Summer 2017 Updates

What’s complete…

Summer semester is over. It’s always fun teaching Theories & Methods of Sexual Counseling–and a lot of work on top of a full client load. I work late hours during the summer–but getting to know the students is worth it! UMKC graduates plenty of competent, inspiring Counseling students. These interactions give me great hope and faith for the Counseling profession. Most of my work in private practice is one-on-one or with couples. It’s something special to see 20+ Counseling students apply themselves to clinical case examples.

Every year I squeeze additional information into the course. This year we fit in brief discussions of Intersex clients and Sex with Spinal Cord Injuries. We also expanded our conceptualization of “Sex Addiction” into Out-of-Control Sexual Behavior treatment.

What’s next…

I’ve organized extra time in my schedule each week for proactive research & development! Stay tuned!

How to Fall in Love (Again)

If you’re feeling distant from a partner or loved one and want to reconnect–you may need to:

  • look at your partner with beginner’s mind
  • do the scary work of emotional vulnerability

36 Questions is structure that can help you with these common sense, yet often elusive practices. These questions were developed and tested by psychologists. The results? A pair of strangers fell in love.

Transgender Assessments

I work with many clients who suffer from gender dysphoria. During any given week, I host several conversations regarding clients’ gender expression as related to their sense of self and well-being. There are several means, depending on the situation, to bolster client efforts in synchronizing their gender expression (cues visible to others) with their gender identity (their self-experienced gender).

Some people seek an official assessment for potential hormone referral therapy. These assessments include an intake of the client’s life history including child & adolescent development; transition goals; coping resources; and any co-occurring problems (such as depression or trauma histories). During later stages in the process, I may invite clients to bring family members into the meetings for increased social support (this part is required earlier for adolescents).

Other clients, such as gender non-conforming people, benefit from deconstructing any unhelpful gender associations & roles they internalized from developmental and social contexts. Then, therapeutic techniques such as assertiveness training help privilege their own unique identity and facilitate choices & empowerment.

Internal Family Systems

I enjoyed a webinar with Richard Schwartz, developer of the Internal Family Systems therapy model. The IFS model grew out of other family therapy models that examined “roles” each family member inherits in reaction to each other & the family’s overall needs. The IFS model examines various “parts”, or roles, within a person, often developed within confusing family dynamics. For example, an individual is likely to develop various “protector” parts and other parts that are “exiles”–parts that express impulsive or other unwelcome behavior. In the IFS model, healing occurs as each part is attended to with curiosity and awareness. When the parts are understood, they relax and trust a well-informed leader–the “self.”

Schwartz’s IFS website: Center for Self Leadership

Technology-Assisted Treatment

Many psychology researchers, including the Veterans Administration, are studying the effects of mental health applications. While indiscriminate screen time is widely known to reduce peoples’ focus, some research indicates that consistent, intentional use of some mental health apps tends to boost self-awareness; effectiveness; and happiness. The Veterans Administration is specifically studying the app PTSD Coach, which I would like to use with a client. Please let me know if you would like to participate in that process! Here are some applications I already find useful with many of my clients:

  • Narrative Therapy Questions: helps the participant conduct a deep self-interview about their preferred life direction and related obstacles
  • Calm: 100+ guided meditations to choose from. The app will track the dates and lengths of of your meditations
  • Relax: helps practice diaphragmatic breathing, which is good for nervous system regulation and panic-attack prevention
  • Mood Tracker: charts symptom severity/remissions/patterns based on pre-programmed OR customized data schemes

Consultation Form

Clients who would like me to consult with another service provider–for example a psychiatrist, school counselor, judge, previous counselor, or medical doctor–are welcome to complete this Release of Information form. It enables the client to describe what type of information they would like shared and to specify the consultation dates. In some situations, consultations boost the effectiveness of one or both practitioners. Clients are welcome to discuss specific consultation considerations with me.

Feedback Informed Treatment

I am enlisting two new tools to build collaborative client relationships! The Outcome Rating Scale measures a client’s life satisfaction–and any positive or negative trends during the course of treatment. At the end of each meeting, clients use the Session Rating Scale to provide feedback about the meeting’s topics and methodology.  These tools are associated with the International Center for Clinical Excellence. This evaluation process encourages transparency, accountability, and “custom-fit” rather than “cookie-cutter” therapy.

Therapy Style, continued…

Another important part of my therapy style is seeking and developing Exceptions. Exceptions are times/places/relationships when the problem does NOT present itself.

It can be argued that some suffering is part of the human condition; however, the worst problems have a way of becoming a dominant theme, encroaching on multiple areas of life. I help people develop problem-free zones. Articulating and building these exceptional experiences helps develop nuanced awareness and the increased personal agency required to respond to difficulties.

Therapy Style

When asked about my therapy style, people often want to know two things: what are some of my core assumptions? how do I relate to clients?

  • I understand that people have variation, including biological variation. One person may be fundamentally different from other people.
  • An individual’s biochemistry and personality may vary and adapt throughout time.
  • A pattern of thoughts/emotions/and actions may be described as a relational template. Relational templates that are adaptive in a previous context may become generalized into other parts of a person’s life. Unfortunately, the generalizations may become problematic in newer contexts. In that case, the person may revise their thoughts/emotions/actions.
  • I position myself as a collaborator with the client. Rather than take a prescriptive approach or a passive approach, I solicit the client’s participation. I expect clients to challenge themselves while I am an active respondent. We share power and control so that new dynamics and opportunities develop.