own your ignorance – with rachel alTvater

It’s human nature to shy away from admitting what you don’t know (especially after thousands of hours of education and clinical practice). But being able to own your ignorance is not only critical to your client’s well being but your career as a health professional too. That’s the topic of this wide-ranging conversation with Licensed Psychologist and author, Rachel Altvater.

You can connect with Rachel Altvater via her website. You can also find her new book ‘Perspective: Contemplating the Complexities of Our Realities Paperback’ on Amazon.

Resources mentioned in this episode:

• Future-Proofing Health Professionals Facebook group
• The Entrepreneurial Clinician book

If you know you need more support, please visit my website at https://jomuirhead.com

TRANSCRIPT:

Jo:

So welcome back to the next episode of the Entrepreneurial Clinician Podcast. And I’m rather excited, which means I’m gonna talk really fast, you know that right? Because I have just met in kind of Zoom person, not just texting online person, Rachel Altvater. No, I’ve said it wrong, but that doesn’t matter. We’ll get there, <laugh>. Maybe I can get away with it because I’ve got a cute accent. Rachel reached out to me, she’s written a fantastic book. She has managed to build an incredible health business in the USA and she’s just full of life and light and energy, and she is the sort of person you wanna have in your world. So, Rachel, how about you give us a lesson in pronouncing your surname, and then when you’ve done that, can you tell us who you are, where you’ve come from, and how you got here today?

Rachel:

Absolutely. I just wanna say, I am so grateful to be here with you and be here with everyone who’s listening and just what a heartwarming connecting introduction. I’m Rachel, last name’s Altvater, but I’m just Rachel. And you know, it’s so interesting when people ask me to introduce myself, my brain immediately goes to I’m human, which I think is a beautiful foundation of a lot of what we’re talking about, because I think that we can have the fancy bios, and I think it’s important, right? Like, especially for our work as entrepreneurs, that we are doing different things within the field, within our craft, and at the core, we don’t wanna lose sight of ourselves. So that’s the message that we’re gonna be conveying today. But I will share a little bit of the professional side because that’s why we’re here too.

I’m a licensed psychologist in America and I’m able to provide teletherapy services in a lot of the States. My home base is in Maryland, and I’m licensed in a couple direct states around Maryland, Washington, DC and Virginia. And I own a group private practice called Creative Psychological Health Services. My specialty is working with children and adolescents and also trauma. And I also have a specialty in what’s called digital play therapy. And it’s incorporating technology into play therapy sessions with children and teenagers. And it’s for all ages. So I will say that we do also implement that for some adults too. I also say I sprinkle myself everywhere. I do love sparkles, <laugh>, so I like to sprinkle a little myself here, a little of myself there. I become quite passionate in a lot of different projects.

And, and one that you mentioned in particular is the book that I recently wrote called Perspective: Contemplating The Complexities of Our Perceptions just started off with an idea. And, you know, I find themes in my life. I find themes in my work, and that was the theme that continued to emerge. And just something within me said, put your words out there. And I think as entrepreneurs, a lot of times we want to put ourselves out there. We want to leave a legacy, we want to make a mark, we want to align with our passions, and I say, just go for it. So that’s what I like to do with my little sparkles, my little sprinkling around. So yeah, I like to do different things within the mental health field, volunteer wise, mentorship wise, supervisor wise, and through direct clinical care.

Jo:

Wow, this is really outstanding. So you’re currently on the east coast of the USA and I’m on the east coast of Australia, and it’s tomorrow here today for you. And that just totally blows my mind that we get to do this. So thank you for staying up late to be able to have this conversation. So tell me about your group practice. Like, how big is it? How many people are there? What are the people there wanna do? Like, tell me about that.

