The Affirming Minds Podcast

Episode 93 | Teletherapy in Practice: Evidence, Access & the Evolution of CareIn Part 1 of this two-part series, The Affirming Minds Podcast host, Shaina Siber LCSW, explores how teletherapy evolved, what changed during COVID-19, and what research tells us about remote mental health care today.This episode looks at the history and rapid expansion of teletherapy, changes in access and reimbursement, the digital divide, audio-only care, and the growth of digital mental health platforms. It also examines current evidence for remote psychotherapy across a range of clinical treatments and populations, along with questions about privacy, clinician autonomy, continuity of care, and what we should protect as teletherapy continues to evolve.Earn 3 CE CreditsThis episode is Module 1 of the full 3-hour CE podcourse, Teletherapy in Practice.Episode 94 will be publicly released on November 17, 2026. Participants who purchase the CE course receive immediate access to the full course, including both Episode 93 and Episode 94.To earn CE credit, participants must listen to both episodes in full and complete the post-test and evaluation. Episode 93 alone does not qualify for CE credit.Part 2 / Episode 94: Teletherapy in Practice: Ethics, Safety & Clinical Decision-MakingRegister for the full 3-hour CE course:https://www.affirmmentalhealth.com/courses/e8a3154b-7d6b-4066-b286-e6b2cf432bf0Learn more at affirmmentalhealth.com.

**Want CE/CEUs for this episode?**   View course information and earn CE/CEUs here:  Looking for more? Explore our convenient, affordable CE bundles or browse our full library of podcast courses, on-demand webinars, and live virtual trainings at affirmmentalhealth.com.  Sexuality is an important part of the human experience, yet conversations about sex, desire, and intimacy can be challenging for both clients and clinicians.   In this episode, we're joined by Camille Espinoza, LICSW, MSPH, CST-S, an AASECT Certified Sex Therapist Supervisor, to explore the fundamentals of sex therapy. We discuss sexual desire discrepancies, intimacy, shame, trauma, and the influence of societal expectations on sexual experiences, along with practical strategies for approaching these conversations with curiosity, compassion, and without judgment.   Connect with Camille: https://www.centerforintimacy.com

**Want CE/CEUs for this episode?**   View course information and earn CE/CEUs here: https://www.affirmmentalhealth.com/courses/fb93a29f-c8b3-435f-91a1-eb521f6bbe36 Looking for more? Explore our convenient, affordable CE bundles or browse our full library of podcast courses, on-demand webinars, and live virtual trainings at affirmmentalhealth.com.  What happens when insight becomes another way to stay at a distance from what we feel? In this episode, Shaina is joined by Lorain Moorehead, LCSW, PMH-C, EMDR Approved Consultant, therapist, and clinical supervisor, to explore intellectualization in therapy. They discuss how intellectualization can function as both a sophisticated form of protection and a barrier to emotional processing—particularly for high-achieving and psychologically minded clients. The conversation explores how intellectualization develops, how to distinguish insight from emotional processing, the roles of certainty and overcontrol, and ways therapists can work with this pattern without shaming or pathologizing a strategy that may have helped a client feel safe and successful. They also discuss therapist countertransference, AI and rumination, and clinical approaches including RO-DBT, ACT, EMDR, and parts work. Connect with Lorain Moorehead: Instagram & TikTok: @theselfcareapist  

**Want CE/CEUs for this episode?**   View course information and earn CE/CEUs here: https://www.affirmmentalhealth.com/courses/c264e836-a6a9-4023-aa2c-bcf465dd8226  Looking for more? Explore our convenient, affordable CE bundles or browse our full library of podcast courses, on-demand webinars, and live virtual trainings at affirmmentalhealth.com.  What happens when childhood looked “fine” on paper, but something still feels missing? In this episode, Shaina Siber, LCSW talks with therapist Carli Kilbourne, LPC about childhood emotional neglect, including how it differs from emotional abuse, why it can be difficult to recognize, and how unmet emotional needs can shape attachment, self-concept, and adult relationships. They discuss people-pleasing, hyper-independence, emotionally immature parenting, achievement-focused families, grief, boundaries, and healing through approaches such as EMDR, parts work, and reparenting. Carli Kilbourne is a licensed therapist, educator, and trauma-informed content creator who works with high-functioning people-pleasers and adult children of emotionally immature parents. Find Carli at: @authenticaftherapy Psychology Today: https://www.psychologytoday.com/us/therapists/carli-kilbourne-phoenix-az/1138739  

**Want CE/CEUs for this episode?** Earn continuing education credit for this episode here: https://www.affirmmentalhealth.com/courses/0b54bd3e-8449-4113-a495-722f7f5b381e    Looking for more? Explore our convenient, affordable CE bundles or browse our full library of podcast courses, on-demand webinars, and live virtual trainings at affirmmentalhealth.com.   This episode explores opioids through a behavioral health lens, with attention to pain, prescription opioid use, opioid misuse and opioid use disorder, diversion, overdose risk, and recovery. The discussion distinguishes tolerance and physical dependence from addiction, reviews signs of problematic opioid use, and examines how stigma, bias, prescribing practices, and inequities in pain treatment can shape clinical care. The course also addresses the changing opioid landscape, including illicitly manufactured fentanyl, counterfeit pills, polysubstance use, naloxone, fentanyl test strips, and other harm-reduction strategies. Treatment approaches for opioid use disorder are reviewed, including methadone, buprenorphine, extended-release naltrexone, contingency management, motivational interviewing, CBT, ACT, DBT, peer support, and recovery resources. Throughout, the focus remains on what behavioral health clinicians need to recognize, assess, discuss, and respond to within their scope of practice.

