Ann: Ha ha ha. Matthew Brooks: We'll we'll do that. So this is I d feel like this is actually my like my first guest I've invited. So hi everybody. Yeah. It's Ann: Yeah. Wait a Hi everyone. Matt, this is the first guest that you invited. And we're so excited. Matthew Brooks: I know. Yeah. So my first official guest is Mary Ellen Ruff, PhD. when I knew Mary Ellen Ruff: Ha. Matthew Brooks: her, she was my l my supervisor who showed me the way as a young baby green therapist, and she was also getting her PhD during time so now I can officially say Mary Ellen Ruff PhD. And Mary Ellen Ruff: Thank you. Matthew Brooks: if I'm remembering correctly you have like over thirty years experience as an art therapist, clinical supervisor, educator, yeah, all of that jazz, right? Yeah, Mary Ellen Ruff: Thirty, graduated in ninety six. Yeah. Yeah. Matthew Brooks: so I'm gonna hand it over to you, introduce yourself, talk about what you've done, who you are, all that jazz. Mary Ellen Ruff: Thank you so much for having me. This is so fun to be a part of your very cool podcast and that I'm your first guest, Matt. That's awesome. yeah, Matthew Brooks: Yeah. Mary Ellen Ruff: so thirty years of experience as an art therapist and I've worked in a lot of different kind of settings from inpatient psychiatric trauma focused units to outpatient practice, which is what I do primarily now. I've also been on the faculty at GW for many years since 2007, so a long time. part of that full time, a lot of that adjunctive, and have taught a bunch of different things. I think for me I've you know I've had a a a lot of really good opportunities to to be in different clinical settings and I think that's where you kind of get fleshed out as a therapist. I think the more experiences you can have. And I feel really lucky that I've had some very cool experiences in and being able to learn in those settings from very experienced therapists. So I think that's one thing I always try and encourage people that I supervise now to really pay attention to the number of years that people in their settings have had. Not that they know everything, but you can learn a lot by watching, observing, picking up on how how you know experienced, seasoned clinicians approach things, what they what they get invested in and what they let go of. I think it's sometimes really good examples when young clinicians tend to have a hard time knowing kind of what to let go of and how to kind of really just lean into the learning process. Matthew Brooks: Yeah. Yeah. Ann: Yeah, and getting comfortable with their therapeutic style. Like even the way that Mary Ellen Ruff: Yes. Ann: they are interacting with clients or patients, or depending on the setting, it's so important to I agree, it's so important to observe those that have done it for a while, even just to see their comfortability level and be like, I can just I mean Matt, maybe you can speak to this because the funny thing is Mary Ellen was Matt's supervisor. Post-grad school, and Matt was my Matthew Brooks: Mm-hmm. Ann: intern during grad school, and we were at Western Psych. And so even I'm just using as an example, even like Mary Ellen Ruff: Yeah. Ann: watching a more experienced clinician just sit down with a patient and going, I can just take them aside and talk to them about their day or they can we can just sing a song together, even if there's an art group going on, which happened often. those kinds of things are really helpful to new clinicians who are just getting used to that. Mary Ellen Ruff: Absolutely. And it's okay. You're still learning. I sometimes say Ann: Yeah. Mary Ellen Ruff: to my grad students, like when you graduate, it's like you just learned how to crawl. Like you are just Matthew Brooks: Mm-hmm. Mary Ellen Ruff: you're not expected to know everything. And I never mean that in a pejorative way. It's really just to normalize the idea that there's still so much more to learn. Because one of the things I often hear is, We didn't learn this in grad school. It's it's two years. It is not, you know, it's not gonna Ann: Yeah. Mary Ellen Ruff: You everything you need in every job that you'll ever have as an art therapist. It really is, we need to give you a lot of information in a relatively short amount of time while you're doing internships, while you're sometimes working. Like there's a lot of things happening during those two years. And so really the idea of learning as you go, this is a this is a profession you choose because you want to be a lifelong learner. And so when I sort of make that comparison of learning how to crawl, I I see like the relief on some faces and then I see the indignance on other faces and I'm like, okay, I know who I'm working with. Okay. Good to know. Good to know. Yeah. Matthew Brooks: Yeah. Yeah. Ann: Ha ha ha I I something similar that I'm always reminding even like interns, supervisees, but even myself, I mean I've I've been I've been out of grad school for quite some time, but I've only had my practice for about 11 years. And there are still things, there are still clients, scenarios, whatever, that walk through my door or even new avenues that I might open up different certifications and things that I recently did that I'm still learning. And I give people the reminder that the clients who are walking this sometimes have more experience in the system than you do as a Therapist. And that doesn't mean that they have a clinical Mary Ellen Ruff: Definitely. Ann: knowledge to provide the service that you're providing, but they have been in the system longer. They know the language, they know the drill, they and that's okay. You're allowed Mary Ellen Ruff: Mm-hmm. Ann: to like walk with somebody who has a client who has had experience with multiple levels of care, multiple therapists. You can still provide that service as long as you're kind of being humble and meeting them where they're at, and Mary Ellen