August 30, 2025 • 38 mins
What happens when mental healthcare providers themselves become targets of political attacks? How do therapists support marginalized communities while managing their own wellbeing? These questions lie at the heart of our conversation with Abby Cota-Logan, a pioneering force in LGBTQ+ affirming mental healthcare.
Abbey takes us inside Clintonville Counseling and Wellness, a practice she co-founded in Columbus, Ohio that's become a lifeline for transgender and queer clients. From offering free gender-affirming letters to accepting Medicaid despite financial challenges, their commitment to accessibility shines through every aspect of their work.
The conversation reveals the profound impact of sociopolitical factors on mental health. "For the LGBTQ+ community, the personal is political," Abbey explains, describing how legislative attacks create a state of constant hypervigilance among clients worried about losing healthcare, marriage rights, and even custody of their children.
Perhaps most compelling is Abbey's perspective on sustainability in helping professions. The pandemic transformed their approach, reducing daily client loads and emphasizing therapist self-care. Through community-building activities like canoe trips and regular supervision, they're modeling what authentic, joyful mental healthcare can look like.
We explore the business challenges facing small practices—from insurance nightmares to venture capitalist buyouts—and how Clintonville has adapted by diversifying services while maintaining their core mission. Their growth from five clinicians to over twenty without any marketing speaks to the desperate need for their services.
Whether you're a mental health professional, someone seeking affirming care, or simply interested in how healthcare adapts to societal challenges, this conversation offers valuable insights on creating brave spaces where healing can flourish despite external pressures.
Guest Biography and Contact Details
Abbey Carter Logan, MA, LPCC-S is a Supervising Professional Clinical Counselor and the Co-Executive Director of Clintonville Counseling and Wellness in Columbus, Ohio. As a queer-affirming clinician and community leader, Abbey is deeply committed to creating inclusive, trauma-informed spaces for LGBTQ+ individuals. She co-leads a thriving group practice focused on accessible, gender-affirming care and also plays a key role in training the next generation of mental health professionals through internships, supervision, and continuing education. Her work blends clinical excellence with advocacy, joy, and community healing.
Title: Co-Executive Director & Co-Owner, Clintonville Counseling and Wellness
Location: Columbus, Ohio
Website: https://clintonvillecounselor.com
Email: abbey@clintonvillecounselor.com
Phone: +1 614-948-7300
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr Andrew Greenland (00:02):
Welcome to Voices in Health and Wellness,
where we connect withtrailblazers across the US who
are shaping the future of care,mental health and integrative
well-being.
I'm your host, dr Andrew Green,and today's guest is someone
who truly embodies a commitmentto both clinical excellence and
community-centered leadership.
Joining us is Abbey Cota-Logan,a supervising professional
clinical counselor andco-executive director and
(00:24):
co-owner of ClintonvilleCounselling and Wellness, based
in Columbus, ohio.
Abby brings a depth ofexperience in both direct
clinical care and organisationalleadership, and she also plays
a key role in training andmentoring future mental health
professionals.
So, abby, welcome and thank youvery much for coming on this
afternoon.
Abbey Carter Logan (00:41):
Oh, thank you for having me.
It's really nice to on thisafternoon.
Oh, thank you for having me.
It's really nice to and weirdto hear all that.
So thank you for theintroduction.
Dr Andrew Greenland (00:49):
You're welcome and are you in Ohio at
the moment?
Are you calling from Ohio?
Abbey Carter Logan (00:53):
Yes, I am.
I'm in Columbus, ohio and,matter of fact, in our community
called Clintonville, which iswhy we're Clintonville
Counseling and Wellness, and I'min the office while people are
seeing clients.
Dr Andrew Greenland (01:04):
Okay, well, maybe we could start there.
Could you talk a little bitabout your role at Clintonville
and your vision for establishingthe practice?
That'll be really interestingfor us to hear.
Abbey Carter Logan (01:13):
Yeah, absolutely, and I think, before
I can talk about any of that, Ireally want to acknowledge my
positionality and the power thatcomes with that by even sharing
my pronouns.
Are she her?
I am a queer woman, yet I amalso a white cisgender woman
married to a man, so I carry animmense amount of power and
(01:35):
privilege everywhere I go, whenI walk into a room, and I think
it's really important for me toacknowledge that I view the
world through that lens, butalso I am working with folks who
have a totally different lensthat I learn from every day.
So that is part of the basis ofwho I am and also who community
(02:17):
and cover a whole wide range ofsexual identity and gender
identities.
The communities just gettreated differently in health
and wellness care.
That doesn't understand how todo affirming care.
We see a lot of LGBTQ friendlyor, you know, we accept all
(02:38):
LGBTQ folks, but we're not, wedon't always hear LGBTQ
affirming, which is reallyimportant to us and gender
affirming practices so thatpeople know that they belong
here.
So you know, part of our visionis providing that space for the
community to come in and seethemselves reflected in the
(02:59):
artwork, even in the furnitureand the plants and I know that
sounds a little weird, but itmatters.
Clients walk in here and theysay I feel safe, I feel seen,
which is so important in themental health field anyway, but
particularly with thispopulation Part of our vision.
(03:22):
From starting and interrupt meanytime because I could talk for
(03:56):
hours about this she was seeingtrans clients and working with
the transgender community andrealized there weren't enough
affirming therapists in Columbusand really not enough people
who understood how to providegender affirming care.
So she started the practice inDecember of 2016, and I promptly
joined post-parental leave inFebruary of 2017.
And we have really created thisbeautiful training program and
we have an internship and weoffer gender-affirming letters
(04:16):
to the community for free andthose letters are what the
health care standards requirefor folks to get medical
procedures.
The health care standardsrequire for folks to get medical
procedures.
Although many trans and queerfolks are interested in medical
procedures, that is a big partfor some.
Our whole goal in that is toreduce gatekeeping and keeping
(04:37):
people from receiving the carethey need to live their best
life.
So we really our vision when westarted was to be a leader in
the queer community for mentalhealth, and I feel very proud of
that.
I feel like we've grown fromfive people who started a
practice and thought we werejust going to have fun and add,
(04:58):
you know, have a service, andthat was greatly needed to now
we have more than 20 full timetherapists and directors.
We have a program and culturedirector and a clinical director
and administrative director sothat we can build more structure
for more queer and transtherapists to see queer and
(05:20):
trans folks.
Dr Andrew Greenland (05:22):
No, no, thank you.
Thank you.
Very interesting to see queerand trans folks.
No, no, thank you, thank you.
Very interesting, I was goingto ask.
So 2016 is when you started.
How has your vision changedsince those early days?
Obviously, you've grown a lot,but is there anything about your
vision for how this has allpanned out?
Has that changed at all?
Abbey Carter Logan (05:36):
Oh yeah, yeah, it's changed a lot.
I think when we started wereally wanted well, I don't know
if fully cooked is the rightword, but we wanted experienced
therapists who'd been in thefield for a long time and really
at that time those were theonly people going into private
practice.
That you know.
You had a lot of experience incommunity mental health or in
(05:58):
bigger agencies, and then yougraduate to private practice and
since I would say since COVIDmore and more folks are
graduating from graduateprograms and going straight into
private practice.
So we went from five you knowmore seasoned clinicians to now
(06:19):
we have a lot of youngerclinicians and seasoned
clinicians because we're reallyworking together for that mutual
transformation andunderstanding what's happening
in the community, becausethere's a lot and also that
clinical piece and teaching eachother.
So then we created a continuingeducation program.
(06:44):
Then we created a continuingeducation program.
