

The Modern Therapist's Survival Guide with Curt Widhalm and Katie Vernoy
Curt Widhalm, LMFT and Katie Vernoy, LMFT
The Modern Therapist’s Survival Guide: Where Therapists Live, Breathe, and Practice as Human Beings It’s time to reimagine therapy and what it means to be a therapist. We are human beings who can now present ourselves as whole people, with authenticity, purpose, and connection. Especially now, when clinicians must develop a personal brand to market their private practices, and are connecting over social media, engaging in social activism, pushing back against mental health stigma, and facing a whole new style of entrepreneurship. To support you as a whole person, a business owner, and a therapist, your hosts, Curt Widhalm and Katie Vernoy talk about how to approach the role of therapist in the modern age.
Episodes
Mentioned books

Mar 7, 2022 • 39min
Thriving Over Surviving: Growing a Practice without Burn Out
Thriving Over Surviving: Growing a Practice without Burn OutCurt and Katie interview Megan Gunnell, LMSW, coach, and Founder and Director of Thriving Well Institute. We explore: What changes are therapists facing as they grow their practice in the telehealth age? How do therapists scale their businesses and what should they be aware of? Can a therapist and their practice thrive, or does something have to give? All of this and more in the episode.Interview with Megan Gunnell, LMSW and Founder & Director of Thriving Well InstituteMegan Gunnell LMSW, is Founder and Director of Thriving Well Institute which aids therapist in building the private practices of their dreams. Megan offers a series of courses and individual coaching to aid therapists in expanding their private practices through building group therapy programs, building online courses, creating in person retreats, and even how to build a group practice. Megan teaches therapists how to build not only their practices but themselves up. Megan has been a practicing clinician for over 20 years working as an individual therapist in addition to her coaching and advisory work. Megan started her work as a music therapist, a passion which she still carries to this day. In this podcast episode we talk about how therapists can build their practices without burning out.With the increase in telehealth therapy options, therapists are confronted with a unique problem. How does a therapist build their practice with so many therapeutic options out there, while simultaneously avoiding burn out? Curt and Katie connect with Megan Gunnell to discuss how therapists can make sure they, and their practices, thrive.How can therapists’ network as telehealth therapists?
Your potential client base has now become the whole state.
Focus on designing your online real estate and increase your SEO.
Joining local Facebook groups of therapists can help expand your referral base.
Speak to specific client issues on your website that you specialize in.
Avoid template and more generalized language in websites and marketing material.
Make your website unique but clear in what you work with.
What is scaling and how does it avoid burn out?
For many therapists, caseloads have increased dramatically over the past couple years
Scaling is more about pivoting than it is creating passive income.
Looking to expand your practice into a group practice can help alleviate referral loads.
Some therapists can avoid burn out by diversifying their workload and reintegrating natural talents such as creativity.
Getting into community, especially with other therapists, is a great way to avoid burn out.
There is still a need for single-focus private practices.
What can therapists do to scale their businesses?
Be in tune with out motivated you are to scale your business; ask how committed am I?
Consistency is key.
Have a willingness to make mistakes and take risks.
Don’t be afraid of failing; use moments of failure to motivate you.
Be open to learning new things like tech, marketing, or automation.
Be realistic of your capacity to take on learning sometimes complicated or frustrating systems that might help your business.
Don’t be afraid of showing who you are as a person as you build out your practice.
It can be scary to expand your practice, and many therapists want assurance, but there is no one way to expand – it’s individual to your unique practice.
It can take support to expand your practice; reach out to your community for help.

Feb 28, 2022 • 46min
What’s New in the DSM-5-TR? An interview with Dr. Michael B. First
What’s New in the DSM-5-TR?Curt and Katie interview Dr. Michael B. First, MD, editor and co-chair of the American Psychiatric Associations’ DSM-5 Text revision, coming out March 2022. We explore: What are the differences between a full update and a text revision? What changes have been made (and how were these changes decided)? What new diagnoses can we expect? Can clinicians continue to use the older DSM-5? How can clinicians advocate for changes in future versions of the DSM? All of this and more in the episode.Interview with Dr. Michael B. First, MDWhat changes have been made in the new DSM-5-TR?
