The Unlicensed Therapist

In this installment of The Wise Ones Series, we sit down with Dr. BJ Durham, a counselor educator, researcher, and former collegiate basketball player who specializes in athlete mental health and identity transitions.
For many student-athletes, their identity is deeply tied to their sport from a young age. But what happens when the cheering stops and the uniform comes off? In this episode, Dr. Durham breaks down the psychological reality of Career Athletic Retirement—the complex identity shift athletes face when transitioning out of competitive sports. We discuss how counselors, coaches, and support networks can help athletes look beyond the game to build a fulfilling life, maintain robust self-awareness, and prioritize mental health.
Whether you are a current or former athlete, a mental health professional, or a mentor, this conversation offers invaluable insights on identity, self-care, and supporting individuals through major life transitions.
Episode Links & Resources
Connect with the Guest:
Learn more about Dr. BJ Durham’s Research Profile & Feature at NC State
Faculty profile at North Carolina Central University Counseling Department
Advocacy & Initiatives Mentioned:
Community Counseling, Education, and Research Center (CCERC) – Accessible community-based mental health support.
NC State Counselor Education Program – Training mental health counselors and researchers.
Related Topics & Athletics Background:
Waynesburg University Athletics Profile – Dr. Durham’s collegiate basketball career.
mrgrimmtherapist@gmail.com

In this episode of The Unlicensed Therapist, host Matthew David Grimm sits down with Nika Orlando, LPC, as part of The Wise Ones Series. Together, they explore the intersection of Narradrama and Therapeutic Tabletop Role-Playing Games (TTRPGs), examining how active immersion, character creation, and structured play can foster emotional regulation, identity exploration, and trauma recovery in clinical practice.
Episode Highlights
The Magic of Character Work: How clients project internal conflicts and build resilience through character mechanics and narrative choices.
Integrating Narradrama: Blending action-oriented drama therapy techniques with tabletop role-playing to facilitate group processing.
Clinical Safety Frameworks: Managing client agency, emotional regulation, and safety at the table.
Guest Contact & Information
Guest: Nika Orlando, LPC (They/Them)
Practice: Orlando Counseling Services, LLC
Directory Profile: Nika Orlando Profile on Psychology Today
Guest Interview: Watch Unpacking the Human Condition with Nika Orlando on YouTube.
Host Contact & Information
Host: Matthew Grimm, LPC, NCC
Practice: The Wellness Collective Counseling & Consulting
Podcast: The Unlicensed Therapist
Resources & Modalities Mentioned
Geek Therapeutics: Geek Therapeutics Website
Geek Therapy Community: Geek Therapy Network & Resources
Drama Therapy Association: North American Drama Therapy Association (NADTA)
YouTube Channels & Actual Play Resources Mentioned
Geek Therapeutics YouTube: Geek Therapeutics Channel
Geek Therapy YouTube: Geek Therapy Channel
Critical Role: Critical Role Channel — Long-form campaign play led by Matthew Mercer showcasing voice acting and character immersion.
Dimension 20: Dimension 20 Channel — Campaign arcs highlighting role-play dynamics, table safety, and creative storytelling.
High Rollers D&D: High Rollers D&D Channel — Campaign play focusing on party communication, character growth, and narrative mechanics.
Rivals of Waterdeep: Rivals of Waterdeep Channel — Streams emphasizing table collaboration, rotating Dungeon Masters, and diverse playstyles.
Legends of Avantris: Legends of Avantris Channel — Character-driven actual play centered on improvisational role-play and team dynamics.
 

In this episode, Nika Orlando, LPC, reflects on their journey from traditional ministry to counseling, sharing how personal experiences with trauma, loss, and self-discovery shape an inclusive approach to clinical therapy.
Key Topics Covered
From Pulpit to Practice: Navigating early training in the United Methodist Church and transitioning toward a career in counseling and psychology.
Lived Experience in Therapy: How personal survivorship with trauma and suicide informs deeper empathy, presence, and relational safety with clients.
Identity and Care: The intersections of pansexuality, non-binary identity, and providing clinical support for the LGBTQIA+ community.
Core Focus Areas: Specializing in complex trauma, personality disorders, grief, and holistic identity work.
Resources & Active Links
Practice Information
Orlando Counseling Services: Visit Nika Orlando on Psychology Today to learn more about practice details, group offerings, and individual care.