Ruff: Absolutely. Ann: saying, Hey, yeah, this. This part's new for me, but I have this knowledge. I'm constantly having those discussions. Mary Ellen Ruff: And it takes a little confidence to be able to say that though. Cause I think a lot of new clinicians are like, I have to be Ann: Yo ya. Mary Ellen Ruff: the expert in the room. I need to know everything. I'm like, you're not gonna know everything about this Matthew Brooks: Yes. Mary Ellen Ruff: person or Ann: Yeah. Mary Ellen Ruff: what they've experienced most of the time. So be humble in in kind of what you're willing to learn. Yeah. Yeah, exactly. Exactly. Matthew Brooks: Yeah. Ann: Yeah. I in most scenarios, even not professionally, I am not the expert in the room. When Matthew Brooks: Ha ha ha. Ann: I am sitting with my child who is five and her classroom of friends, I am not the expert in the room. Matthew Brooks: Ha ha ha. Mary Ellen Ruff: Yeah. That is true. Nothing will make you less less confident than being in a room full of children. You're like, what is happening? Ann: Yeah. Yeah. You're like, okay, I'm Matthew Brooks: Yeah, yeah. Ann: not in charge. I had an idea, but we can switch it up. But yeah, I think Mary Ellen Ruff: Yeah. Ann: that that's so important. And I love that our conversation is starting off as far as just like supervision, being a new clinician growing, because this is a process that never ends. The learning never stops. And then there's Mary Ellen Ruff: Yeah. Yeah. Ann: all of these things that you pick up along the way, even as like mid you know career and further, you're you're constantly learning. And I'm learning from my younger interns or supervisees, I don't have interns Mary Ellen Ruff: Yeah. Ann: anymore, but all the time because they're coming through school with information that we weren't given. Mary Ellen Ruff: Yes. Matthew Brooks: Mm-hmm. Mary Ellen Ruff: Absolutely. It's a it's a very different way that grad school looks now than it did in the mid nineties when I was there. So, you know, there's a whole different thing. Ann: Ha ha ha. Matthew Brooks: Yeah. I I I will even say it looks different from twenty twenty before the pandemic and how everything with Mary Ellen Ruff: Sure. Matthew Brooks: therapy flipped with like technology and everything. So all the new supervisees and baby therapists coming out, they're experts in a whole different realm of therapy that I I think all three of us have, you know, a Ann: Yeah. Matthew Brooks: a different perspective on. Ann: struggled with interns during and post COVID or supervisees because there was ev they were in programs that were virtual and I Matthew Brooks: Yeah. Yeah. Mary Ellen Ruff: Yeah. Ann: was I was teaching at Point Park when COVID happened like mid semester or beginning. Mary Ellen Ruff: Mid semester, yeah. Ann: It was really like towards the beginning. It was in but anyways and we just shut down and I struggled with teaching virtually. Awful. Mary Ellen Ruff: Yeah. Ann: And then I had my first kid and you know, but but having those supervisees post COVID who were even coming from programs that were mainly virtual was a challenge because Mary Ellen Ruff: Yes. Ann: we're so used to working with new clinicians or people that are coming out of programs who have had all of that person experience, internship experien and s it it wasn't there as much. It was it was it was interesting. Matthew Brooks: Mm-hmm. Yeah. I I think some of that too and how we're talking about, you know, especially with the the newer therapists coming out and we're saying it's okay to not be the expert in the room and and be humble with that, when also the biggest topic that we we're gonna be kind of coming in with today is the Lindsay Clancy trial and Not necessarily talking about the the hot topic of the trial itself, but one part of it that, you know, pro professional clinicians are talking about. I've been seeing a lot of like memes online of like, make sure your notes are right, make sure, you know, these are right, because part of the trial is there was a clinician's notes that were pulled from Lan Lindsay Clancy and they were picked apart. And they were the credibility of the clinician was picked apart. So we're sitting here saying and telling clinicians, like you don't have to be the expert in the room, but what happens when you are the expert in the room? When you get called to court Ann: Yeah. Matthew Brooks: and they're like, you wrote this, what does this mean? Right? How do you infer this? So that's why I wanted to bring Mary Ellen on because she has a wealth of experience being in the court with and Mary Ellen can give us more of a background on that, but How to write notes, because if you write notes with the mindset of someday it will be read aloud in a courtroom, you will have a very different mindset of how to write that versus the maybe a flowery narrative, detailed sort of thing you may have been taught in school because the the teachers and the professors want to know how you're thinking. So you need to write in a narrative in a longer form so they can kind of see where your mindset is going and how you're doing it. But then when you get out in the real world and a lawyer can pick apart the narrative and your inferences and everything, that can be detrimental to you, the relationship you have with the client, all of the things. So I wanna toss it over to Mary Ellen and how she even guided me on how to write notes with that court mindset. 