Book Review: Deliberate Practice for Psychotherapists, by Tony Rousmaniere

 ~ Tony Rousmaniere,  Deliberate Practice for Psychotherapists

~ Tony Rousmaniere, Deliberate Practice for Psychotherapists

In Dr. Benjamin Caldwell's book Saving Psychotherapy, he outlines four tasks that psychotherapists must embrace to help "save" the field of psychotherapy. If you've read my review of the book, you know how much it resonated with me. However, the final task (accepting accountability for the quality of our work by deliberately working to better our skills) has haunted me.

I do want to be the best therapist I can be, but I've felt a little lost about how exactly I'm supposed to work on my skills to get there. The unarticulated message I've received during my first year of graduate training has been that "getting good" just happens through some alchemy of learning theory, being congruent, asking circular questions, avoiding microaggressions, and seeing clients. Lots of clients. (I'm obviously being reductive for the lulz--I think my program is doing the best they can within the current paradigm of therapist training. Even so...) 

It's this last bit, simply seeing lots of clients, that really hasn't been sitting well with me. Learn by doing just seems like a cop-out, like no one was able to figure out how to teach something so they presumed the best way to learn must be the way they learned, which is by muddling through until it gets easier. That's all fine and good when we're talking about needlepoint or something. But I'm being asked to help people who are having serious life problems. Needlepoint this is not.

And y'know what, since you bring up needlepoint . . . there's actually a deliberate way to work on getting better at needlepoint. Samplers. Young girls used to work on them to perfect their skills before they were married off and had to work on their husbands' socks or waistcoats or whatever.

 
 A sampler! Click to enlarge.

A sampler! Click to enlarge.

 

Where's the sampler for psychotherapy??

<<MUCH FANFARE>> Meet Tony Rousmaniere, author of Deliberate Practice for Psychotherapists: A Guide to Improving Clinical EffectivenessY'all, I'm a little frustrated I haven't been assigned this book in any one of my classes yet. Why wouldn't you assign a beginning graduate student a step-by-step guide to becoming an effective clinician? I am forever grateful to my friend and colleague, Ben Fineman, who recommended this book to me and lent me his copy. Because what Rousmaniere has to offer is, in fact, a sampler for psychotherapy.

Rousmaniere begins with his own experience as a clinician in training, despairing about the fact that no matter how hard he tried, about half of his clients were not benefiting from therapy. As it turns out, this is not an outlier--in fact, this rate is about average. Which seems to directly contradict the research presented by Caldwell as a beacon of hope in Saving Psychotherapy--that therapy is effective. How can half of clients not benefit from therapy if therapy itself is effective? The problem, Rousmaniere and Caldwell seem to agree, lies with therapists.

Rousmaniere argues that the current model of clinician training is a "path to competence." That is, the end goal of the current system of training and licensing therapists is simply to produce competent therapists, who have a decent success rate. But the truth is, some clinicians are better than others--and those that are better have better success rates. What makes some clinicians better than others? Rousmaniere argues these clinicians take the "path to expertise."

This path is the harder path. The research presented by Rousmaniere demonstrates that the only way to get to expertise is through deliberate practice. He takes issue with the misconception popularized by Malcolm Gladwell that it simply takes 10,000 hours of doing something repetitively to achieve mastery--what it actually takes, he says, is repeatedly and deliberately working at a level just beyond your current skill level. Simply playing tennis matches over and over will only incidentally improve your serve, but spending an hour every day drilling serves will deliberately improve your serve. This, Rousmaniere argues, is the faster and more effective path to mastery than simply muddling through a learn-by-doing process.

So how can psychotherapists deliberately practice? We can't conjure up a fake patient to do therapy with when we're off the clock (yet). The good news is--we don't need to. Rousmaniere has created a curriculum of sorts composed of several exercises designed to isolate specific psychotherapeutic skills, and the cornerstone of all of them is the humble video camera. He recommends video-taping as many of your actual sessions as possible, then using the taped sessions--both alone and with a coach--for the prescribed exercises.

For those of us in COAMFTE-accredited programs, we're already familiar with the idea of video-taping sessions; it's a requirement for our fieldwork and we can't accept a placement that won't allow recording of at least some sessions. But most other graduate programs do not require recording of sessions, and the whole idea might seem crazy. What client would be ok with this?? But apparently, clients seem to be pretty ok with the idea of their therapist recording the session both as a quality-control measure as well as a way to get more (maybe better) input.