Text revisions occur to avoid letting the text become stale while supporting ongoing updates.
New disorders, specifically Prolonged Grief Disorder, have been added.
New codes, modeled off symptom codes, created for documenting suicidality and non-suicidal self-injury with another diagnosis.
New categories of Unspecified Mood Disorder.
New Criteria set for Autism Spectrum Disorder which is more conservative.
How are cultural differences addressed in the DSM-5-TR?
Starting with DSM-IV, there has been a special committee created for culture and culture related issues
Hypothetically, the criteria sets should apply to everyone, but in the text, there is a section on Culture Related Features which is more specific.
The impact of the George Floyd protests inspired the creation of a new committee to look for systemic racism, lack of nuances, and prevalence issues within the DSM.
There are conflicting opinions if “transness” should be included in the DSM and if it’s even a mental disorder.
As the DSM is a diagnostic tool to code for insurance, the DSM takes the stance that the Gender Dysphoria diagnosis stay included so individuals can have access to medical intervention and treatment.
The Steering Committee for new diagnosis is small, but there is diversity.
Before a diagnosis is approved, it is posted for 45 days on the DSM website for all, including people with lived experience, to comment and advocate for diversity
What is the Process for Accepting New Diagnose?
The steering committee accepts proposals through the DSM portal for new diagnosis
Some diagnoses are qualified based on the United States’ continued use of ICD-10, whereas the ICD-11 is more progressive.
With Complex Post Traumatic Stress Disorder, some of the criteria from the ICD have been incorporated into the DSM diagnosis of PTSD
Proposals are floated around often, but they often don’t have enough empirical research yet.
Proposals need to show a pool of patients who don’t fit other diagnoses, a gap in treatment, and a difference from other possible similar diagnoses.
New diagnoses will be approved on a continuum, making the electronic DSM-V-TR the most up to date resource.

Feb 21, 2022 • 40min
How Therapists Promote Diet Culture: An interview with Rachel Coleman
How Therapists Promote Diet Culture: An interview with Rachel Coleman Curt and Katie speak with Rachel Coleman, LMFT, CEDS about what therapists should consider in working with clients who have eating disorders, the impact of society on body image, and how clinicians can increase their competency in an area many feel they are lacking. Why do so many clinicians feel under trained in treating eating disorders? How do societal views impact our client’s body image and what is the impact of diet culture? Does a lack of graduate education in eating disorders ethically impact our ability to treat eat disorders in a non-specialized practice? What’s missing from our understanding of eating disorders? All of this and more in the episode. Interview with Rachel Coleman, LMFT, CEDSWhat do clinicians do when therapeutic interventions might trigger eating disorder behavior?
Many interventions call for physical activity that might trigger eating disorder behavior or feelings in clients.
If a client wants to participate in a physical activity intervention, consider their motivation.
Ensure that a client has multiple tools in their anxiety toolbox.
Be mindful if the modalities and treatment recommendations are based in fat phobia or weight stigma.
How can clinicians assess their clients for an eating disorder?
Eating disorders can present meeting full DSM-V criteria or, in many cases, seem at the “subclinical” or mildly clinical level.
Evaluate how your client feels about societal messaging and the impact it might have on them.
In assessing clients, look to determine the impact of behaviors and patterns on daily functioning. If client’s are sacrificing other values to focus on weight or body, it should be discussed.
How can clinicians increase their education in treating eating disorders?
Clinicians need to do their own work surrounding their bodies and internalized messaging.
Therapists should focus on learning about the complexities of eating disorders and the social justice movements that surround weight stigma and fat phobia.
Familiarize yourself with the ideas of body trust, body neutrality, and health at every size.
Many treatment centers offer free webinars to educate clinicians in eating disorder treatment.
What are the ethical and legal considerations in treating eating disorders in a non-specialized private practice?
Always get consultation.
Some clients might present with “subclinical” or mildly clinical levels of an eating disorder.
There is a difference between asking questions and treating the answers.
Clinicians should encourage clients to see a medical doctor when necessary.
Working with dieticians and medical doctors to create a holistic team, best serves the client.
Clinicians should be aware when to refer to a higher level of care.