'Cause I've Mary Ellen Ruff: Yeah. Matthew Brooks: I've had the same thing. I've had divorce settlements and different things like that where notes had to be pulled. Mary Ellen Ruff: Right. So so just to lay that foundation, I did I've done a lot of court work, both all in juvenile court really, but juvenile and domestic relations. So for about five, a little over five years, I was the director of the family drug court in Alexandria and subsequent to that worked with youth in involved with the juvenile detention. or the juvenile court world, so a lot of them in detention or the youth shelter. But I think the the the most profound experience I had with writing notes that were picked apart in court is in in family drug court, families are typically involved because of abuse and neglect petitions against them. And and it often stems back from substance use. And so their their kids are either under protective orders or are sometimes in foster care. But the goal really is for reunification of the children with with their parents. So e even though I was, you know, testifying all the time around their progress and things like that, it typically wasn't until a termination of parental rights trial kind of was really involved. And and thankfully that wasn't all the time, that wasn't in a lot of cases, because a lot of times parents were really able to turn their lives around and be in a better place to regain custody or to get out from under a protective order. But it's it's tricky when you think you're you're sort of doing good good work clinically, someone is progressing and and for reasons beyond I I could do a whole commentary on on that that world and how sometimes Matthew Brooks: Mm-hmm. Mary Ellen Ruff: not fair it is. But but for reasons beyond what the what the client was doing, someone doesn't want them to get their kids back. Or someone doesn't feel like they've done enough to get their kids back. And in in my mind, it's like, okay, but that's sort of moving the goalpost after the the game has started. And and and I and I did have that experience of having notes really picked apart and and it's it's an unfortunate thing and I really You have to do enough, but but less is more. And and I think, you know, we we learn typical things like soap notes, right? We learn sort of these typical frameworks for how to what to include in a note and how to write it. And I I think notes can be very brief. with some exceptions, right? If someone's expressing suicidal ideation, homicidal ideation, self harm impulses, an a a real change in in significant symptoms, things that are very notable, always very important to include with as much detail as you can. But I think for the average note, just looking looking very briefly at one to two sentences for each section. It doesn't need to be Matthew Brooks: Mm-hmm. Mary Ellen Ruff: a novel. And I think that's sometimes hard when young clinicians especially want to make sure they're capturing everything and often include a play-by-play. And and that's not necessary, nor is it helpful. And it's incredibly time consuming if you have a lot of notes to write. So not not easy to do. Matthew Brooks: Mm-hmm. Yes. Ann: Yeah. Mary Ellen Ruff: But if you, you know, if you think about just starting with that SOAP framework, what do you include in like what is the patient saying about what's going on? What are they reporting? about the concern they're having, the problem that they're experiencing, any kind of you know, anything that they may have tried. So just to be very just this is what they're reporting, this is what they're saying, this is how it's impacting them. that could be one or two sentences, right? That doesn't have to be Ann: What? Mary Ellen Ruff: a a lot. Sometimes sometimes they may be saying a lot, but you can distill that Matthew Brooks: Mm-hmm. Mary Ellen Ruff: into this is what they're saying. Keeping it simple. Ann: yeah, absolutely. And I'm not pretending that I've following a trial like click by click, but there was something that stuck out with me when the clinician was like, I know what I meant in the note. Mary Ellen Ruff: Yes. Ann: Because Matthew Brooks: Yeah. Ann: my gosh, is that so me with notes? And Mary Ellen Ruff: Yes. Ann: I have v probably a handful. Like five, maybe six times in my entire time pros post grad school have been called to f t for something legal for h to have my notes. And most of the time, like the other times that it's happened, they didn't I didn't need to give them everything. It kind of boiled down to like actually you don't need that. which is another thing maybe we want to talk about. But anyways, Eve Matthew Brooks: I was gonna go there, I got that marked. Ann: Even in these short notes, because Mary Ellen, I completely agree, like even in these one to two sentences, I find myself jotting stuff down, and when I do have to submit and I'm going back and looking at them, I'm like, that doesn't make sense anymore. And I know that it did when I wrote the note a year ago or whenever Mary Ellen Ruff: Right. Made perfect sense. Yeah. Ann: I did it. But now that I'm looking at it, I'm like, what am I talking about? And so That's I really connected with that kind of whatever it was. Like I know what I meant. I was like, my gosh, it that's why it's so important too to take a step back and kind of write it from the perspective of going to be read those couple sentences. Mary Ellen Ruff: It's gonna be read by somebody, whether it's in court, an insurance company, it it it could be read by a number of people. Ann: Mm-hmm. Matthew Brooks: Mm-hmm. Mary Ellen Ruff: And it's hard because sometimes at the end of the day you might be writing eight or ten notes or however many, Matthew Brooks: Mm-hmm. Mary Ellen Ruff: you know, note notes, whether it was a group note, individual note, you're writing something. And I Ann: Mm-hmm. Mary Ellen Ruff: think to to be really I think brief and clear, and even when you know you think you're being brief and clear, there's gonna be things that get by. Like the the Ann: Yep. Cause I think I don't remember correctly, but I think what she wrote was it was the word like no. and it was about presenting symptoms, and then she listed them and the lawyer shifted it to, well, this one was no, but if this one was yes, then it wasn't psychosis or it was Matthew Brooks: Mm-hmm. Ann: psychosis or