Now, I hate watching myself on camera. But Rousmaniere points out that this very reaction is standing between me and becoming a better therapist. So while I have been dreading having to record my sessions, I'm now looking forward to it (at least I'm telling myself I am). Rousmaniere has even created an exercise specifically targeted towards working with this reaction and I can see how it would really be effective.

After reading this book, I'm now planning to make recording sessions standard in my personal practice once I'm a licensed clinician, and I'm going to try to implement deliberate practice as soon as possible.

I know what you may be thinking, because I thought it, too--what graduate student has time to do MORE practice outside of everything else?? Rousmaniere beat us to this punch, though, and he addresses the issue of not having a lot of extra time to dedicate to practice outside of work by encouraging us to start small--just a few minutes per day at first. This goes for students as well as already-practicing clinicians who are interested in upping their game. No matter who you are or what your schedule is, you can make some room in your life to work towards expertise.

And when I step back and think about it . . . a lot of Olympic athletes aren't superstars with lucrative sponsorship deals and personal assistants. They're regular people with normal jobs who happen to also have a crazy passion for shot-put or sprinting or skiing. They manage to put in the extra time and effort to become world-class athletes in order to represent their country at the Olympic Games. The least I can do to help my clients is put in the time and effort to become a world-class therapist. Now, with Rousmaniere's guide, I feel like I finally know how to get started.

 

Points of Interest:

  Listen to Dr. Caldwell's podcast on iTunes!

Listen to Dr. Caldwell's podcast on iTunes!

3 Things You Can Do as a Pre-Licensee to Set Yourself Up for Success

Caroline Wiita Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate
 

This post originally appeared in the AAMFT Emerging Professionals newsletter. Join the network and subscribe to the newsletter here!

As a first-year student in a master’s program, I’ve only just set out on the road to becoming a marriage and family therapist. When I stop and think about the distance I have yet to travel, I can get a little demoralized. However, I’ve found some things I can focus on now to make sure I’m ready to hit the ground running once I get that license. Focusing on each step makes me feel a little better about how far away that finish line is, and maybe it can do the same for you! 

#1 – Start Thinking About a Specialty

First, I’m using this time in graduate school to narrow down my future area of focus. There are a lot of papers to write, and I’m trying to use them for the greater purpose of determining what I may want my specialty to be. So when I’m given the chance to choose a topic, I tend to choose something that may help inform that decision rather than researching exotic diagnoses or very specific populations I’m unlikely to encounter in practice. I see these papers as great opportunities to learn about what I do (and do not) enjoy under the guidance of professors who can help me decide whether something might be a good fit for me. For example, I studied family-based treatments for adolescents with depression in my Clinical Research class; I enjoyed it and my professor gave me encouraging feedback, so when it came time to pick a paper topic in my Diagnosis class, I chose Major Depressive Disorder. I got to use some of the research I’d done for the first paper, and I discovered that I’m still not sick of studying it, so I think that’s a good sign! The same logic could work as you consider elective, fieldwork, and continuing education workshop options (especially if you’ve already graduated).

#2 – Build a Professional Network

It’s never too early to start making contacts! I’m cultivating relationships with professors and peers now to start building my professional network. I don’t mean this in a fake, shallow, or inauthentic way. I recognize that this network will be key to scaffolding my career in the future, so I want to set a good foundation. This means that in class, I try to be an active participant; not only is this good for participation points towards my final grade, but I’m able to demonstrate to the professors that I am an engaged and motivated future therapist. I want to make sure they are familiar with me and my work, because I will be needing letters of recommendation and I want to help them both remember me and feel confident vouching for me. I also reach out for guidance on assignments and attend office hours where necessary. Again, this isn’t about sucking up or making a nuisance out of myself—it’s about recognizing that professors are often so overwhelmed that it can be hard to form individual relationships with students. I want to make it as easy as possible.