So we have we providecontinuing education to both
providers and then also thecommunity at large, so that
there's more understanding ofgender affirming care and
transgender people in general.
You know they're, and I'veheard, anywhere from one to 4%
of the population in the UnitedStates and probably globally.
(07:05):
So people don't know how towork with them and, honestly, in
this country and probablyabroad too, people don't know
how to recognize that they'rejust human beings, that we, we
just treat human beings whohappen to be transgender and
(07:27):
queer and part of the LGBTQcommunity.
So I think that we're justtraining more clinicians and
then part of the Continuing Edprogram is to do that across the
state of Ohio and nationally,so that we're not just it's not
(07:48):
just our clinicians who arelearning, but we're spreading
the word to the community.
We also added an internshipprogram, we've added a
queer-centered ADHD testing,because it looks different in
queer people and the traditionaltestings don't always work in
the same way and we're about toadd an autism testing program
(08:11):
and, of course, our genderaffirming letters program, which
is free.
So we just said we've grownthese more programs to support
the community and also tosupport our staff, because
therapists in general, I think,get really burnt out if they're
just seeing client after clientafter client after client and
especially for our clinicianswho are also queer or trans or
(08:35):
both, they're hearing theirstory reflected back at them 24
hours a week, back at them 24hours a week.
So you know, you had, when wewere communicating, you had
talked about burnout and I thinkthat not only are clinicians
feeling that burnout but alsoour clients are feeling that
(08:57):
burnout because for the LGBTcommunity the personal is
political.
The political is personal,especially in the United States
right now, where there isconstant rapid succession of
executive orders attacking thecommunity, new laws attacking
the community, the Supreme Court, taking away rights and you
(09:23):
know that's easy for cisgender,heterosexual people to do
because they don't realize howthe impact, the incredible
impact this has on our lives,healthcare and literally taking
away healthcare, wond, wonderingif your marriage, equality
(09:46):
rights are going to get strippedaway, so many more things like
do I have to leave the country?
Are my kids going to get takenaway?
And all of that is coming downfrom the federal level and being
reflected at the state levelhere in Ohio and the amount of
stress that that causes.
(10:07):
I mean, let alone treating themental health concerns.
The mental health concerns areall exacerbated by those
sociopolitical factors thatreally it's really hurting our
community and so it's feltreally by the clinicians and the
clients alike.
(10:27):
But I also I think ithighlights both this shared
struggle and the shared strengththat the community has, because
as we come together we canpractice rest and self-care and
joy and really experiencing thatas a community, because this
(10:49):
stuff doesn't get to take ourwhole lives.
We can't live engulfed intragedy all the time.
It's just coming at us.
So we have to find our joy andcelebrate that together as a
community, so that we're justnot I mean comatose.
Dr Andrew Greenland (11:09):
So it sounds like you're creating
movement, but let's go back tothe nitty gritty of the day to
day.
What does a typical day looklike for you at the moment,
between seeing clients, leadingthe organization, managing your
training programs?
Abbey Carter Logan (11:20):
Okay, it's changed a little bit because our
director roles are new in 2025,which is a direct impact of
feedback that we receive fromour clinicians and our clients
of needing additional support,where I supervise more of the
(11:49):
clinical programs and my partnersupervises more of the outreach
programs, the culture programsinternally and the training
program.
So I'm working a lot with ourclinical director daily right
now to solve problems, consultwith clinicians, make sure that
everybody knows what their roleis and the clear lanes so that
they can feel supported by that.
(12:10):
So I write a lot of policy andprocedure and I talked to a lot
of people in the community and Iattend a monthly meeting called
the LGBTQ Roundtable of CentralOhio, where it's just
professionals from media.
We have a great publicationcalled the Buckeye Flame.
(12:31):
Here in all of Ohio we haveleaders who've been leading the
community for decades, differentorganizations like Equality
Ohio I apologize because I can'tname them all and I really want
to, but it's just a reallygreat community, so I'm part of
that.
(12:51):
I meet with other group practiceowners because it's really
important to me, now more thanever, to protect the
sustainability of our businessand make sure that we are here
to not only for our clients butfor our clinicians, and so I do
a lot of that and I also seeclients.
(13:14):
So I see very few clients.
I have about six appointments aweek on my schedule.
Some get filled, some don't.
I supervise clinicians.
I'm also, you know, trying tostay up to date on all of the
current events and protocols andways to approach therapy so
(13:38):
that I don't fall behind.
Especially as a leader of aplace, you need to be on top of
that.
And then there's theadministrative, like financial
decisions.
So we have an amazingadministrative director who does
all of our bookkeeping,insurance, credentialing and so
(13:59):
many more things like managesour benefits for our clinicians,
and we meet with Emily and I,my partner, meet with him weekly
to really manage what's goingon financially, our payroll,
what's happening with insurancecompanies, because that is a
whole nother topic in the UnitedStates right now.
Dr Andrew Greenland (14:27):
So I don't cry um every person I've spoken
to in north america that is oneof the major bottlenecks and
irritations, so it's interestingthat yet again, you're
affirming this.
Abbey Carter Logan (14:39):
I'm hearing from everybody it's just
infuriating um reimbursementschanging sometimes.
Sometimes they're sayingactually we're going to pay you
less as our economy is gettingmore and more expensive.
They are denying claims, whichthey've always done.
Sometimes they'll take backmoney after they paid you and
(15:00):
said oh, actually we changed ourrates in January, so we're
going to take back thousands ofdollars that we already paid you
.
Or this person had secondaryinsurance, so we're going to
take all of the money back andhave Medicaid pay for it.
But Medicaid is getting strippedright now in our country.
So it's just a lot.
(15:21):
It's a lot to manage all ofthat, especially when you serve
a marginalized population,because here in Ohio, a lot of
the people that we serve have tobe on Medicaid.
It might be their only option,and we're not willing to stop
taking it because we want toprovide accessibility for our
people.
(15:41):
So we're keeping an eye on that.
So that's a big part of my job.
And then, of course, likeadding benefits for clinicians
and making sure that it'ssustainable for them and trying
to think about how we can offermore benefits but not offer them
too early, before they're allfigured out.
So you talked aboutadministrative overload in your
(16:02):
email, so there it is.
Dr Andrew Greenland (16:06):
Outside of your clinic?
What are you seeing in themental health space more
generally?
Whether that's sort of clinicalissues, operational issues or
more systemic issues in societyin general.
Abbey Carter Logan (16:16):
Yeah.
So there's a couple of thingsthat are really big that are
happening out there.
One of the biggest things, inaddition to insurance barriers,
is venture capitalists and eveninsurance companies are buying
small private practices.
So this small private practicemodel that we're operating under
(16:38):
and a lot of other placesthey're getting bought out for a
large amount of money.
But then it really impacts theintegrity of that counseling
because there's differentapproaches and they're also
snatching up therapists who saywell, actually they're going to
pay me three times more, so Ihave to go.
(17:00):
So it makes it a little scaryfor small private practice.
People are really having todiversify their services in
order to survive, becauseinsurance companies are not.
I mean, they're our bread andbutter, but we're not going to
survive on those payments.
One I really want to highlightoh, it really this breaks my
(17:20):
heart People using AI as acounselor.
The AI is not trained in safetyand legal and ethical practice.
It's not a counselor.
It has no idea how to do that.
And sadly here the story justcame out that a minor actually
ended his own life because chatGPT told him to and they said
(17:45):
they have safeguards because ifsomeone says I want to commit
suicide, then they'll say here'sthe hotline.
But this kid had a month's longrelationship with AI and so it
got convoluted.
