Clinician's Digest - Page 3

Teaching Old Therapists New Tricks

If you spend time hanging around cognitive-behavioral therapists, especially the research-oriented ones, says Yale psychologist Joan Cook, you'll hear so much enthusiasm these days about Acceptance and Commitment Therapy (ACT), the "third wave" of behavioral therapy, that you'll think it's swept across the entire field of psychotherapy. Yet you'll hear virtually nothing about newer therapies such as Internal Family Systems that have garnered more enthusiasm among psychodynamic or humanistic-oriented therapists. The converse is probably also true: how often do psychodynamic therapists show much interest in learning about ACT?

Most people would agree that therapists with a wider repertoire of skills and perspectives have a better chance of helping more clients. But learning a new treatment takes considerable time, money, and effort. So Cook began to wonder what makes therapists expand their clinical repertoire.

The scant research on the question has so far focused on samples too narrow to adequately answer her question. Then she realized that Psychotherapy Networker readers represented the broad spectrum she needed: the psychologists, counselors, and social workers who subscribe to the magazine have a wide range of experience and work in a variety of practice settings stretching across the United States and Canada. Over 2,000 Networker clinicians took part in Cook's survey, which is reported in the May 2009 Psychiatric Services.

It turns out that most therapists aren't influenced to learn a new treatment by reports of its effectiveness published in journals or the fact that a professional organization has designated it as having empirical support. One of the three top reasons clinicians learn a new therapy is a belief that it can be integrated with the approach they already practice. The other top two reasons are that it's endorsed by a respected therapist or mentor and that there are local training opportunities.

The strongest combination of motivations to learn a new treatment, as Networker readers might suspect, results from networking: therapists' colleagues introduce them to something new and demonstrate to them how the new technique can resonate with their existing skills and predilections.

Internet Self-Help for Porn Addiction

More than 41 million smart phones were sold worldwide in just the third quarter of last year, and the boom has helped increase the effectiveness of online support groups. Although such groups have been around since the early days of the Internet, the advent of smart phones, which allow people to communicate with text, video, and other graphics and to interface with social-networking sites like Facebook, have transformed online support groups.

Before smart phones and social networking, such groups were little more than electronic bulletin boards; people would post a message and check back later for a response. Despite exchanging messages with someone who shared the same problem, such groups did little to break the grip of isolation and shame. But now support group members share photos, videos, and their Facebook pages, and communication takes place 24/7.

Some people insist this form of communication just provides an excuse to avoid the "real" contact of face-to-face support groups or therapy. However, for the increasing numbers of people who have grown up using electronic communication, it may not be an intimacy dodge, but real communication, and research finds that checking in electronically with people who are also struggling with depression, anxiety, or substance abuse can reduce symptoms.

In an article on an Italian online support group for Internet pornography addicts, Israeli social worker Gabriel Cavaglion, from Israel's Ashkelon Academic College, reports that many of the group's more than 2,500 registered members have found that using the same Internet that enabled their difficulties has provided an avenue out of shame and isolation to deeper human connection. A group member who fears surrendering to the temptation of porn can choose instead to send out an e-mail for help and receive instant support. "Stand up, go drink a glass of water, go OUT, take the first train without even looking where it's headed," another member may reply instantly. "Start looking at things as if it's the first time, and you'll discover how we look at things only superficially."

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