Therapists should limit self-disclosures
How does Diet Culture impact our clients?
Diet culture is a mindset and system of theories we all exist in, that credits a person’s shape and size as the primary indicators of health and moral superiority.
When bodies don’t meet these “standards” of beauty as societally defined, they are often oppressed.
Messaging about dieting and our bodies is inescapable in our society, so it’s easy for subconscious beliefs about food and bodies to infiltrate sessions.
Therapists’ self-disclosures should be limited and focus on affirming client’s experience.

Feb 14, 2022 • 1h 17min
What to Know When Providing Therapy for Elite Athletes
What to Know When Providing Therapy for Elite AthletesCurt and Katie chat about the specific competence required to work with elite athletes. We explore how elite athletes present (including diagnosis) as well as what treatment looks like for elite athletes. We also talk about the training cycles and periodization, developmental stages, and identity formation for competitive athletes. We also look at what healthy training environments include and how athletes can take care of their own well-being. In this podcast episode we look at what therapists need to know about working with elite athletesFor our second continuing education worthy podcast, we wanted to support therapists in understanding what they need to know (or know that they don’t know) about working with elite athletes.The differences between being a fan and being competent to work with elite athletes
The types of competence needed to support athletes who are at an elite level
Sports psychology and other areas of specialty to support athletes
The stringent criteria to be called a sports psychologist
What diagnoses do athletes present with when they enter therapy?
Not necessarily anxiety, but it can be anxiety related or unrelated to sport
Diagnoses can be related to the sport due to body, substance, or changes in circumstances
Diagnoses can also be related to other elements of their life and transitions
What does treatment look like for elite athletes?
High school and college athletes are most likely the clients we’ll see
The integral nature of their team and who is best to be included in the treatment team
Logistics and scheduling due to games and practices, obtaining required consents
Training schedules, food information is relevant to therapeutic work
The different goals for elite athletes than for other folks who enjoy sports
Looking at in the moment frustrations versus a desire to leave the sport
Sports assessments to identify athletic coping skills
Helping athletes to make decisions for themselves and identify when it’s burnout and when it’s a mismatch
Understanding training cycles and the impact on athlete clients
Specific language that athletes may use
Periodization, micro, meso, and macro cycles in training
The importance of planned growth and rest as well as peaking at the right time
The focus of timing for everything
How injuries or changes in schedule (like with covid) can impact this timing and what that means for athletes
Developmental factors for young athletes
The focus of training for younger children as well as the investment phase for youth
Developing one’s identity as an athlete
What can positively impact and negatively impact the future commitment to sport
Other developmental factors related to being a teen interacting with these developmental elements
What a balanced life looks like for elite athletes
Who athletes spend time with, share their life with
The hobbies that complement the sport
Understanding how maintenance impacts the rest of the schedule
The factors that improve an athlete’s well-being
Myths related to the tangential benefits of being an elite athlete (i.e., I’ll get college paid for)
The importance of having a therapist who isn’t just a “fan”
The differences between team and individual sports
The competency needed related to understanding the sport to understand all of the dynamics
What good social systems around athletes have in common
The understanding of how each person in the athlete’s circle interacts with the goals
The culture created within the team and with the people around the athlete
Simone Biles and Naomi Osaka – a look at how they have been taking care of themselves
The transition out of being an elite athlete
Injury and unplanned retirement
Planning for an intentional retirement
Moving out of the athlete identity into something new

Feb 7, 2022 • 45min
Antiracist Practices in the Room: An Interview with Dr. Allen Lipscomb
Antiracist Practices in the Room: An Interview with Dr. Allen LipscombCurt and Katie speak with Dr. Allen Lipscomb, PsyD, LCSW about what therapists should consider in working with Black clients, common mistakes, and implementing anti-racist procedures into practice. What can therapists do better? Where is graduate education lacking? How do we respect and explore our Black client’s narratives? Who can work with Black clients? How can therapists help clients heal from race-based trauma?How can we do better with our Black male clients?
Black male grief shows up in different ways than other client’s grief might show up.