The AI helped him write asuicide note to his family and
helped him negotiate ways to doit.
(18:06):
It's just really, really it'smaddening and so sad and so
scary, so we're trying to lookout for that.
I actually have a colleague inBarcelona who's creating her own
chat GPT to train it with ourlegal and ethical standards
because we got to get on thetrain.
Dr Andrew Greenland (18:30):
I don't want to be the person who
creates that, but I'm obviouslygiving an example of a very,
very tragic case, but can yousee any value in something that
gives a bit of accessibility topeople that might not be able to
access professional help, ifthey can at least have a
starting point with somethinglike an AI tool obviously not
(18:50):
the one that you've justdescribed, because there weren't
safeguards in place, butsomething which was properly
programmed, tested, tried,safeguarded?
What do you think?
Abbey Carter Logan (19:00):
Yeah, I mean , I think that's exactly what my
colleague out in Barcelona istrying to do is to help people,
provide them hope and someclearer, more professional
advice that they can actually goto and say, ah, I'm feeling
anxiety, what are my options?
And then I think that you couldgo in and say I'm in Columbus,
(19:24):
ohio, I am closeted, gay andscared, who can I see?
And then it would bring themhopefully to us or another
practitioner, who's queer,affirming so things like that.
But I think people don't knowhow to ask the right questions.
(19:45):
My experience at least with AIis you have to write really
pointed questions like is thismessage clear, concise and
compassionate?
That's a prompt I use a lot toput my own message in and just
ask is this working?
And I don't think that peopleare asking kind of clear
(20:06):
questions.
They're really going to AI as,like, a relationship.
So if the relationship could bemore professional as opposed to
just shooting out random thingspulled from the internet maybe
(20:30):
that's not a very well thoughtout question I think I'd have to
sit with that some more toreally answer it Okay.
Dr Andrew Greenland (20:35):
And what changes are you seeing in the
client needs or expectations ofthose coming to your clinic
since the pandemic, and how areyou and your colleagues adapting
to these changes?
Abbey Carter Logan (20:45):
the pandemic ?
That's a great question.
We actually didn't dotelehealth prior to the pandemic
and here in columbus, ohio, welocked down on march 13th.
I remember that date clearlybecause my three-year-old
stopped taking naps on that dayand my partner and I said we're
(21:08):
not going to survive if we don'tcreate this telehealth platform
for our business.
So we took the weekend, wewrote a telehealth manual.
We had lots of other businessowners and practitioners
collaborating to make thishappen.
Thankfully, we have a EHRsystem that integrates it, so it
wasn't hard for us to get it upand running.
We have a EHR system thatintegrates it, so it wasn't hard
for us to get it up and running.
By Monday we were doingtelehealth sessions and I think
(21:31):
it was a big learning curve forclinicians who weren't providing
that prior to.
The pandemic.
Sessions were different.
The body language is differentwhen you can only see this far
up, and body language is a bigpart of mental health.
When people are more nervousand I'm sure you experienced
this in your practice toothere's so much you can get from
(21:52):
the body language of a personand we had to learn how to do
that.
Also, it's exhausting to be ona screen to see eight clients a
day, most of our clinicians,including myself.
Eight clients a day online mostof our clinicians, including
myself.
Eight clients a day online itjust is so draining Went down to
really five feels like the max.
When I was trained I did eight,nine, sometimes 10 clients in a
(22:23):
day, nothing but a granola barfor lunch in between and that
mm-mm.
That's not.
That cannot, no way.
You will burn out immediatelyif you work that old way.
So I think five clients max hasbeen a big change.
I think there's a lot moreemphasis on self-care and taking
time to really nourish andground yourself outside of your
work and ground yourself outsideof your work Because I think
(22:47):
what we learned during thepandemic too is you know, when
we're going through thatcollective trauma altogether,
you have the whole new skill ofgoing through something that big
with the clients who you'reholding space for and you're
processing simultaneously.
That's a whole different skillthat we weren't taught in
(23:10):
graduate school.
So we had to learn in real timeand I think, particularly with
our clients, their expectationsof that, I think, are different
with the community we work with,especially because that's still
happening for us, we're stillin a major collective trauma,
(23:32):
not that the pandemic is notstill impacting everyone,
because it is but I think theglobal political climate right
now, especially in the UnitedStates, is really impacting us
so much more.
So we really, I think forclients, the expectations is
(23:53):
having a safe space or a bravespace, a space where they can
come in and process, because thechanges are happening in rapid
succession and I don't think Idon't see that slowing down, so
they need time.
I think that the emphasis in ourfield has been more on
self-care.
In fact, the NASW of Ohio wroteit into their ethical code that
(24:16):
you have to integrate self-careinto your practice for yourself
.
But yeah, I think a lot ofpeople working in other
environments don't have that.
So their expectation is to havethat for one hour once a week
or twice a month, that theyreally have that space where
(24:36):
they can flop on the floor andcry or process what's happening,
the fear and uncertainty ofwhat's going to happen to their
lives, because they're reallythey're fighting for their lives
right now, every day, and it'shyper alert.
I listened to another one ofyour podcasts talking about the
cortisol steal and that'shappening.
So, yeah, I don't know if thatanswers your question.
(25:02):
No, it does.
Dr Andrew Greenland (25:03):
Thank you.
It's interesting perspective onthe pandemic, interesting about
the fact that eightappointments online were more
draining than eight appointmentsperhaps in person, which is
probably a little feels a littlecounterintuitive to some people
because you might think, well,if you're in a room with
somebody there may be moretransference of what's going on
with them and it might be moreof a strain.
But it's interesting that yousay that strain on the therapist
comes through even onlinetherapist comes through even
(25:25):
online.
Yeah, so I was going to ask youwhat's working really well for
you and your colleagues in theclinic and what sort of systems
or approaches are really reallyclicking with you and your
clients.
Abbey Carter Logan (25:38):
That's a great question.
Let me sit with that for aminute.
So I do think what's working isauthenticity.
I think, especially in clinicalmental health setting, it's
really the changes come from therelationship.
It's not about the approach.
It's more about relationshipwith your therapist and your
(26:00):
therapist's perspective being amodel of a regulated nervous
system.
So we have to bring our calm tothis.
If we don't bring our calm andwe're in panic with our clients,
their mirror neurons are goingto match that and they're
already in panic.
So our job really right now isto be the calming presence while
(26:24):
holding space for them to freakout and then mirror us.
Dr Andrew Greenland (26:29):
if that makes sense, yeah, uh, so we
have to really hold that groundjust talking about in general
what's working well for you andyour colleagues in the clinic
yes, yeah.
Abbey Carter Logan (26:41):
so self-care and rest, I think is working
really well when we can take it.
Um, we went on a canoeing tripa couple of weeks ago and just
had fun together.
I think that having fun andjoyful, the clinicians we went
on this canoe trip and partnerscould come and really building
that community.
(27:02):
I think community is the bigpiece of it is that we have
shared community.
Community is the big piece ofit is that we have shared
community and we have a weeklysupervision group for folks who
are dependently licensed, whichis kind of like oh, what's the
word I'm looking for?
It's just their traininglicense, so they're licensed,
but they're getting supervision.
(27:22):
They have a weekly meeting.
We have a lot more supervisionthan most private practices
provide.
Because we want that support andcommunity, we just hired a
couple of new clinicians and wehad a pizza party and everybody
came and ate pizza.
We laugh together and I thinkthe more genuine and authentic
(27:44):
we can be together, the more wecan show up for our clients.
So that's working.
I do think joy is a huge thingright now.
That's working if we can findit, and what I've been working
with with my clients is what are?
