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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: Mind  Pat Ogden’s Luncheon AddressBody Wisdom, Lost and FoundToday’s luncheon address featuring Pat Ogden, a clinical leader on the forefront of incorporating bodywork into therapy, was fabulous. Throughout her address, she used video demonstrations to reflect her insights about integrating mind/body into therapy, which made everything she was saying feel both so present and so vivid. She also had us “try on” different gestures and postures to see how they feel. Comments Meet the 2012 Symposium VisionariesOver the last 35 years, one of the most noteworthy aspects of the Networker Symposium has been the depth and wisdom of the keynoters who address the conference. This year’s Symposium is no exception. Opening the conference with a morning keynote on Friday is Andrew Weil, the world’s leading proponent of integrative medicine. Next will be Scott Miller’s luncheon address on “Charting Your Path to Clinical Excellence,” a topic that’s been much discussed in the Networker community during this past year. He’ll share what research is showing us about how to achieve excellence, and how we can apply these understandings to gain mastery in the consulting room, as well as in our personal lives. Mary Pipher has achieved national renown as the author of Reviving Ophelia, a Pat Ogden will be Saturday’s luncheon address speaker and she’ll cover her transforming, trailblazing work that incorporating bodywork in psychotherapy. Later that day, Jane Fonda will be speaking with Networker Editor Finally, Sunday holds even more opportunities for discovery, as brain science pioneer Dan Siegel will be discussing whether our growing knowledge about brain science is making us wiser. If you’ve never heard Dan Siegel speak before—or even if you have—his presentations are always a treat. For more information about the incredible lineup of Symposium 2012 speakers, click here. Make sure to check back for more Symposium blogs soon—this blog will continue to give you a detailed view of the people and events coming up at Symposium 2012. Whether or not you decide to travel to Washington, D.C. this spring, it’s definitely worth knowing about all the exciting features this year’s conference has to offer. Comments NP0014, Diets, Session 4, Geneen RothThank you for attending this fourth and final session of “Diets and Our Demons.” We hope you’ll come away from this course with a better understanding of the scientific research on diets and an understanding of the variety of viewpoints and skills about mental and physical health that therapists can bring into the consulting room.
02.07.2012 Posted In: NP0014 Diets and Our Demons By Psychotherapy Networker
During this session with Geneen Roth, who’s the author of eight bestselling books and a leader in looking at our relationship with eating, will delve into how our eating habits reflect our basic beliefs and attitudes about ourselves. She’ll cover why eating is inseparable from our core beliefs about life, the roots of our relationship with food, how to trust your body, and how to demystify weight loss. After listening to the course, please take a few minutes to write on the Comment Board about what was most interesting to you during this session, and to reflect on the course in its entirety. What was most relevant to you in your professional and personal life? What questions remain for you? If you have any technical questions, please feel free to contact support@psychotherapynetworker.org.Thank you again for your participation in this series, and for taking the time to share your thoughts. Comments NP0014, Diets, Session 3, Linda BaconLinda Bacon, researcher, professor, and author of Health at Every Size: The Surprising Truth About Your Weight, will discuss the evidence illustrating that popular ideas regarding weight loss as equal to positive self-care can actually hinder a healthy lifestyle. She’ll cover the science that disputes conventional perspectives about health and weight, how working toward weight-loss goals can undermine a client’s ability to achieve positive, healthy habits, how to help clients understand that self-nourishment is more important than weight loss, and much more. If you have any technical questions, please feel free to contact support@psychotherapynetworker.org. Thanks for your participation. Comments Andrew Weil and the Future of PsychotherapyThis year’s 35th-Anniversary Symposium will not only offer an up-to-the-minute perspective on the field’s recent innovations and advances, but a vision of its future. We'll be exploring how all the ferment of the moment--the exciting possibilities opened up by brain science, the growing understanding of the mind-body connection, the clinical influence of mindfulness practice, the emerging science of human performance--will shape therapeutic practice in the years to come. In his Symposium keynote address, "The Vision of Integrative Mental Health," Andrew Weil, world-famous pioneer in the development of complementary medicine, will explore the new skills and knowledge the practitioner of