Welcome to the Online Counselling Podcast, exploring the practice of counseling through technology. Here’s your host, Clay Cockrell.
Clay Cockrell: Hello and welcome to the Online Counselling Podcast. My name is Clay Cockrell. If you’ve listened to some of the previous episodes, you know a little bit about me. I have an online practice where I work with couples all over the world to improve their relationship. It’s called maritalcounseling.com. I have a therapist that works with me. He’s located upstate New York. His name is Patrick Cayouette. I thought he would be great to bring on to the show and learn from him because he’s relatively new in practicing online. We’ve talked with people that had been doing this for years. Now let’s talk to someone that is new and some of the struggles and challenges that he’s learning.
He brings a lot to the table too. He has a focus for men working on men’s issues, also sexual addiction, working with pornography and prostitutes. He’s going through a certified sex addiction therapist training. We’ll learn more about that in the recording. He’s also a Christian counselor. He brings a lot of different flavors, if you will, to his practice. It was just great talking with him, learning about him. Hope you will enjoy the show. This is Episode 8, Patrick Cayouette.
Hello and welcome to the Online Counselling Podcast. Today we have Patrick Cayouette with us. He is a licensed therapist located in upstate New York. He works with me actually at maritalcounseling.com doing online counseling for couples. I’m just really excited to bring him on the podcast and introduce him to all of you and get to know him a little better myself. Patrick, welcome to the show.
Patrick Cayouette: Good morning, Clay. How are you doing?
Clay: I’m doing pretty good. Remind me where in New York are you.
Patrick: I’m about 20 miles south of Rochester, the city of Rochester in a little town, a little village called Lavonia.
Clay: Lavonia.
Patrick: It’s right in the Finger Lakes.
Clay: Alright. You are doing online counseling with couples. First of all, tell us a little bit about your story and how you became a therapist.
Patrick: I started probably honestly when I failed biology in college. I didn’t know where to go. I went to the social work route, but it’s been something I’ve done all my life. As far as with friends and everything, people have always come to me.
Clay: The listener.
Patrick: I was the listener and sometimes to a fault. But here I am today with some family challenges, and it just seems like this is where I was meant to be. This is my calling, my location. I love every minute of it so far.
Clay: That’s great. There’s a couple of different things that you do. You just don’t work online. Tell us about that.
Patrick: You mean with my career or with outside the career? Currently, I have been on the board of Catholic Social Workers National Association which I have been on the board as director of member services for probably going on seven years. I actually just stopped this past year to take a look at my further career options. Other things I’ve taken on, I do an agency here locally in which I am mostly working with men. It’s an in-office agency. I do have a history and currently working some case management type social work for a medical home visiting nursing agency.
Clay: So you’re kind of all over the place.
Patrick: A little bit.
Clay: You wake up every day and go “Who is Patrick today?”
Patrick: Absolutely, absolutely.
Clay: I think a lot of people start out that way as they build a private practice. They put pieces together here and there.
Patrick: Absolutely.
Clay: This fascinates me is you are specializing in men. You have a passion working with men and men’s issues. Tell me a little bit about that.
Patrick: One of the biggest things as I started working… Let me back up a little bit. One of my first jobs as a counselor was working with families that had children or teenagers that were at risk of being removed from their home. I looked at a lot of the families and I looked at a lot of the dynamics.
I started to realize that there is one common factor and that was majority of them were male, majority of them their father was either not present or their father was struggling himself with his own challenges and wasn’t able to give his son and/or his daughter what they needed in life. With that, that’s kind of developed into looking at fatherhood issues and then also looking at today in our society men have a lot of challenges that we gladly accept and hide behind but there’s a lot of challenges in which we don’t that are just thrown at us. It’s sometimes sad to see the state of manhood today. I’ve developed quickly a place in my heart for other guys who just are struggling. That’s kind of led me into more and more research about man anything from their “mid-life crisis” to inability to connect with their wives, their children, work stress.
Some of the biggest things that I’m facing now is the aspect of addiction. One of the biggest addictions is becoming prominent is sexual addiction. That’s pretty much the path of my goals in working with men. Right now in my local agency, I’d say 98 percent of the people that I work with are men.
Clay: Yeah. I talk with other therapists, and I think in our industry in social work, there are more women in the profession than men and they are kind of surprised at what the percentage of men are in my practice. I think that many times men feel more comfortable talking to another guy.