Regional LGBTQIA+ Support (Western PA)
Washington County: Washington County Gay Straight Alliance provides local youth programs, peer discussions, and community support.
Greene County & Southwestern PA: Hugh Lane Wellness Foundation and the PERSAD Center offer health, mental health, and social services tailored to LGBTQIA+ individuals and youth across Southwestern Pennsylvania.
Statewide News & Network: QBurgh serves as a central platform for regional Western PA LGBTQIA+ news, events, and community resources.
Suicide Awareness & Crisis Resources
988 Suicide & Crisis Lifeline: Call or text 988 (Available 24/7, free, and confidential) or visit 988 Lifeline.
The Trevor Project (LGBTQ Youth): Call 1-866-488-7386 or text START to 678-678 for 24/7 LGBTQ-affirming crisis support, or visit The Trevor Project.
Crisis Text Line: Text PA to 741741 to connect with a crisis counselor 24/7.
Prevent Suicide PA: Visit Prevent Suicide PA for Pennsylvania-specific task forces and suicide prevention initiatives.

Matthew Grimm: Hello and welcome back to The Unlicensed Therapist. My name is Matthew Grimm, and if you've been listening, I'm back in the host seat again today. Today, we are going to explore the world of cultural humility, what it's like to be a therapist who is bilingual, someone who works with some truly underserved populations in refugee work and immigration work. Francisco Betancourt, who is also owner of his own counseling firm, will be joining us.
I am going to give everyone a heads up here real quick. Francisco wanted to be supportive, and so we recorded this episode over the weekend while he was at home so he could be around his family. So you will hear a little bit of background noise from time to time from his family members, and that's just showing how much he was willing to give of himself, but also wanted to be present for his family, which I truly believe is a beautiful thing.
I also want to give a content warning because we're going to discuss refugees, because we're going to discuss immigration, we do discuss ICE and some other highly publicized and what may be seen as political topics. We are not looking at these as political in any way, shape, or form. What we're looking at them as is, in the view of a counselor, how do we work with these agencies? How do we help someone feel safe and can we? So I invite everyone to sit back, relax, and I'll be right back to begin my conversation with Francisco.
[01:52 - Musical Transition]
Matthew Grimm: And so we are back with Francisco Betancourt, LPC, founder of Betancourt Counseling LLC. Francisco has a Master of Science in Counseling Psychology, is a Certified Advanced Alcohol and Drug Counselor, Certified Clinical Trauma Professional, Certified Dialectical Behavior Therapy Professional, and a National Certified Counselor. And what makes him stand out from anyone else that we've had on the podcast so far is Francisco is bilingual. So that makes him very unique from who's been on the podcast. However, I will say that I've met a second therapist who is bilingual as well, and after the podcast recording, we'll have to put the two of you in contact.
Francisco Betancourt: Yes, definitely.
Matthew Grimm: Thank you so much for taking the time to be here and share with everyone a little bit about you, your journey, and your uniqueness. And I wanted to start with just this question: So many clinicians have this pivotal moment or personal evolution that leads them to mental health work. What initially drew you to the helping professions, and specifically, why was it counseling over any other discipline?
Francisco Betancourt: Hmm, that's a good question. So, I feel like from my own experiences, I was in a house fire when I was three. And my little brother, I was in it as well, and he was two. And he did not survive that. I did. I was treated for burns at West Penn Hospital. And part of the treatment experience was that I was able to go to a burn camp for other children who had been burned. And, you know, it was a good place where we could all relate to one another and, you know, understand what it's like to look different from the rest of our peers.
And it was really there that I felt myself a little bit more drawn to try to provide counsel, I guess, you know, support, really, to some of the younger kids who hadn't quite figured out how to feel comfortable in themselves. And it felt uplifting, it felt right. And, you know, I just thought I was being nice. And it wasn't until, you know, maybe about the end of high school we started having to get, you know, some of the pressures we all get to figure out what you're supposed to do with the rest of your life. I wasn't exactly too sure. And it was around then that I learned that counseling was even a thing. And when I kind of put my experiences at the burn camp to what I was leaning into and looking into and really felt enthralled with, I just feel like I couldn't do anything else. I mean, it was like my calling.
Matthew Grimm: Awesome. And first and foremost, I'm so sorry for your loss. I don't have any siblings, but I can't even imagine losing a sibling at that age and going through all of that. It shows how strong of an individual you are.
Francisco Betancourt: Thank you.
