyone until April 11. These classes are focused on relaxation and restoration which may be useful during these increasingly stressful times. Share this email with your family and friends so they have access too. Class descriptions are on our website.

1. 15-Minute Midday Yoga with Chanel Sledge
2. Breathing Techniques to Relieve Stress & Anxiety with Nikki Dixon-Ewing
3. Grounding Practice for Vata with Jo-Jo Jackson
4. Chair Yoga - Erica Rascon
5. Family Yoga - Jerrell Simpson
6. Meditation for Calmness and Centeredness - Jessica Young
7. Meditation for Healers - Tenci Campbell
8. Yoga for Healing and Restoring - Raikeis Timm
9. Gentle Faith & Flow - Sherrell Moore-Tucker
10. Yoga for Neck & Shoulders with Biola Akanni
11. Yoga Nidra - Jessica Young

I have no affiliation with Yoga Green Book, other than having done some of the classes with my own family.

A couple of good articles on racism and other marginalization in helping professions

This Vice article about not posing with Black children in Africa has been making the rounds, and it's good advice for people to be aware of, but not really a topic I have particular background to speak on. I do want to share Ally Henny's commentary on it though, because she relates it to people doing the same thing in the United States, often in connection with community organizations and helping professions:

Here, it is usually cops eating ice cream or playing basketball with black kids. Or it could be a church group visiting a Reservation to hand out shoeboxes of plastic trinkets to Indigenous kids at Christmas. Or the teacher in the “hard neighborhood” who shared classroom photos with sappy captions. Or the weekend warrior who paints over graffiti in the “bad part of town.”

It should go without saying, but black, brown, and indigenous folks are not props for your latest feel good activity. Unhoused people are not props. Poor people are not props. Disabled people are not props. Older adults are not props. Queer people are not props.

Do you detect a theme?

That’s right. People are not props.

These messages are very important for people working in helping professions in the U.S. to hear and to recognize.

Jarell Skinner-Roy gives some similar advice in his article, specifically giving tips for nonprofits to stop referring to people as "at-risk" and avoid savior narratives in pleas for donations and other support:

And can we please eradicate all language about giving a voice to the voiceless? We can certainly help by providing a platform or a megaphone, but communities already have a voice. As Arundhati Roy eloquently put, “There’s really no such thing as the ‘voiceless’. There are only the deliberately silenced, or the preferably unheard”. This is beyond semantics; Language reflects our values and has real life consequences.

I often refer to this dynamic as "us and them" when labeling it in healthcare and community contexts. One personal example I noticed was a religious congregation consisting of mainly wealthy families that published in its bulletin how to donate to various food and other assistance programs, but not how to access them. When I pointed this out, I was told "we don't exactly have that population here." I can see why, when you aren't willing to welcome "those people." (For what it's worth, that congregation did have members who received various forms of assistance, but folks are of course careful about sharing this kind of information with people who do not come across as safe people.)

The way we use language can help make sure we are truly treating people the way we want to be treated. When we as professionals speak about a program or service, we can use language indicating that we might just as easily be the ones using it as providing it. We don't want to claim to have had experiences we have not had or to minimize our privilege if we are not someone who receives or has received a particular service, but those of us with financial and/or nondisabled privilege should constantly be considering and acknowledging that these things are temporary. We can speak about how a food bank is available for any of us wishing to use it or donate to it. When we explain a service to community members or refer to it when giving trainings, we can give examples in which we ourselves might be calling to enroll in a service for ourselves or a family member. Again, we want to make sure we are simultaneously minimizing us-and-them while also not ignoring our privilege. We can send a message that I do not currently know what it is like to be a recipient of a particular service thus I need to defer to the expertise of people who do, but I also can envision myself or my family some day needing the service, since things can change.

MFA swiftly and actively addresses racism; I hope more institutions follow suit

As someone whose family and community frequently participate in the youth offerings at the MFA, I have been following the story about a middle school educator calling attention to racist comments and racist microaggressions her class experienced while on a trip there. I have witnessed and been told of similar microaggressions at the MFA, mostly from patrons but occasionally from staff. I will say that the MFA is not unique in this, and it's along the same lines of the microaggressions my children of color receive at most institutions that are not Black-owned.

I have only once ever complained to staff at an institution about the behavior of a specific other patron. This was a time when a white man followed me and my child around, physically getting into my child's space, telling me specifically how I should be helping my child (who is Black, has disabilities, and did not need any help with this activity). I told a staff member on duty what was happening, who told me it was not his job to handle such things. I have on other occasions given feedback or helped my youth and other youth to give feedback on racial, disability, and other microaggressions, both on the part of patrons and on the part of staff. If we do get any response back, it is usually something very generic thanking us for our comment, or something explaining that the organization is not responsible for the behavior of others. Sometimes the feedback about racist or otherwise marginalizing behavior is met with more marginalizing behavior, in the form of a response that rationalizes it, usually by explaining that people are allowed to have different opinions, or stating that it did not happen because the organization did a training on bias or has a policy against it, or because the person in question certainly does not hold biased beliefs.

In a few instances, my children and I have actually had the experience of someone taking issue with us having complained. We once had an administrator at a healthcare provider tell us that children feel unsafe when they sense that "people caring for them" are not aligned with one another, thus it was problematic of me to call out the provider's inappropriate behavior. The administrator of this practice actually believed that it is better for my children if I align with racist and homophobic behavior than if I show my children that I unconditionally support them and will never ask that they accept such behavior.

