Carly DeCotiis, MA, NCC, LPC, ACS, CCS, CCTP-II
MEET THE EXPERTS
Dialectical Behavioral Therapy
Carly DeCotiis, MA, NCC, LPC, ACS, made the decision to become a counselor when she was a senior in high school. Due to significant struggles she had with a close family member, she learned as a teenager what it felt like to be on “the other side of the couch.” As a young person, DeCotiis believed that these experiences afforded her a unique perspective on personal emotional struggles. Over time, she became convinced that, as an adult, she would make an effective counselor. Her convictions proved to be true. Today she is a Nationally Certified Counselor (NCC), a Licensed Professional Counselor (LPC) and an accredited clinical supervisor (ACS).
DeCotiis’ practice is unique because she specializes in extremely “difficult populations” with whom most professionals try to avoid. Extensively trained in Dialectical Behavioral Therapy, she works with a variety of difficult diagnoses, including Bipolar Disorder and Borderline Personality Disorder.
Please describe what it took to get you where you are today.
My educational journey was a struggle. As an undergraduate, I attended Rutgers University in New Jersey. There I majored in psychology and graduated with a Bachelor’s DEGREE IN psychology. I interned at the University of Medicine and Dentistry of New Jersey (UMDNJ) and worked in two psychology research labs. I wanted to get my Psy.D so my senior year in college I applied, but didn’t get in. I then applied for my Master’s degree and was accepted into Fairleigh Dickinson University in Madison, New Jersey – the fall after I graduated from college with my Master’s degree in clinical and counseling psychology. The program was two years but in order to be eligible for your license you had to complete 60 credits. My goal was to work in private practice. However, I didn’t understand the difficulties of obtaining my license along with building clientele. It took me three years to receive my full license to enable me to independently practice.
What was the most challenging aspect of your educational experience?
Undergraduate studies were the hardest for me as Rutgers is an extremely difficult school. My Master’s degree was a walk in the park.
What is unusual about your particular practice?
My training in Dialectical Behavioral Therapy means that my patients are amongst the hardest to work with because they have different diagnoses such as Borderline Personality Disorder. They are considered the “difficult populations.” In fact, the majority of clinicians would say they are the hardest of patients to work with. I see anyone who has experienced any type of trauma or domestic abuse as well as patients who are chronically suicidal, patients practice self-harm behaviors (cutting, high risk behaviors, burning, eating disorders, substance-abuse), and patients who have dissociative disorders and Bipolar Disorder. I take a genuine, real-life approach where I utilize methods of therapy, breaking them down so they are understandable and then relating it to the patient’s actual life, not hypothetical situations. Many times it is not that patients don’t understand the skills; but there are significant barriers that keep them from using them. These are barriers which many don’t address and consequently the patient doesn’t improve.
Do you have a special story from your practice?
I had a patient – a 19 year-old girl – who was chronically suicidal and in and out of hospitals. She had been institutionalized for a period time and had many high-risk behaviors including cutting (not superficial cuts, deep cuts that typically always required stitches) and extensive trauma and attachment issues. I had to tolerate her acuity and fight the urge to constantly put her back in the hospital, which always made her worse. She said to me one day, “you actually teach me about various theories and therapies to use, no one has ever broken it down like you and actually made it understandable and taught me how to actually use them in my REAL LIFE.” It was the best compliment I have ever received because this patient had years and years of therapy validated. I was able to use all my knowledge (which can be very intimidating to patients) and show her how to use it to improve the quality of her life. I always ask myself when working with patients what I feel would have helped me–it hasn’t failed me yet. This all came from experience of sitting on the other side of the couch!”
What advice would you give to someone thinking about becoming a therapist?
I would tell people that even though you obtain your Master’s degree without a license, you are basically a mental health worker, which you can do with your Bachelor’s degree. Many people think you will make a relatively decent amount of money with a Master’s degree which is so FAR from the truth. Not until you obtain your full license can you make a significant amount of money. It is a challenge to get a job while trying to obtain your license because you can only work in limited settings and need constant supervision. It’s a long and difficult ride, so if you are okay with weathering the storm, then I would do it. The payoff is worth it. If you have your full license you can have SO MANY more opportunities and make much more money. You can also open your own practice, which was my main goal that I finally achieved. I now have two offices.
NJ Family Lawyer Volume 37, No.2- November 2016
SENSITIVITY IN THE DIVORCE PROCESS
By: Charles F. Vuotto, Jr., Esq.