Matthew Grimm: You're welcome. And you may have answered this next question, or you may not. Let's see. Was there a specific experience early in your journey—whether school, community outreach, or life—that solidified your focus on complex areas like addiction, trauma, and refugee support?
Francisco Betancourt: And this would be early in the career that might have solidified that?
Matthew Grimm: Anytime within your life.
Francisco Betancourt: Well, you know, especially as it relates to those specialties, I mean, I will say those weren't exactly things that I was really looking for at the time. And I would even go chronologically. I mean, I was the first in my family to graduate. And even that with a Master's. So I mean, just making it there was the goal. And my first job, I was working with, you know, community outreach, community mental health. And it was a lot, you know. I was just looking for employment, really.
And it was one of those situations where there was a lot of addiction. We were co-occurring/dual-disorder specialists. So we needed the mental health competency and the dual-disorder, and you know, I felt like that was my role at the time. It was my job, so, you know, I didn't know everything, so I might as well start somewhere. That was my attitude, that was my philosophy. And that's kind of what the structure of that employment was, to push me towards the IC&RC/CAADC to become, you know, an addictions expert. It took a couple of years, you know, but that's right around the time when I got licensed as well. I kind of got both of those around the same time. So I mean, it was just, that was the structure I was in, that was the expectation on me. And I rose to that occasion.
And, you know, similar things happened down the pipe. The employment that I had at the time, you know, there wasn't really much in the way of promotion or a raise or anything like that because those were just expectations, you know. You needed to just get that certification. The license was not necessary originally for the job, which is probably why I got it. So the refugee populations, you know, I had always wanted to be able to be in a place where I could use my Spanish and, like I mentioned with the burn camp, to work with children.
And, you know, I had been applying for a position to be sort of a trauma therapist for children. And I could never quite get it because the team was full, right? And shortly after I got licensed, I reached out again, and I just got lucky. It was—we call it a political and humanitarian crisis. This was back when we had President Trump's first term. There were declarations made at the time that we were going to, you know, de-incentivize families making the trip from Central and Southern American countries to the United States, and we would forcibly separate families from each other.
And these children who were separated from their parents, they would be sent to different institutions, right? Different places where the government would take care of them for a little while until we could figure out where they needed to go next. I just wanted to do the trauma therapy part. I didn't really know too, too much about the politics part of it. So they called me back and asked if I would be a lead clinician for that team. And, you know, I just felt like it's—it's not like I asked for the timing on that, you know. Nobody would ask for something like that, but that happened to be the timing. I happened to have the bilingual components, and I had already been studying trauma on the side as certifications. So I mean, it just kind of made sense. It was maybe the right person for the right time. And I learned more even on that job, yeah.
Matthew Grimm: So it's sounding to me like you went to school for your clinical mental health, but when you got different jobs, that's where, all of a sudden, where you could have gone down a substance use track in school, it ended up being on the job. And then even though because you had this calling towards trauma, it again didn't happen until you were on the job. And it was a continual learning and continual growth process.
Francisco Betancourt: Absolutely. Yes.
Matthew Grimm: So when you look back at what brought you into the field versus where you are now running a practice, how has your personal "why am I here?" evolved over time?
Francisco Betancourt: There's a good saying, it says—and it's about mental health, it's about therapy, we can make it that way—it says: "People don't burn out because of what they do; they burn out because they forgot why." And you know, when I hear that question, it does, it makes me sort of reflect back to why I got into the field in the first place. There's something deeper there, I suppose. It is a calling. I feel like I came back for a reason, right? I might not know what that reason is. I just call it a calling. My work is not done here yet. And I guess over time, it just solidifies that as an even more and more concrete, foundational reason for existence. And that foundation only gets stronger, and the stronger I feel it, the more I want to build.
Matthew Grimm: So, a question that is totally not listed on my little list of questions here, but it hit home: So, I live in Washington, Pennsylvania—little Washington, Pennsylvania—and for those that don't know, 30 minutes south of Pittsburgh. And about three weeks ago, on the street that I grew up on, ICE showed up and took some families, and we don't know what happened to them. And then a week or two later, my father-in-law's caregiver told us that ICE was on her street taking, you know, families. As you're someone who is really working with people who are immigrants, refugees, just bilingual and may look different, how are you helping them—

Matthew Grimm: And welcome to The Unlicensed Therapist. In our last episode, Julie Perry stepped in and began interviewing me so that I could share a little bit about my journey into the counseling world. And that conversation lasted longer than what we expected. So because of my vacation and the lack of content, I decided to split that episode into two podcasts, and you're getting a bonus episode of Part 2 this week. So sit back and enjoy the remainder of the conversation with host Julie Perry.