something. And again, I didn't follow directly, but I was like, my gosh, that would be me. That would be me. Matthew Brooks: Yeah. Mary Ellen Ruff: Right. And it and I could see, and that was the psychiatrist, and of course she got picked apart for a lot of reasons that I think are really unfair Ann: Yeah. Yeah. Mary Ellen Ruff: and unfortunate. but absolutely, because it was very clear how they were trying to discredit her completely. Matthew Brooks: Yeah. Mary Ellen Ruff: and how she was just trying to say, This is what I observed, this is what this Ann: yeah. Mary Ellen Ruff: is what this is meaning and they're like, That's not what it says. It's like, Well You know, do you read a lot of things and think it's exactly what it says, or do you interpret what it says? Like you that's Ann: Yeah. Yeah. Matthew Brooks: Yeah. Yeah. Mary Ellen Ruff: how we read. We interpret what's being what you know, what we're what what is connecting with our brain on some level. And if this is what she's saying, then let's take her at her word. But that's that's not what happens in court. Ann: Yeah. Matthew Brooks: Yeah. Ann: And it's it is Matthew Brooks: And Ann: scary as a clinician. Mary Ellen Ruff: Yeah. And that's exactly Matthew Brooks: Yeah. And I I think also like we we covered like we are growing as clinicians. So if you write something that's a year ago and you go back and look at it and be like, ooh, that's like I've I've changed. I've grown as a c clinician. I know I can word this better. Mary Ellen Ruff: Right. Matthew Brooks: And then it gets dropped in court, then it's like, Well yeah, you wrote that a year ago. You're a different clinician than you were a year ago. So whatever you're asking me that I wrote then, it's not that I wasn't unaware. I've just honed my skill set in in a more fine-tuned way. So if you're asking like, well, you said this, it's like, well, yes, but you know, that's here's what I meant with it, or here's here's how it was. So I think Mary Ellen Ruff: Yeah. Matthew Brooks: for all those those green clinicians out there who are like, now I need to double take everything that I'm writing and I need to think it and everything. I think there's a part of it of like just be clear and concise with what the observations are and you know, y that can be your foundation for how you write everything, right? Yeah. Yeah. Yeah. Mary Ellen Ruff: Yeah. Yeah. And that's the objective part, right? That's the O and the so it's like be clear on what you're observing as much as you can. And I always think do the mini mental status. Do something that's very structured and very hard to mess up. Like Ann: Yeah. Mary Ellen Ruff: it this is either what you're seeing or what or not. And and I will say too There are a lot of times where the person sitting in front of you for this, you know, sort of 50 minute session is is may not may not be like outliers in any of those areas. That Ann: Yeah. Mary Ellen Ruff: doesn't mean they're always going to be. That's not a this is a point in time. I think that's the other thing that that we're missing. and again, I I haven't watched every day of the trial, but I did watch that testimony. And it's like this is a point in time of what this clinician observed, and Ann: Mm-hmm. Mary Ellen Ruff: this is what she experienced with. Ann: And it can shift in a day's time. It can shift Mary Ellen Ruff: Yes. Ann: in a a a s well, I don't want to say especially, but the postpartum stuff. You are battling so many Mary Ellen Ruff: Absolutely. Yeah. Ann: significant changes within a short period of time. again, that's why it's so important that presented on the day that this note was taken. Fine, great. Like this is what I observed. This is Mary Ellen Ruff: This is what I observed. Yeah. Ann: these are the things, the boxes that were checked. that Matthew Brooks: Mm-hmm. Ann: does and I think that of course that's gonna get picked apart by lawyers, of course that's gonna get picked apart by the public. but the reality is I think the reason why there's a lot of mothers and women kind of following this case is because we we know, mothers know that that can shift on the flip of a hat. Like, Mary Ellen Ruff: Yeah. Ann: we know that that can shift and change. And so and then you know you also have the therapist hat on watching this and you're like, my gosh, how? Matthew Brooks: Yeah. Ann: How could you possibly document something because and then also very much know, yeah, it could have changed. I know what I meant, but I'm not denying that that didn't shift. then that's hard. Mary Ellen Ruff: Yeah. And I think that's like for for both sides, I mean I know there's not it's not a question about whether she Ann: Yeah. Mary Ellen Ruff: killed her children, but obviously the criminal kind of negligence or responsibility. But if you think about a postpartum experience and and how Matthew Brooks: Mm-hmm. Mary Ellen Ruff: protracted that can be for a lot of women and and and what the defense has described with her her sort of deterioration. Her mood was worsening. She's experiencing insomnia, she's having intrusive thoughts, you know, she's expressing safety concerns, suicidality, th you know, treatments Meds are changing, treatment interventions are evolving. I think it's like you become so desperate to feel better when Matthew Brooks: Mm-hmm. Mary Ellen Ruff: you've got three little ones and you're constantly being needed for all of them. None of them are independent of you. And I think that's a really hard place to be. So I have a lot of empathy for her. I'm glad I don't have to decide whether she's, you know, in that moment was she psychotic. I think that's a tricky. Tricky one too, because Ann: Yeah. Mary Ellen Ruff: there, you know, the the the prosecution's argument, if you will, is that she planned it. She sent her husband away on errands, she did research on the internet, she has these, you know, these word searches in her in