Rachel:

Yeah, so we have a little under 20 therapists across two locations and virtual therapy. So I’ll take a couple steps back. I started the practice in 2018, but didn’t actually start seeing clients to 2019, and I was working elsewhere. So I just kind of slowly start to build up my practice because in all honesty, I was anxious, right? Like, and I think that that’s so common for so many of us when we start something new or anxious and either we confront that anxiety head on and we reach our goals, right? I mean, not to say that there aren’t barriers and obstacles along the way, but we work towards reaching our goals or we say, oh, I can’t do this, right? Mm-Hmm. We convince ourselves that we’re not able to do it. So I said, let me take a baby step, let me just open the practice, you know, start some of the behind the scenes work.

Let me then start one day a week. By the end of 2019, December of 2019, to be specific, we opened up our first location prior to that was sharing space. And then I had connected with two therapists who were interested in child and adolescent work, specifically play in expressive based therapies who were interested in working at my practice. So December, 2019 opened the first location. Three of us are there. I kind of worked a bit more towards full-time. At that time I was still working elsewhere cause I had clients there still, and then part-time, two part-time therapists, and then we all know what happened a couple months later mm-hmm. And for those of you who are listening to this in the future, Covid happened three months later. Well, it was starting to emerge in different areas of the globe at around that time, but it really shut down the world in March of 2020.

So three short months after I opened the practice, everything shuts down. I went to that practice cause I was the only person in the whole building. And the only person in my practice is I am sitting here, <laugh> I’m gonna be doing therapy from this office. I built this, I’m gonna be here. So I held strictly teletherapy sessions from the practice and the other therapists were providing virtual therapy, but the mental health need expanded rapidly, and especially for child and adolescent clients who were struggling with the transition to virtual schooling and just a variety of things. There’s a lot of heightened anxiety, global trauma, and my practice during the pandemic thrived, which in part is so heartbreaking and in part is inspiring at the same time. So I kind of grapple with conflicting feelings and over, so what would that be? Over three years? A little over maybe a little over three years now. It has expanded rapidly and I just opened the second location in the fall of last year, 2022.

Jo:

Wow. I was writing down the history and looking at how quickly things had occurred for you. And one of the things that I have observed is that there was a lot of expansion for mental health services, regardless of discipline, a lot of expansion for health services throughout the pandemic, right? And when we got shut down and there was lots of opportunity, but some professional practices or some group practices haven’t been able to navigate or maintain or continue to grow now that we’re opening our borders again, there was like this huge influx and referrals were coming and you couldn’t keep up with demand. And I’ve gotta be credentialed over here and take referrals over there. And I need more people and I need all the people and I need the people now. And we’ve all gotta work from home. And oh my God, what mask are we wearing today? Not that I’m traumatised by this at all, but I’m curious to know, Rachel, what have you done to enable you to maintain and continue to grow now that there’s not as much, I guess, pressure?

Rachel:

Yeah. My brain goes a couple different directions. The first thing is actually, I should probably ask for feedback on this, which I think is important for us as entrepreneurs as well, asking for feedback. What is it that draws people to the practice? Because my perspective, just put the book in there for a second, but perspective is one of a handful, right? And so what I share with you may or may not actually align with the reason why people gravitate towards the practice. My assumption though, is one of the primary reasons is my expertise within the field. So, to piggyback a little bit, my dissertation research and my doctoral program was on incorporating technology into play therapy. I recognize that there was a surge in implementing technology-based toys in free time, right? So I’m learning about play therapy at this time and learning about traditional play therapy, toys, doll houses, sand tray puppets, art materials, right?

And children at home are playing with devices. So I asked myself, how is this impacting our work? And this was back in 2015, 2016, conducted my dissertation research on this topic, graduated, started doing presentations in 2017, 2018 on incorporating technology into play therapy. And it was met with reluctance, understandably so, then the pandemic happened and people panicked within the field. They had no idea what to do. They didn’t know how to incorporate technology into sessions, hadn’t had teletherapy experience. And that was something that I was very comfortable with. My clients seemingly transitioned relatively smoothly, granted global trauma. Right? So I’m not gonna say that it was an easy experience for everyone. No. However, moving to the virtual platform and incorporating digital tools definitely was something that I felt very comfortable with. And I recognised that my colleagues were not comfortable.

