Therapy on the Cutting Edge W Keith Sutton PsyD

In this episode, Carmen discusses her work in family therapy and her Socioculturally Attuned Family Therapy. Carmen shared that she entered the field when there were feminist critiques of family therapy and a focus on power in the therapeutic relationship. She explained that she went to Loma Linda University to direct the family therapy doctoral program, and worked with Douglas Huenerardt, Ph.D. doing cotherapy. They invited students to observe, and their goal was to be able to articulate the work they were doing, and later finalized it into a research study. She explained that the model that evolved out of that work was named Socioemotional Relationship Therapy. Later, she moved to Oregon to teach at Lewis and Clark College, and worked with Teresa McDowell, EdD, LMFT, and wrote the textbook, Socioculturally Attuned Family Therapy, with Teresa and Maria Bermudez, Ph.D., LMFT. We discussed how Carmen’s background in sociology led her to always be thinking about sociocultural aspects and how they play out in relationships. She explained that Teresa introduced the idea of Third Order Thinking or Third Order Change to her, which goes beyond the Systemic concept of Second Order change, to bring awareness to the therapist and client of how the sociocultural system the relationships are embedded in and influence their experiences. She also discussed how this helps therapists be aware of how they are accountable for possibly unknowingly reinforcing and repeating larger societal patterns. Carmen discussed the Socio-Emotional Relationship Therapy Model and how it is influenced by experiential, structural therapy, and social constructionist theory and technique, while centering sociocultural awareness. She discussed how emotions are the window into the larger context by helping us see the thinking that is happening and how that thinking may be a product of social-cultural influences. She also discusses the role of power in the model, and being aware of how that determines what is important, what is valued and the meaning of things, and seeing how power plays out in the couple or family dynamics. She explained that they operationalize relational equity as the Circle of Care, which consists of four parts: 1) Mutual Vulnerability - openness and willingness to admit mistakes, safe to express one’s sensitivities, 2) Mutual Attunement - that each person is aware of the other person and their needs, as often the person with more power is less attuned, 3) Mutual Influence - whose interests are organizing the relationship and whether there is a willingness to be influenced, and 4) Shared Relational Responsibility - where both are taking responsibility for the wellbeing of the relationship. Carmen discusses how when these are balanced, there is a more equitable relationship, and by the therapist’s awareness of power, they can support the changes in the relationship to be more equitable and mutually supportive.

Carmen Knudson-Martin, Ph.D., LMFT is a professor emerita in the Marriage, Couple, and Family Therapy program at Lewis and Clark College. Her scholarship focuses on how the larger social context influences health and well-being and how therapists can address the inequities that result. Carmen especially loves working with couples and is widely recognized for her work regarding gender, marital equality, and relational health. She is a founder of Socio-Emotional Relationship Therapy, an approach that attends to the ways couple interaction, emotion, and socio-cultural context come together in clinical process. Carmen’s teaching and practice are based on her conviction that how therapists conceptualize client concerns is an ethical issue and that clinical practices have consequences that are never neutral. Carmen is an AAMFT approved supervisor and licensed MFT. She served as an associate editor of the Journal of Marital and Family Therapy, vice-president of the Family Process Institute, board member of the America

In this episode, Terry discusses starting off his career working in residential treatment programs for kids and becoming interested in the idea of probability, and how in making behavior goals, he could increase the probability for the child’s success. In grad school he focused on instructional strategies for kids with challenging behaviors, and finding effective ways to intervene. He discussed how many people think that positive and negative feedback are equal, but positive reinforcement has more of an effect. He discussed focusing on creating opportunities for success, including being intentional about how you want to be (e.g., body posture, tone) with children. He talks about the research on the optimal ratio of positive to negative interactions, which is somewhere between five to one and three to one, but how this is very difficult for teachers, parents and others to do. He explained that in elementary school, teachers make positive statements once every 6-7 minutes, in middle school every 13 minutes and in high school every 23 minutes. He discussed his interest in why it is so difficult for adults to increase their positive statements, whether it may be related to culture or human nature or other factors. He explained that there is not a great deal of variance between teachers and that the research has found teachers tend to overestimate the number of positive statements they make, including himself when he steps in to teach a class. He said that his research has found that you can predict behavioral disruptions in classrooms by by looking at whether there is active engagement with the children and a higher ratio of the number of opportunities to respond positively and the positive responses, which may even be just a thumbs up or nod. He explained that kids with problem behaviors often need more in the range of 14 to 1 ratio of positive to negative because they have often had a lifetime of 1 to 1 million positive to negative. He discussed how teachers are able to give instruction when it comes to correcting academic mistakes, but very little instruction is given when correcting behavioral mistakes, with corrective statements being so low that in their research it was only observed once per nine schools. Terry talked about how many times teachers might say that they’ve already told the child before or after getting a consequence like being sent to the principal’s office that child has not been punished enough, asking how they are supposed to treat them like nothing happened? He explained that although teachers know that repetition is fundamental to learning academically, they struggle applying that to behavioral learning and often don’t persist in how often, how intense and how long they change their approach, since they may not see results immediately. He discussed his next research project which looks at the physiological responses of children in classrooms, similar to a study done on the physiological reactions teachers have when viewing video of misbehavior, and possibly looking at the interaction effects of the child’s physiology and the teacher’s physiology and their interaction effect with a focus on emotional regulation.