What are the glimmers or thesparkles, because there's so
much shit it could just you justcover the whole thing, but
(28:08):
there are sparkles in there.
What are the?
What are the micro moments thatare happening in your life that
you can really sit with andsavor, that nourish you, um, and
really build up that sense ofjoy in their lives, because
without joy we won't survivetrue, and on the flip side,
(28:30):
what's sort of been the mostfrustrating or challenging
lately in the day-to-dayoperations of your practice?
I actually wrote this outbecause it is really hard, I
think, um, to survive as apractice, especially an
insurance-based practice, we dohave to diversify our services,
(28:50):
but we also have to create thetime, the labor, the space, the
money to do that.
While we are still seeingclients fostering a work culture
and community supervising theclinical work of practitioners
while fostering their well-beingin the workplace and also
(29:17):
looking at the global and thefederal and the state and the
city changes that are happening,it's so hard.
That's not even the financialpieces and the legal and the
ethical pieces.
Yeah, I think that it's reallyreally frustrating and hard to
be serving our own communitywhile they're going through it
and also trying to create morejoy and love and community to
(29:42):
bolster each other, and thatpart's not frustrating.
But having the time, the moneyand the space to part's not
frustrating.
But having the time, the moneyand the space to do that is
frustrating.
Dr Andrew Greenland (29:53):
If you had a magic wand that could fix one
thing in your business overnight, what would that be?
Abbey Carter Logan (29:59):
Probably increasing our pay and getting
PTO, Because the way we're paidby insurance we actually
currently cannot offer PTO.
We offer unlimited take thetime you need off, but it's not
paid.
If I could give all my peoplefour to six weeks of paid time
off and give them more money, Iwish I could pay them all a
(30:24):
million dollars, because whatthey're doing matters so much
agreed.
Dr Andrew Greenland (30:31):
I'm going to ask you.
So I don't know, is anybodyelse doing what you do locally
or more nationally in the states, because you obviously have a
very sort of niche interest withthe queer and transgender
community?
Is anybody else taking this onas a kind of a specialist clinic
sort of thing, and does thatmean that you're exceptionally
busy because everybody's beingdrawn towards what you do with
(30:54):
your approach?
Abbey Carter Logan (30:57):
I would say in in our local community
there's a lot of solopractitioners doing what we're
doing in terms of treating thetrans and queer community.
We're so grateful for them.
Many of them started offworking here and have gone off
and started their own things, sothere are solo practitioners
doing it.
There are a few privatepractices who are smaller than
(31:20):
us doing this work.
So, yes, we're very busy andwe're one of the only ones that
take Medicaid um, becauseclinicians can't survive on the
reimbursement for Medicaid,especially, you know, trying to
create accessibility and theypay you less for telehealth
sessions, but that I don't wantto digress into that Um, but uh,
(31:43):
of course I lost my train ofthought when I digressed into
that cause it makes me so angry.
What was the question?
Dr Andrew Greenland (31:51):
again, Just talking about you having this
niche sort of interest in what?
You do and whether you know,being one of the few people that
do this, mean that you have asort of massive following
massive demand for your services.
Abbey Carter Logan (32:05):
I'm just kind of curious to get a sense
of what's going on in this spacemore nationally, yeah yeah,
there is a clinic that's hereand also I believe they're in
Pittsburgh called CentralOutreach and that's a health
clinic health clinic that'sdoing this work for general
health, pcp kind of stuff andhormones and those kinds of
(32:27):
things, and and we have a directpartnership with them so they
can just refer us peopleregardless if we're on a wait
list, we'll we'll prioritize ourpeople and get them in as
quickly as we can.
Um.
I know nationally there areother practices doing this Um
and it really varies state tostate how they're doing it, but
(32:50):
locally and in the state of Ohiothere's few of us.
There are some.
Cleveland, cincinnati, some ofthe bigger cities have other
practices that are doing whatwe're doing.
Dr Andrew Greenland (33:01):
So I mean, if you had a massive surge of
referrals next week, what wouldbe the first thing that would
break or strain or put theclinic under pressure?
Abbey Carter Logan (33:11):
That's a great question.
So we do constantly have a waitlist because there is a lot of
demand for our services andright now we just hired five new
people since May.
No six because we have anotherone starting in October.
So that is, for now, takingcare of that.
(33:33):
But if we had an influx ofpeople I think we could handle
it up to 100 people.
We used to have a waitlist of100 people all the time.
We don't currently because wehave those new clinicians, but
that's not always going to work.
So that's really why we formthose community partnerships, so
(33:54):
we have people we trust torefer to.
I'm not really thinking aboutwhat would break us, because
I've been thinking so hard aboutwhat will sustain us and keep
us going and keep our doors open.
I don't want to think aboutwhat would break us, but you
know, if all these people camein and they didn't have
insurance and Medicaid getsbusted and they need pro bono
(34:17):
services.
We have a big heart.
We offer a lot of sliding feescale when we can, but we also
have to sustain the business sothat it sustains our clinicians.
Dr Andrew Greenland (34:33):
So it's a tricky balance.
Of course, I think I was comingfrom the kind of the nice
problem to have if you had thismassive influx of patients who
could afford what they needed toafford for the service.
It always sounds like a niceproblem until you can't
necessarily you have theinfrastructure to cope with it.
I just wonder if there'sanything that would stop you
from coping with a massiveinflux.
Now I have to sit with thisbecause I it was just more of a
(34:58):
rhetorical question, I guess.
Abbey Carter Logan (34:59):
I know I really want to sit with that and
think about that, because Ithink we would, because I think
we would one.
We're just hiring people asmuch as we can.
We're going to run out of spaceeventually and have to get more
(35:23):
space to house and see moreclients.
Yeah, you know it's interestingtoo, dr Greenland.
We've never marketed ourservices.
We've never had to, because mybusiness partner was so well
known in the community thatpeople have been sending us.
We know a lot of the medicalpractitioners who work with the
queer and trans community and wehave this waitlist simply by
word of mouth, which is wild.
So when we do start marketing,that might happen, which is wild
(35:48):
.
Dr Andrew Greenland (35:48):
So when we do start marketing, that might
happen.
Okay, looking back, if you wereto start Clintonville
counseling all over again, isthere anything that you would do
differently from the beginningbased on, you know, your
knowledge and experience ofdoing this for a number of years
?
Abbey Carter Logan (35:59):
Mm.
Hmm, I think I would have had abusiness plan.
Business plan, you know, we'repractitioners, we're not
business people.
And yeah, I would.
I would have maybe studied upon business more and had a
(36:21):
business plan Also.
I think I would have alsogotten more leadership training,
because as a leader, I had noidea how much of my own stuff
would be reflected in how I ledother clinicians.
I'm a person who doesn't reallylike authority, so it was
really hard to be in a positionof authority, and so I had.
(36:41):
There's a great organizationhere called the Ohio Rest
Collective, who I have gottenleadership coaching from, and I
also work with a level upleaders coaching.
I wish I would have known aboutthem.
The day I started here, I alsodidn't realize that I was going
to have to be such a leader, soI wish I would have known that
(37:02):
too.
Dr Andrew Greenland (37:05):
And finally , looking ahead to the next six
of six or twelve months, whatare you most excited about?
Do you have any particulargoals that you and your team are
working towards?
Abbey Carter Logan (37:13):
yeah, I am most excited about offering more
programs, more support groupsuh, we have a dungeon dragons
therapeutic group and buildingon those kind of things, more
creative ideas.
I think we finally have thespace to get really creative
with the programming we offerthat can really be queer
centered.
