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Tough Customers: Is It Them or Us?
By Rich Simon As therapists, many of us practice in two different worlds. In the first, we see polite, well-behaved, articulate clients with solid values. They engage fully in therapy, talk cogently about their problems, listen attentively to our responses, make reasonably good-faith efforts to follow our suggestions, and sooner or later get better. No wonder we genuinely like these people! Does This Kid Need Medication? with Ron Taffel
Meds: Myths and Realities: NP0035 – Session 3
Do you feel like you could be a more effective therapist with your younger clients? Do you find it hard to determine when interventions--psychological and pharmacological--might be needed? Join Ron Taffel and learn to identify key diagnostic signs that indicate medications could be helpful when dealing with depression, anxiety, AD/HD, and affective disorders. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.In Consultation
Peer Supervision Groups that Work
By Eleanor Counselman
Three steps that make a difference
Q: I’d like to organize a peer supervision group, but I’ve heard their failure rate is high. What do you recommend? A: Peer supervision groups provide a welcome respite from the isolation of private practice and an informal, nonevaluative setting after years of formal supervision, particularly for young therapists. They offer valuable guidance on difficult cases and tough ethical dilemmas to therapists at any level of experience. And they’re free! However, as you note, many of them fail. In my experience, careful attention to the initial contract and the ongoing group process can make a huge difference in helping them sustain their membership and thrive. Though they’re often called peer supervision groups, it would be more accurate to call them peer consultation groups. Members don’t have direct supervisory responsibility for one another’s cases: they simply offer suggestions, which members can accept or reject. They typically have four to six members who have approximately the same level of professional experience or share a specific area of interest. Members meet on a regular, usually biweekly, basis. Group consultation, with or without a leader, offers advantages over individual consultation. It includes the possibility of multiple perspectives on the same problem and the reduction of clinicians’ shame about confusions and mistakes as they share similar stories about their struggles with difficult cases. Another benefit is peer interaction, which develops one’s professional sense of self. The hall-of-mirrors effect—seeing yourself as others see you—which is so potent in therapy groups, is a major component of the supervision group experience. Nevertheless, despite the many benefits, it’s challenging to start and maintain a consultation group, particularly if it’s a leaderless one. They can fail to thrive or suffer from “task drift,” moving them away from discussing clinical material and into a form of therapy. It can be difficult to integrate new members and maintain clarity about the group’s own process. Presenting cases in supervision in any format poses obvious risks to one’s self-esteem, and group dynamics add additional risks: issues of power, competition, exposure, and shame can lead members to drop out. It’s especially challenging to manage group dynamics in leaderless groups, as it’s usually the leader’s role to remain aware of what’s happening within the group, and without a leader in charge, shame or fear of being judged may silence members. The most successful leaderless groups seem to be those in which the group members find a balance between a focus on cognitive and emotional issues—talking about cases and about the feelings that arise when seeing clients—while consciously managing the functions that a designated leader would serve. These include protecting the group contract, setting and maintaining appropriate norms, and handling gatekeeping matters, such as bringing in new members. A crucial component of maintaining an atmosphere of group safety is regular, dependable member attendance. Without this, a group will never feel like a place to take risks. Members need to be willing to bring up concerns about irregular attendance because, just as in a therapy group, member lateness and absences can indicate issues that need exploring. Chronic irregular attendance can be demoralizing and cause a group to fail. When it comes to group safety and cohesion, Woody Allen was right: 90 percent of supervision group success is about showing up. A significant issue in any supervision group is shame and the reluctance to expose oneself. To make supervision groups feel safer, therapist David Altfeld developed a model of group consultation in which all group members simply share their emotional reactions and associations to a situation being discussed, instead of one person presenting a specific case issue and everyone else giving advice as resident “experts.” This procedure levels the playing field by not allowing members to compete for the best case analysis. It leaves room for highlighting emotional issues, countertransference reactions, and parallel process. Making everyone vulnerable in this manner avoids opportunities for excessive criticism (or its counterpart, excessive niceness) and encourages emotional sharing. Another group consultation model, developed by Irish therapist Bobby Moore, focuses only on minimal case information, such as a patient’s age, length of time in therapy, and perhaps a little demographic information. Then the presenter talks about his or her thoughts, fantasies, feelings, and associations about the patient and the therapy. Group members then share their associations. Following that, the initial presenter is invited to share any further associations. Only at this point does the presenter give the facts of the case and the clinical dilemma. Finally, the group thinks together about what’s been discussed and what it indicates about the case. For those interested in the power of the collective unconscious, this is a fascinating process to experience. To succeed, a consultation group must feel safe and useful to its members. Here are a few simple principles to follow: Clarify the group structure. The group needs to agree on the frequency and length of meetings, which is best accomplished with a predictable schedule. The group needs to agree on its task and focus: is this group for any clinical issue or just for couples, or trauma, or group therapy? How much time will the group spend on “schmoozing,” and will there be one or more than one case presented each time? What will be the presentation format? While most groups use verbal presentation, some groups are now using videoclips—which makes the discussion much livelier. Agree on membership issues. How many members will the group have, and how will new members be integrated? Once a group has formed, I believe that decisions about adding more members should be a group decision. While