**Want CE/CEUs for this episode?**   View course information and earn CE/CEUs here: https://www.affirmmentalhealth.com/courses/883839f8-bb1a-4dab-97bf-4966b1a7be13 Looking for more? Explore our convenient, affordable CE bundles or browse our full library of podcast courses, on-demand webinars, and live virtual trainings at affirmmentalhealth.com.  In this episode of The Affirming Minds Podcast, host Shaina Siber, LCSW, is joined by Lou Lasprugato, LMFT, to explore how Acceptance and Commitment Therapy (ACT) can be applied within couples therapy. The conversation focuses on yearnings—deep, enduring psychological longings for experiences such as connection, security, validation, understanding, partnership, and shared meaning—and how they influence relationship patterns. Shaina and Lou discuss how ACT’s psychological flexibility processes can be extended interpersonally, how threat responses and underlying vulnerabilities can contribute to conflict, and how clinicians can help couples move toward greater flexibility, safety, connection, and values-guided action. The episode also highlights practical ACT-informed interventions for couples, including workability, “us as context,” co-regulation, and experiential exercises that support relational change.

**Want CE/CEUs for this episode?** Earn continuing education credit for this episode here: https://www.affirmmentalhealth.com/courses/9c5ad152-0781-4b43-8ec1-77cc4e1be9c0    Looking for more? Explore our convenient, affordable CE bundles or browse our full library of podcast courses, on-demand webinars, and live virtual trainings at affirmmentalhealth.com. Suicide assessment is only the beginning of suicide care. In this continuing education podcourse, we move beyond identifying risk to explore how clinicians can formulate suicide risk, directly address suicidal thoughts and behaviors, develop collaborative safety plans, reduce access to lethal means, and determine appropriate levels of care. We discuss suicide-specific approaches including CAMS, CBT for Suicide Prevention (CBT-SP), and DBT, as well as the role of psychiatric treatment and interdisciplinary coordination. The course also explores chronic suicidality, medication considerations, hospitalization and alternatives to hospitalization, post-crisis care, and more complex presentations involving violence risk, postpartum psychiatric emergencies, financial crises, and emerging technology.

**Want CE/CEUs for this episode?** Earn continuing education credit for this episode here: https://www.affirmmentalhealth.com/courses/9ca63c70-af79-4f1b-8853-b5efcca3c0f6    Looking for more? Explore our convenient, affordable CE bundles or browse our full library of podcast courses, on-demand webinars, and live virtual trainings at affirmmentalhealth.com. Suicide is one of the most complex and consequential issues mental health professionals encounter. In this CE-eligible episode of the Affirming Minds Podcast, Shaina Siber, LCSW, explores what we know about why suicidal thoughts develop, what increases the risk that thoughts become actions, and why understanding suicide requires looking beyond diagnosis alone. We explore psychological pain, hopelessness, entrapment, perceived burdensomeness, thwarted belongingness, trauma, mental illness, chronic pain, social conditions, minority stress, and access to lethal means. We also examine how human cognition and our capacity to imagine the future may contribute to suicidal suffering. The episode considers major theories in suicidology, disparities in suicide risk, the distinction between suicidal ideation and suicidal behavior, and the complicated role of psychiatric hospitalization. Throughout the conversation, the focus remains on understanding the individual person: What has become unbearable? What feels impossible to escape? And what does the person believe suicide would solve?  

Child sexual abuse prevention is a conversation every therapist should be part of. In this Mental Health Edit episode, Shaina sits down with Chris Yadon of Saprea to discuss child sexual abuse prevention, survivor healing, child-on-child sexual abuse, healthy sexual development, disclosure, the evolving role of technology and AI in exploitation, and practical ways clinicians, parents, and communities can help protect children. Chris also introduces Saprea's incredible free resources, including prevention education, support groups, online learning, and a trauma-informed retreat for adult survivors. Resources: Saprea: https://saprea.org/ If you enjoyed this episode, please subscribe, leave a review, and share it with a colleague. Together, we can help bring these important conversations to more clinicians.

**Want CE/CEUs for this episode?** Earn continuing education credit for this episode here: https://www.affirmmentalhealth.com/courses/9e17027a-8651-4111-b994-8a5bb1a76741    Looking for more? Explore our convenient, affordable CE bundles or browse our full library of podcast courses, on-demand webinars, and live virtual trainings at affirmmentalhealth.com. How do trauma and attachment shape the way we connect with our closest relationships? In this episode, Shaina speaks with Kathy Gusenkov, LMFT, about how developmental trauma influences adult relationships and explores trauma-informed approaches to fostering safety, co-regulation, and secure functioning in couples therapy.