Terrance M. Scott, Ph.D. is a professor, distinguished scholar and director of the Center for Instructional and behavioral Research in Schools in the Department of Special Education, Early Childhood and Prevention Science at the University of Louisville. Dr. Scott spent 24 years as a professor and researcher in special education and was the senior principal education researcher at the Stanford Research Institute (SRI). He began his career as a counselor in residential treatment and has worked with students with challenging behaviors across a variety of settings. Since receiving his PhD in Special Education at the University of Oregon in 1994, Dr. Scott has written over 100 publications, has conducted well more than 1,000 presentations and training activities througho

In this episode, I speak with Laco about his work and research in the area of Emotion Focused Therapy (EFT). Laco discusses how he originally was trained in Client Centered Therapy and was drawn to Les Greenberg’s, Emotion-Focused Therapy as it was an extension of Carl Rogers’ work, with Les Greenberg being a student of one of Rogers’ students. We discussed Emotion-Focused Therapy and how Les Greenberg and others were studying the change moments in therapy, and were conducting process research on Gestalt interventions using empty chair work and two-chair dialogues with self-criticism. He explained that in EFT, the therapist is trying to access the core of the pain and the unmet needs. He discussed how emotions are seen as either being at the symptom level, or are the underlying emotions, and the therapists is identifying those underlying emotions and emotion schemes, which are the target of intervention. He discussed his work on identifying transdianostic features of Emotion-Focused Therapy and discussed how most of these pivotal painful moments had to do with either the emotions of feeling sad/lonely, shame, or fear. He explained that through the imaginary chair dialogues, the client is able to have a corrective experience, where compassion is elicited, like speaking to their younger self who was hurt, or healthy boundary setting anger for protection. These processes help the person’s emotion schemes become more flexible, moving them from sad/lonely to feeling connected, from shame to validation and acceptance, and from fear to safety or protection. We discuss how EFT conducts extensive process research, and discussed Laco’s work in research and writing, recently publishing the Transdiangosic Emotion-Focused Therapy: A Clinical Guide for Transforming Emotional Pain book with Daragh Keogh, Ph.D., and also creating a workbook for clients to be able to continue the work outside of therapy. He also discussed his work in making resources available online and possibly creating more online programs for clients to continue their work.

​Ladislav Timulak, PhD is Professor in Counselling Psychology at Trinity College Dublin. He is Course Director of the Doctorate in Counselling Psychology. Ladislav (or short Laco; read Latso) is involved in the training of counselling psychologists. His main research interest is psychotherapy research, particularly the development of emotion focused therapy as well as online mental health interventions. He has written (or co-written) 10 books, over 100 peer reviewed papers and chapters in both his native language, Slovak, and in English. His most recent books include Transforming Emotional Pain in Psychotherapy: An Emotion‐Focused Approach (Routledge, 2015) and Transforming Generalized Anxiety: An Emotion-Focused Approach (Routledge, 2017)(with James McElvaney; 2018), and Essentials of Descriptive-Interpretive Qualitative Research: (with co-author Robert Elliott) and Transdiagnostic Emotion-Focused Therapy (with co-author Daragh Keogh) published by the American Psychological Association (2021). His latest books include Essentials of Qualitative Meta-Analysis (with Mary Creaner; American Psychological Association) and Transforming Emotional Pain: An Emotion-Focused Workbook (with several co-authors; Routledge). He provides trainings for clinicians using the approach presented in his books internationally. He directs Emotion-Focused Therapy Research Group and co-directs an E-Mental Health Research group.He previously co-edited Counselling Psychology Quarterly. He serves on various editorial boards and provides expert reviews of academic papers and research grants internationally.