I'm also really excited aboutour new leadership structure
(37:36):
because it allows me to reallylook at the bigger picture and
be able to do this podcast withyou and things like that get our
name out there in other waysand also having positions for
folks to step into so thatclinicians aren't just seeing
clients but they get to beclinical directors or lead
(37:58):
clinicians, because I think thatmakes them feel better and when
they feel better and moregrounded, they're better able to
give really excellent clinicalwork and support to their
clients.
And so I'm excited about that.
And I'm excited about thecommunity building aspect and
being able to do more in thecommunity but also provide that
(38:18):
community for our clients hereat Clintonville Counseling and
Wellness.
Dr Andrew Greenland (38:22):
Amazing.
Abby, thank you so much foryour time this afternoon.
It's been really interestinglyinspiring hearing about what you
do, your approach.
You're offering somethingreally special for your people.
So I'm really grateful fortalking to me this afternoon,
really appreciate it.
Abbey Carter Logan (38:35):
Oh, thank you so much, dr Greenland.
I appreciate talking with you.
I just love talking about this,so it made me really happy to
sit here with you and Iappreciate all your kind words.
Dr Andrew Greenland (38:45):
Wonderful Thank you.
Welcome to Voices in Health and Wellness,
where we connect withtrailblazers across the US who
are shaping the future of care,mental health and integrative
well-being.
I'm your host, dr Andrew Green,and today's guest is someone
who truly embodies a commitmentto both clinical excellence and
community-centered leadership.
Joining us is Abbey Cota-Logan,a supervising professional
clinical counselor andco-executive director and
(00:24):
co-owner of ClintonvilleCounselling and Wellness, based
in Columbus, ohio.
Abby brings a depth ofexperience in both direct
clinical care and organisationalleadership, and she also plays
a key role in training andmentoring future mental health
professionals.
So, abby, welcome and thank youvery much for coming on this
afternoon.
Abbey Carter Logan (00:41):
Oh, thank you for having me.
It's really nice to on thisafternoon.
Oh, thank you for having me.
It's really nice to and weirdto hear all that.
So thank you for theintroduction.
Dr Andrew Greenland (00:49):
You're welcome and are you in Ohio at
the moment?
Are you calling from Ohio?
Abbey Carter Logan (00:53):
Yes, I am.
I'm in Columbus, ohio and,matter of fact, in our community
called Clintonville, which iswhy we're Clintonville
Counseling and Wellness, and I'min the office while people are
seeing clients.
Dr Andrew Greenland (01:04):
Okay, well, maybe we could start there.
Could you talk a little bitabout your role at Clintonville
and your vision for establishingthe practice?
That'll be really interestingfor us to hear.
Abbey Carter Logan (01:13):
Yeah, absolutely, and I think, before
I can talk about any of that, Ireally want to acknowledge my
positionality and the power thatcomes with that by even sharing
my pronouns.
Are she her?
I am a queer woman, yet I amalso a white cisgender woman
married to a man, so I carry animmense amount of power and
(01:35):
privilege everywhere I go, whenI walk into a room, and I think
it's really important for me toacknowledge that I view the
world through that lens, butalso I am working with folks who
have a totally different lensthat I learn from every day.
So that is part of the basis ofwho I am and also who community
(02:17):
and cover a whole wide range ofsexual identity and gender
identities.
The communities just gettreated differently in health
and wellness care.
That doesn't understand how todo affirming care.
We see a lot of LGBTQ friendlyor, you know, we accept all
(02:38):
LGBTQ folks, but we're not, wedon't always hear LGBTQ
affirming, which is reallyimportant to us and gender
affirming practices so thatpeople know that they belong
here.
So you know, part of our visionis providing that space for the
community to come in and seethemselves reflected in the
(02:59):
artwork, even in the furnitureand the plants and I know that
sounds a little weird, but itmatters.
Clients walk in here and theysay I feel safe, I feel seen,
which is so important in themental health field anyway, but
particularly with thispopulation Part of our vision.
(03:22):
From starting and interrupt meanytime because I could talk for
(03:56):
hours about this she was seeingtrans clients and working with
the transgender community andrealized there weren't enough
affirming therapists in Columbusand really not enough people
who understood how to providegender affirming care.
So she started the practice inDecember of 2016, and I promptly
joined post-parental leave inFebruary of 2017.
And we have really created thisbeautiful training program and
we have an internship and weoffer gender-affirming letters
(04:16):
to the community for free andthose letters are what the
health care standards requirefor folks to get medical
procedures.
The health care standardsrequire for folks to get medical
procedures.
Although many trans and queerfolks are interested in medical
procedures, that is a big partfor some.
Our whole goal in that is toreduce gatekeeping and keeping
(04:37):
people from receiving the carethey need to live their best
life.
So we really our vision when westarted was to be a leader in
the queer community for mentalhealth, and I feel very proud of
that.
I feel like we've grown fromfive people who started a
practice and thought we werejust going to have fun and add,
(04:58):
you know, have a service, andthat was greatly needed to now
we have more than 20 full timetherapists and directors.
We have a program and culturedirector and a clinical director
and administrative director sothat we can build more structure
for more queer and transtherapists to see queer and
(05:20):
trans folks.
Dr Andrew Greenland (05:22):
No, no, thank you.
Thank you.
Very interesting to see queerand trans folks.
No, no, thank you, thank you.
Very interesting, I was goingto ask.
So 2016 is when you started.
How has your vision changedsince those early days?
Obviously, you've grown a lot,but is there anything about your
vision for how this has allpanned out?
Has that changed at all?
Abbey Carter Logan (05:36):
Oh yeah, yeah, it's changed a lot.
I think when we started wereally wanted well, I don't know
if fully cooked is the rightword, but we wanted experienced
therapists who'd been in thefield for a long time and really
at that time those were theonly people going into private
practice.
That you know.
You had a lot of experience incommunity mental health or in
(05:58):
bigger agencies, and then yougraduate to private practice and
since I would say since COVIDmore and more folks are
graduating from graduateprograms and going straight into
private practice.
So we went from five you knowmore seasoned clinicians to now
(06:19):
we have a lot of youngerclinicians and seasoned
clinicians because we're reallyworking together for that mutual
transformation andunderstanding what's happening
in the community, becausethere's a lot and also that
clinical piece and teaching eachother.
So then we created a continuingeducation program.
(06:44):
Then we created a continuingeducation program.
So we have we providecontinuing education to both
providers and then also thecommunity at large, so that
there's more understanding ofgender affirming care and
transgender people in general.
You know they're, and I'veheard, anywhere from one to 4%
of the population in the UnitedStates and probably globally.
(07:05):
So people don't know how towork with them and, honestly, in
this country and probablyabroad too, people don't know
how to recognize that they'rejust human beings, that we, we
just treat human beings whohappen to be transgender and
(07:27):
queer and part of the LGBTQcommunity.
So I think that we're justtraining more clinicians and
then part of the Continuing Edprogram is to do that across the
state of Ohio and nationally,so that we're not just it's not
(07:48):
just our clinicians who arelearning, but we're spreading
the word to the community.
We also added an internshipprogram, we've added a
queer-centered ADHD testing,because it looks different in
queer people and the traditionaltestings don't always work in
the same way and we're about toadd an autism testing program
(08:11):
and, of course, our genderaffirming letters program, which
is free.
So we just said we've grownthese more programs to support
the community and also tosupport our staff, because
therapists in general, I think,get really burnt out if they're
just seeing client after clientafter client after client and
especially for our clinicianswho are also queer or trans or
(08:35):
both, they're hearing theirstory reflected back at them 24
hours a week, back at them 24hours a week.