This also goes for my classmates, who are my future colleagues in addition to being good friends. The relationship network we forge now will be a critical source of client referrals, word-of-mouth job opportunities, and much-needed emotional support as we enter the field. Which brings me to…

#3 – Join Groups and Organizations to Broaden Your Experiences

That professional network will also include colleagues I meet outside of school, which is why I feel it’s important to be active in groups and organizations. This kind of involvement can expand both your contacts and your experience in the field, and you can start at any stage of your career! I’ve found that informal groups—like those found on social media—can be a great place to get peer support as well as to ask questions in a low-pressure environment. Professional organizations like AAMFT foster both collaboration and advocacy, and membership demonstrates to potential employers that you’re serious about your profession. Personally, I’m really looking forward to getting involved with AAMFT’s Topical Interest Networks!

Ready, Set, Go!

I’ve found that focusing on these steps now keeps me engaged in the present moment and reminds me that I’m making progress towards my goal every day. I hope some of these ideas can help you, too, as you keep putting one foot in front of the other towards that finish line!

Points of Interest:

Learn about the many benefits of membership in California's largest Marriage and Family Therapy Association, from unlimited access to our on-staff legal team, to our enriching educational and networking opportunities, and so much more. Become a CAMFT member and enjoy the many benefits that await you.

Full-Time? Part-Time? Online? Or...?

Caroline Wiita Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

The decision to go to graduate school involves, at least in my experience, a realistic evaluation of how much time you have on a daily basis to dedicate to a program. The nice thing about master's programs in general, and marriage and family therapy programs in particular, is there tends to be more of an awareness that master's-level students are more likely than undergraduates to have very busy lives--often involving full-time employment and/or families.

This means that master's programs are offered in a wide variety of format options. Whatever schedule you want, there is a program for you. Want to get in and out in the least amount of time? You can pick a full-time program with a daytime schedule that will most likely get you graduated in two years. You could also pick a full-time program with a choose-your-own schedule and just pile on as many classes as you can handle. 

A caveat here--when I first realized that CSUN's schedule involved classes from 4pm-10pm two days per week, and was still somehow a full-time program, I felt like I was getting away with something. I thought it would be so easy to work during the days and just go to school a couple nights a week. LOL. Let me just say, a full-time class load means a full-time workload, even if you're not PHYSICALLY in class every day. You've been warned. (If you want to read more about what my classes were like in my first semester, check out my post on that here.)

If you're trying to juggle a master's program with other life commitments, like work or family, you may want to consider a truly part-time program. These programs can often get you graduated in 4-6 years (be careful, though, because this generally increases your overall tuition amount). You may only take one or two classes at a time. A evenings/weekends-only program may give you the flexibility to maintain your day job while still getting your master's.

Finally, there are always online programs to consider. There's, of course, wild debate about online programs. Some people think they're every bit as good as brick-and-mortar programs, but others make the (well-made, IMO) point that if you're trying to get training in a profession that is ALL ABOUT FACE-TO-FACE INTERACTION, why would you choose training that's online? It's truly hard to tell what the reputation of online schools is--I don't have much evidence to show, unfortunately, but like all careers, it seems there is some sort of stigma attached to degrees from online universities. And bear in mind, even with an online program, you MUST conduct in-person direct client-contact hours; these field placements are usually obtained in the student's local community.

From my personal experience, I want to say that perhaps the most invaluable part of my education so far has been getting to know my classmates. They are truly wonderful people who will be friends and colleagues for life. I feel like I'm building a very important professional (and personal) network that will be critical for my success in the future. I honestly don't think I'd have this opportunity in an online program. For more of my thoughts on why I think program location is an important factor to take into consideration when deciding on an MFT program, check out my longer post about that.

 

On MFT California, the site I created that catalogs MFT master's programs across the state of California, I've made an effort to make each program's format options clear. Let's take a look at some examples of the different formats you can choose from:

San Diego State University
At one end of the spectrum, you can attend a full-time program like SDSU. You can be finished with this program in only TWO YEARS, but it will need to be your main life priority while you're there. The program begins with online courses during the first part of summer, followed by day-long classes during the second part of summer. Then, they jump right into fieldwork (in addition to all other classes) in the fall. It's intense, but it also means you spend less time overall in a program. At a program that is affordable to begin with, that makes this program a pretty good deal--if you can afford to spend two years focused solely on school.

Antioch University - Santa Barbara
This program is much more amenable to the needs to working students. If you want a full-time course load, the AUSB full-time option involves class one day per week over 24 months of full-time study. Students can also opt to go at their own pace, taking as many or as few units as they desire--as long as they complete the degree in five years.