And so I put myself out there. I provided a free 45 minute training that I posted on YouTube. I started providing free resources. I started becoming a bit more innovative. And some of the ideas that I saw other disciplines were integrating into their work, like virtual classrooms, let’s do virtual playrooms. So I think that was a big reason because I have made a name for myself in the field. And so I think people are interested in learning that expertise. I also think just on a human level, that I really do try to create a very natural, connected, cohesive, open, vulnerable, authentic culture. But I lead by example. I describe myself as a leader and not a boss. And people really appreciate that I’ve received that feedback. So I think of me as a human also just have been able to form connections with other humans. And you want to be where you feel good, right? And where you feel appreciated and important and that your thoughts matter. So I think that that’s probably another big reason why this is great.

Jo:

I love this conversation. So I’m gonna take down the two topics that have come up into my head here. I find it incredible that health professionals were always looking for the next hack. Like physical therapists, always looking for the next modality. I’m getting occupational therapy and digital prosthetic people contacting me every week saying, come and try our new way of doing this. And it’s not like digital stuff isn’t in our world. Like most people talk to Alexa or Google or some sort of nest. I saw a funny meme the other day where a teacher was saying, I know the generation I’m now working with. I was called Alexa today. But when we get into the therapy room, we get really concerned and about how much gaming you’re doing or how much time you spend on social media or the bullying and harassment.

Like we’re so good at seeing the negativity around it, but yet you have kind of gone, well, we have to meet people where they’re at. And yes, this is what kids do, they play games and guess what? Mum and dad, you are giving them the iPad when you need some time out, you are giving them the game to play. So how can you then send them to therapy to work out their anger and anxiety? And the first thing I get to do is punish them by taking away the thing they enjoy the most. So I love the fact that you’ve kind of gone, but this is what we are dealing with every day. We can’t ignore this.

Rachel:

Gosh. Yes. And one of the biggest things with this exact point is so many times caregivers will bring their children in and say, I don’t want my child to engage with these, insert whatever technology, devices, gaming, whatever, right? These digital tools, they’re addicted. I’m air quoting for those listening. They’re addicted. I don’t want them to. Let’s talk about the problems, right? And here’s the thing that is synonymous to saying my child is depressed, but that is something they’re struggling with too much. Do not address the depression in the room. We gotta address something else. But if this is the problem, the best way to understand the problem is to lean into it and to recognise it from the child’s perspective, this comes back to the themes I kept seeing in my work and my personal life, right? Come back to the child’s perspective. What are they seeing? What are they experiencing? How does this serve them? Is this meeting a need that they don’t have met in the same manner that they desire elsewhere? Right? Gaining insight into that will help us recognize the best course of action, seemingly for that child to be able to heal, to resolve some of the problem behaviours or whatever their internal or external struggles are. So yes, I love that you bring that up. It’s so true. And I’m very humanistic. So my approach to therapy is truly meeting people where they are.

Jo:

Hmm. Well that’s obvious in everything that you’ve said so far that’s come through. So I’m curious to know now what gets in the way for us incredibly smart, highly educated health professionals who have all this incredible expertise when we go, I don’t wanna talk to anybody about their gaming experiences and don’t want to make it a therapeutic modality. Yes. And I am winging and crying to make a point here. What gets in the way of us embracing it

Rachel:

Ourselves!

Jo:

<Laugh>

Rachel:

We learn, and I’m sure this is the same across disciplines, right? I can confidently say this, and I’m speaking ignorantly, so I’m gonna own my ignorance too. We are taught to make sure that we are operating under certain ethical guidelines. And within those ethical guidelines across the board, I’m going to assume competence falls underneath that. If we do not feel a sense of competence within a certain modality, a certain craft, of course we’re gonna shy away from it because we do not want to practise unethically, right? Also, we bring our own stuff into the room. I always say, is this my stuff? Is this their stuff? Is this a combination of our stuff? Right? And so it’s important for us to do our own work. Perhaps if we’re bringing our own stuff into the work and we don’t feel comfortable with technology, of course that’s gonna guide how we participate in the work, right? If we’re going to decide to push something away, if we’re gonna decide to bring something into our work. So I think that’s another big part. But it really boils down to competence and comfort.