So you know, you had, when wewere communicating, you had
talked about burnout and I thinkthat not only are clinicians
feeling that burnout but alsoour clients are feeling that
(08:57):
burnout because for the LGBTcommunity the personal is
political.
The political is personal,especially in the United States
right now, where there isconstant rapid succession of
executive orders attacking thecommunity, new laws attacking
the community, the Supreme Court, taking away rights and you
(09:23):
know that's easy for cisgender,heterosexual people to do
because they don't realize howthe impact, the incredible
impact this has on our lives,healthcare and literally taking
away healthcare, wond, wonderingif your marriage, equality
(09:46):
rights are going to get strippedaway, so many more things like
do I have to leave the country?
Are my kids going to get takenaway?
And all of that is coming downfrom the federal level and being
reflected at the state levelhere in Ohio and the amount of
stress that that causes.
(10:07):
I mean, let alone treating themental health concerns.
The mental health concerns areall exacerbated by those
sociopolitical factors thatreally it's really hurting our
community and so it's feltreally by the clinicians and the
clients alike.
(10:27):
But I also I think ithighlights both this shared
struggle and the shared strengththat the community has, because
as we come together we canpractice rest and self-care and
joy and really experiencing thatas a community, because this
(10:49):
stuff doesn't get to take ourwhole lives.
We can't live engulfed intragedy all the time.
It's just coming at us.
So we have to find our joy andcelebrate that together as a
community, so that we're justnot I mean comatose.
Dr Andrew Greenland (11:09):
So it sounds like you're creating
movement, but let's go back tothe nitty gritty of the day to
day.
What does a typical day looklike for you at the moment,
between seeing clients, leadingthe organization, managing your
training programs?
Abbey Carter Logan (11:20):
Okay, it's changed a little bit because our
director roles are new in 2025,which is a direct impact of
feedback that we receive fromour clinicians and our clients
of needing additional support,where I supervise more of the
(11:49):
clinical programs and my partnersupervises more of the outreach
programs, the culture programsinternally and the training
program.
So I'm working a lot with ourclinical director daily right
now to solve problems, consultwith clinicians, make sure that
everybody knows what their roleis and the clear lanes so that
they can feel supported by that.
(12:10):
So I write a lot of policy andprocedure and I talked to a lot
of people in the community and Iattend a monthly meeting called
the LGBTQ Roundtable of CentralOhio, where it's just
professionals from media.
We have a great publicationcalled the Buckeye Flame.
(12:31):
Here in all of Ohio we haveleaders who've been leading the
community for decades, differentorganizations like Equality
Ohio I apologize because I can'tname them all and I really want
to, but it's just a reallygreat community, so I'm part of
that.
(12:51):
I meet with other group practiceowners because it's really
important to me, now more thanever, to protect the
sustainability of our businessand make sure that we are here
to not only for our clients butfor our clinicians, and so I do
a lot of that and I also seeclients.
(13:14):
So I see very few clients.
I have about six appointments aweek on my schedule.
Some get filled, some don't.
I supervise clinicians.
I'm also, you know, trying tostay up to date on all of the
current events and protocols andways to approach therapy so
(13:38):
that I don't fall behind.
Especially as a leader of aplace, you need to be on top of
that.
And then there's theadministrative, like financial
decisions.
So we have an amazingadministrative director who does
all of our bookkeeping,insurance, credentialing and so
(13:59):
many more things like managesour benefits for our clinicians,
and we meet with Emily and I,my partner, meet with him weekly
to really manage what's goingon financially, our payroll,
what's happening with insurancecompanies, because that is a
whole nother topic in the UnitedStates right now.
Dr Andrew Greenland (14:27):
So I don't cry um every person I've spoken
to in north america that is oneof the major bottlenecks and
irritations, so it's interestingthat yet again, you're
affirming this.
Abbey Carter Logan (14:39):
I'm hearing from everybody it's just
infuriating um reimbursementschanging sometimes.
Sometimes they're sayingactually we're going to pay you
less as our economy is gettingmore and more expensive.
They are denying claims, whichthey've always done.
Sometimes they'll take backmoney after they paid you and
(15:00):
said oh, actually we changed ourrates in January, so we're
going to take back thousands ofdollars that we already paid you
.
Or this person had secondaryinsurance, so we're going to
take all of the money back andhave Medicaid pay for it.
But Medicaid is getting strippedright now in our country.
So it's just a lot.
(15:21):
It's a lot to manage all ofthat, especially when you serve
a marginalized population,because here in Ohio, a lot of
the people that we serve have tobe on Medicaid.
It might be their only option,and we're not willing to stop
taking it because we want toprovide accessibility for our
people.
(15:41):
So we're keeping an eye on that.
So that's a big part of my job.
And then, of course, likeadding benefits for clinicians
and making sure that it'ssustainable for them and trying
to think about how we can offermore benefits but not offer them
too early, before they're allfigured out.
So you talked aboutadministrative overload in your
(16:02):
email, so there it is.
Dr Andrew Greenland (16:06):
Outside of your clinic?
What are you seeing in themental health space more
generally?
Whether that's sort of clinicalissues, operational issues or
more systemic issues in societyin general.
Abbey Carter Logan (16:16):
Yeah.
So there's a couple of thingsthat are really big that are
happening out there.
One of the biggest things, inaddition to insurance barriers,
is venture capitalists and eveninsurance companies are buying
small private practices.
So this small private practicemodel that we're operating under
(16:38):
and a lot of other placesthey're getting bought out for a
large amount of money.
But then it really impacts theintegrity of that counseling
because there's differentapproaches and they're also
snatching up therapists who saywell, actually they're going to
pay me three times more, so Ihave to go.
(17:00):
So it makes it a little scaryfor small private practice.
People are really having todiversify their services in
order to survive, becauseinsurance companies are not.
I mean, they're our bread andbutter, but we're not going to
survive on those payments.
One I really want to highlightoh, it really this breaks my
(17:20):
heart People using AI as acounselor.
The AI is not trained in safetyand legal and ethical practice.
It's not a counselor.
It has no idea how to do that.
And sadly here the story justcame out that a minor actually
ended his own life because chatGPT told him to and they said
(17:45):
they have safeguards because ifsomeone says I want to commit
suicide, then they'll say here'sthe hotline.
But this kid had a month's longrelationship with AI and so it
got convoluted.
The AI helped him write asuicide note to his family and
helped him negotiate ways to doit.
(18:06):
It's just really, really it'smaddening and so sad and so
scary, so we're trying to lookout for that.
I actually have a colleague inBarcelona who's creating her own
chat GPT to train it with ourlegal and ethical standards
because we got to get on thetrain.
Dr Andrew Greenland (18:30):
I don't want to be the person who
creates that, but I'm obviouslygiving an example of a very,
very tragic case, but can yousee any value in something that
gives a bit of accessibility topeople that might not be able to
access professional help, ifthey can at least have a
starting point with somethinglike an AI tool obviously not
(18:50):
the one that you've justdescribed, because there weren't
safeguards in place, butsomething which was properly
programmed, tested, tried,safeguarded?
What do you think?
Abbey Carter Logan (19:00):
Yeah, I mean , I think that's exactly what my
colleague out in Barcelona istrying to do is to help people,
provide them hope and someclearer, more professional
advice that they can actually goto and say, ah, I'm feeling
anxiety, what are my options?
And then I think that you couldgo in and say I'm in Columbus,
(19:24):
ohio, I am closeted, gay andscared, who can I see?
And then it would bring themhopefully to us or another
practitioner, who's queer,affirming so things like that.