Northcentral University
If you're interested in an online program, NU makes it very easy to start. Students can enroll and begin classes almost any time (start dates occur several times per month). NU is COAMFTE-accredited (read my post on accreditation to find out why--and if--that should matter to you). The only thing students need to do in-person are their client contact hours, and the thing I appreciate about NU is that they make sure students understand how this works at the point of applying to the school; this ensures that students are not caught off-guard when they realize they will be responsible for procuring their own fieldwork site (read more about how that works in my post on fieldwork).

Pepperdine University
This program exemplifies all possible format options. On the one hand, Pepperdine offers a full-time format--students attend the Malibu campus during the day and the course schedule is lockstep and predetermined. A flexible part-time program is also available; not only are classes offered during evenings and weekends, but they are offered at three different campuses across the Los Angeles area, and students are allowed to take courses at any or all of these locations. Finally, Pepperdine even offers an online-only option. The drawback, however, is cost. Estimated total program tuition for the online-only option is $92,690 - $101,660, roughly the same as that of the full-time program tuition. The evening-format estimated total program tuition, however, is only $71,700 - $78,870.

Hope this post has helped clear up what sort of format options you have as an MFT graduate student. 

Points of Interest:

Learn about the many benefits of membership in California's largest Marriage and Family Therapy Association, from unlimited access to our on-staff legal team, to our enriching educational and networking opportunities, and so much more. Become a CAMFT member and enjoy the many benefits that await you.

What is "Fieldwork" and Why Does It Matter?

Caroline Wiita Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

Oh man. You have no idea how hard I laughed when I uploaded this photo. Fieldwork. HA! I'm still laughing.

Annnnyyywaaaaayyy...

If you're researching MFT programs, you've probably heard the term "fieldwork" and gathered that it is a requirement for graduation. Your "fieldwork placement" is where you gain direct client contact hours ("practicum" is the class you're enrolled in while you are working at a fieldwork site). You actually counsel clients while you're in graduate school.

Full disclosure: I am in the middle of the fieldwork process. I've applied to some sites and am waiting for interviews. I'm basing much of the following info on research instead of personal experience, but I will update as I learn new and exciting things!

So, what is fieldwork, exactly?

During your program, you will need to get supervised direct client-contact experience in order to graduate (the specifics of this are laid out on the BBS website). Some schools have an on-campus clinic and guarantee you that you can meet this requirement at their clinic. Others, however, require you to "go out into the field" (the community) and find your own placement--this is also called a traineeship, as you are considered a "trainee" when you are enrolled in a graduate program and seeing clients. Many schools frame their approach to traineeships in terms of "support"--programs who funnel students into an on-campus clinic or who provide lists of university-approved field sites typically refer to themselves as "very supportive." The programs that leave the process entirely up to students normally don't mention it...

If you're at the point where you're trying to decide which graduate program to enroll in, you may want to take each program's fieldwork situation into account. As a conscious consumer, here are some things that you should be aware of when it comes to an MFT program's traineeship process:

Total Hours

First of all, you should know that the state of California requires at least 225 hours of direct client contact in order for you to graduate. If that's what a program requires, they are requiring the bare minimum. That could be good or bad--on the one hand, you'll get out sooner, but on the other hand, you'll have less experience than other graduates. The maximum number of direct client contact hours you're allowed to log while in graduate school is 1300. You could log more, of course, no one will stop you as long as you're following all the rules, but you won't be able to count more than 1300 hours towards the 3000 hours you need for licensure.

On-Campus Clinics

Some programs have on-campus clinics, and many who do guarantee that students can meet all their hours at the on-campus clinic. For example, at CSUN, you can apply for the Mitchell Family Clinic/Strength United cohort--this track of the MFT program completes all of their fieldwork hours through these two university-affiliated programs. This situation has both pros and cons. On the pro side, you would not need to worry about finding a placement and the whole process will be pretty convenient. You'll avoid the application and interview process entirely (apart from applying for the program itself). On the con side, you probably won't have a ton of say in what sorts of populations you work with or what kind of supervision you'll get.