In this episode, I speak with Dave about his journey to becoming the first podcaster in the field of psychology and his prolific career publishing over a 1,000 interviews. Dave explained that he had learned about podcasting very early on and it fit with his interest in radio, which, as a teenager, he got involved with amateur radio, had taken the FCC exams, and built his own components. This lead him to go to college to study electrical engineering, but he quickly learned that his high school had not prepared him for an engineering major. He said he took a Psychology 101 course, but it was completely focused on behaviorism, which turned him off to the field, and instead got a degree in creative writing. At the end of college, he explained that a friend told him he was studying to become a Rogerian psychologist, which sounded interesting, and Dave had always enjoyed helping people with their problems, so he took an abnormal Psychology class, and then went to graduate school for a doctorate in psychology. Dave discussed how his graduate school was focused on psychoanalytic theory, which he didn’t find to be a good fit for him, so he gravitated more towards Humanistic Psychology. He discussed running encounter groups and we discussed the Human Potential Movement in the 60s and how he and others were seeking alternative perspectives. He explained that he had published articles in the Human Behavior journal and after learning about podcasting, thought that interviewing his fellow professors at Sonoma. State University where he met, which was Humanistically focused, would be a great way to begin his program Shrink Rap Radio and Wise Counsel. We discussed that during the 80s, when personal computers were becoming more popular, he became interested in the tech and business world, and began doing market research focus groups, and used online focus groups in the early days of the internet. He continued this work while he taught, had a psychotherapy practice and all of these skills assisted him in his podcast interviews. He explained that he challenged himself to be open to a wide variety of perspective, interviewing a broad range of clinicians and non-clinicians. Dave lastly discussed his interest in Positive Psychology and how he saw it as an outgrowth of Humanistic psychotherapy, and how Positive Psychology’s coaching aspects have been adopted in the business world.

David Van Nuys, Ph.D. is past-chair and professor emeritus in Psychology at Sonoma State University, a department with an international reputation for humanistic, existential, and transpersonal psychology. He also taught at the University of Montana, the University of Michigan, and the University of New Hampshire. In addition, David runs a market research business, e-FocusGroups, which has served a distinguished list of clients, including The New York Times, Apple Computer, IBM, Hewlett Packard, and QuickenLoans, among others. He leads personal growth workshops at various growth centers around the U.S. and abroad. David earned his doctorate in clinical psychology from the University of Michigan and has worked as a licensed psychotherapist in both New Hampshire and California. A frequent public speaker, he has also published in professional journals, popular magazines, and co-authored a book on the infamous Zodiac serial killer. He also produces two popular podcasts: Shrink Rap Radio and Wise Counsel. David is a longtime dreamworker himself and a past IASD presenter and for many years taught a course on Myth, Dream, and Symbol at Sonoma State University. In 2018, he received an award from the American Psychological Association for his pioneering podcast, Shrink Rap Radio. The award was presented at Harvard University by the APA president before a crowd of several hundred educational podcasters. Since 2005, he has conducted around one thousand interviews with movers and shakers around the broad world of psychology (including dreamworkers , dream r

In this interview, I speak with Diane about her expertise in sex therapy, and her American Association of Sexual Educators, Counselors, and Therapists (AASECT) certification. She discusses sex therapy, couples therapy with sex issues, and she discusses the PLISSIT model, which describes various levels of intervention, which include Permission, Limited Information, Specific Suggestions and Intensive Therapy. She discusses her eclectic approach, which is grounded in a Humanistic perspective, helping clients accept themselves and address shame. She explains that sexual relationships are complex involving how each partner feels about each other, the challenges people experience in their life, and their different stages in their relationships. She discusses her blog article, “To the Wife Upset About Her Husband’s Porn Viewing: An Open Letter From a Sex Therapist”, and how she addresses how porn is symbolic and is a “fantasy” and what we can learn from this about our partner. She explains how she often sees men who come in by themselves, because they’re partner is upset with them about their pornography use, and how this often suggests an Identified Patient perspective, and missing the couple dynamics and how the couple can heal and improve their relationship together. We also discuss the conflict between being respectful of women, but then also, for heterosexual men particularly, to also be enjoying pornography and objectification of women. She discussed perpetrator fear and how it become more pronounced after the #MeToo movement, and how a number of clients came to work with her to discuss their past sexual encounters. She discusses consent and what that means and looks like in sexual encounters and relational sexual relationships.

