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. I then decided I wanted to counsel as well as prescribe medication for a more effective level of care. In 2008, while working towards my license, I went back to school and completed my nursing pre-requisites, which took me a year and a half. I then applied to school and didn't get in twice. My third time I was accepted into an RN program. I am still in the RN program and will then have to get another Master’s degree in nursing science, which will take me another two to three years.
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. The other most difficult thing was getting my nursing pre-requisites. Now, I am attending nursing school, which is hands-down the hardest thing I have ever done.
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.
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