For what it's worth, this is why most people do not even bother complaining about marginalizing behavior. If an organization is not already actively addressing it, chances are, they are of the view that this type of behavior is acceptable. When my family and I look into an organization to determine whether it is a good fit for us, we look to see if there is explicit mention of how the organization supports and uplifts people of color, queer people, people with disabilities. If there is no mention, the organization has not usually thought about this, and usually has a very homogeneous clientele.

Along these lines, I have seen much talk, exclusively from white people, about boycotting the MFA and/or cancelling their membership. While I appreciate the support, and I am not one to dictate how others should do their activism, I am not sure this is the best approach. In my family's experience, and from what I've heard from other youth with whom my family spends time, the MFA is not unusual in the presence of racial and other microaggressions. Most white-owned organizations we frequent are rife with racial microaggressions. Youth of color are going to experience this in any predominately white space. We need to teach youth of color to recognize and to decide how and whether to respond. But we don't want to teach them to boycott every organization in which microaggressions are present, because there would be nowhere left. I want to teach my children that they belong everywhere. I want to empower them to choose to tolerate, but never accept, microaggressions, if they determine for themselves that there are enough positives for them to want to be somewhere.

I do think that while an organization cannot control the behavior of its patrons, as I have had so helpfully explained to me, they can control how they respond. An organization absolutely can set expectations for behavior and can enforce these.

The MFA released a statement on Friday explaining that in response to this post, they used security footage and witness interviews to determine the identity of the patrons who had made racist statements to a group of youth, and responded by revoking their memberships and banning them from the premises.

I think this response is absolutely amazing. I was very pleasantly surprised to hear of it. I am hoping that more organizations will explicitly adopt statements stating that marginalizing behavior is not permitted, and will take steps to remove offenders to create places where all people truly belong.

How Making History Unmade a Family

I'm sharing this article partly because today is the 15th anniversary of marriage equality in Massachusetts, and partly because I think it illustrates an aspect of human nature and relationships that is applicable to so many other situations:

After spending all day in the public eye, often discussing their relationship, the last thing they wanted to do when they got home was discuss their relationship.

"We kind of went our separate ways in the house," says Julie.

Annie echoes that sentiment: "When you have to be so public about every tiny detail of your lives, it really exacerbates any minute divide between how you deal with stress and what you need to do at the end of the day."

The article of course is specifically discussing the Goodridge family, who were the lead plaintiffs in Goodridge vs. Department of Public Health. The couple ended up divorcing, which they attribute largely to the stress of having to spend time as activists in the public eye in order to have their family legally recognized.

I think this dynamic plays out in many other situations though in which one's fitness, sanity, truthfulness, or worthiness is scrutinized. I see it happen with families who are involved in the child welfare system or otherwise court involved, people who are being sued, individuals who have been psychiatrically hospitalized, and individuals who have been charged with crimes. People describe a psychic change, in which every thought is now viewed through the lens of whether they are a nurturing parent, an honest person, a safe partner, an ethical employee, a good decision-maker. Every private decision feels like it could become a matter of public scrutiny. People feel they are no longer able to argue, be sick, be injured, eat junk, make a mess, make a frivolous purchase. Even if they know in their logical mind that a particular interaction or decision will never become known to a social worker, judge, probation officer, or the media, shadows of the scrutiny and intrusion are constantly present in every thought and every decision. Having a very real need to constantly act as if you are being watched can make someone with no underlying mental illness think and act much like someone with an organic thought disorder. Everything becomes exhausting, and there is certainly no room for any "extra" interactions or undertakings when just the basics are so challenging.

The takeaway from this I guess is that these type of "fishbowl" situations are too be avoided. In the case of the Goodridges, they independently chose to involve themselves in such a situation, which I and many other families like mine thank them immensely for. Of course, no one should have ever been in the position to have had to secure the civil rights of their family and others through a personal lawsuit. In many other cases though, we can avoid this type of dynamic by resolving situations in a non-punitive and non-intrusive manner.

Let's reserve calling the police, crisis teams, or child protection services for those dire situations in which it's truly necessary. And those who work for such organizations, be continually working to do better. Look to your colleagues who are handling things in the most respectful and humanitarian manner, and emulate them.

Likewise, let's save lawsuits, firings, internal investigations and so forth for those situations in which there really is no other option. Remember that we can usually resolve issues by remembering the human, and treating people the way we want to be treated. As the article illustrates and as I've had described to me so many times, treating people punitively and using adversary processes usually only serves to make things worse, and then it's a self-fulfilling prophecy. When these processes are used, and the functioning of the person in question declines, this is not to be taken as indication that bringing in the big guns was the right thing to do; rather, it's an indication that anyone's relationship, sanity, or performance is going to suffer if you push them hard enough.

May 14 and 15 in Newton: Free course offering 12 LMHC CEUs

Trauma Treatment with Individuals with Intellectual and Developmental Disabilities
Presenters: Nora J. Baladerian, PhD & Karyn Harvey, PhD
Full course info and registration page can be found here.


Note: Unless stated otherwise, I have no affiliation with this course, presenter, or organization, and this post is not any type of endorsement. I am committed to publicizing low-cost CEU opportunities to assist fellow clinicians in locating these, and will generally publish any I encounter.