Patrick: Absolutely.
Clay: I think that the more we can understand where they’re coming from because society does kind of say this is what you should be. Just like society says this is what you should be typically to women, they say that to men, and we don’t always fit in to the mould that they want us to. Sometimes that mould is unhealthy, that stereotype of “Never cry. Don’t show your emotions. Handle everything yourself.”
Patrick: Absolutely.
Clay: It’s not good for us.
Patrick: Even a different aspect, if you look through the media how we are supposed to “be,” you look at the average sitcom and the father is aloof and dumb and not with it or there isn’t a father involved. Even some of the preteen shows like on Nickelodeon or this or that, this is where our kids understand how to become men and women and how to treat our fathers and mothers. Even in the media I see that as being what are we being asked to be as men.
Clay: Something you mentioned earlier, the pornography addiction. I rarely work with anyone these days that is not struggling on some level with porn addiction. Tell us about that. You’re going to be a certified sex addiction therapist. Is that the right phrase?
Patrick: It is. It’s called CSAT, certification sexual addiction therapy. I have recently been approved. I will be starting my first module this March which there are four modules to get the certification. It’s I think about a 3-year process depending on how soon I can get my modules done and a lot of behind-the-scenes reading and research which some of it I’ve already started knowing that I was going to take this route. So yeah, my goal is to bring that to not only working with men but also working with my couples that I meet on a regular basis because this impacts many, many marriages that a simple secrecy of the porn… It’s no longer even a porn stash of the past. It’s the porn file of the present and on the computer and/or chatting and all these chat apps. It just leads us to a place of very dangerous acting out in many different ways, the hook-up scene or even just finding somebody, an old friend through Facebook.
Clay: Right, right. I think technology has helped us a lot but it’s also of course brought a lot of challenges and never before in our species has sexual urges been able to be met on demand so quickly in such varied ways. I think the brain is being impacted. A lot of studies are showing that. There’s a huge movement going on right now on men who are stepping away from pornography and supporting one another. Good luck on that journey. I think there’s definitely going to be a market for it. Kind of moving in to the online work, you’ve been doing online work for the last six months or so?
Patrick: Six to nine months, yes.
Clay: How has it been for you?
Patrick: I’ve enjoyed it. It allows me to bring my skills to many different people that I may not have the opportunity to… I’ve had the opportunity to work with people overseas or even people here in the United States. I think one of the biggest aspects of that is that you’re able to help people out and not have to be there face to face in person, but you can help them out through—it almost sounds surreal— but through the computer.
Clay: You’re reaching through your computer.
Patrick: Yeah. It’s definitely opened my eyes to the small impacts we can have on life towards other people even if those other people are an ocean away.
Clay: Right. Have you found a common factor in people who choose to do online work? They could potentially find somebody down the street or in their town. Is there kind of a different mindset of those clients or is it constrained because of location? What are you seeing?
Patrick: I think a couple of the commonalities that I’ve experienced are where a couple is separated fir different means whether it be military service, which is always an honor to do as far as somebody who was in Afghanistan and their spouse who’s in Tennessee. The other thing that I experience a lot if work-related distance where the husband is working away and the wife, or just the opposite, is home with the kids. It just brings them together because the distance in itself is a complication and then you add the regular complications to marriage. That brings it to a whole new level. I think in my current experience, those are the two main aspects in which I have met with people.
I’ve also met with somebody who just wasn’t comfortable meeting with somebody in person. They felt more comfortable behind the screen in a sense. They felt that there was more security. But that was also due to their role in their career. They didn’t want that risk and they thought that this was a safer opportunity.
Clay: It’s fascinating, is it? There was a therapist. I’m hoping to get her on the show in the coming weeks. She’s in Paris now. But she had a client that she was doing online work with in Russia. At first, he only used audio. He would not turn on the camera just because he didn’t feel safe and that there was a lot of shame in some of his issues. As the therapy continued over the weeks that they worked together, he gradually turned on the camera and they began to see one another. There are a lot of clients out there that are in need, that this is the only means that they feel comfortable in reaching out.
Patrick: Absolutely. It’s interesting to be able to see them open up even over time as they begin to themselves get used to talking to a computer.