Diane Gleim, LMFT is a Licensed Marriage and Family Therapist and AASECT Certified Sex Therapist and Supervisor practicing online throughout California and in-person in Santa Rosa, California. As the first Certified Sex Therapist in Sonoma County, Diane treats the many diverse issues related to sexual identity, sexual expression, sexual behavior, and sexual relationships. Her clients include everyone with a sexual concern: individuals and couples ages 18-85, and the LGBTQ+, kinky, and poly populations. In addition to her private practice, Diane’s work also includes providing trainings and consultations on sex therapy; writing the blog "Underneath the Sheets" on Psychology Today’s website; and supervising sex-therapists-in-training. She has been quoted in various press and a guest on podcasts. Diane has been voted Sonoma County’s Best Sex Therapist by the readers of the North Bay Bohemian five times.

In this workshop, Karin discussed her career where she trained in Argentina, then came to Palo Alto to learn at the Mental Research Institute forty years ago. She discussed the place the MRI has in the history of developing family and systemic therapy. She worked with Paul Watzlawick, Dick Fisch, and John Weakland, and eventually became the Director of the Brief Therapy Center, a title she still holds. In 1966, the group was interested in seeing what type of changes they could help create within 10 sessions (hence the term brief), which was very different from the prevailing psychoanalytic approach during the time. She discussed how the approach based in systems theory, but is a minimalistic family therapy/systems therapy way of promoting change, where they don’t need the whole system to be present in the office for change to occur. Interactions are always in the clinician’s mind, understanding who is this effecting, how is someone reacting to this, which allows you to intervene with the person who is the most motivated for change in the system. She explained that they’re not necessarily trying to achieve perfection, but instead help the person in pain and asking for help at the time to get out of a hole. She shared the quote by John Weakland that “when you have a problem, life is the same damn thing over and over again, and when you no longer have a problem, life is one damn thing after another”. Karin discussed identifying whom to focus on in the therapy by identifying who is most in pain and therefore is most motivated to work with the therapist to promote a positive change. If working with a family, the therapist might not put all of their energy into the child since they have the least power in the system, and the most motivated one in the family might be the parent, so they will be the one you need to engage to make change. She also pointed out that they go straight into the problem that brought clients in, and stay in the here and now, and try not to “open doors” to the past, which is what allows the work to be so brief. We discussed how the approach postulates that the attempted solution is what has become the problem, keeping the system stuck, so instead, having the individual, couple or family do the 180 degree opposite of that, even if it goes against common sense, then observing what happens and discussing in the following session. As opposed to many other models of systemic and family therapy, the Brief Therapy Center works with fewer people and change happens outside of the session. She pointed out that they were able to make significant change in a matter of ten sessions, with the average amount of sessions being six. Karin explained that there have been many different models and techniques developed over the years, although the simplicity of the Brief Therapy approach still stands as an effective treatment and could be the key to reduce the mental health crisis in the U.S. currently.

Karin Schlanger, LMFT was the Director of the Brief Therapy Center in MRI since 2008 until the sale of the building in 2019. She continues to be the director of the BTC currently. She has worked as a psychologist, supervisor in the Brief Therapy Model and professor at several universities internationally. She studied Psychology in the Universidad of Buenos Aires – Argentina and graduated in 1982. She arrived at the MRI in 1983 having heard of the work of John Weakland, Dick Fisch and Paul Wazlawick and worked with them until the end of their days. In 1990, she opened the Centro Latino de Terapia Breve to do research on how this pure American model of Problem solving can be applied in other cultures. This project continues today, working with low income Spanish-speaking families, who are at the worse end of society’s inequality. In 2012, she founded a NGO, Room to Talk, to offer psychological services to students, families and school staff at the school. She was the Executive Director. She h