Jo:

Yeah. Agreed. I had this massive realisation when I led a retreat a couple of weeks ago and, and you know, you’re leading a retreat and you wanna be on your game and all of a sudden all this stuff comes crashing into your own self going, Ooh, I’ve got work to do here. So I’ve been operating out of a model since 2020 where it says, look, everybody needs to understand their physiology, like what’s going on in their body. We need to understand what’s going on in our psychology, and then we need to understand what’s going on with our sociology. And, and now I truly believe that the next layer of that is what is our relationship to technology. Because we can’t ignore it. Like I’ve worked with people who have biomechanical arms. Like their brain is now telling a piece of machinery that is attached to their upper arm, into their shoulder, how to operate. Like this stuff has been around for ages yet, right now we’ve got some fears around it. And I remember my son being 15 and at high school and they had a horrible thing happen where an image of a young girl should not have been shared around the school, but it was, and the police were called in and the parents were called in. And my son ended up with this image on his phone and the police in their ignorance said, don’t let your kids have social media. And I just went, that’s the dumbest thing you could say. That’s just dumb. Don’t say that, and then the school didn’t like it cause I sat there and went, how do we get the kids involved in solving the problem they wanna know? Cause as far as I was concerned, I dunno how to solve this problem. I didn’t grow up with social media. Bullying for me was getting called a name as I walked out of the school gate. Not all this other stuff that these kids are being pressured with. So again, it’s like we’ve gotta be prepared to meet people where they’re at.

Rachel:

Yes. Gosh, I love what you just said about working towards solving the problem. Do we all want to be a part of creating that resolution or to be able to steer something in a healthy direction and become active participants? Or do we wanna step back and say, this is bad, this is wrong. Right? And we shouldn’t be engaging in this or implementing this. It’s important that we’re part of the change and we as health professionals, recognise that it’s important for us to be change agents. Yes. Right? So if we are experiencing some apprehension about changing, but then we’re encouraging people to change, it’s like a do as I say, not as I do situation right?

Jo:

And that’s the medical model. We would all very, very vehemently say the medical model for us, is defunct and unhelpful. But I think the wisdom that we bring, so, you know, I’m in my fifties. What I worked out is that I don’t need to know every single parts of these games. I do not need to know how they operate. I do not need to have the highest score to be, what I need to do is learn how to ask the questions that allow the person using the games or using the tools to think it’s like, what are we doing over here? Show me how it works. I’ve learned so much stuff from working particularly high level quadriplegic clients cause of the ways they have to use technology to exist in the world. I’m going, that’s really cool. I wanna learn how to do that. So it’s about coming at it from a place of curiosity. So that’s my perspective. See what we did there, people, we brought the book back again!

Rachel:

And we want people to be experts in their world, right? Just like we wanna be experts in our craft, in our world, we wanna encourage people to be experts in their world as well. And so if we go into it saying, I’m an expert in everything, how approachable are we really? Also, that’s just unrealistic, right? Like, let’s be realistic with ourselves. We are not gonna know everything there is to know. The more we know, the more we realise how much we don’t know, the less we know, the more we think we know. So allowing people to show the way, right? Lead the way. Teach me, I’m such what’s called a noob. Like, you know, a newbies, I get it. Someone’s new who not skilled. I’m a noob in so many of these games and it empowers children to teach me. How many places do these children feel a sense of inferiority, low self-esteem, a lack of control, and they finally are in this space where they are able to dominate and they’re able to teach and people wanna listen. How powerful is that for someone’s mental health alone?