When assessing Black males for psychosis or conspiracy theories, ensure that you look at the context of their lived experience before determining psychosis
The traumatic experiences of racialization, trauma, and mistreatment that many Black people can sound like lead to thoughts that might sound psychotic to an uneducated clinician.
Listen to the client’s narratives. Question what the themes and patterns are and if the thought is maladaptive to their functioning and well-being.
Utilize FIDO: frequency, intensity, duration and onset in questioning clients
If a clinician is unsure if a thought is a conspiracy or legitimate threat, assess for how the client’s community is responding to the client’s narrative
Ask clients how the session was for them. How was it for you to meet with me? Acknowledge your cultural limitations and create an invitation for the client to let you know when you can do better.
Be mindful, Black male clients might be minimizing their experiences to be “less threatening.” This is the cultural congruency dichotomy that clients often have to take to avoid further potential trauma.
What does it mean to be antiracist?
Clients might be resistant to bringing up a clinician’s whiteness in the space.
Black clients might not think that a white clinician has the capability or desire to talk about race. It is the responsibility of the clinician to actively establish the openness of the space to discuss race and the client’s lived experience.
This should be a continuous conversation that is led by therapists, to make the topic open until it feels naturally open.
It’s affirming to have someone who is white in a position of power to say to me – hey I recognize we’re racially different and we could have a different experience how that shows up in this space.
You can catch moments where anti-racist action could’ve been taken or acknowledged in the next session, if missed during a session.
The need to revamp our graduate programs to be anti-oppressive and anti-racist
How to show up as an ally in the room, without centering your own experience
What is Dr. Allen Lipscomb’s BRuH Method?
The BRuH Method, or BAT, stands for BRuH Approach to Therapy.
BRuH stands for Bonding through Recognition to promote Understanding in Healing when providing therapeutic services to Black men specifically.
The approach is modeled off of other therapeutic approaches like CBT and DBT
Phases include: Bonding Phase, Recognition Phase, Understanding Phase, Healing Phase
The clinician is always doing aspects of the various phases throughout the course of treatment
This is not an evidence-based practice but an honoring based practice
The evidence of efficacy in this practice comes when you see your clients continuously returning to receive more sessions, from the feedback they give you, and the improvements in day-to-day life.
Who can work with Black male clients?
There can be an urge for white therapists to refer clients of color, especially Black men, to Black clinicians
These referrals are unnecessary. A therapist of any background, if holding the space correctly and connecting with the client’s felt experience, can work with a client of color, specifically Black men.
It’s important to be mindful that questions asked to clients are not investigative or for the purpose of educating the therapist.

Jan 31, 2022 • 1h 6min
What Can Therapists Say About Celebrities? The ethics of public statements
What Can Therapists Say About Celebrities? The ethics of public statementsCurt and Katie chat about whether therapists should make public statements and diagnose public figures. This is our first continuing education eligible podcast, discussing the ethics of speaking out about the mental health of people in the public eye. We explore the origins of the Goldwater rule, a group of psychiatrists who purposefully broke it, and how masters level organizations address this concern. We also provide you with some ideas about how you can make this decision for yourself.In this podcast episode we look at the ethics of modern therapists diagnosing public figuresFor our first continuing education worthy podcast, we wanted to address something that is becoming more and more prevalent in our field: therapists speaking out about the mental health of public figures.What is the Goldwater Rule?
The history of the Goldwater Rule
The impact of DSM II (and the update to DSM III)
The original intention of the rule versus the current interpretation of the Goldwater Rule
Fears from the American Psychiatric Association that seems to have driven the development of (and on-going commitment to) this rule
How the Goldwater Rule (and Similar Ethical Principles) Have Shifted Over Time
Perspective from one of the original framers of the Goldwater Rule
Moving from teleological to deontological interpretations
How the internet and social media has changed the landscape
The American Psychiatric Association expanding their commitment to the Goldwater Rule, stating reasons psychiatrists should not assess
The Goldwater “Caveat” or “Principle” versus Goldwater “Rule” or even Goldwater “Doctrine”
Beyond diagnosis to restricting any comment on the behavior or mental health of a public figure
The stance on this ethic from American Psychological Association and the large Masters Level Organizations (AAMFT, ACA, NASW, and CAMFT, for example)
The Dangerous Case of Donald Trump – the Public Diagnosis of an American President
The group of psychiatrists who pushed back on the Goldwater Rule
The Duty to Warn – does it apply here?
