I’ve been a supervisor for MSWs since 1995, for Psy.Ds since 2004. I’ve done groups, family, individual and couples treatment for people who struggle with bipolar, depression, anxiety, severe trauma and addictions. I’ve worked in community mental health and hospice.  I’ve been in full time private practice since 1995.

It seems to me that finding a way to make ACT or any other model your own is an important part of learning. I try hard with my trainees to help find their own voice. I’ve done a lot of trying to be Kelly Wilson, or Robyn Walser or Steve Hayes or… you get what I mean. I came to realize that the only person I can be is myself in the room, and I need to find a way to work effectively with the people who come to see me.  Oscar Wilde said it really well: “Be yourself, everyone else is already taken.”

So what I see a lot of in myself and in other therapists is a conflict between our fear of failing and being really present in the room. Mostly we need to do our own exposure work around our fear and helplessness to be able to stay present for our client’s fear and helplessness. (I highly recommend Kelly Wilson's Client Descending exercise for that.)  Doing our own exposure work  is a necessary condition, but not a sufficient condition for being a great clinician.  What’s also needed is a theoretical and philosophical core. I’ve found that core in functional contextualism and behavior analysis.   I provide an opportunity for my trainees to do both—learn a philosophical stance and do your own exposure.

Let’s face it; thinking contextually is just flat out weird. There aren’t a lot of reinforcers in our verbal community for conceptualizing this way. We need all the help we can get to stand in this place and it’s really easy to slip into a mechanistic position.

For a lot of clinicians, as soon as we exit our graduate programs we never read another theoretical article. Dirty secret, but there it is. I understand that. We’re often inundated by our work and we don’t often see the value or applicability of the research and philosophy to our work. In my training, I ask clinicians to read, and we immediately apply this reading to the work of therapy.  It’s tempting to only learn a new technique or tool to take into the therapy room.  But I believe that although the immediate payoff isn’t there, learning a way to think about what we’re doing is ultimately much more powerful.

So many of us haven’t had great training. That was true for me.  I walked out of graduate school with a few techniques and some vague ideas about what I needed to do, but no actual tools that worked.  We are often thrown into therapy settings and confronted with terrifying pain from our clients with little or nothing to offer. No wonder we grasp for immediate techniques and tools.   We struggle not because we’re weak or stupid or lazy; we struggle because it’s damn hard to do this.

When a consultee comes in, cues up their tape or DVD and tells me, “Here’s where I really screwed up,” I feel that we’re on our way. To become an extraordinary therapist I believe that we must be willing to utterly and completely suck.  We must do exactly what we ask our clients to do. If you won’t have it, it has you.

It’s like the fishing thing:  you can give someone a fish or you can teach them to fish. I wanted to learn how to fish and I wanted to learn how to fish in ponds, streams, lakes, and the ocean.  I believe having a coherent philosophical and theoretical stance allows me to do this.

Finally, I believe that we never stop learning.  Not knowing what’s happening can go from an aversive experience to an appetitive one. We can be delighted and intrigued rather than hostile when our client does something that we don’t expect.