Jo:

Wow. Boom. I’m hoping everybody’s having the whole mic drop moment pressing pause going, whoa. What? Just in case you wanna know, the whole transcript of this recording will be on the website. So you can come back and copy ’em the paste the bits that you want. And you can also connect with Rachel to make sure that you get into her training. cause I think we all need to go do that. Okay. So we understand how you have led change by willing to meet people where they’re at. From a client perspective, I’m now curious to know, cause it sounds like your leadership in your business is pretty much the same. So I’m of the generation where we turned up to work, we clocked in, we clocked out, and excellent management was all about how efficient I was today. How much time could I bill? How much time could I bill, how much time could I be, you know, drove me to distraction. Made me very, very sick. And it’s a very unhelpful way that we work from industrial revolution times. But your sense of management or leadership feels a bit different. You can you talk into that again? Share with us how you meet your people, where they’re at as the leader in your business.

Rachel:

Yes. You allow them to be experts in their craft. And I’m gonna credit my husband. When I started this business, my husband said, hire people who are experts in what they do or who are budding experts in what they do and allow them to lead. So as a leader, I want to build other leaders. I don’t want to encourage followers to do, as I say. I think it’s so important for us to truly listen to ourselves. So any student, and I’ll say, I mean it’s really anybody, but I’ll say students specifically because that’s the beginning of their career. And we really try to help a lot of early career professionals at the practice. And I say we, because I view everyone as a team. That’s another thing. It’s not my practice, it’s our practice. We are all in this together.

I mean, I know that it is my practice, but I hope you all hear what I’m saying, right? It’s a team effort. I call everyone my team. But with students when they join, I say from the start, my goal for you over this academic year is for you to develop your clinical expertise and your clinical style. And of course I ask ’em what their goals are too. And with developing their own expertise and style, I say we will provide guidance and suggestion and support and models, maybe for clinical documentation or models in terms of recorded sessions or even if they’re able to join some of the sessions, absorb what works for you. Someone had said once, take what resonates, leave the rest, right? So absorb what resonates with you, and then I’ll leave the rest and establish a sense of comfort in your clinical identity.

Quick little caveat. When I graduated, I had become so used to doing what everyone told me to do, my supervisors, my professors, you know, my guides, that I felt very shaky, very shaky foundation. And I started to question my own clinical instinct because I thought, well, what would so-and-so say? What would so-and-so say? And what this person would say is different from what this person would say? And then we become so stuck in our head with what’s the right way to do things that we start to lose sight of ourselves. So I really encourage students, and again, everyone to align with that which aligns with them. And when people are experts in what they do, it ultimately contributes to the whole, it’s not be carbon copies of one another or follow what I say. It’s lead, lead the way for yourself, for your clients, for whatever it may be.

Jo:

This is wonderful. I’m so grateful for this conversation. So anybody who’s struggling, maybe you are Gen Xer like I am or <laugh> around that time. Like we haven’t got this leadership stuff nailed, in fact, we’re part of the problem, not part of the solution. Generationally at the moment. Huge generalisation waiting for your hate mail. It’s all okay. Please go back and listen to what Rachel just shared about creating experts. You wanna bring people into your practice who actually know more than you. You don’t wanna be intimidated by them, you don’t wanna be scared of them. Your job is to lead them, to make them become the best they can be. Because when they can become the best they can be, they’re actually gonna serve you to the best of their ability. I think, you know, the management models that my generation are still trying to let go of are so outdated and we don’t even realise that it’s a part of the biased opinion of Jo. Disclaimer, just letting you know, that’s the opinion of Jo.

So the themes that are coming out really clearly in this conversation today is that we all come with a perspective, right? And your challenge to us through this conversation is how do you understand your perspective to help you meet people where they are at so that you actually stop being the expert and you start meeting humans where humans are at. Have I kind of summarised that? Okay. You’re nodding your head. That makes me feel good.

