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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: CE Comments  Overcoming Resistance in Male Clients with Terry RealMen in Therapy: NP0020 - Session 2
Learn how to get through to resistant male clients by avoiding the potential pitfalls of therapeutic neutrality. Renowned family therapist Terry Real, the founder of the Relational Life Institute, explores how to deal with male clients by highlighting the negative consequences of their resistance, and challenging them to change their behavior by “joining through the truth.” 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 When Therapy Stalls with William DohertyThe 6 Most Challenging Issues in Therapy: NP0021 - Session 1Welcome to “The 6 Most Challenging Issues in Therapy…And How Therapists Can Overcome Them.” In this series, leading innovators in the field will explore specific kinds of cases and clients that can stump even veteran therapists—narcissists, resistant clients, individuals with borderline personality disorder, and more. Each session will focus on concrete, practical strategies that’ll help you when facing these kinds of difficult cases. In this first session, marriage and family therapist William Doherty highlights some techniques to follow when a client isn’t following the treatment plan, continues to follow a self-destructive path, or simply isn’t making progress. Learn how to avoid sounding like a disappointed parent or threatening to abandon the client when therapy stalls. 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. If you ever have any technical questions, please feel free to email support@psychotherapynetworker.org and our Support Team will help you. Comments Cyber Intimacy and Cyber Solitude with Sherry TurkleParenting Skills: Bonus Session – NP0019Consider the enormous psychological and cultural impact of today’s digital technologies on children, adolescents, parents, and society in this enlightening address with renowned MIT psychologist Sherry Turkle. You’ll discover that our smartphones, laptops, tablets, social media sites, and other electronic gadgets have a deeper impact on us as individuals, families, and society at large than we might have previously realized. 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. What were the most important or interesting takeaways from this series for you, professionally or personally? 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 Defusing Male Shame with David WexlerMen in Therapy: NP0020 - Session 3Discover why men avoid emotional confrontations because of their inherent fear of shame. David Wexler, who specializes in the treatment of relationships in conflict, describes how to develop a therapeutic relationship based on straightforward guidance and “guy talk,” rather than ambiguous “therapy-speak.” 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 Parenting with the Brain in Mind with Dan SiegelParenting Skills: Session 7 – NP0019Explore with renowned clinician Dan Siegel how applying the latest advances in the neuroscience of child development to clinical practice can have practical implications for parents and families. You’ll discover how therapists can help parents raise calmer, happier children by teaching kids to think and listen before reacting, shifting their emotional states through physical activities, and paying attention to their left brain story-telling. 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 Men and Sexuality: Challenging the Myths with Esther PerelMen in Therapy: NP0020 - Session 4Explore the poorly understood world of male sexuality by challenging some of the pervasive myths about men and their “nonrelational” attitude toward sex. Esther Perel, author of Mating in Captivity and specialist in sexuality and couples relationships, ascribes practical tools for helping men examine their own sexual blueprint. 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 The Kids Skills Approach with Ben FurmanParenting Skills: Session 6 – NP0019Teach parents a new way to praise and encourage their children while getting them to comply and overcome difficulties by shifting the focus from “problems” to helping kids gain meaningful new skills. In this approach, parents will take on the role of guides and cheerleaders and children will gain confidence in themselves. Ben Furman, psychiatrist and trainer of solution-focused psychotherapy, will explore this method and take you through case studies. 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 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 NP0018, Smarter Therapist, Bonus, Don MeichenbaumDon Meichenbaum, the founder of Cognitive Behavioral Modification, will lead you in this Bonus Session, “What Expert Therapists Do” on learning how to master the core tasks of psychotherapy and how to enhance your practice and expertise using web-based training procedures. Discover how to use new computer technology as an adjunctive tool in the psychotherapeutic relationship to improve your outcome and better help your clients. We encourage you to take a few minutes after this session to comment on what you’ve learned from this presentation, and from the course as a whole. What was most striking or most relevant to you? What questions do you have? As always, if you ever have any technical issues, just email support@psychotherapynetworker.org for help! Comments Overprotective Parenting with Michael UngarParenting Skills: NP0019 – Session 5Explore the effects that overprotective parenting can have on children with Michael Ungar, director of the Resilience Research Center and author of 11 books for therapists and children. Discover how parents can best offer children opportunities to experience risk and responsibility while ensuring their safety and give them boundaries without suffocating them, increasing their anxiety, or reinforcing their need for rebellion. 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 NP0018, Smarter Therapist, Session 6, William PinsofHow can therapists bring the science of measuring feedback and tracking change into clinical practice? Learn with William Pinsof how to work collaboratively with clients for assessment, treatment planning, progress tracking, and termination planning. Pinsof, the president of the Family Institute, will discuss how to track client change in specific symptom domains, and how to monitor the therapeutic alliance and, when ruptures occur, how to repair it.