it may be tempting to accept a request from someone who wants to join the group, a total of six members seems to be the maximum number for each member to have enough opportunities for presentations. Attend to the group process and dynamics. While groups should build in a “schmooze” or “check-in” time, there needs to be an agreed-upon limit to the socializing, so that the group doesn’t become a therapy group or a coffee klatch. Without a leader, the members themselves must monitor the group’s procedures and raise any important issues. Some groups do this ad hoc; others schedule a regular review meeting to evaluate how things are going. Leaderless peer supervision groups can help clinicians at any stage further clinical learning and combat professional isolation. They’re likeliest to succeed when the group members have a clear working agreement, maintain regular attendance, and create an environment in which both emotional and cognitive learning occurs. Eleanor Counselman, Ed.D., is a past president of the Northeastern Society for Group Psychotherapy and an assistant professor of psychiatry at Harvard Medical School. She’s published numerous articles on psychotherapy and has a private practice in Belmont, Massachusetts.
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Tag: Couples Therapy  Riding the Wave: Harnessing the Power of Emotion with Kathryn RheemWho’s Afraid of Couples Therapy?: NP0022 – Bonus Session 2Discover with Kathryn Rheem how to respond effectively when clients express strong feelings in session. Based on Emotionally Focused Therapy, you’ll explore attunement and how to use your own emotions to help clients move beyond attachment injuries. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org. Comments The Logic of Eroticism with Marty KleinWho’s Afraid of Couples Therapy?: NP0022 – Bonus Session 1Join Marty Klein, a marriage and family therapist and certified sex therapist, us for a candid discussion about the assumptions that both clients and therapists often share that can get in the way of improving couples’ sexual relationships. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org. Comments Taking Off the Masks: Truth-Telling in Couples Work with David SchnarchWho’s Afraid of Couples Therapy?: NP0022 – Session 6Hear an unconventional perspective on couples therapy from David Schnarch, who believes that the best way to help couples is to challenge partners to change their individual behaviors and attitudes. Schnarch’s direct, upfront approach to helping clients will illustrate a different viewpoint on effective couples therapy. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org. Comments Angry Women, Withdrawn Men: Breaking Through in Couples Therapy with Jette SimonWho’s Afraid of Couples Therapy?: NP0022 – Session 5Explore this classic dynamic of couples therapy—an angry woman and a withdrawn man—that’s often confusing for therapists, with couples therapist Jette Simon. Learn more about what’s behind the feelings of anger and the behavior of withdrawing, and how clinicians can more effectively work with shame and fear of disconnection. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org. Comments Confidentiality, Secrets, and How to Deal with Affairs with Esther PerelWho’s Afraid of Couples Therapy?: NP0022 – Session 4
Is it possible to rebuild trust and intimacy in a couple’s relationship after a partner has had an affair? How can therapists help? Hear from Esther Perel, author of the international bestseller Mating in Captivity: Unlocking Erotic Intelligence, on how to help couples after an infidelity and the role that cultural perspectives have in this emotional situation. After the session, please let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org. Comments Helping Couples with Different Divorce Agendas with William DohertyWho’s Afraid of Couples Therapy?: NP0022 – Session 3What happens when partners in couples therapy have two different agendas in mind? Hear from expert William Doherty on this little spoken about topic. Learn how Discernment Counseling, an approach that helps couples clarify their feelings about the next step in their relationship, can help both clients and therapists. After the session, please let us know what you think. What’s your experience with mixed-agenda couples in therapy? What questions remain for you now? Let us know what you think. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org. Comments The Choreography of Healing with Hedy SchleiferWho’s Afraid of Couples Therapy?: NP0022 – Session 2How can therapists most effectively work with emotion in the consulting room—particularly when it comes to couples therapy? Learn with internationally known couples therapist Hedy Schleifer how to help create a nourishing connection between partners, define a role as therapist-as-guide, and much more. Schleifer, who’s pioneered the training of Imago Relationship therapists internationally, will go into how to use this theory in practice and how to best work with emotions. After you hear this presentation, please take a few minutes to comment about what you found most interesting or relevant, to ask any questions you have of the presenter or your colleagues, or to share any experiences. As always, if you ever have any technical questions, please feel free to email support@psychotherapynetworker.org and our Support Team will help you. Comments Overcoming Our Fears with Ellyn Bader and Peter PearsonWho’s Afraid of Couples Therapy?: NP0022 – Session 1Welcome to our “Who’s Afraid of Couples Therapy?” This exciting series, back by popular demand, is based on our November/December 2011 issue on this topic and will explore the challenges of couples work. What are the most effective strategies in working with couples? How can therapists structure therapy—particularly in the early sessions—so that couples leave with a sense of hope, rather than frustration? Can working with individuals who have serious issues in their relationships actually be detrimental to them? Find out the answers to these questions and much more. In this first session with expert couples therapists Ellyn Bader and Peter Pearson, the creators of the Developmental Model of Couples Therapy, you’ll find out why clinicians often avoid working with couples and how you can better prepare yourself for couples therapy work. Throughout the series, a Comment Board after each session will be available. The Comment Boards are a way for participants to share thoughts and reflections about what was most interesting and to ask questions of the presenters and of each other. We invite and encourage you to use these Comment Boards as a forum for thought and to continue the conversation sparked by each session. After listening to this first session, please just take a few minutes to share what you think. What was most striking about this session? What questions do you have? Thank you so much for your participation, and welcome to this relevant and important series. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org.