What are the challenges of accurately diagnosing Trump?
Where expertise is helpful (and how the public can water down diagnosis)
Current Guidelines for Modern Therapists
Whether diagnosis is required for a duty to warn
The tactic of putting forward information without drawing conclusions (and why we don’t like this strategy)
Specific guidance from the professional organizations on what therapists can and cannot do
Taking special care in how one decides what they say about an individual in public settings
Using one’s professional judgement and special care
Cautions When Using Your Professional Judgment
The potential harm of discussing diagnosis on social media
Bias, cultural factors, and other information that could make an inaccurate or harmful diagnosis
Mental health stigma and other concerns related to diagnostic language (ICD-10, DSM-V)
Speaking outside of your professional expertise
Questions to ask yourself before making a public statement

Jan 24, 2022 • 45min
Working with Trans Clients: Trans Resilience and Gender Euphoria
Working with Trans Clients: Trans Resilience and Gender EuphoriaAn interview with Beck Gee-Cohen, MA CADC-II, about how therapists can be better clinicians for trans people. Curt and Katie talk to Beck about gender identity (and why every therapist should do their own work around gender), historical perspectives on masculinity and femininity, the concepts of trans resilience and gender euphoria, the real problems with the DSM diagnosis of gender dysphoria and considerations for providing therapy to trans clients. Interview with Beck Gee-Cohen MA CADC-II Director of LGBTQ+ ProgrammingIn this podcast episode we talk about trans mental healthWe invited Beck Gee-Cohen, MA CADC-II to come talk with us about providing therapy for trans individuals.Modern therapists need to keep learning when working with trans clients
Getting pronouns correct is a basic expectation at this point
Finding the balance between focusing on a client’s trans identity and other elements of their identity and experience
Understanding trans identity 101 is a basic level of knowledge that all therapists should have
What you do need to learn from your trans clients
Therapists need to do their own work around gender
The work that therapists must do around gender
The role that society plays in defining gender and the binary
The privilege cis folks have in not being asked to assess/address their gender
“Women’s” and “men’s” issues
Societal expectations related to gender
The history of gender expression and how what is acceptable has shifted
Cultural and generational differences related to gender
The Concept of Trans Resilience
The tendency to focus on the pain of being trans
The bias and hate that trans folks face, and how they continue to show up
The importance of celebrating who you are as a trans person
“You’re so brave” doesn’t see the full picture
How hard it is to show up – and what it means that trans folks continue to do so
Moving away from just focusing on gender dysphoria versus looking at gender euphoria
Gender Dysphoria versus Gender Euphoria and the problems with the DSM
How the DSM is used for the medical needs of trans folks
The problem with assigning the diagnosis of Gender Dysphoria to an individual
Internalized gender dysphoria (it is not my dysphoria, it is the dysphoria of the people around me about my gender)
Playing around with gender shouldn’t be a diagnosis, it is so culturally bound
Trans individuals have to know what to report so they can get hormones (i.e., they may have to lie about being dysphoric in order to “check the boxes”)
The problem with gatekeeping and the hope that trans folks being in work groups to help shift these guidelines
Better Therapy for Trans Clients
Therapeutic alliance is the most important
How therapists can appropriately use vulnerability when a client comes out as trans
The likelihood of someone coming out initially versus after trust is built and how to handle it
Sharing the therapeutic process and how you will learn and educate yourself
The problem of signaling that you are capable of working with LGBTQ+ people when you are not trained
Awareness of how being trans impacts the client in front of you
When the client is coming into therapy due to their gender identity
Understanding the back story and how someone identified that “something is different”
Looking at what they want to do next (which may be very little or a full plan on how they handle being trans).

