Surfing and Psychotherapy (or, How Two of My “Love Affairs” in Life are Alike)
I'm neither a great psychotherapist or surfer. I love doing both, however. Turns out, the two share a fundamental similarity critical to successful execution; in a word, responsiveness. /rəˈspänsivnəs/ NOUN The quality of reacting quickly and positively. In surfing, you take advantage of the waves coming your way. In psychotherapy, ...
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Time for a New Paradigm? Psychotherapy Outcomes Stagnant for 40 years
You've heard it said before. Flying is the safest form of transportation. Facts back up the claim. In fact, it's not even close. In terms of distance traveled, the fatality rate per billion kilometers is .003, improving dramatically over the years. Cars, by contrast, are almost 1,000 times more dangerous. Still, since ...
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Beating the Dodo Verdict: Can Psychotherapy Ever Achieve Better Results?
Nearly two decades have passed since I met Saul Rosenzweig at his home in St. Louis, Missouri. He was well into his nineties and still working every day. Truth is, I was surprised to learn he was still alive! In 1936, he'd penned an article --three and a half pages in ...
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“Clients Won’t Like It” and Other Concerns about Feedback Informed Treatment
In my travels each year, I meet 1,000's of clinicians--professionals who truly want to help others, and are willing to try almost anything to do so. That's why I always "lean in" whenever one expresses concern about the rising popularity of using formal measures of progress and the therapeutic relationship ...
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Aren’t You the Anti-Evidence-Based Practice Guy? My Socks. And Other Crazy Questions.
It's just two weeks ago. I was on a call with movers and shakers from a western state. They were looking to implement Feedback Informed Treatment (FIT)--that is, using measures of progress and the therapeutic relationship to monitor and improve the quality and outcome of mental health services. I was ...
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What Works in Psychotherapy? Valuing “What Works” rather than Working with What We Value
Most clinicians agree, the therapeutic relationship is an important ingredient in effective psychotherapy. However, ask them the last time they: (1) read a study on the subject; (2) attended a postgraduate training specifically aimed at improving their skills in this area; or simply to (3) identify and define the factors ...
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“What works” with eating disorders (and how long will it take the field to swallow these results)?
What works in the treatment of people with eating disorders? Search around a bit on the internet, or consult official treatment guidelines, and you'll find cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT) listed as the "best-supported" or "preferred" psychological approaches for bulimia, anorexia, and binge eating. Such recommendations strongly imply ...
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What heals trauma?
"Exposure!" a choir of professional voices sings, "its the only proven way." "No, no," others insist, "You can tap yourself to emotional freedom." "Poppycock!" another group jumps in, "Horizontal saccadic eye movements are the ticket!" "Beware the dominant discourse," a few, particularly literate warn, "focusing on what was done to the ...
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Feedback is NOT Enough: A Brief Update about the Empirical Evidence
The use of routine outcome monitoring (ROM) is on the rise. In the United States and abroad, regulatory bodies are actually mandating the gathering of outcome data as the new "standard of care." As agencies rush to implement--often at great cost in terms of time and money--the question remains: just ...
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Science is Real (confusing)
The graphic above is a small sample of the many posts I encountered on social media last week. Obviously, science has a great deal of currency in public discourse. Now, look at the bottom row. On the far left, we are told that drinking wine will help you live a longer life. ...
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Psychotherapy’s Most Closely Held Secret: Some Practitioners are more Effective than Others
Take a good look at the picture below. Do you recognize this person? Let me give you a hint. In 1974, he published the first empirical study documenting one of psychotherapy's most closely held secrets: some therapists are more effective than others. It's true. You know it. I know it. Everyone ...
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Just how good are our theories about the causes and alleviation of mental and emotional suffering?
Does the name Barry Marshall ring a bell? Probably not if you are a mental health professional. For decades, the Australian physician was persona non grata in the field of medicine -- or perhaps stated more accurately, persona sciocca, a fool. Beginning in the early 1980's, Marshall, together with colleague Robin Warren, ...
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I have some magic beans for sale…you want them?
So, you're out for a walk. It's a beautiful day but you're caught up in your thoughts, feeling a bit discouraged and concerned. For whatever reason, some of the people you are working with aren't improving. You're no novice clinician. You know impasses are a common feature of therapeutic work. ...
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Who cares about you anyway? The Role of the Psychotherapist in the Era of Evidence-based Practice
Which of the following are bad for health and longevity? A. Smoking; B. Consuming too much alcohol; C. Being overweight; D. Not flossing regularly. If you answered "yes" to any or all of the items, you are WRONG--that is, at least, if you are determined to rely on evidence ...
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Finding Meaning in Psychotherapy Amidst the Trivia and Trivial
I don't know if you feel the same way I do. Looking back, I'm pretty sure its been going on for a while, but somehow I didn't notice. Professional books and journals fill my bookshelves and are stacked around my desk. I am, and always have been, a voracious--even compulsive--reader. In the last ...
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