Therapists

Wise therapists know that there is always room for growth and improvement.

If you find yourself feeling frustrated, stuck or uncertain, it's probably time to get some help.

Attending meetings, staying on top of the literature and reading primary texts are all fantastic, but there is no substitute for quality supervision.

I have years of experience supervising psychologists and psychiatrists and would be delighted to help you as well.

Here are some areas where you might want to gain expertise:

Testing

Would you like to know how to rapidly screen for the major Axis I and Axis II psychiatric disorders, as well as suicide risk, homicide risk and psychosis without having to waste valuable therapy time, burdening your patient, by asking hundreds of time-consuming and impersonal questions?

Would you like to know, in your very first session, how motivated your patient is, what the main challenges will be in the therapy and whether the patient is likely to complete the therapy?

Would you like to know how satisfied your patient is with the work you are doing and what you could do to improve their satisfaction and reduce the risk of premature termination?

Would you like to know how to take a thorough psychosocial history?  If so, I can help!

Empathy

Have you had the experience of working with unappreciative, critical, demanding, angry and even hostile patients?  We all have good intentions, so this type of response from the people we are trying to help can be hurtful, frustrating, anxiety-provoking and demoralizing.  Although it's easier on our ego to blame the patient for these difficult encounters, close inspection almost always reveals a failure, on the part of the therapist, to respond in a genuine, respectful and empathic manner.

The good news is that these empathic "failures" are also our greatest successes in disguise.  If we are willing to set aside our egos and learn from these mistakes, we can quickly develop world-class empathy skills.

On a practical note, most therapists experience high drop-out rates and frequent no-shows.  Studies show that therapists tend to underestimate the drop-out rate in their own practices.  This puts our patients at risk and us at medico-legal risk.

Furthermore, a good therapeutic alliance has been repeatedly shown to be one of the best predictors of good outcomes in therapy, but there is often little attention paid to developing empathic listening skills during our training.

If you are interested in a systematic approach to developing superb listening skills, so that you can facilitate your patient's recovery, improve your reputation in the community and keep a full practice, then I have great news:  You can do that and I can help!

Agenda Setting

Are you locked in a battle of wills with some of your patients, unable to get them motivated to exercise, eat right, stop a bad habit or just do anything at all?  Are they constantly complaining but stubbornly refusing to accept help, saying "yes, but..." or angrily protesting when you suggest something that seems helpful and reasonable?  Do you ever find yourself talking around and around in circles without accomplishing anything or watching the whole session go by without ever saying a word?

If any of this sounds familiar, then you're probably experiencing one of the many different types of agenda-setting problems.  Having a therapeutic agenda means that the patient and therapist have agreed-upon goals for the therapy, these goals are realistically achievable with the tools that the therapist is familiar with, and the patient is motivated and willing to participate actively in the therapy by using those tools.  In fact, most problems in therapy are agenda-setting problems.

For example, therapists (including myself) frequently make the error of assuming that their patient wants help with the problem they are discussing.  They rush in, trying to be helpful, with advice and suggestions, exercises and solutions without ever asking whether the patient wanted help with this problem.  The common result is that we force the patient to reject that help and they feel criticized and hurt because we have given them the message that we don't accept them as-is or believe in their ability to solve their own problems.

This is just the tip of the iceberg when it comes to agenda-setting.  These skills, even more than empathy skills, have changed the way I practice and the rate at which my patients recover.  If you want to learn how to bypass the most common problems in therapy, I can help!

Methods

If you want to be able to help people with a wide range of different problems, you need a diverse and powerful set of tools at your fingertips.  I am frequently choosing from a list of over 50 techniques that can help transform a person's life.  None of these techniques has that much of a chance to help a person with any given problem.  However, by selecting multiple techniques and then failing with these as rapidly as possible, we greatly expedite the process of finding the method that works and brings about recovery.

For example, a person who is depressed and believes they are worthless might benefit from basic techniques like empathy, agenda setting, identifying the distortions in their thought, "I'm worthless," and talking back to this negative thought.

Often this isn't enough, however.  We frequently have to fail at ten or even fifteen techniques before the patient recovers completely.

We might need to use a cost-benefit analysis to see what are some good reasons to tell oneself:  "I'm worthless," and compare these to any disadvantages.  We may want to "define terms" by clarifying what it means to be worthless and what one would have to do to be worthwhile.  We might use "socratic questioning" to determine whether this definition stands up to scrutiny.  We might want to "examine the evidence" by making a list of all the things they have done in their lifetime that were meaningful, etc. etc.  However, the techniques we might use for treating this thought would be different from those we would use to treat an anxious thought or a relationship problem.

This is yet another reason why agenda setting (conceptualization, in particular) is so important- it helps us select the best tools for the problem at hand.  If you would like a broader range of tools to use when treating your patients, I'm happy to say:  I can help!