her search history, and so she knew what she was doing. I I I don't know. I mean, I feel like I've known a lot of patients over th my career that have had Sometimes loose connections with reality and other Matthew Brooks: Mm-hmm. Ann: Yeah. Mary Ellen Ruff: times stronger connections with reality. And sometimes it depends on the time they take their meds versus the time I'm seeing them in the day. Sometimes it t depends on something they've experienced that day. What kind of stressors are they Ann: Mm-hmm. Mary Ellen Ruff: under? There's so many things that are hard to to exactly make black and white because this is not a black and white issue. Ann: And that is what is so challenging about being a mental health professional that is pulled into court because you're Mary Ellen Ruff: Yeah. Ann: and and the importance of note taking to be able to almost feel like you're always defending that it is a giant gray area. Like here Mary Ellen Ruff: Yeah. Ann: is what's happening, but here's all of these other factors and it's it's really, really difficult. I I recently added an arm to my practice which is collaborative divorce work and there's custody and all of those things involved and even though I have personally walked through divorce and kids and postpartum and figuring all that out, I am still met with, okay, well, maybe or or Matthew Brooks: Yeah. Ann: okay, well, not really that clear cut, you know, and the law Matthew Brooks: Yeah. Ann: is so and Mary Ellen Ruff: Yeah. Ann: lawyers are so black and white. We speak different languages. Mary Ellen Ruff: Yes. Matthew Brooks: Yeah. Yeah. And I think I mean that that leads into another question I had too, that I want to circle back with is when or if you ever get subpoenaed for notes, what what do you do to turn over stuff? Like is it you have to turn over turn over your exact notes word for word? Do you have to turn over a letter of here this client showed up? for these days to these days and they have been doing this, what is it that you actually have to turn over? Because I think that sometimes scares the younger clinicians of like, my gosh, they I have to here's all of my notes. Like, I'm so sorry, kind of a thing. So Mary Ellen Ruff: Yeah. Matthew Brooks: what is the process for that too? Mary Ellen Ruff: I think it really depends on the setting that you're in. When I was working for the court for, you know, a local jurisdiction, because city attorneys are involved in every department that's that's client-facing, you know, that's serving their constituents, they they y y they really gave everything to what was subpoenaed. So if you if you receive a subpoena You know, in private practice, I've tried to either quash the subpoena or provide something that that is consistent with what they're asking without providing the actual record. And that's been successful. So I haven't I haven't had my private practice notes subpoenaed in that same way that they were when I was Matthew Brooks: Mm-hmm. Mary Ellen Ruff: working for a public agency. That said, both are super stressful. I this is a little plug for getting your own private liability insurance. Nobody should be practicing Ann: Mm-hmm. Mary Ellen Ruff: without it. even if you're covered by your workplace, it's still important for you to have that. Most professional organizations offer some kind of discounted rate for liability insurance, but it's like the easiest, you know, bill I pay every year just Matthew Brooks: Uh-huh. Mary Ellen Ruff: to just to ensure that I have access to be able to call an expert and say this is a superior. I got, you know, do you have any like recommendations on how to respond? if you have lawyer friends, sometimes they can be very helpful in helping you respond or or family members or if you just know someone that could be that could be a a a consultant in that way. But I I think either way it can be stressful. And I think the least that you can provide is is probably always the best. Ann: Mm-hmm. Matthew Brooks: Yeah. Yeah. Ann: That's what in private practice is the only time that I have been subpoenaed. And or sometimes it won't even be a subpoena. And I'll get a phone call or an email, and this isn't necessarily of just like, hey, this we're we're on the divorce case for whatever, and we would just love to hear if you can get an ROI for you to release. And I'm like The kids notes? Like what? Matthew Brooks: Ha ha. Ann: But but the response is that I've I've I have been successful is successful almost every time with just saying, What is it exactly what you need or what are we looking for? So I can send you a summary or I can send you Matthew Brooks: Yeah. Ann: because do you really want to know what's going on in high school every day? I don't think you need to. And it's work, but it's stress and it's r having to respond. And it wasn't until I gained experience having a couple of those under my belt that it became Mary Ellen Ruff: Yeah. Ann: kind of the like immediate response of, Well, Matthew Brooks: Mm-hmm. Ann: let's hold on, let me see what you really need. Yeah. Mary Ellen Ruff: What are you really looking for? And I think that's a great way to respond to an attorney request for a record. in one I had one case that was in in private practice that was I was seeing a seventeen year old and his parents were were getting divorced and he in the the He was primarily living living with mom. Father was was father's attorney was the one asking for the record. And and it was it was a lot because he was refusing to go on like the visits. He was seventeen, sort of short of eighteen, by a little, and was kinda like, I'm not doing this anymore. And I think a lot of peop people, older adolescents who are in that situation, I've heard say the same thing. Like at some point I just sort of stopped coming Ann: yeah. Mary Ellen Ruff: to the visits because it i i I didn't want to. and like I no one was gonna make me and