Understanding the Schizophrenia Prodrome and Early Intervention for Psychosis

In this episode, I speak with Bill Miller about his road to developing Motivational Interviewing. Bill explained that he started off heading into pastoral ministry but instead chose to be trained as a clinical psychologist. His behavioral PhD program required a two-semester course on how to work with clients before engaging in behavior therapy, and that's where he was introduced to Carl Rogers and a person-centered approach, which significantly influenced his career. He mentioned watching Gerald Patterson doing behavior therapy with families and seeing how he was with clients: warm, engaging, empathic, and funny, which was not covered in published descriptions of the method. On a sabbatical leave in Norway, Bill was asked to demonstrate his own therapeutic approach through role plays in which the clinicians would stop him and ask good questions: "What are you thinking just now? "Why did you ask that particular question?" "How did you decide what tor reflect from all that the client said?" These interactions helped him reflect on what he was doing and why he was doing it, and he wrote down a description that became the first description of motivational interviewing. Seven years later, on sabbatical leave in Australia, he found himself officed next to Stephan Rollnick who would become his career-long co-author. Rollnick had already been teaching motivational interviewing based on Bill's first article and they decided to write together the first book about motivational interviewing that was published in 1991. When they began teaching the method they noticed that some trainees seemed to be using MI techniques “on” rather than “with” clients. What had they left out? They began writing and teaching about the underlying spirit or attitude with which MI is to be practiced. Therapists also shared with them that this way of practicing seems to prevent burnout. In a later book with Theresa Moyers, Bill discussed eight clinical skills that characterize more effective therapists, which are: accurate empathy, genuineness, positive regard, acceptance, hope, evocation, giving advice, and having shared goals or direction. Bill and I explored the term “resistance” and how it is something that happens between people yet is often attributed to client pathology. In yet another book he argued that ambivalence is natural human nature and even a virtue, as it means the person is weighing the options. He and Rollnick reformulated "resistance" as sustain talk (a natural part of ambivalence) and/or discord in the therapeutic relationship. We discussed how in motivational interviewing the therapist is a guide rather than an expert-director. Lastly, he touched on his work on quantum change, which is transformational change that that can occur within a matter of moments or hours and tends to be both permanent and benevolent. Dr. William R. (Bill) Miller, Emeritus Distinguished Professor of Psychology and Psychiatry at the University of New Mexico. He is the author of 67 books including four editions of Motivational Interviewing, Effective Psychotherapists: Clinical Skills That Improve Client Outcomes, Listening Well: The Art of Empathic Understanding , and On Second Thought: How Ambivalence Shapes Your Life. He has been teaching the skill of accurate empathy for over 50 years.

In this episode, Judye discusses growing up in a family where her father was a psychoanalyst and became interested in the field. In graduate school, she became interested in family therapy, and worked at a youth guidance center in Massachusetts, but didn’t find working with children and play to be a way she really wanted to work. Her supervisor had trained at the Ackerman Institute in New York City and had her start working with families, which really fit well for her and her work. She explained she moved to California and worked at Xanthos, now Alameda Family Services, and studied with Alan Leviton, one of the founders of the Association of Family Therapists of Northern California. Additionally, she started teaching at California Institute for Integral Studies in San Francisco, where she taught family therapy by having the students bring in their families to have a family therapy session, or role play if the family was unable to come in. She discussed her work and how she ended up writing a book about her approach called Core Focused Family Therapy. She discussed one of her strategies in the beginning of a family session was to do some dyadic work with two members of the system who were not the central focus, which seemed to help open up conversation and soften stuck systems, and then moving on to the focus on the areas the system might be struggling. Judye explained that one of the reviewers of her book wrote that her approach is love and truth, using a warm, but direct approach. She explained another strategy is to move the focus off of the identified patient, and look at how the whole system is involved with the difficulties that are happening, so they can make a systemic change, which she calls increasing the surface area of the problem. She discussed connecting with he vulnerabilities behind the defenses, and in helping the dyad that seems most open, the rest of the system then usually also become more open to vulnerabilities. She talked about using this model to make significant changes in the family system in a short period of time. She discussed how she focuses on working with families with adult children, and the variety of clients who reach out to her, with family cut offs being a common issue clients are seeking help in repairing their family. Judye Hess, PhD, has worked with families since 1974 when she began her family therapy career at Worcester Child Guidance Center in Worcester, Mass. In 1977, Judye moved to the west coast and found a home at Xanthos, a family counseling center in Alameda, CA, where she worked for the next three years. In 1984, she began teaching at the California Institute of Integral Studies, where she was on the core faculty and taught family dynamics, couples counseling and group process until 2015. She is the author of Core Focused Family Therapy: Moving From Chaos to Clarity and she is now Professor Emerita from CIIS, and since then has maintained a private practice, seeing couples and families of adult children exclusively.