tomorrow will need. We interviewed him recently and here's what he had to say: 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 NP0013, Mindfulness, Session 3, Tara BrachExplore RAIN, a simple but powerful technique for directing attention to one’s inner world, with Tara Brach, a leading Western teacher of Buddhism, known for her ability to integrate psychotherapy with meditative and mindfulness practices. Understanding and learning how to implement RAIN into your clinical practice will allow you to help clients discover the thoughts, emotions, and feelings that make up their true inner experiences, and will open the door for deconditioning unconscious patterns. After the session, please take a few minutes to engage in the Comment Board and let us know your reflections. What do you think about this technique and how it might be implemented into your professional or personal life? 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 NP0014, Diets, Session 2, Judith BeckJoin Judith Beck, one of the world’s leading cognitive-behavioral therapists, in this second session of “Diets and Our Demons.” She’ll cover the skills that are necessary for successful dieting, and detail what’s most important to effective weight loss. Beck will explain how to help clients follow through on a healthy lifestyle by facilitating the development of pre-dieting skills, regularizing eating, changing food selection, planning for special occasions, and keeping the motivation to integrate these skills into everyday life in a long-term manner. Comments NP0014, Diets, Session 1, Judith MatzWelcome to “Diets and Our Demons,” a 4-week webcast series, which will cover a variety of perspectives about helping clients maintain mental and physical health.
01.17.2012 Posted In: NP0014 Diets and Our Demons By Psychotherapy Networker
In this first session with Judith Matz, the director of the Chicago Center for Overcoming Overeating, she will present some of the research that shows that dieting is actually counterproductive. Matz will discuss why the practices of attuned eating and weight acceptance can offer a more effective substitute to conventional dieting techniques. After each webcast session, a Comment Board will be provided so that all of you can share reflections on what you’ve learned, or any questions you may have. We believe these forums create a sense of community of learning and help inspire each other. Please take a few moments to comment on what was most interesting or relevant to you, and we encourage you to include your name and hometown with your comments. Thank you so much for your participation, and welcome to this relevant series. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org anytime. *Make sure to check out our January/February 2011 issue, which was also called “Diets and Our Demons.” This issue reported on research and case studies related to different ways of looking at dieting and maintaining a healthy lifestyle. If you’re interested, check out that issue here. Comments NP0013, Mindfulness, Session 1, Jack KornfieldWelcome to the New Perspectives on Practice series, “Is Mindfulness Enough?” This series will explore the benefits and limitations of both psychotherapy and mindfulness as well as the integration of these two wisdom traditions. In the first session with leading Buddhist teacher Jack Kornfield, he’ll discuss the erroneous belief that prayer and meditation is all that’s needed for personal transformation, talk about how to combine meditation with our daily activities, and describe how to bring the sacred into the practice of therapy.
01.10.2012 Posted In: NP0013 Is Mindfulness Enough? By Psychotherapy Networker
Throughout the series, a Comment Board after each session will be available. The Comment Boards are a way for course participants to share thoughts and reflections about what was most interesting after each session 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 engage in the Comment Board. What was most striking about this session? What questions do you have? Thank you so much for your participation, and welcome to this relevant series. If you ever have any technical questions or issues, please feel free to email support@psychotherapynetworker.org anytime. Comments |
He’ll be discussing the meaning of integrative mental health and how therapists can enrich their knowledge and understandings to help clients—and themselves—achieve optimal health. To learn more about integrative mental health, see the recent Networker article on his work 
nd she will be inspiring attendees as the Saturday morning keynote speaker. Her subject—“Facing the Challenge of 21st-Century Activism” is a compelling presentation of her vision of the many ways therapists can influence the world-at-large and why doing so can make us feel more joyous, connected, and empowered.
Rich Simon about her life, career, and beliefs about how to improve your life while growing older. Yes, that’s right… Jane Fonda will be at the Networker Symposium! You really won’t want to miss this conference and especially not this particular dinner event.
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