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The New Therapist
with Anthony D. Smith, LMHC

Anthony Smith

Welcome to The New Therapist!

I’ve never witnessed any profession so varied in encounters, except perhaps emergency medicine, as being a psychological therapist/evaluator. It’s a courageous career path, and like anything worthwhile is an intricate experience that can feel overwhelming at the outset. The New Therapist aims to help you feel more prepared to do your best.

“What do I do? Am I really prepared enough to be doing this yet!?” many a supervisee has launched at me in our initial meeting. Not infrequently this question surfaces more than once as new experiences arise. It’s an exciting time, but there’s lots to juggle.

I’ve always thought of psychology careers as arts-informed by science. There seems to be an equal need to be both subjective and objective in our work, like a double duty, and prepared for anything. It’s often an intricate dance of being able to relate and empathize and know when to say just the right thing, all the while employing the science of your chosen theoretical approach. 

To perform well, clinicians not only need book smarts and collegiate consultation, but they need curiosity and to hone the finer points. At the start, it may feel it is all you can do to make sure the boxes are checked: review for symptoms, be supportive, provide an intervention. Indeed, that’s a good starting point! But you’re motivated and curious and want to refine, and it’s impossible to address everything in supervision.

As a new therapist, it can feel like the experiences are catapulted at you from your growing pool of clients as if you’re being baptized-by-fire while the water is rising. Like a taste of exposure therapy, after seeing the sky didn’t fall the first day on the job, the next encounters get incrementally easier. There’s a fine line between this anxiety and excitement and there is no choice but to walk this tightrope. There’s excitement to apply your education and help dampen suffering, and there’s understandable anxiety as you make sure you’re not only checking the boxes but doing it well.

Even 20 years later, it is not unusual to receive a case reminding me that no matter how confident we’ve become, challenges await. Colleagues double my years have assured me it is part of the never-ending process of refining, for they, too, confess to trying encounters with items from rapport with challenging clients to diagnostic uncertainty. Even the renowned psychiatrist and author Irvin Yalom, at the age of almost 90, relays that the process never ends. Thankfully, with solid foundations, even the most challenging new encounters can be met with confidence.

As a beginning mental health professional, I didn’t know what I needed to succeed. I figured it was trial and error, and along the way, supervisors would fill me in on the rest. How difficult could it be? I learned the hard way. There is nothing formulaic to guarantee more hits than misses. Even with the sage guidance of a senior clinical supervisor, clinicians encounter stumbling blocks and are left to polish skills on their own through self-study and seeking experiences to do so. Supervisors can’t hold your hand all day or consult on everything. They’re busy people with whom supervisees are often allotted but an hour a week, and this is usually dedicated to managing select cases.

For almost a decade, I’ve noticed it never fails that students and supervisees bring to me many things I struggled with at the start. This often regards finer points and curiosities; things to help them not just feel they have more direction in their work, but how to do it with precision and feel more confident, to have an edge. They’ve learned about diagnoses and diagnostic interviewing, but there’s so much to consider. How can you reduce room for error? A client is pushing buttons, and, while keeping their countertransference under wraps, the new therapist wrestles with what to do with that energy in the room. The list seems endless.

The New Therapist takes this learning curve into consideration and aims to help new clinicians to begin refining from the start. Through presenting topics I wished I had known more about at the beginning, to items that students regularly raise, and stumbling blocks I’ve noticed students and new therapists struggle with, I hope to satisfy your curiosities and add to your foundation as you develop in the field. Hopefully it will feel a little less hard to become more prepared.

Welcome to The New Therapist!

Anthony Smith, LMHC

Anthony Smith is a licensed mental health counselor in Massachusetts with 20 years of experience. He has worked in facilities and in private practice performing therapy and diagnostic evaluations across a wide array of populations both demographically and clinically. This includes 17 years in the forensic arena, where he currently provides assessments for the juvenile courts. Aside from interest in the intersection of psychology and law, Anthony is particularly in interested differential diagnosis and supervision of new practitioners. He regularly teaches abnormal psychology and creates courses on the lived experience of people with mental illness, along with supervising graduate student counselling practicums at a local university. When not providing clinical services, teaching or blogging, Anthony can be found hiking and fly-fishing around the Northeast and American West.


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APA Reference
Smith, A. (2020). Welcome to The New Therapist!. Psych Central. Retrieved on September 18, 2020, from