Carly DeCotiis, MA, NCC, LPC, ACS, CCS
We all know that divorce is a very stressful occurrence in anyone’s life. It is stressful not only for the parties and their children, but also for the lawyers and even the judges involved. However, the authors posit that there are some things that lawyers can do to help their clients that do not technically fall into the category of the law. Generally, family law attorneys may be more effective when working with divorcing couples if they focus on empathy and sensitivity to the emotional issues experienced by couples. This is a skill set that most mental health experts possess and practice on a daily basis. This column seeks to offer lawyers a brief overview of some of the tools they can employ to help their clients deescalate the situation, rather than escalate it (within ethical guidelines, of course). First, lawyers may wish to try to approach "divorce" as more of an uncoupling and be more sensitive to everyone's feelings. In most cases, such an approach will facilitate the process by causing the parties to be less emotionally distressed (most importantly for the children). Lawyers are taught to be advocates. That's who they are. That's not wrong in most kinds of legal work, but in divorce, lawyers are faced with many scenarios where advocacy takes a back seat to preservation of the family and the children. Lawyers are not typically trained in psychology, which would help them be more aware and sensitive to their client’s emotional needs. There are exceptions, in terms of those trained in mediation and Collaborative Law. Unfortunately that is a small part of most lawyers’ educational process yet lawyers are forced to navigate the emotional impact of divorce without that training.
The following are some of the tools that family lawyers can utilize to achieve the aforementioned goals for their clients. Many lawyers may instinctually use some or a combination of these techniques in their daily practice, however if lawyers consciously engage in these techniques they can assist their clients more effectively.
Validation: Validation is the recognition and acceptance of another person’s thoughts, feelings and behaviors as understandable/valid. In many cases people are invalidated, in which a person’s emotional experience is rejected, judged or ignored. Validation does not mean agreeing or approving. Validation can be one of one of the best tools to help emotionally sensitive people (i.e. a person getting a divorce) to manage their emotions effectively. It’s crucial for divorce lawyers to be mindful of this and practice validating their clients.
Building rapport: Building rapport with your client is essential for them to trust their lawyer and their judgment. A client wants to feel like you genuinely care about their situation, not that you are just another “case”. Answering emails and calls promptly fosters rapport. Creating rapport at the beginning of the attorney/client relationship will often make the interpersonal interactions more successful along with the outcome.
Positive affirmations/encouraging words: During a difficult time such as while in the process of getting a divorce encouraging words can go a long way. Encouragement is one of the most important attributes when getting along with others/clients.
Use “common” language: Legal jargon can make the intimidating divorce process even more intimidating and scary. It can also be confusing. It’s important to use understandable language in order to ensure the client understands the points the lawyer is explaining.
Review the divorce process: It is important to verbally explain to the client the sequence of events in the divorce process along with a handout reiterating those points. When a client is emotionally distressed they often do not pay full attention to what is being explained or can miss certain parts. A handout helps them feel more secure because they have something to reference and do not need to constantly call their lawyer with questions.
Reflective listening: It is important to fully understand what the client is saying before offering suggestions, feedback or ideas. Reflection lets the client know you are listening and trying to understand their point of view. When engaging in reflective listening, the lawyer will reiterate back what they heard their client state. This technique gives the client the opportunity to correct any misunderstandings or share additional information.
Obtain client’s objectives: It is essential for the lawyer to understand their client’s objectives and gauge whether their objectives are realistic. If they are not realistic it gives the lawyer the platform to explain why.
Discuss client’s worst fears about the divorce process: If a lawyer understands their client’s fears about the process, they can be sensitive to those topics and pay extra attention to helping them work through those issues.
Understand family dynamics: In order to truly understand your client in the divorce process it’s imperative to know the specifics about their family dynamics. It is important to ascertain whether your client or their spouse came from divorced families. Determine the quality of their relationship within their nuclear family and whether there was any mental health or substance abuse in the family.
Review aspects of the divorce process that may be emotionally taxing: (i.e. custody evaluations, mental health or substance abuse evaluations, testifying if it goes to trial): Often times lawyers may not fully consider the emotional toll custody evaluations, testifying in court and other aspects of litigation will have on him/her or their children. It is imperative for the lawyer to discuss the processes in detail, prepare the client and perhaps role play with the client.
Give list of professional resources: It is helpful if the client is provided with a list of recommended couples, child, individual and family counselors as well as mediators. If a client goes to a professional and does not have a positive experience they often will not go back and will not find someone else. Clients who trust their lawyer feel comfort in going to someone they recommend. During the divorce process it’s imperative for the client and their family to have professional support.
Some mental health experts may have the view of lawyers that they are too aggressive, divisive and only concerned with money. Conversely, some counselors may not fully understand the divorce process and the legal issues involved. Concepts clash at times. Both sides, in our humble opinion, could benefit from education about the other for the betterment of divorcing (uncoupling) parties and most importantly, the children, who often are the ones most impacted by the process. If lawyers employ the above techniques, it may help them to possess a skill set that can be used to enable them to be more emotionally sensitive ultimately for the betterment of the divorcing couples and their children.