In this episode, Haim discusses his extensive experience providing group and being an early adopter of group therapy in 2006, which lead to his work on the effectiveness of telehealth. He discussed how in 1995 he started an internet forum called GP Listserv which now consists of 400 group therapists from all over the world who join together to discuss group therapy. Haim talked about his group analytic relational approach to therapy and discusses the difference between psychodynamic and relational approaches. He talked about how the research has found clinicians experience four obstacles to online therapy, and discusses the various ways one can address them. He explained that these obstacles include (1) Setting (2) Disembodied Environment (3) Presence and (4) Ignoring the Background in Online Settings. He discusses the body of research surrounding online therapy which is very promising and explains how a meta-analysis concluded that for individual therapy, there is no difference in the results for online vs in person therapy. According to research, the best predictor of success in individual therapy is the therapeutic alliance and goes on to list the three components of the therapeutic alliance which are agreeing on goals, agreeing on tasks, and bonding. While online group therapy is less researched, Haim’s experience suggests that it is very effective. He explained how in group therapy, the factor that is most predictive of success is the cohesion of the group, rather than the therapeutic alliance. He goes on to discuss how the preference of modality –such as having an auditory or visual preference– influences one’s ability to effectively do online therapy. He talked about how in groups, time, space, and attention are always shared, which can create turmoil for group members. He also discussed how keeping attention can be difficult online because there are more distractions and people may feel more unnoticed, which can promote disengagement in an online group setting. He recommends that small group therapy should consist of group sizes between six and ten people and for people who are not as skilled or experienced, groups should not exceed eight people. In 2018, Haim created an online training process group for therapists, and these groups consist of therapists from all over the world where they discuss their experiences with group therapy and learn how to improve their practice, but also use them to work on their personal issues, thus providing professional and personal growth. Dr. Haim Weinberg is a licensed psychologist in California (PSY 23243) & Israel and has a private practice in Sacramento, California, with more than 40 years of experience. He is also a group analyst and Certified Group Psychotherapist. He is past President of the Israeli Association of Group Psychotherapy and of the Northern California Group Psychotherapy Society, and list-owner of the group psychotherapy professional online discussion forum. Haim was the Academic Vice-President of the Professional School of Psychology in which he created and coordinates an online doctoral program in group psychotherapy and marital therapy. He published books on Internet groups and about Fairy Tales and the Social Unconscious, and co-edited a book about the large group and a series of books about the social unconscious. He is on the clinical faculty of Psychiatry at UC Davis Medical Center and Fellow of the American Group Psychotherapy Association and of the International Group Psychotherapy Association, as well as a Distinguished Fellow of the Israeli Group Psychotherapy Association. He has received several awards including the Harold Bernard Group Psychotherapy Training Award and the Ann Alonso Award for Excellence in Psychodynamic Group Therapy. He also co-edited the books: 1. Theory and Practice of Online Therapy: Internet-delievered Interventions for Individuals, Groups, Families, and Organizations. 2. Advances in Online Therapy: Emergence of a New Paradigm. 3. The Virtual Group Therapy Circle: Advances in Online Group Theory and Practice with Arnon Rolnick and Adam Leighton.