Jan 17, 2022 • 31min
Who’s in the Room? Siri, Alexa, and Confidentiality
Who’s in the Room? Siri, Alexa, and ConfidentialityCurt and Katie chat about how therapists can maintain confidentiality in a world of AI assistants and smart devices. What duty do clinicians have to inform clients? How can we balance confidentiality with the reality of how commonly these devices are involved in therapy? Can telehealth therapy be completely confidential and data secure? We discuss our shift in clinical responsibility, best practices, and how we can minimize exposure of clinical data to ensure the confidentiality our clients expect and deserve.In this podcast episode we talk about something therapists might not consider: smart devices and AI assistantsWe received a couple of requests to talk about the impact of smart devices on confidentiality and their compliance with HIPAA within a therapeutic environment. We tackle this question in depth:What are best practices for protecting client confidentiality with smart devices?
Turning off the phone, or placing the phone on “airplane mode”
Warning clients about their own smart devices and confidentiality risks
The ethical responsibilities to inform about limits of confidentiality and take precautions
It’s all about giving clients choice and information
What should therapists consider when smart devices and AI assistants are in the room? – Curt Widhalm
Whistle-blower reports on how often these devices are actually listening
Turning off your phone is a lot cheaper than identity theft
Consider your contacts, geolocation, and Wi-Fi connection
Some of this, as we progress into a more technological world, might be unavoidable
How do Alexa and Siri impact HIPAA compliance for therapists?
The importance of end-to-end encryption for all HIPAA activities (and your smart device may not be compliant)
The cost of HIPAA violations if identity theft can be traced back
Understand the risks you are taking, do what you can, and remember no one is perfect
What can modern therapists do with their smart devices?
GPS location services can be left on for a safety reason, emergency services use GPS location
Adjusting settings for voice activation, data sharing, when apps are running, locations, etc.
Turning off and airplane mode are also options
Always let the client know the limits of confidentiality
Resources for Modern Therapists mentioned in this Podcast Episode:We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!Psychotherapy in Ontario: How Confidential is my Therapy? By Beth Mares, Registered Psychotherapist The Privacy Problem with Digital Assistants by Kaveh WaddellHey Siri and Alexa: Let's Talk Privacy Practices by Elizabeth Weise, USA TodayPatient and Consumer Safety Risks When Using Conversational Assistants for Medical Information: An Observational Study of Siri, Alexa, and Google Assistant, 2018Hey Siri: Did you Break Confidentiality, or did I? By Nicole M. Arcuri Sanders, Counseling TodayAlexa, Siri, Google Assistant Not HIPAA Compliant, Psychiatry AdvisorHey Alexa, are you HIPAA compliant? 2018Person-Centered Tech

Jan 10, 2022 • 40min
How to Understand and Treat Psychosis
How to Understand and Treat Psychosis: An interview with Maggie Mullen, LCSWCurt and Katie interview Maggie Mullen, LCSW, a national trainer on culturally responsive, evidence-based care for psychotic spectrum disorders. We talk with Maggie about their anti-racist and disability justice framework of psychosis, understanding psychosis on a spectrum, what to do when psychosis enters the treatment picture, assessment of psychosis, and treatment using Dialectical Behavior Therapy (DBT). We also talk about how society defines “normal” and pathology, exploring cultural differences in these definitions.Interview with Maggie Mullen, LCSWIn this podcast episode we talk about looking at psychosis differentlyMaggie Mullen’s anti-racist and disability justice framework of psychosis
Maggie came from a community organizing background
Inequity and lack of resources for people who experience chronic psychosis
The focus on medication rather than other forms of treatment for psychosis
BIPOC individuals being shot by police when psychosis shows up in a public space
“Psychotic spectrum” versus the segregation of psychosis as “other”“We are often the least prepared to deal with our most acute clients”
The continued segregation of psychotic disorders
Cultural considerations when determining what is psychosis or other types of experiences
The lack of inclusion of psychosis in the research
Psychosis is not “other” but is actually a spectrum of behaviors and are very common
The symptoms of psychosis are not constant, they fluctuate for every individual
The importance of following the model and voices of the disability justice movement
Including education on the treatment for psychosis, rather than allowing therapists to opt out
Folks with psychosis are often not included in the research, which needs to change
What to do when psychosis comes into the treatment picture for our clients
We need more training on psychosis to feel confident
Normalizing the experience of psychosis
Helping to make peace with psychotic symptoms (i.e., making friends with the voices) to decrease distress
Looking at treatments beyond medication
How to identify psychosis and assess for impact and impairment
The myth that all elements of psychosis are distressing and bad
Why Maggie Mullen is using Dialectical Behavior Therapy (DBT) to treat psychosis“People with psychosis deal with emotion dysregulation, actually more so than the average person…that's where we know DBT is really effective”
We frequently underestimate the ability to help folks with psychosis
Using DBT skills for emotion regulation concerns that frequently come up in psychosis
Psychosis and PTSD oftentimes occur together and aren’t always diagnosed
Trauma can influence the onset of psychosis AND psychosis can be traumatic
Maggie’s pilot program with DBT for psychosis
The concrete and straight forward nature of DBT skills make them very accessible
Understanding psychosis differently, including the cultural differences of what is “normal”
How to identify what is “real” and what is psychosis
How do you define what is normal for someone?