05.24.2012 Posted In: NP0018 Becoming a Smarter Therapist By Psychotherapy Networker
We invite you to take a few minutes after this session to comment on what you’ve learned from this presentation, and from the entire course. What questions do you have? What was new, or most interesting, or most relevant to you? As always, if you ever have any technical issues, just email support@psychotherapynetworker.org for help! Comments How to Stop Bullying with Stan DavisParenting Skills: NP0019 – Session 4
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 NP0018, Smarter Therapist, Session 5, Robbie Babins-WagnerDiscover how to solicit, hear, and effectively use negative feedback from clients to enhance treatment and understand how to use outcome measures to develop mastery within specific domains. Robbie Babins-Wagner, who implemented Feedback Informed Treatment at the Calgary Counselling Center in Alberta, Canada, will illustrate how you can create a work environment that supports this kind of practice. We invite you to take a few minutes after this session to comment on what you’ve learned from this presentation, and from the course as a whole. Does your practice currently support a kind of Feedback Informed Treatment? If not, would you be interested in implementing this kind of practice? What questions do you have? As always, if you ever have any technical issues, just email support@psychotherapynetworker.org for help! Comments Attachment Issues in Stepfamilies with Patricia PapernowParenting Skills: NP0019 – Session 3Explore the distinct challenges to attachment and intimacy that the stepfamily structure often creates. Patricia Papernow, who’s worked as a trainer, consultant, and therapist with stepfamily relationships, will cover practical strategies for helping clients form healthy stepfamily relationships. 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 NP0018, Smarter Therapist, Session 4, Michael LambertIn this fourth presentation in Becoming a Smarter Therapist, learn how to actually incorporate measures of change in session with Michael Lambert. Lambert, a researcher in the areas of psychotherapy outcome, process, and the measurement of change, will discuss how to include these measures in symptoms, interpersonal problems, social-role functioning, and quality of life in your work. He’ll explain how to determine a client’s progress between sessions, and when to use clinical support tools with the client if interventions have been ineffective. We invite you to take a few minutes after this session to comment on what you’ve learned from this presentation, and from the course as a whole. What was new, or most interesting, or most relevant to you? What questions do you have? As always, if you ever have any technical issues, just email support@psychotherapynetworker.org for help! Comments Family Therapy for the Postmodern Family with Martha StrausParenting Skills: Session 2 – NP0019What are the benefits and drawbacks of working individually with a child in therapy as opposed to working with the family at large? When is it effective to involve parents and other family members in treatment? Explore with Martha Straus the best ways to work with postmodern families in therapy. 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 NP0016, Attachment, Bonus Session 2, Jerome Kagan & Daniel SiegelAt the 2010 Networker Symposium, an impromptu debate was sparked between noted researcher Jerome Kagan and esteemed psychologist Daniel Siegel about the relevance of Attachment Theory to clinical practice. This spontaneous exchange became the highlight of the conference that year and was continued to be talked about long afterward. Now, hear Kagan and Siegel back together for a conversation about Attachment Theory, the research, and its implications in clinical practice. Afterward, please take a few minutes to let us know what you think. As always, if you have any technical questions, please feel free to email support@psychotherapynetworker.org and our Support Team will help you. Comments NP0018, Smarter Therapist, Session 3, Barry DuncanWhat’s the most important key to improving as a therapist? How can we radically and consistently improve our effectiveness as clinicians? Get the answers to these questions and more in today’s session with Barry Duncan. He’ll go over ways in which we can improve as therapists, including what more than 1,000 studies have taught us about the science of the therapeutic alliance. You’ll learn what “healing involvement” is and how to achieve it with any client and how you’ll come away with a much better understanding of why outcome measurement is essential to improvement. As always, we encourage you to take a few minutes after the session to comment—what was new, or most interesting to you about this session? What questions do you have or relevant experiences to share? And as always, if you ever have any technical questions, just email support@psychnetworker.org! Comments Reclaiming Parental Authority with Ron TaffelParenting Skills: Session 1 – NP0019Today’s culture, new technologies, rough economy, and many other factors undermine the foundations of parental authority. Many parents feel confused and blamed. In this series, “Parenting Skills: All You Need to Help Family Today,” we’ll explore practical tools that therapists can use in dealing with the challenges of raising kids today. In this first session with Ron Taffel, you’ll gain a broader perspective on the social context of parent-child relationships today. He’ll explain how clinicians can help parents reassert their authority by creating effective “I mean it” moments with their kids and teens and other practical strategies for parents. After each session is over, please take a few minutes to engage in the Comment Boards. Feel free to comment about what you felt was most interesting about the session, to ask any questions you may have of the presenter or your colleagues, or to share any relevant experiences. If you ever have any technical questions, please feel free to email support@psychotherapynetworker.org and our Support Team will help you. Comments NP0016, Attachment, Bonus Session, Ed TronickThank you for your participation in “The Great Attachment Debate,” which has covered a wide range of viewpoints on attachment theory and research and how the role of attachment theory in the consulting room. For our Bonus Session, “What Therapists Should Know about Human Development,” development researcher Ed Tronick will join us to discuss development, attachment, and psychotherapy. After listening, please take a few minutes to comment about what’s been most interesting to you throughout this webcast series, what stood out to you the most after this session, and ask any questions you may have. We invite you to include your name and hometown to continue creating a sense of community and to read and respond to others’ comments and questions. As always, for any technical questions, please feel free to email support@psychotherapynetworker.org and our Support Team will help you. Comments Page 3 of 8 |
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