and so I think that's an important Ann: Yeah. Teenager. Mary Ellen Ruff: thing so I actually asked the kid I'm like well how do you feel about this I I I need to respond in some way what would like what would you like me to share and we sort of settled on that he I wrote a letter that he was you know he had had X number of sessions and that was kind of it like he's attending that Ann: Yeah. Mary Ellen Ruff: And I think the you know, that I I think it just sort of came down to they were like, All right, we're really not gonna get anything from from him. Ann: Yeah. And I've found in private practice at least, in most cases, it is just kind of something on their list that they can see if they can get a little more info, but it's not necessarily their main presenting goal. no. Mary Ellen Ruff: Yeah. This isn't gonna make or break break the divorce or custody. Like he's gonna be eighteen. Matthew Brooks: Yeah. Mary Ellen Ruff: It's not gonna be a matter of custody. So Ann: Yeah, and and it's so interesting now that I'm doing more divorce work professionally because when I would when I was newer in private practice and I was doing you know, seeing kids going through custody cases or even clients who were going through divorce, I didn't necessarily even realize all of the behind the scenes stuff that happens on the lawyer's end and they they can just have a list of are they in therapy? Can we contact therapists? Like if that can be an intake paperwork. question. And Mary Ellen Ruff: Yep. Yeah. Matthew Brooks: Yeah. Ann: and again, a good lawyer will contact. And sometimes that's it. And sometimes you just say, Yeah, they're here. and age is such a tough thing when it comes to kiddos too. Mary Ellen Ruff: Yeah. Matthew Brooks: Uh-huh. Ann: in that process. So Matthew Brooks: I think, and Mary Ellen would be more familiar with this with the the area, but I when I was working out in Loudoun County, there were a lot of families who were getting divorced and lawyering up and a lot of the the practice I was working at was probably getting subpoenas at least once or twice a month, you know, of E one side of the parent disagreeing of the kids being in therapy or wanting to see the notes. So there would be these subpoenas of like I need your entire notes because dad wants to read them over to see what the kid is talking about. And you know, all of these things where that is where it kind of I I've learned this skill set of questioning. It's like what exactly do you need? Like the summaries and e everything you guys were just talking about, but it it is very prevalent, not even in like a murder trial, but a lot of the times when it does come to the subpoenas for the notes, it most likely would be if you're working with families, it will be these divorce ones where one side wants to know exactly what's being said, exactly what's going on, and wants to see the notes. Mary Ellen Ruff: Mm. Mm. Matthew Brooks: So even thinking about that of like it may not be read in court, but it might be an angry parent looking for something to weaponize in in your notes. Mary Ellen Ruff: Sharp. Matthew Brooks: So, you know, thinking about that for the younger clinicians again, I'm seeding like, great, now I gotta think about how a family member's gonna weaponize my notes, right? But it is like being c clear, short, brief, concise, like these these are the guidance tools that, you know, I I think we can talk about for the younger clinicians listening on how to do it. Because I think the other side is that social media where it is the memes and everything about how clinicians are freaking out over their notes and everything. It's like well if you ac like If you were working with it right, you don't have anything to worry about, right? Mary Ellen Ruff: Right. I do think yeah, I was just gonna say with that, Ann: Yeah. Mary Ellen Ruff: I think there's one thing I would just sort of a plug and I know this is probably an unpopular opinion, but a plug to say coming out of grad school, maybe don't jump right into a private practice setting. Like That's something that I feel like you need a good ten years of experience to to really understand how systems work, how agencies work, how to collaborate, how to be a part of a team, how to learn from other clinicians. In private practice, it's very siloed. You're not in an o you may be sharing space with other clinicians, but everyone's in their office with the door closed seeing a client. You're not learning from each other in the same Matthew Brooks: Yes. Mary Ellen Ruff: way that you do in an agency where you're able to have a lot of different experiences. and I just think right now, because there's such a demand for mental health help in general, practices have just popped up everywhere and everyone's hiring, you know, new new new new graduates, residents in counseling, whatever it is in your state, that it's it's just like, it it's cringy to me. and and that's not to say that it might not Be okay for some people, but I I feel like a lot of new graduates, early, you know, mid-20s maybe, not a lot of life experience, not a lot of clinical experience. Really hard to be in a setting where you're expected to know a lot about a lot of things, to be able to see people across a lifespan when you you haven't figured it out yet. Ann: I I think Matt, you and I have had this conversation, maybe, but I have I do have a group practice now. I that just happened within the last two years, and there are newer clinicians who have applied or who are here and I sit down with them and during these interviews I'm like, so have you done inpatient or have you done residential? Have you done Mary Ellen Ruff: Yeah. Matthew Brooks: Yeah. Ann: community in any like capacity? Capacity. Mary Ellen Ruff: Yeah. Ann: and man, is there a difference? Because I don't think I would be the practitioner that I am if I didn't work inpatient and residential. I would