But I think people don't knowhow to ask the right questions.
(19:45):
My experience at least with AIis you have to write really
pointed questions like is thismessage clear, concise and
compassionate?
That's a prompt I use a lot toput my own message in and just
ask is this working?
And I don't think that peopleare asking kind of clear
(20:06):
questions.
They're really going to AI as,like, a relationship.
So if the relationship could bemore professional as opposed to
just shooting out random thingspulled from the internet maybe
(20:30):
that's not a very well thoughtout question I think I'd have to
sit with that some more toreally answer it Okay.
Dr Andrew Greenland (20:35):
And what changes are you seeing in the
client needs or expectations ofthose coming to your clinic
since the pandemic, and how areyou and your colleagues adapting
to these changes?
Abbey Carter Logan (20:45):
the pandemic ?
That's a great question.
We actually didn't dotelehealth prior to the pandemic
and here in columbus, ohio, welocked down on march 13th.
I remember that date clearlybecause my three-year-old
stopped taking naps on that dayand my partner and I said we're
(21:08):
not going to survive if we don'tcreate this telehealth platform
for our business.
So we took the weekend, wewrote a telehealth manual.
We had lots of other businessowners and practitioners
collaborating to make thishappen.
Thankfully, we have a EHRsystem that integrates it, so it
wasn't hard for us to get it upand running.
We have a EHR system thatintegrates it, so it wasn't hard
for us to get it up and running.
By Monday we were doingtelehealth sessions and I think
(21:31):
it was a big learning curve forclinicians who weren't providing
that prior to.
The pandemic.
Sessions were different.
The body language is differentwhen you can only see this far
up, and body language is a bigpart of mental health.
When people are more nervousand I'm sure you experienced
this in your practice toothere's so much you can get from
(21:52):
the body language of a personand we had to learn how to do
that.
Also, it's exhausting to be ona screen to see eight clients a
day, most of our clinicians,including myself.
Eight clients a day online mostof our clinicians, including
myself.
Eight clients a day online itjust is so draining Went down to
really five feels like the max.
When I was trained I did eight,nine, sometimes 10 clients in a
(22:23):
day, nothing but a granola barfor lunch in between and that
mm-mm.
That's not.
That cannot, no way.
You will burn out immediatelyif you work that old way.
So I think five clients max hasbeen a big change.
I think there's a lot moreemphasis on self-care and taking
time to really nourish andground yourself outside of your
work and ground yourself outsideof your work Because I think
(22:47):
what we learned during thepandemic too is you know, when
we're going through thatcollective trauma altogether,
you have the whole new skill ofgoing through something that big
with the clients who you'reholding space for and you're
processing simultaneously.
That's a whole different skillthat we weren't taught in
(23:10):
graduate school.
So we had to learn in real timeand I think, particularly with
our clients, their expectationsof that, I think, are different
with the community we work with,especially because that's still
happening for us, we're stillin a major collective trauma,
(23:32):
not that the pandemic is notstill impacting everyone,
because it is but I think theglobal political climate right
now, especially in the UnitedStates, is really impacting us
so much more.
So we really, I think forclients, the expectations is
(23:53):
having a safe space or a bravespace, a space where they can
come in and process, because thechanges are happening in rapid
succession and I don't think Idon't see that slowing down, so
they need time.
I think that the emphasis in ourfield has been more on
self-care.
In fact, the NASW of Ohio wroteit into their ethical code that
(24:16):
you have to integrate self-careinto your practice for yourself
.
But yeah, I think a lot ofpeople working in other
environments don't have that.
So their expectation is to havethat for one hour once a week
or twice a month, that theyreally have that space where
(24:36):
they can flop on the floor andcry or process what's happening,
the fear and uncertainty ofwhat's going to happen to their
lives, because they're reallythey're fighting for their lives
right now, every day, and it'shyper alert.
I listened to another one ofyour podcasts talking about the
cortisol steal and that'shappening.
So, yeah, I don't know if thatanswers your question.
(25:02):
No, it does.
Dr Andrew Greenland (25:03):
Thank you.
It's interesting perspective onthe pandemic, interesting about
the fact that eightappointments online were more
draining than eight appointmentsperhaps in person, which is
probably a little feels a littlecounterintuitive to some people
because you might think, well,if you're in a room with
somebody there may be moretransference of what's going on
with them and it might be moreof a strain.
But it's interesting that yousay that strain on the therapist
comes through even onlinetherapist comes through even
(25:25):
online.
Yeah, so I was going to ask youwhat's working really well for
you and your colleagues in theclinic and what sort of systems
or approaches are really reallyclicking with you and your
clients.
Abbey Carter Logan (25:38):
That's a great question.
Let me sit with that for aminute.
So I do think what's working isauthenticity.
I think, especially in clinicalmental health setting, it's
really the changes come from therelationship.
It's not about the approach.
It's more about relationshipwith your therapist and your
(26:00):
therapist's perspective being amodel of a regulated nervous
system.
So we have to bring our calm tothis.
If we don't bring our calm andwe're in panic with our clients,
their mirror neurons are goingto match that and they're
already in panic.
So our job really right now isto be the calming presence while
(26:24):
holding space for them to freakout and then mirror us.
Dr Andrew Greenland (26:29):
if that makes sense, yeah, uh, so we
have to really hold that groundjust talking about in general
what's working well for you andyour colleagues in the clinic
yes, yeah.
Abbey Carter Logan (26:41):
so self-care and rest, I think is working
really well when we can take it.
Um, we went on a canoeing tripa couple of weeks ago and just
had fun together.
I think that having fun andjoyful, the clinicians we went
on this canoe trip and partnerscould come and really building
that community.
(27:02):
I think community is the bigpiece of it is that we have
shared community.
Community is the big piece ofit is that we have shared
community and we have a weeklysupervision group for folks who
are dependently licensed, whichis kind of like oh, what's the
word I'm looking for?
It's just their traininglicense, so they're licensed,
but they're getting supervision.
(27:22):
They have a weekly meeting.
We have a lot more supervisionthan most private practices
provide.
Because we want that support andcommunity, we just hired a
couple of new clinicians and wehad a pizza party and everybody
came and ate pizza.
We laugh together and I thinkthe more genuine and authentic
(27:44):
we can be together, the more wecan show up for our clients.
So that's working.
I do think joy is a huge thingright now.
That's working if we can findit, and what I've been working
with with my clients is what are?
What are the glimmers or thesparkles, because there's so
much shit it could just you justcover the whole thing, but
(28:08):
there are sparkles in there.
What are the?
What are the micro moments thatare happening in your life that
you can really sit with andsavor, that nourish you, um, and
really build up that sense ofjoy in their lives, because
without joy we won't survivetrue, and on the flip side,
(28:30):
what's sort of been the mostfrustrating or challenging
lately in the day-to-dayoperations of your practice?
I actually wrote this outbecause it is really hard, I
think, um, to survive as apractice, especially an
insurance-based practice, we dohave to diversify our services,
(28:50):
but we also have to create thetime, the labor, the space, the
money to do that.
While we are still seeingclients fostering a work culture
and community supervising theclinical work of practitioners
while fostering their well-beingin the workplace and also
(29:17):
looking at the global and thefederal and the state and the
city changes that are happening,it's so hard.
That's not even the financialpieces and the legal and the
ethical pieces.
Yeah, I think that it's reallyreally frustrating and hard to
be serving our own communitywhile they're going through it
and also trying to create morejoy and love and community to
(29:42):
bolster each other, and thatpart's not frustrating.