What do we decide what we pathologize?
Breaking up the binary of normal or not normal – reframing as “experience”
The importance of understanding what is negatively impacting the client and how to keep clients safe
Take the lead of your client and trust that they know themselves best
The tension between taking the lead of the client and mandates and requirements as a therapist
The Dialectical Behavior Therapy Skills Workbook for Psychosis by Maggie Mullen, LCSW
Maggie wrote a book to democratize DBT skills
Using DBT, but making the skills more concrete and accessible

Jan 3, 2022 • 35min
Which Theoretical Orientation Should You Choose?
Which Theoretical Orientation Should You Choose?Curt and Katie chat about how therapists typically select their clinical theoretical orientation for treatment. We look at the different elements of theoretical orientation (including case conceptualization, treatment interventions, and common factors), what impacts our choices, the importance of having a variety of clinical models to draw from, the types of practices that focus on only one clinical theory, and suggestions about how to approach choosing your theories for treatment, including some helpful assessments.In this podcast episode we talk about how therapists pick their theoretical orientationWe received a couple of requests to talk about clinical theoretical orientation and how Curt and Katie chose their own. We tackle this question in depth:Choosing a clinical theoretical orientation
The problem with the term “eclectic” when describing a clinical orientation
How Curt and Katie each define their clinical orientations
“Multi-modal” therapy
The different elements of clinical orientations
Case conceptualization
Treatment interventions
Common Factors and what actually makes therapy work
What impacts which theoretical orientation we choose as therapists
Clinical supervision
Training
Personal values and alignment with a theoretical orientation
Common sense (what makes sense to you logically)
Choosing interventions that you like
The importance of having a variety of clinical theories that you can draw from
Comprehensive understanding is required to be able to apply and know when not to apply a clinical orientation
Avoid fitting a client’s presentation into your one clinical orientation
Deliberate, intentional use of different orientations
Why some therapy practices operate with a single clinical model
Comprehensive Dialectical Behavioral Therapy (DBT) therapists run their practices and their lives with DBT principals
Going deeply into a very specific theory (like DBT, EMDR, EFT, etc.) while you learn it
Researchers are more likely to be singularly focused on one theory
Suggestions on How to Approach Choosing Your Clinical Theoretical Orientation
Obtain a comprehensive understanding of the theoretical orientation
Understand the theory behind the interventions
Recognizing when to use a very specific theory or when you can be more “eclectic” in your approach
Deciding how fluid you’d like to be with your theoretical orientation
Find what gels with you and do more of that
The ability to pretty dramatically shift your theoretical orientation later in your career
Instruments for Choosing a Theoretical Orientation
Theoretical Orientation Scale (Smith, 2010)
Counselor Theoretical Position Scale
Resources for Modern Therapists mentioned in this Podcast Episode:We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!Institute for Creative MindfulnessVery Bad Therapy PodcastPetko, Kendrick and Young (2016): Selecting a Theory of Counseling: What influences a counseling student to choose?What is the Best Type of Therapy Elimination Game The Practice of Multimodal Therapy by Arnold A. LazarusPoznanski and McClennan (2007): Measuring Counsellor Theoretical OrientationRelevant Episodes of MTSG Podcast: Unlearning Very Bad Therapy Interview with Dr. Diane Gehart: An Incomplete List of Everything Wrong with Therapist Education