In this episode, Michael discusses his work in therapy, resilience research, and helping people find diverse systems to support their well-being. Michael explains how he became interested in predictions of psychopathology and pathways to adolescent well-being through resilience and advocacy. Throughout his early career, he noticed how there had been greater efforts to suppress disorders, but these efforts did not create a sustainable, clinical outcome for people. He explores how intrapsychic systems and larger, systemic environments are important for supporting and maintaining resilience. Michael defines resilience as 1) a navigation to the resources you need and 2) a negotiation for these resources in culturally relevant ways. He states that stimulating optimism for teenagers doesn't just come from internal self-affirmation, but also from living in predictable environments. He also emphasizes the importance of caregivers and social networks in an adolescent's life. These relationships support a positive identity in adolescents, allowing them to have control and self-efficacy. We discuss how both stimulating a social network and giving young people a sense of identity are vital to promoting resilience. Michael then moves on to explain how there are differences between positive psychology and the study of resilience. The study of resilience is about matching the right protective factor to a particular risk profile. He explains that through his research, he has identified a core list of 52 potential resilience predictors. He developed a program, R2, where he takes the list of 52 predictors and identifies which factors are most relevant to the population in a specific region. Through this process, Michael and his team have been able to provide a more tailored approach to promoting resilience. For example, he mentions how in certain cities, transportation systems and housing are the key factors for promoting resilience in people. We then go on to discuss how changes in even just one of these systems can result in virtuous or negative cycles in someone’s well-being. Changes in transportation and housing may have a cascading effect on co-occurring systems of a person’s life, which may then affect their overall well-being. We emphasize how in therapy with an individual, it is important to work in the context of their external systems, such as their school or their workplace, instead of simply focusing on the individual’s depression. Though it may seem like social work, he believes it is vital to not delineate between what psychologists do and what social workers do. Michael finds that expanding various aspects of one’s identity and engaging their social networks in therapy can cultivate better mental health and resilience for a person. Finally, he touches upon the idea of wear and tear on adolescents. There is a toll that resilience and stress take on adolescents: They may seem successful in some ways, but then may crash later in life. Michael states that resilience is a constant dance between helping people navigate and negotiate for their needs, but never assuming that the journey for healing is complete. Michael Ungar, Ph.D. is the founder and Director of the Resilience Research Centre at Dalhousie University where he holds the Canada Research Chair in Child, Family and Community Resilience. In 2022, Michael was ranked the number one Social Work scholar in the world in recognition of his ground-breaking work as a family therapist and resilience researcher. That work has influenced the way human development and organizational processes are understood and studied globally, with much of Dr. Ungar’s clinical work and scholarship focused on the resilience of marginalized children and families, and adult populations experiencing mental health challenges at home and in the workplace. In addition to providing consultation to international NGOs like the Red Cross and Save the Children, government agencies in more than a dozen low, middle, and high income countries, and educational institutions at all levels of study, Dr. Ungar’s research has also influenced the HR and corporate social responsibility initiatives of Fortune 500 companies like Unilever, DHL and Cigna. Michael’s work emphasizes how to use the theory of resilience to increase both individual and institutional agility during crises, with numerous organizations having adopted his concept of resilience as a negotiated process that enhances wellbeing and social responsibility. He is the author of over 250 peer reviewed articles and book chapters and 17 books. His blog, Nurturing Resilience, can be read on Psychology Today’s website.

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 American Family Therapy Academy (AFTA), and president of the California Division of the American Association for Marital and Family Therapy (AAMFT-CA). She is currently editor of the AFTA Springer Series in Family Therapy. Prior to coming to Lewis and Clark, she directed family therapy programs at Loma Linda University in Southern California, Montana State University, and Valdosta State University in Georgia.

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 throughout the United States and across the world, and has successfully competed for more than $24 million in external grant funding. In 2004 he received the Distinguished Early Career Award from the Research Division of the International Council for Exceptional Children, and in 2012 he received the Outstanding National Leadership Award from the Council for Children with Behavior Disorders. He was elected president of this organization in 2013 and served as a two term editor of the journal, Beyond Behavior. His research interests focus on schoolwide prevention systems, the role of instructional variables in managing student behavior, functional behavior assessment/intervention, video-based training for school personnel, and scientific research in education.

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 researchers, and Jungian analysts).

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 has been a professor in several local Universities — University of San Francisco, Stanford University, School of Psychiatry and Behavioral Sciences, College of Notre Dame de Namur, and other Universities of Spain — Valencia International University, Universidad de Abat Oliva, Institute Systemic de Barcelona. She is a supervisor in the Hospital of San Pau, in Barcelona. Karin is the author of a book that has been translated to 5 languages, and the author of many articles and chapters of lots of books throughout the years. Also, in 2012, she has started the Grupo Palo Alto Internacional, which was officially launched in Mexico, January – 2016. Currently, Karin trains and supervises therapists internationally as well as locally through county mental health programming. She provides trainings through the https://www.brieftherapycenter.org/