But having the time, the moneyand the space to part's not
frustrating.
But having the time, the moneyand the space to do that is
frustrating.
Dr Andrew Greenland (29:53):
If you had a magic wand that could fix one
thing in your business overnight, what would that be?
Abbey Carter Logan (29:59):
Probably increasing our pay and getting
PTO, Because the way we're paidby insurance we actually
currently cannot offer PTO.
We offer unlimited take thetime you need off, but it's not
paid.
If I could give all my peoplefour to six weeks of paid time
off and give them more money, Iwish I could pay them all a
(30:24):
million dollars, because whatthey're doing matters so much
agreed.
Dr Andrew Greenland (30:31):
I'm going to ask you.
So I don't know, is anybodyelse doing what you do locally
or more nationally in the states, because you obviously have a
very sort of niche interest withthe queer and transgender
community?
Is anybody else taking this onas a kind of a specialist clinic
sort of thing, and does thatmean that you're exceptionally
busy because everybody's beingdrawn towards what you do with
(30:54):
your approach?
Abbey Carter Logan (30:57):
I would say in in our local community
there's a lot of solopractitioners doing what we're
doing in terms of treating thetrans and queer community.
We're so grateful for them.
Many of them started offworking here and have gone off
and started their own things, sothere are solo practitioners
doing it.
There are a few privatepractices who are smaller than
(31:20):
us doing this work.
So, yes, we're very busy andwe're one of the only ones that
take Medicaid um, becauseclinicians can't survive on the
reimbursement for Medicaid,especially, you know, trying to
create accessibility and theypay you less for telehealth
sessions, but that I don't wantto digress into that Um, but uh,
(31:43):
of course I lost my train ofthought when I digressed into
that cause it makes me so angry.
What was the question?
Dr Andrew Greenland (31:51):
again, Just talking about you having this
niche sort of interest in what?
You do and whether you know,being one of the few people that
do this, mean that you have asort of massive following
massive demand for your services.
Abbey Carter Logan (32:05):
I'm just kind of curious to get a sense
of what's going on in this spacemore nationally, yeah yeah,
there is a clinic that's hereand also I believe they're in
Pittsburgh called CentralOutreach and that's a health
clinic health clinic that'sdoing this work for general
health, pcp kind of stuff andhormones and those kinds of
(32:27):
things, and and we have a directpartnership with them so they
can just refer us peopleregardless if we're on a wait
list, we'll we'll prioritize ourpeople and get them in as
quickly as we can.
Um.
I know nationally there areother practices doing this Um
and it really varies state tostate how they're doing it, but
(32:50):
locally and in the state of Ohiothere's few of us.
There are some.
Cleveland, cincinnati, some ofthe bigger cities have other
practices that are doing whatwe're doing.
Dr Andrew Greenland (33:01):
So I mean, if you had a massive surge of
referrals next week, what wouldbe the first thing that would
break or strain or put theclinic under pressure?
Abbey Carter Logan (33:11):
That's a great question.
So we do constantly have a waitlist because there is a lot of
demand for our services andright now we just hired five new
people since May.
No six because we have anotherone starting in October.
So that is, for now, takingcare of that.
(33:33):
But if we had an influx ofpeople I think we could handle
it up to 100 people.
We used to have a waitlist of100 people all the time.
We don't currently because wehave those new clinicians, but
that's not always going to work.
So that's really why we formthose community partnerships, so
(33:54):
we have people we trust torefer to.
I'm not really thinking aboutwhat would break us, because
I've been thinking so hard aboutwhat will sustain us and keep
us going and keep our doors open.
I don't want to think aboutwhat would break us, but you
know, if all these people camein and they didn't have
insurance and Medicaid getsbusted and they need pro bono
(34:17):
services.
We have a big heart.
We offer a lot of sliding feescale when we can, but we also
have to sustain the business sothat it sustains our clinicians.
Dr Andrew Greenland (34:33):
So it's a tricky balance.
Of course, I think I was comingfrom the kind of the nice
problem to have if you had thismassive influx of patients who
could afford what they needed toafford for the service.
It always sounds like a niceproblem until you can't
necessarily you have theinfrastructure to cope with it.
I just wonder if there'sanything that would stop you
from coping with a massiveinflux.
Now I have to sit with thisbecause I it was just more of a
(34:58):
rhetorical question, I guess.
Abbey Carter Logan (34:59):
I know I really want to sit with that and
think about that, because Ithink we would, because I think
we would one.
We're just hiring people asmuch as we can.
We're going to run out of spaceeventually and have to get more
(35:23):
space to house and see moreclients.
Yeah, you know it's interestingtoo, dr Greenland.
We've never marketed ourservices.
We've never had to, because mybusiness partner was so well
known in the community thatpeople have been sending us.
We know a lot of the medicalpractitioners who work with the
queer and trans community and wehave this waitlist simply by
word of mouth, which is wild.
So when we do start marketing,that might happen, which is wild
(35:48):
.
Dr Andrew Greenland (35:48):
So when we do start marketing, that might
happen.
Okay, looking back, if you wereto start Clintonville
counseling all over again, isthere anything that you would do
differently from the beginningbased on, you know, your
knowledge and experience ofdoing this for a number of years
?
Abbey Carter Logan (35:59):
Mm.
Hmm, I think I would have had abusiness plan.
Business plan, you know, we'repractitioners, we're not
business people.
And yeah, I would.
I would have maybe studied upon business more and had a
(36:21):
business plan Also.
I think I would have alsogotten more leadership training,
because as a leader, I had noidea how much of my own stuff
would be reflected in how I ledother clinicians.
I'm a person who doesn't reallylike authority, so it was
really hard to be in a positionof authority, and so I had.
(36:41):
There's a great organizationhere called the Ohio Rest
Collective, who I have gottenleadership coaching from, and I
also work with a level upleaders coaching.
I wish I would have known aboutthem.
The day I started here, I alsodidn't realize that I was going
to have to be such a leader, soI wish I would have known that
(37:02):
too.
Dr Andrew Greenland (37:05):
And finally , looking ahead to the next six
of six or twelve months, whatare you most excited about?
Do you have any particulargoals that you and your team are
working towards?
Abbey Carter Logan (37:13):
yeah, I am most excited about offering more
programs, more support groupsuh, we have a dungeon dragons
therapeutic group and buildingon those kind of things, more
creative ideas.
I think we finally have thespace to get really creative
with the programming we offerthat can really be queer
centered.
I'm also really excited aboutour new leadership structure
(37:36):
because it allows me to reallylook at the bigger picture and
be able to do this podcast withyou and things like that get our
name out there in other waysand also having positions for
folks to step into so thatclinicians aren't just seeing
clients but they get to beclinical directors or lead
(37:58):
clinicians, because I think thatmakes them feel better and when
they feel better and moregrounded, they're better able to
give really excellent clinicalwork and support to their
clients.
And so I'm excited about that.
And I'm excited about thecommunity building aspect and
being able to do more in thecommunity but also provide that
(38:18):
community for our clients hereat Clintonville Counseling and
Wellness.
Dr Andrew Greenland (38:22):
Amazing.
Abby, thank you so much foryour time this afternoon.
It's been really interestinglyinspiring hearing about what you
do, your approach.
You're offering somethingreally special for your people.
So I'm really grateful fortalking to me this afternoon,
really appreciate it.
Abbey Carter Logan (38:35):
Oh, thank you so much, dr Greenland.
I appreciate talking with you.
I just love talking about this,so it made me really happy to
sit here with you and Iappreciate all your kind words.
Dr Andrew Greenland (38:45):
Wonderful Thank you.
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