(Jazz transition music plays)
Matthew Grimm: So when it comes to that idea of that person coming in with, you know, the TikTok video: "I learned this about EMDR, CBT, DBT, whatever it may be, and you can cure me in this many sessions."
Number one, I talk to them about that whether you heard this from TikTok, a previous therapist, your best friend, wherever you heard this, is it plausible that EMDR or this treatment could have an effect on you in six sessions? Sure, it could have an effect on you, but there's no guarantee. It could be session one; it could be session 2,001. There is no time scale when it comes to many of these techniques. But there are behind-the-scenes things that you don't realize, and let's talk about that.
So with EMDR, if—you know, I'm introducing resourcing pretty early on to see if this is even something that works for you, and you're not even always realizing what I'm doing. Because I'll talk to you about "this is EMDR resourcing," but you have no clue how deep into EMDR it's truly getting.
You know, number two, even with introducing that, there's this whole pyramid of if you're not ready, if you can't just trust and let go, then it's not going to work. And as much as you want it to, and as much as I want it to, there has to be a therapeutic bond first. It comes back to that first. You have to trust me. I have to know what it is you're truly here for. You may walk in here and say, "You know, I had this trauma; I was in a car accident, and now I can't get back in my car." But what you're not telling me, or what you're not remembering, is being in the car and your father slapping you and you taking that as abuse, and those two things are connected.
So the EMDR is not only going to affect that car accident that you just had, but it's going to go all the way down into that core, that first trauma, and help you work through that, too, that you don't even know in this moment is an issue.
And have you ever felt safe before? Because I've already seen it: people who have never felt safe before and think they have, when they experience EMDR and feel truly safe for the first time, they pretty much think that I've performed witchcraft on them, and they freak out! (Laughs)
Because, I mean, imagine that you have never felt sad before, and then you go into your therapist's office, and your therapist makes you cry, or they say something and you cry. You'd think, if you'd never cried before, never felt sad before, "What did this person do to me?" Well, no, it's an emotion that you just hadn't experienced, is all it is. But for it being a first time, that would be pretty overwhelming.
So it is a lot of psychoeducation, reminding, and also, if you want this to be done in six sessions, I can't guarantee that. I am not going to make you a promise or a guarantee that I cannot follow through with, and I can't guarantee that. So the options are: you're more than welcome to continue to come to me, and we will work through this using whatever we need to, or if you feel you were stuck on six sessions and six sessions alone, I can refer you out to a few other people that I know who are EMDR trained. But I want to give you a heads-up: everyone that I'm going to refer you out to are going to look at you and tell you, "I can't guarantee you six sessions alone, either."
Julie Perry: Absolutely. Absolutely. Do you ever get pushback from a client, or have you—speaking of experiences where you've had pushback from a client?
Matthew Grimm: Oh, yes. Very, very much so. And sometimes, um, that individual is in a place in their mental health that that pushback is coming, and there's nothing that I can say or nothing that I can do. They just need to sort of ride it out, and either there's some assistance that they need via medication, they need a higher level of care, or there are other things that need to be worked through first. Or they're just not ready to be there.
Julie Perry: Absolutely.
Matthew Grimm: I think there are times that people come into the therapy room, and they're like, "Okay, I'm here," and they touch on something and it scares them or upsets them, or they spend five years in therapy and don't realize that not only as a therapist can I get burnt out, but as the client, you can get burnt out on therapy. And it's okay to go, "You know what? I need to take a month or two off just so that I can process through all of this stuff and then come back to this."
Julie Perry: Yeah. And I appreciate you saying that because, as a newer therapist, I'm recognizing as time goes on that clients sometimes need a break. And I'm not talking just about for personal reasons—maybe their kids are doing something, maybe something's going on in their life, whatever that looks like. Sometimes they need a little bit of a break to be able to have time to process through those feelings on their own, to maybe apply a little bit of what has been talked about on their own.
Matthew Grimm: Mm-hmm.
Julie Perry: Yeah. Absolutely. So, with that in mind, talking about building a therapeutic relationship, in your opinion, what do you think new counselors sometimes focus on too quickly with a client?
