Clinically Thinking

A very practical discussion with Dr Tracey Wade on 10 ways to improve client outcomes in your current clinical practice. Talking points in this packed episode 03:00 What is a competency? 07:12 Firm empathy 13:15 Don’t overestimate a patient’s fragility 18:35 Prioritise early change 25:39 The role of epigenetics 30:44 Measure symptoms at each session.. 35:15 Don’t put your clients into a coma 36:58 Benefits of weekly sessions.. 40:30 Don’t assume more complex therapy is required.. 46:54 Adapting the protocol to the patient 51:08 Cognitive dissonance and motivational enhancement 55:27 Setting goals between sessions 57:29 WOOP and fantasy realisation therapy 58:21 Prioritising training and supervision Lisa and Tracey are discussing the paper "Ten generic competences to improve outcomes of cognitive behaviour therapy: Evidence, postulated processes, and clinical implications" by Tracey D Wade and Glenn Waller Grab a copy and read along at: https://www.sciencedirect.com/science/article/pii/S0005796725001482?via%3Dihub FACE TO FACE TRAINING Tracey Wade will expand on this material, and then apply it with reference to perfectionism, at a practical one day workshop being held in Adelaide, 19 June 2026. Information and registration at: https://www.bridgepsychologists.com.au/training

Dr Catherine Hynes brings Neuroscience and Neuropsychology underpinnings to her Clinical work with trauma and dissociation. Lisa and Catherine discuss the impact of trauma on memory, the controversies around repressed memories, recovered memories and false memories, and explore best practice guidelines for therapists working in this space. www.catherinehynes.net/training/ to learn more about Catherine's training and workshops. Recommended reading and research in this topic: Callus, E., Gallina, E., & Fernandez, I. (2024).EMDR: dispelling the false memory creation myth in response to Otgaar et al. (2022a). Frontiers in Psychology, 15, 1366137. doi: 10.3389/fpsyg.2024.1366137 Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardeña, E., Spiegel, D. (2012). Evaluation of the evidence for the trauma and fantasy models of dissociation. Psychological Bulletin, 138(3), 550-588. Freyd, Jennifer (1996). Betrayal Trauma: The Logic of Forgetting Childhood Abuse. Cambridge, MA: Harvard University Press. Geraerts, E., Schooler, J. W., Merckelbach, H., Jelicic, M., Hauer, B. J. A.,& Ambadar, Z. (2007). The reality of recovered memories: Corroborating continuous and discontinuous memories of childhood sexual abuse. Psychological Science, 18, 564 –568. doi:10.1111/j.1467-9280.2007.01940.x Goodman-Delahunty, J., Nolan, M. & van Gijn Grosvenor, E. Empirical guidance on the effects of child sexual abuse on memory and complainants’ evidence, Report for the Royal Commission into Institutional Responses to Child Sexual Abuse, 2017. Houben, S. T. L., Otgaar, H., Roelofs, J., & Merckelbach, H. (2018). Lateral eye movements increase false memory rates. Clinical Psychological Science, 6, 610–616. doi:10.1177/2167702618757658. Lee, C., de Jongh, A., & Hase, M. (2019). Lateral eye movements,EMDR, and memory changes: A critical commentary on Houben et al. (2018) [Letter]. Clinical Psychological Science, 6, 403–404. doi:10.1177/216770261983039 Loftus, E. (1993) The Reality of Repressed Memories. American Psychologist. 48(5):518-37 Pezdek, K., Finger, K., & Hodge, D. (1997). Planting false childhood memories: The role of event plausibility. Psychological Science, 8(6), 437–441. https://doi.org/10.1111/j.1467-9280.1997.tb00457. Ross CA, Ridgway J, Neighbors Q, Myron T. Reversal of Amnesia for Trauma in a Sample of Psychiatric Inpatients with Dissociative Identity Disorder and Dissociative Disorder Not Otherwise Specified. J Child Sex Abus. 2022 Jul;31(5):550-561. doi: 10.1080/10538712.2022.2067096. Epub 2022 Apr 19. PMID: 35437119.a van der Hart, O. & Nijenhuis, E.R.S. (1995) Amnesia for traumatic experiences. Hypnosis 1995; 22:73-86 van der Hart, O. & Nijenhuis, E.R.S. (1999) Bearing Witness to Uncorroborated Trauma: The clinician’s development of reflective belief. Professional Psychology, Research and Practice. Vol 30, Number 1, pp 37-44.

Dr Michael Proeve is a Clinically and Forensically endorsed Australian Psychologist. Dr Lisa Chantler asks Michael why remorse, guilt and shame are common factors in therapeutic issues such as Social Anxiety and Depression, and how clinicians can help.

Dr Vanessa Spiller explains the history of Fetal Alcohol Spectrum Disorder, offers tools to diagnose FASD and helpful pathways for Clinical Psychologists offering therapy. She explains why it is so easily overlooked in comparison with other commonly co-occurring diagnoses, and reveals FASD's alarmingly high rates of involvement with the criminal justice system.

Our guest today is Prof Tracey Wade. Dr Lisa Chantler speaks to Prof. Wade about the State of the Art and Science of Clinical Perfectionism. They discuss how it is defined, how therapists can identify traits of Clinical Perfectionism in the clinic, the history of the disorder, about the most recent CBT treatments, and what resources are available for clinicians.

Emeritus Professor Don Carveth draws on psychological wisdom from religion, philosophy, literature, as well as from empirical research and clinical practice, to understand how guilt influences our lives. Aaron Neaves explores the themes of Don’s latest book “Guilt: A Contemporary Introduction” in a wide ranging, thoughtful conversation. Together they discuss if there a biological basis for conscience; the distinction between persecutory guilt and reparative guilt; if psychopaths and narcissists have a conscience; if psychoanalysis can claim to be morally neutral; how understanding guilt changes our practice of trauma informed care, and much much more.

World leading neuroscientist, pain researcher and educator, Prof. Lorimer Moseley, discusses the complex relationship between our minds, our bodies and pain.

Professor Robyn Young from Flinders University is our guest discussing the presentation and diagnosis of Autism specifically in female clients. Our wide ranging discussion covered broader issues including Autism and the criminal justice system, changes in Autistic presentation with age, training for Autism assessments, clients who camouflage Autistic characteristics, the impact of Australia's NDIS funding on the diagnosis and assistance for Autism, and much, much more. Follow our Clinically Thinking Facebook page to find links or resources mentioned in the show.

Dr Aaron Frost with a challenge to clinicians: the path to improving client outcomes lies not in learning yet another new therapy, but in improving the way we do therapy, with consistent use of Deliberate Practice and Routine Outcome Measures.

Dr Allen Frances was chair of the task force writing the DSM-IV, but subsequently became an outspoken critic of the rapid expansion of mental health diagnoses in DSM-5, and what he sees as the over medicalisation of behaviours that fall into the normal range of human life. Dr Frances offers a US perspective on issues such as treating ADHD and Autism, the pros and cons of early diagnosis, the appropriate role of drugs in mental health, and strategies to bring public mental health care to the greatest numbers of people.