Comments Treating the Mixed-Agenda CoupleWhat Should You Do When Partners Have Contradictory GoalsWhat should you do when one partner in a couple is serious about divorce while the other hopes to save the marriage? In this clip from our upcoming streaming-video webcast series “Who’s Afraid of Couples Therapy?” family therapist William Doherty discusses the problems that arise in couples therapy when one partner is leaning in and the other is leaning away from the marriage. Listen to the clip below to find out what he thinks you can do if you find yourself in this challenging situation.
William Doherty, Ph.D., is a professor and director of the Citizen Professional Center at the University of Minnesota. He’s the author or coauthor of 12 books on families and family therapy, including Take Back Your Marriage, Take Back Your Kids, and Family Therapy, with Susan McDaniel. Want to hear more on this topic? Bill Doherty also wrote an article that explores this topic in our popular November/December 2011 issue, which you can read here. Have you ever found yourself in this situation with a couple? How did you handle it? Let us know. Who's Afraid of Couples Therapy? Comments Angry Women, Withdrawn MenBreaking Through in Couples TherapyIf you’ve ever worked with a couple, you know the palpable tension of a first session. There’s the fed-up wife and the husband who’s reluctantly agreed to come to therapy. In the clip below, Jette Simon, a Senior Clinical Instructor in Imago Therapy, offers a step-by-step account of how she goes about creating a safe therapeutic space for both partners—despite their history and conflicts—and begins to engage them in a process of change. To read more about the challenging work of couples therapy and how we can become more prepared to work with couples in session, see our November/December 2011 issue on couples therapy here. Jette Simon, Lic., who conducts basic and advanced training programs in Imago Relationship Therapy, is the director of the Washington, D.C. Institute for Couples Therapy, and is a Senior Clinical Instructor for Imago International. She’s the author of Imago: The Therapy of Love. Who's Afraid of Couples Therapy? Comments Beginning Therapy with High-Conflict CouplesTips from Ellyn Bader and Peter PearsonHighly distressed couples seek out help for immediate solutions for their pain and suffering. Why is tackling the issues head-on a big mistake for a therapist? Learn from noted couples therapists Ellyn Bader and Peter Pearson on how couples in therapy have deeply complex, embedded issues that need to be approached thoughtfully. Watch the video clip below: This clip is from our streaming-video webcast series, “Who’s Afraid of Couples Therapy?” Join us for thought-provoking conversations with noted couples experts and explore the challenges of couples work and how you can be more effective in the consulting room. Ellyn Bader, Ph.D., and Peter Pearson, Ph.D., couples therapists for more than 25 years, are the founders and directors of The Couples Institute and creators of the Developmental Model of Couples Therapy. They’re the authors of In Quest of the Mythical Mate: A Developmental Approach to Diagnosis and Treatment in Couples Therapy. Who's Afraid of Couples Therapy Comments Male-Friendly Psychotherapy with Pat LoveMen in Therapy: NP0020--Session 1Welcome to “Men in Therapy: What Clinicians Need to Know.” In this series, leading innovators in the field will delve into the latest research on gender differences and discuss practical ways to make therapy more inviting and helpful for male clients. Comments NP0016, Attachment, Session 5, Sue JohnsonHow is Attachment Theory relevant to effectively couples therapy? Learn with Sue Johnson how understanding and working with attachment relationships will help therapists deepen their emotional presence and work with clients’ emotional reactivity in session. Johnson, one of the originators of Emotionally Focused Couples Therapy, will explore the principles of this empirically validated treatment and how to apply Attachment Theory in therapy. After this session, please take a few minutes to engage in the Comment Board and let us know what you think about using this method with couples and whether you think Attachment Theory is applicable in couples therapy. What was new or most striking about this presentation? What questions did this bring up for you? We invite you to include your name and hometown along with your comment. If you ever have any technical questions, contact support@psychotherapynetworker.org. Comments What’s Hot in Psychotherapy Today: The Symposium Top 5Curious about the presenters and approaches attracting the most attention at this year’s Symposium? Here’s your chance to find out. In addition, with the early registration deadline just around the corner (February 6th), now’s a good time to consider workshop choices. You can peruse the Symposium program a number of easy ways—online, via our digital brochure, or in print—but we wanted to let you know about the workshops people seem most excited about so far. In reverse order, the 5 top workshops to date are: Comments NP0011, Couples, Bonus 2, Kathryn RheemDiscover with Kathryn Rheem how to respond effectively when clients express strong feelings in session. Based on Emotionally Focused Therapy, you’ll explore attunement and how to use your own emotions to help clients move beyond attachment injuries.