Matthew Grimm: I think they focus too quickly on "What modality am I going to use?" Go in, use the modality, "Okay, you've got to talk to me about what your problem is or what the issue is, and we stick just to that." You know, it's clean and clear: "You're here because you want to talk about your relationship, then just talk to me about that singular relationship and only that," instead of "Well, I've got, you know, maybe hundreds of relationships that I could talk about, or that if I'm talking about them, it's giving me, the counselor, a lot of information."
That sticking just—you know, just because I walk in and I have grief over the loss of my mother, that doesn't mean that there aren't other things going on in my life that are stemming from maybe that loss, but it may not look that way. It may look like they're two totally different things. But I need to talk, and that's what you're here for. You're here to listen to me.
And is there a time to go back to that treatment plan and talk about that treatment plan and, "Hey, what do you really want to discuss and be here for?" Sure! Do I think that that is an every session, or the first session that someone doesn't discuss what's in the treatment plan? No. I also think that the way you write a treatment plan, though, is so that it's a little bit more fluid to allow for discussions of other things, because, again, we're human.
We're going to come in and talk about that altercation I had with my boss, that great date that I had, that I got an A on my test, or that I was so nervous in gym class that I wet my pants and now I'm so embarrassed and what am I going to do? All these different things are going to come up that may or may not have anything to do with what I said on day one I was here for. Because also, on day one, I may have not realized really why I was here.
That's why we're giving a preliminary diagnosis for billing and not the end-all, be-all diagnosis.
Julie Perry: Exactly. Because that does change. It does change; life circumstances change. Speak to a little bit about expectations in sessions in terms of some sessions feel more productive than others. Um, I'm normalizing this like for—for clients. There's going to be sometimes a client comes in, and yes, you're utilizing psychoeducation for anxiety, you're using psychoeducation for depression, and you're building toolboxes for those type of things. But then for that client, something happens in their life and maybe, like you said, grief comes in. Um, just normalize productive sessions can look differently, and they sometimes come outside of what the treatment plan looks like, right?
Matthew Grimm: Exactly. I—I—there can be sessions—I think where what we are sort of programmed into is: the session is the client comes in, we teach a skill, they leave the office, they practice the skill, they come back. "Okay, how did using that skill go in the real world? Did it work? Didn't it work? Give some feedback, teach another skill, move on." Is that sometimes a session? Yes, and is that a productive session? Absolutely!
But also, that person that comes in and says, "Nothing's working. Absolutely nothing is working whatsoever," and just letting them talk it out is a productive session. The individual who doesn't want to be there and comes in and just sits there—they're mandated. And having the simple conversation of: "You have free will. I am not forcing you to walk in the door. You are mandated by your spouse, by the courts, by whatever. You have signed certain releases of who I can and cannot talk to. If you choose not to come to these sessions, that is your choice. I'm not going to be making phone calls and tattling on you. If I can't contact you, I'm probably going to reach out to an emergency contact or a parole officer or something like that for a safety check-in. But other than that, if you look at me and you say, 'I'm ending services as of today,' and you walk out, I'm not calling that person. But that person will call me eventually, and when they do, I'm going to have to say, 'On this date, they ended services,' and that's where the consequence will come in. So you need to decide if coming in here and sitting in silence is what you want to do. Awesome! But remember that sooner or later, someone is going to ask how your progress is, and my answer will be, 'Well, for the last 17 sessions, they have sure shown up, and I can say I'm proud of them, but they've sat in silence, and I've done some talking, and there's been sessions where we've both been silent.' And that's not going to look all that hot. But again, yeah, that's just how it is."
Julie Perry: Right. Talk about something that maybe you believed early in counseling, early in your career, that you no longer believe, or you believe now.
Matthew Grimm: Mm.
Julie Perry: And let me—I'll—I'll give it—I mean, I'm looking at it like: that could be boundaries. That could be how much of your personal style you infuse into things.
Matthew Grimm: I think that just starting off, you know, day one of practicum to today, there was a huge question of: how much of my story do I share versus not share? And questioning what is helpful for the client, what is helpful for me? And I went at first on the end of, "Okay, I'm not going to talk about me whatsoever; I'm just here for the client and the client alone." And I think we all start there.
But I began to have some clients where it was like, we have so many similar life experiences, and we've taken them in different ways or made different choices, that am I missing an opportunity to say...
www.wellnesscollective.llc/matthew-grimm
mrgrimmtherapist@gmail.com