Clay: I always think it’s interesting to talk with people in their homes. There is a comfort that they have that they don’t have in my office. They’re just in their environment, their safety there.
Patrick: That’s something that I’ve experienced even early on in my career. As I mentioned earlier, I was able to do work with families that had children that were at risk. I went to their homes. You do see a different perspective. You see the dynamics, the real dynamics at home than you would in the office. Sometimes that was more interesting than others. But even here in Skype, people can just sit on their couch and even snuggle. I just worked with a couple that, yes, they’re going through a difficult time, but they were able to sit and just snuggle through their session. That in itself was a huge step for them. As they’re working through some vulnerability and some scary issues that had been brought up, they have that sense of security, they have that sense of each other which may not have taken place in an office of a regular therapist.
Clay: Right. Their guard is off. I will remind all the listeners. I am in New York and you’re going to hear the ambient sounds of New York. My wonderful sound guy tries to wash those away as best he can. But that’s just part of living in New York. You’re going to hear sirens and whistles and the stupid doorman across the street when he blows his whistle when he wants a taxi. I guess that kind of brings me to there are things that we as online therapists have to deal with that regular doctors don’t have to work with. Have you found any particular challenges just with the technology or internet connections or cameras or anything like that?
Patrick: Sometimes, yeah. There are a lot of times. I think it’s the programs themselves or even just the connections. Sometimes you have a little bit of fuzziness. Sometimes you have some freezing. But for the most part, beyond the small things, I have experienced a lot of positive aspects of the technology. However, I have had my share of five minutes before my computer is acting up, and it’s like am I going to be able to fulfill this obligation or not? Usually at the last minute it comes through. But that’s what makes it fun. That’s what makes it interesting.
Clay: Yeah.
Patrick: I’m thinking of one couple in which we went through this session and there was something wrong with their connection. They knew it but they kept the appointment. Every five minutes we would have to call each other. But we were able to get through the appointment. It made it fun, I guess.
Clay: Wow. That’s an interesting way of looking at it. Making it fun.
Patrick: Because we are able to laugh. Believe it or not, it seemed like the computer actually shut off or the program shut off right at the times where it just seemed appropriate. There was a confrontation about ready to take place and bloop!
Clay: Bloop! They’re gone. That’s great.
Patrick: We were able to laugh about it at the end of the hour.
Clay: That’s good. That’s good. I’ve had workarounds where the sound wasn’t working for some reason or I think the husband was in a different location and he couldn’t join because he was on a mobile device. The wife was on Skype with me, and he was on Facetime with her. She would hold his iPhone up to the screen so that I can see him. It was just like there was so many technology and devices going on in one session. But I think the people that are drawn to this are kind of outside the box thinkers. People who use technology know it doesn’t always work and there are some challenges to it.
Patrick: Absolutely. I do find that majority of my clients who have jumped on the online aspect, they are patient with it. They know their way around the computer like you said. It is expected. If need be, we’ll just reschedule if that’s what it takes. At least it’s not preferable.
Clay: Right. I don’t know if you’ve done this, but there have been times where I don’t feel comfortable as a business person taking your money. This connection has been so poor. We’ve not been able to talk. We’re 20 minutes into it and it’s not working. I say, “Look, I’m not going to charge you for this. Let’s reschedule. The technology just shot us in the foot today.” They really appreciate that. Have you done similar?
Patrick: I haven’t had the need to do that as of yet. But I would definitely. If it wasn’t a quality session, if I didn’t feel it was a session which we were able to complete what we have set out to complete, then absolutely. It’s not their fault. It’s not my fault. It’s just an aspect of that’s just the way it is. I would totally support them and let’s just reschedule this and take away the added frustration because we’re here for other purposes, not to fight with the computer.
Clay: Another aspect that I wanted to let people know about your practice is that you work with Christian issues. I guess you would call yourself a Christian marriage counselor, correct?
Patrick: Yes, yes. My Christian faith is very important for me. To have the opportunity to incorporate that into my vocation, my career, it brings my ability to counsel to a higher level. I understand that not all people are interested in the Christian aspect and it doesn’t mean I can’t work with them. But my Christian faith is part of my makeup. It’s been there for years. For me to step out of that sometimes is a challenge. But if the client is not interested, I’m more than capable of working with clients who don’t want that Christian aspect. But I am more comfortable bringing in a Christian aspect to my therapy. I find there’s a lot of great aspects to the Christian faith which support a healthy marriage and support healthy human beings in general which I try to bring to all aspects of my counseling.