Because, I didn’t realise how much of my own perspective or bias was getting in the way of my work. And it was really confronting until I started having to work with clients I knew nothing about. And like you said, my sense of being competent went through the floor and I know, and I’ve worked with enough health professionals over the world now to know that what most people do is refer out. And I’m like, well, hang on a minute. You’re getting caught up in the tactic there. Like  the tactic says, I need to be an expert in play therapy specialising in digital technologies for children. Well, no, you’ve probably got the skills and resources as a health professional who’s been around for a while, who knows how to ask really good questions, who understands how to diagnose and then refer out rather than being scared of it in the first place. Yeah. Because you know what? People, if we’re scared of kids playing games, God forbid we turn up when they have actual romantic relationships with their artificial intelligence. Cause that’s where it’s headed. If we don’t keep on top of that and if we don’t become the experts on how to deal with that, we are gonna become redundant. <Laugh>. Sorry Rachel, do you have something to say about that? <Laugh>?

Rachel:

I just agree. I echo your statements and I think that one of the biggest things that’s sticking out for me with what you’re saying right now is when we feel insecure, and I am making a generalised statement as well. So this is a common thing for humans, and I recognize not everyone fits in boxes. When we feel insecure as humans, there is a defence mechanism. Sometimes it occurs to protect our ego. And so either we say no, I do know everything because we feel challenged or we will say, okay, you know what? I actually don’t know more about this. Let me lean into this. Right? Like, I own my ignorance. And I think when we view ignorance as a sign of weakness or a sign of a lack of intellect, then we’re gonna operate from a more powered mindset or trying to evoke more power to prove a point perhaps. If we pause though and recognize this is a teachable moment for me, and I can model to those that I am teaching, that we are all teachable, that’s actually gonna be so much more impactful in the long run than trying to prove a point that we know something or to preserve our ego.

Jo:

Yeah. Great. Very, very wise words and words that we probably need to hear over and over again. So Rachel, I’m gonna talk to you about your book now. Who did you write it for?

Rachel:

Everybody. <laugh>.

Jo:

<Laugh> Excellent on the Christmas list now. <Laugh>.

Rachel:

Yeah. I mean my hope was it’s really for all humans and because of the information shared really for adults. And more so just because I think the information provided in the book is just too intellectually advanced for children to understand and to read. So it’s not for children in that way, but the lessons are very beneficial. So if we’re able to convey it to children, then that’s the message for everybody. I want it to be for all humans to really recognize this is who we are and this is why we come to be who we are and how can we all find our space confidently and comfortably, authentically in the world and develop deeper understandings of other people.

Jo:

Nice. So getting to know yourself so that we can actually understand others and meet them where they’re at. I think this is a book that everybody needs to go and grab a hold of. So where can we actually get it, Rachel? Is it in some secret place or is it on Amazon?

Rachel:

Amazon. It’s at secret place then. Yes. but yes, it’s on Amazon. And it should be accessible for a lot of people across the globe

Jo:

Yeah, we can get it here in Australia. I checked before we got on today, so I wanted to make sure of that. So the most important question now as we finish this interview, what’s your favourite coffee to drink?

Rachel:

Oh, so I call them my foo-foo drinks, but I will say what is empty right now, <laugh> is. Should I give the actual order?

Jo:

Yeah, please go for it. Like you’re walking into the coffee shop right now. What would you say?

Rachel:

It is a venti iced upside down caramel macchiato. And right now, because I am expecting, I get it two thirds decaf <laugh>.

Jo:

Oh my god. So say the whole thing again. Like pretend like you’re gonna order I’m the barista. I wanna hear this outta your mouth. Off you go.

Rachel:

Can I have a venti upside down iced caramel macchiato, two thirds decaf? That sounds really extra <laugh>, but you know what? We embrace who we are and I’m extra, so I own it, you know?

Jo:

<Laugh>. That’s ok. That’s alright. I will forgive you for being a Starbucks customer, but that’s okay. But at least I know what to do next time, well the first time, I get to meet you in real life how to order your coffee for you. So that’s very cool.

So Rachel, thank you so much for asking to come on, being here, sharing so vulnerably and openly with us. I will put the links to how you can get in touch with Rachel in the show notes and all over the social media so you get a chance to be able to connect with her as well.

Thank you again for being here today, and until next time, go be your awesome self.