working in mental health when you have did

For those of you who have been followers of my blog for a long time, you may recall that I left the direct-care work of mental health back in 2012. This was so I could devote my energy towards working with my system in therapy. Although I stayed in “the field,” I did mostly administrative work, which limited my contact with patients. Instead, I worked directly with other clinicians and mental health professionals providing guidance in their work and authorizing funding for treatment.

Unfortunately, after 8 years in this position, my work environment became emotionally unhealthy. A change in management, in turn, impacted the rest of management negatively. I made the decision to leave the job because it became too stressful and triggering. Self-care, FTW!

I’ve taken a new position with a completely different organization as a remote counselor. In the past, I worked as a therapist. So, being a counselor is a step in the direction of my long-term goal (to return to being a therapist).

Let’s talk about what the difference is (in my role) being a counselor vs. a therapist. There is overlap and they can seem quite similar. A counselor is one who provides guidance, usually related to social or psychological problems. A counselor has usually been certified or received specific education and training in a mental health-related field (like psychology, social work, or human services). A bachelors degree is typically the sufficient amount of education required for these positions.

A therapist is akin to a more skilled version of a counselor. They usually hold post-graduate degrees like masters or doctorates. This higher level of training has permitted them to become highly specialized in the treatment area of their choice (mine was addiction and trauma).

The direct-care work I am doing with patients is “easier” so to speak, as I’m not required to be specialized in my specific area. Although I am skilled at the work I do, years ago, it had become too triggering and it was exhausting assisting clients back-to-back, hour after hour, while managing my own CPTSD reactivity and dissociation.

Today, I speak with new patients telephonically. Although I do talk to patients at length about their situation, we keep things as abbreviated as possible. For example I do ask trauma, but I guide the patient to only provide general responses. The information allows me to assess which of our organization’s programs is the best clinical match for the patient. The organization is massive and not only has specific programs for addiction vs. mental health, but also womens-only services, and touts itself as one of the few organizations on the east coast to offer certain specialized programs.

I’m excited and happy to be working with patients again, even though I may only talk to them once and never again. My role is important, as we are more than just scheduling patients for services. We are that first connection, that first voice, and in some cases, we are the first person they have ever begun to tell their story to.

Working remotely has not been as challenging as I thought. I’ve been able to learn electronic health records rather quickly. Sometimes there are a few bugs, but I’m able to work around them.

Most importantly, my new management and fellow counselors are excellent. Everyone has a pleasant attitude, can work independently, and is supportive. They all have a fantastic sense of humor, too.

Everything hasn’t been perfect, with sunshine and daisies. I do need to also post an update on why I stepped down from moderating several DID subreddits and what’s been going on with therapy (and the lack thereof). However, the new job is a big win for us amidst struggle, and we wanted to share the good news.


  1. This job sounds like an excellent replacement for a toxic workplace. I’m glad to read you have work you like (even if it’s not all sunshine and daisies) and especially where you can see you are making a real contribution to the clients you work with.

  2. So happy for you! I always liked intake because of the variety of people I got to meet. And there is nothing better than colleagues who have a sense of humor. It doesn’t sound too pressured, either. I hope you relax into the new job and that you find it satisfying on many levels.

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