01.25.2012 Posted In: NP0011 Who's Afraid of Couples Therapy? By Psychotherapy Networker
After the session, please take a few minutes to let us know what you think, both about this session and about the series as a whole. What stood out for you? What questions remain? We encourage you to take this opportunity to share your thoughts, questions, and revelations. Please include your name and hometown with your comments. As always, if you have any technical questions or issues, please feel free to contact support@psychotherapynetworker.org. Thank you so much for your participation during this series. Comments NP0011, Couples, Bonus 1, Marty KleinJoin Marty Klein, a marriage and family therapist and certified sex therapist, us for a candid discussion about the assumptions that both clients and therapists often share that can get in the way of improving couples’ sexual relationships. After the session, please take a few minutes to let us know what you think. What was most interesting or relevant to you? We invite you to share your thoughts, questions, and revelations. Please include your name and hometown with your comments. Comments NP0011, Couples, Session 6, David SchnarchHear an unconventional perspective on couples therapy from David Schnarch, who believes that the best way to help couples is to challenge partners to change their individual behaviors and attitudes. Schnarch’s direct, upfront approach to helping clients will illustrate a different viewpoint on effective couples therapy. After the session, please take a few minutes to let us know what you think about these ideas and this way of working with couples. What was most interesting to you? Do you have any similar experiences working with couples? We invite you to share your thoughts, questions, and revelations, as well as including your name and hometown with your comments. If you have any technical questions, please feel free to contact support@psychotherapynetworker.org. Thanks for your participation. Comments NP0011, Couples, Session 5, Jette SimonExplore this classic dynamic of couples therapy—an angry woman and a withdrawn man—that’s often confusing for therapists, with couples therapist Jette Simon. Learn more about what’s behind the feelings of anger and the behavior of withdrawing, and how clinicians can more effectively work with shame and fear of disconnection.
12.30.2011 Posted In: NP0011 Who's Afraid of Couples Therapy? By Psychotherapy Networker
After the session, please take a few minutes to let us know what you think. What did Simon discuss that was new to you? What was most interesting to you? Do you have any similar experiences working with couples? We invite you to share your thoughts, questions, and revelations, as well as including your name and hometown with your comments. If you have any technical questions, please feel free to contact support@psychotherapynetworker.org. Thanks for your participation. Comments NP0011, Couples, Session 3, William DohertyWhat happens when partners in couples therapy have two different agendas in mind? Hear from expert William Doherty on this little spoken about topic. Learn how Discernment Counseling, an approach that helps couples clarify their feelings about the next step in their relationship, can help both clients and therapists.
12.19.2011 Posted In: NP0011 Who's Afraid of Couples Therapy? By Psychotherapy Networker
After the session, please let us know what you think. What’s your experience with mixed-agenda couples in therapy? What questions remain for you now? Let us know what you think. Thank you so much for your participation, and welcome to this relevant and important series. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org. Comments NP0011, Couples, Session 2, Hedy SchleiferHow can therapists most effectively work with emotion in the consulting room—particularly when it comes to couples therapy? Learn with internationally known couples therapist Hedy Schleifer how to help create a nourishing connection between partners, define a role as therapist-as-guide, and much more. Schleifer, who’s pioneered the training of Imago Relationship therapists internationally, will go into how to use this theory in practice and how to best work with emotions. We encourage you to use the Comment Board as a way to engage with each other and the presenters in this course, to share what you felt was most interesting, to ask any questions you may have, and to reflect on what you’ve learned. What was most relevant for you in this session? Thank you so much for your participation, and welcome to this relevant and important series. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org. Comments Page 1 of 2 |
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