Clay: I was fascinated that you had someone contact you. I forget the story but they knew, they particularly chose a Christian person even though they weren’t Christian. Do you remember this?
Patrick: Yes. I worked with a couple and, not giving too much information due to the HIPAA log, I worked with a couple who they themselves were in between —I’m sorry not in between—in the middle of a challenge of two face colliding within their marriage. One was not Christian, not identifying with any religion, and one had just discovered religion. They wanted to meet and look at how they could either bring this into their marriage and find ways to not have it be a wall between them or how to come to the same page. They’re both looking at all opportunities as to incorporate it or even maybe now is not the time to fully bring it into their marriage and maybe hold it enough.
We talked a lot about the aspects of what it meant to have Christianity brought into their marriage and how a lot of it related to what was already existing in their marriage. It wasn’t necessarily something that was going to infiltrate their marriage and ruin them, but how they could use it as a positive even though their beliefs were still not the same.
Clay: Yeah. I had a client, a couple who contact me and they were both Christian, grew up in the Christian faith. One of the reasons I brought you onboard for online marital counseling was to offer that service. When they said they have a strong faith and I don’t offer that in my particular approach, I said, “You should maybe look at Patrick. He’s a therapist that works with us.” They said no, they wanted a secular, non-Christian approach to this, kind of an outsider’s observation of their marriage outside of the faith issue. It’s just fascinating what people are either limited or not limited by their faith or religion and kind of what they’re looking for. I think it’s a very valuable thing that you bring to the table.
Patrick: It’s exciting like I said to be able to offer that. Even to meet people where they are like you said. They were both Christian but they wanted the secular aspect, and even just the opposite way. Even if you are Christian and you’re seeking your Christian counselor, having a choice whether we bring that into the full aspect of the counseling aspect or we know it’s there, we know we’re getting even a Christian philosophy from a counselor but it’s not the focus. Counseling is not centered around. So you do have a lot of room to play with in any aspect of where we really want to go with including our faith or not including our faith into our counseling.
Clay: To be clear, you do both. You bring Christianity into your approach, and then those that that’s not what they want, you don’t.
Patrick: Absolutely. I’m a firm believer that I meet people where they need to be met. I’m not there to say to the client “You should be doing this. You should be doing that in an aspect of faith.” Client creates their own goals. They have desires in where they want to be. I’m just your tour guide to do that.
Clay: Let’s talk a little bit more about the business. We kind of want to be cognizant of your time and wrap up quickly. But tell us a little bit about how you get your name out there, directories, conferences. How do you advertise?
Patrick: It’s been a slow start, but I have begun to reach out to different areas of the country in which there may not be an abundance of counselors. One of the areas that I’m reaching out to are actually the Roman Catholic diocese. I know the Roman Catholic diocese they have usually a list of counselors that they would prefer to send the people of their diocese to. I’ve been reaching out to diocese in Alaska, Iowa, Montana, the areas with small pockets of people but not necessarily large cities or there’s people remote.
I’ve also had the opportunity to attend to conferences in which I was able to network on a one-to-one basis and hand out information regarding this is who I am and my goals and where I want to be able to help people as well as just even using the media itself, working through things like LinkedIn or Facebook, so on and so forth. Also the other programs as to the specialized programs that people are able to seek out online therapists. It’s been a slow start but I feel like I’m getting some people to recognize me. I’ve had three or four diocese that have added me to their list, one being in Montana and one being in Alaska. Just to provide that opportunity for people to have for them a faith-based counselor to be able to speak with.
Clay: It’s a learning curve, isn’t it?
Patrick: It is.
Clay: We didn’t learn this stuff in grad school. We learned about unconditional positive regard and now we’re learning about internet connection speeds and directories and advertising.
Patrick: Absolutely.
Clay: It’s a learning curve. We’ll get there. But I just want to thank you so much for spending your time. I know you’ve got so many things that you’re juggling. I’m just really glad to see you practice growing. Hopefully in a few months we’ll check in and we’ll see how things are.
Patrick: Absolutely. Thank you for giving me this opportunity to speak with you.
Clay: Great, Patrick. Have a great day!
Patrick: You too. Thanks.
Clay: Bye.