Mary Ellen Ruff: Yes. A hundred percent. Matthew Brooks: Yeah. Ann: I would not hang the same, I would not form therapeutic relationships as quickly, and my bullshit meter wouldn't be the same. I don't know how else to say that, but like it's just it's it is so so important that you're kind of on the front lines initially, and Mary Ellen Ruff: Yeah. Ann: you can see that when you're sitting with people, even if they're newer clinicians. I have a woman at my practice right now, actually she probably needs to take a step back. That's who the benefit was that we meant for that we mentioned Matthew Brooks: Mm. Ann: last episode, everybody. She we raised a ton of money, so thank you. But anyways, she is this was a second career and she had been working in mental health for Mary Ellen Ruff: Mm-hmm. Yep. Ann: at some time. And even though she was newly licensed, she had experience under her belt. Mary Ellen Ruff: Yes. Ann: And sometimes when I sit with clinicians that maybe have even been licensed for five, ten years but they have worked in and this is still hard work, but maybe worked in a like wealthier public school setting, there's a difference. There's a difference Matthew Brooks: Mm-hmm. Ann: in your experience that you're bringing in. And kind of like we were saying at the beginning of session, some of the mo the majority of your clients are going to have more experience in the system than you do as a therapist. And Mary Ellen Ruff: Yes, yep. Ann: that happens no matter where you're at. And so it's really important that again you remember you're not the expert in the room, but that you gain that experience. So that you can reference, I know what well they don't even call them BSCs anymore, but like I know what community work looks like. I know what and you can meet them. Matthew Brooks: Yeah. Yeah. Yeah, and and I wholeheartedly agree with that. Like the like we've joked around before, the meat grinder of getting your licensure and you know, going through the community services, inpatient, you know, Mary Ellen Ruff: Yeah. Matthew Brooks: s route really, really hones the skill to be be a very good clinician because I've I've met clinicians who jumped off into private practice immediately and in the other ones who have been, you know, in it in the community setting for like ten years and then like, I think I'm ready to go off into my private practice. And they can handle anything, right? Mary Ellen Ruff: Yep. Yeah. Matthew Brooks: So it really really shows. Mary Ellen Ruff: Yeah. Ann: I will say though, all of the social media and buzz around this case did make me go, ooh, I need to get on my notes. Like I need to get back. I I have definitely Mary Ellen Ruff: I could be better. I could be better. Yeah. Matthew Brooks: Yeah. Ann: fallen down a little bit of a lazy hole. Matthew Brooks: yeah. Ann: And I need Mary Ellen Ruff: I think that's just that's so honest and I think that's so real. That's just like a Matthew Brooks: Yeah. Yeah. Mary Ellen Ruff: real part of it's it's you know, paperwork is not why we became therapists. It's like my Ann: Yeah. Mary Ellen Ruff: like my least favorite thing to do. And I know I'm not alone in that. But Ann: Yeah. Mary Ellen Ruff: it's yeah. Matthew Brooks: yeah. Because we're human. We're human. Ann: to mention that because I know that people that know me that are listening to this are like, Anne, you are not on top for your notes. Like you are Matthew Brooks: Ha ha ha. Ann: not. I know you're not because I saw you at the office yesterday and you were like my notes. so Matthew Brooks: Yeah. Ann: I think it's it's important to acknowledge like yes these things happen and these are all really important things that we're talking about to remember and reference and but this is why continue the continuing education is important. This is why Mary Ellen Ruff: Yes. Ann: coming back and meeting with super supervisors and doing supervision even post licensure is important when you're at a practice or at a Mary Ellen Ruff: Yeah. Ann: agency or whatever because we do get into our groove I get into my groove I can I see a client Back to back, and then I'm like, all right, I'm gonna do the notes on this time, or and we fall into our little comfort spaces, and we need the reminders that we should get back on track every once in a while, and it's not like we're gonna be on a global court case, but it is important to remember Mary Ellen Ruff: But we could be. Ann: we could be. It is important to remember that we could be. Yeah. Matthew Brooks: We could be. Yeah. Mary Ellen Ruff: Like they didn't think they would be either. Like they didn't, you Matthew Brooks: Yeah. Mary Ellen Ruff: know, think they would be either. That's why there's such a Matthew Brooks: Yeah. I didn't go to school for this. Ann: yeah, I thought of that. I thought of that well I and again I didn't follow, but while I was reading reading up, I was like, Could you could could I imagine sitting there right now in my life? I would be like, Odd mess. A mess. Matthew Brooks: I would be a mess. Yeah. Mary Ellen Ruff: Right. Right. Ann: And that's such a challenge, but again, it it was a reminder for me. And I know that I'm joking, but it's an honest joke, which is like I maybe I should get back on track. Maybe Mary Ellen Ruff: Yeah. Ann: I need to give these reminders to myself. So it was, you know, Matt was spot on for us to talk about it today. Mary Ellen Ruff: Yeah. Yeah. And I think I think at their I don't know if they've ha have they done closing arguments yet in that case? I can't remember if they've done it or not. So okay, okay, okay, okay. Yeah. So Matthew Brooks: I think it's still going on. Is it? Okay. Ann: think it's t I think it's today. Yeah. Mary Ellen Ruff: I ha I kind of lost track exactly. I knew they I knew everyone had rested, but I didn't know if closing arguments had happened. So that'll be interesting to see just I'm glad I'm not