Online only
Fee: My standard fee is $300/hr, although I charge less for former students and clinicians still working on licensure. Groups can split the fee among the participants.
Individual and Couple’s Therapists
I provide consultation and supervision to individual and couple’s therapists. I have conducted tens of thousands of therapy sessions with people struggling with all sorts of psychological problems, and I have supervised or consulted on countless others. I can help you distinguish trauma reactions, internal conflict, personality disorders, bad luck, biology, societal problems, situational issues, and existential concerns.
“Supervision” typically means that I would take legal responsibility for your cases while you work toward licensure. Currently, I am set up to do that only in Colorado. “Consultation” means that you are independently licensed and retain legal responsibility for your cases. For that, you can be anywhere. Informally, I tend to use “consultation” for the provision of ideas about a case within your current theoretical orientation and approach, and “supervision” for something more like helping you change the way you’re working.
The work of supervision and consultation occurs broadly in three main forms. Each of these applies to trauma-focused work or to internal conflicts and identity concerns.
Burnout and coasting
Many therapists report that their work has become like punching a clock. “Okay, I guess,” they say, when I ask them about their careers. They’ve lost their mojo for achieving excellence. They resort to meeting their patients’ emotional and social needs rather than helping them change what interferes with getting their needs met with other people. Their sense of vocation dissipates and they wind up selling friendship and advice to needy people whom the succoring relationship makes even more needy. Refocusing on the complexity of psychotherapy and the thrill of doing it well can make a difference. Many of these therapists have defined the role of therapist in a way that drains them or, at least, doesn’t engross and engage them. I can help them find their mojo by focusing on the immediacy, and the metaphorical meanings, embedded in the psychotherapy exchange. I can help therapists find a way to do therapy that is joyous, effective, and fun, involving the therapist’s whole self.
Clinical problems
Brief or sporadic consultations can help therapists resolve clinical problems related to a particular patient. “What could I have said?” is a typical theme. Many clinical problems make sense only in the context of an agreed-upon case formulation. A good case formulation explains how the patient’s personality and response tendencies interfere with their life satisfaction, and it also spells out what will happen in therapy to change the personality pattern. A film or theater director makes hundreds of decisions always keeping in mind what the movie or play is about; a good therapist sees every decision through the lens of the case formulation. Thus, many consultations involve articulating a plausible case formulation that the patient can buy into.
Learning therapy
Contemporary psychotherapy training is woefully inadequate. Therapists learn techniques and the application of manualized treatments that are ineffective and unengaging. Real therapy is intersubjective, relational, and improvisational. Real therapy depends on the patient messing up the therapy the way they mess up their other relationships, with the therapist using the messes as occasions for promoting change. Real therapy induces the patient to remove the social mask and reveal the authentic self to experience a sense of belonging and connection.
Therapy is supposed to be intriguing. Let’s keep it that way!
A Few Supervision Posts (others are on the menu)
An Argument Against Techniques in Psychotherapy
The Lose-Lose Comment is a Therapist’s Best Friend
Michael Karson, Ph.D. 