on the jury because I feel like I'm a Matthew Brooks: Yeah. Mary Ellen Ruff: person who can make a case for different ways of thinking about things. Ann: This is this is so funny, but and I'll just share this before because we do have a a couple like announcement things to make, but when you said I'm so glad I'm not a jury I had that thought too and then I remember that every time I've been called to jury duty, even if I've been brought in, when they learn I'm a therapist, they kick me right out. Yeah. They're like, Mary Ellen Ruff: You're out. Yeah. Yeah. We'll never be able to serve on a jury. Matthew Brooks: Yeah. Ann: No, you're you're not who we're looking for. Matthew Brooks: No. Yeah. Yeah. Mary Ellen Ruff: Yeah. Ann: Which is funny that when we have to actually show up in court, we're like, actually we can Matthew Brooks: Yeah. Ann: see both sides. We're very Yeah. Mary Ellen Ruff: Yeah. We're really objective. Matthew Brooks: Yeah. I need to question your thinking and thought process in your character, you know. Yeah. Ann: Yeah, and then you're ha I start I start asking the lawyers reflective questions. I'm like, well where do we think that that's coming from? that would be Mary Ellen Ruff: Ha ha. Yeah. Yeah. Ann: anyways, I've never actually had to to be a juror because of that, so Mary Ellen Ruff: Me either, but I sometimes when I watch these kind of cases, it makes me want to be a consultant to the attorneys. Ask this. You're you're you're barking up the wrong tree. Like this is better. This is a better line of questioning. I feel like I can be very helpful. Ann: Yeah. Yeah. Matthew Brooks: Yeah. Yeah. yeah. Ann: And I don't know yeah, I don't know if you, Mary Beth, know much about the collaborative divorce process, which is a which is okay, so I do that work now and so I'm working with lawyers as the like mental health professional in the room who's Mary Ellen Ruff: Yeah. Ann: supposed to be this neutral of like talking through and it is really hard to hear lawyers learning mental health language to support the private Or to the to support the collaborative process 'cause it's out of Matthew Brooks: Yeah. Ann: court and we're talking together and it's like, No, you can just check it and see how they're feeling. Maybe today's not a good day like Mary Ellen Ruff: Yeah. Right. Matthew Brooks: Yeah. Mary Ellen Ruff: So true. That's very cool work that Ann: It's a t Mary Ellen Ruff: you're doing. Ann: yeah th yeah, it's in it's inter it's it's good stuff. Everybody should know about it. I didn't even know about it. so anyways, okay, we're talking about all of these things and these sessions, these recordings always just fly by. Mary Ellen Ruff: Yeah, Matthew Brooks: Yes. Mary Ellen Ruff: just it's like. Ann: it's a good fly. but we were so excited to have you on the show and we also wanted to take a minute because everybody that has been listening for the past couple weeks knows that we are going to be at the Ada conference, pretty much just being the social butterflies of the Ada conference Mary Ellen Ruff: Yay. Ann: and doing a two live recordings and hopping in on some of the events and Mary Beth, you're actually presenting. Mary Ellen Ruff: I am, yeah. So I'm doing a workshop with Jennifer Baldwin on cultural competence and anti-oppressive supervision. So excited to be sharing that again. we we did a workshop last year also on supervision and you know, sort of strengthening feedback and how to provide that for supervisees. So I'm really excited. I love giving talks. So looking forward to it. Ann: Awesome, so now everybody can go and see us just bumping around being like little whatever and then you can go to Mary Beth's presentation. Mary Ellen Ruff: Yeah. Ann: And get some education. so yeah, that's gonna be happening. And I feel like today's episode, we do get questions and comments and messages every once in a while, and I feel like the content of today might receive some. So we will pass those questions along to you if they pop up. but also if you guys have them. Mary Ellen Ruff: Yeah, please feel free. Ann: Yeah, if you guys have them, drop them and it was fun hanging out today. Mary Ellen Ruff: Yeah, thanks so much Matthew Brooks: Yeah. Mary Ellen Ruff: for having me. This is really, really cool. I'm glad you guys are doing Ann: Yeah. Matthew Brooks: Yeah, Mary Ellen Ruff: this. Matthew Brooks: thank you. And I also just want to correct a little bit. It's Mary Ellen, not Mary Beth. Ann: Yes. what am I saying? Mary Ellen Ruff: All good. All good. I've been called every merry combination. Matthew Brooks: You were saying Mary Beth. Yeah. I would try. No, who's Mary Beth? okay. Yeah. Ann: Fix it. You have to go back. Do you know who Mary Beth is? Mary Beth Mary Beth is my old biller. It's just Mary Beth I'm so sorry, Mary Ellen Ruff: Notes are on the brain. Ann: Mary Beth is my old biller. Matthew Brooks: Yeah. Mary Ellen Ruff: That's all right. Ann: You're just gonna have to go back and cut out every single Beth. Matthew Brooks: Just peep, peep just Ann: Just beep like an an noise that's like Matthew Brooks: Yeah. Yeah. Mary Ellen Ruff: No, all good, all good. That's really funny though. Matthew Brooks: Yeah. Ann: I apologize. Yeah, that's so funny. That's I just had Billy on the brain. Matthew Brooks: Yeah. Mary Ellen Ruff: Yeah, with notes, billing comes next, so yeah. Ann: Yeah. Matthew Brooks: I know. Ann: And then again, always when we're doing all these things with therapists, it's always like, We understand, it's fine, we're all good. We're all good. Yeah. So appreciate it. All right. Mary Ellen Ruff: Yeah. It's still I make the connection, I get it. Matthew Brooks: Yeah. Yeah. It was good. Okay, well thank you everybody and thank you to Mary Ellen and being our guest and keeping us informed on how to write notes. Mary Ellen Ruff: All right, thanks you guys. Ann: Thanks, bye. Matthew Brooks: Thank you. Bye guys.