Fieldwork Programs

The alternative are programs where you find a placement out in the community. At CSUN, the school provides students with a list of approved community sites, but it's up to the student to apply and get accepted. This approach ALSO has pros and cons. The pros? You get to find a placement that interests you--but there's no guarantee they'll take you on as a trainee (you have to apply like you're applying for a job). You also have an opportunity during the interview to get hopefully get a sense of what supervision will be like, and if it rubs you the wrong way, you can try somewhere else. Some sites will train you  in specific evidence-based treatments, which are proprietary modalities that can cost thousands of dollars to become certified in, at no cost to you. But the cons are real. It can be confusing and stressful trying to find a placement in the community. Personally, I didn't find the process overwhelming because I've applied for jobs before; some of my classmates, though, found the process incredibly trying--many were putting together resumés and cover letters for the first time, and interviews were intimidating. 

You should also know that it seems like there's a non-zero number of graduate students who continue working at their fieldwork site post-graduation. Either they continue to do it for free to earn the rest of their 3000 hours towards licensure, or some even get hired by the site. My school has low-key suggested that you shouldn't really stress about what site you end up at, but I think if you have a long-term goal of being hired at a site post-graduation, it's something you should keep in mind when you're applying to schools. For example, if you're applying to a program that requires you to work at the on-campus clinic, I doubt you would be able to stay on there post-graduation.

If You Currently Work in Mental Healthcare

If you're currently working in mental healthcare, and you think it will be easy-peasy to log your hours at the site you're currently employed at, you may want to clear this with the program before applying. Other schools seem to be fine with this arrangement, but my program "encourages" students to seek another placement to gain broader experience. 

If you currently work in a private practice, you should know that in California, trainees cannot log hours in a private practice (though they can once they become Associates).

Does It Matter?

Ultimately, I don't know if the fieldwork placement situation would be a dealbreaker for any program, but you'll probably want to know a bit about what you're agreeing to when you enroll.

Personally, I'm glad I made the choice to attend a program where I could choose my own field site. Friends of mine, however, have said they wish they'd chosen the other CSUN cohort where you are placed into the on-campus clinic. Now that I have met several CSUN professors who serve as supervisors at that clinic, I think I also would have enjoyed that, but I don't regret my decision.

Again, in my own opinion, I would be wary of programs that offer NO support to their students in terms of finding a fieldwork placement. It seems that these students need to take on the extra work of researching agencies in their area with traineeship programs and vetting them to ensure the site meets the school's criteria. It's extra work that I'm very glad I don't need to worry about, on top of everything else I have due!

On my site, MFT California, I tried to include any information programs make available about how supportive they are when it comes to fieldwork. I hope it helps you in your hunt for the right grad program!

 

 

Points of Interest:

Learn about the many benefits of membership in California's largest Marriage and Family Therapy Association, from unlimited access to our on-staff legal team, to our enriching educational and networking opportunities, and so much more. Become a CAMFT member and enjoy the many benefits that await you.

Location, Location, Location

Caroline Wiita Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

If you're trying to decide where to go to graduate school for marriage and family therapy, one of your primary concerns will most likely be location.

It seems like most people select an MFT program that is close to where they live--I know that's what I did. But I do know some people who were willing to relocate for school. Why would anyone uproot their life for school, when chances are pretty good there's at least one program within driving distance??

Let's take a look at some of the reasons physical location of a graduate program is important, and then maybe you'll have a better idea of how important location is to you--and whether you're willing to uproot yourself.

Fieldwork

During your program, you will need to get direct client-contact experience in order to graduate (the specifics of this are laid out on the BBS website). Some schools have an on-campus clinic and guarantee you that you can meet this requirement at their clinic. Others, however, require you to "go out into the field" (the community) and find your own placement--this is also called a traineeship, as you are considered a "trainee" when you are enrolled in a graduate program and seeing clients (check out my post on fieldwork for a more thorough look at the differences between those options).

If you're in an area like Los Angeles, you will have absolutely no problem finding such a placement--your challenge becomes deciding which one you want.

If, however, you're in a more rural part of California, your opportunities for field placement sites may be limited. Trainees are not allowed to earn hours in private practices, so you will need to find some sort of local non-profit or agency that can meet the requirements (including supervision) of the BBS.

As I've gleaned from some forum discussions online, this can be really hard. I have no personal experience with what you do if you're in a rural program and you can't find a traineeship, but it seems like a real problem, and one of the reasons I suggest attending a program in an area with robust mental health services options.

Networking

Hopefully, during your time in graduate school, you'll be building the foundations of your professional network. The mental healthcare field is largely a community-oriented profession, and while the internet provides opportunities for you to connect with other therapists anywhere in the world, the most important contacts will probably be the ones you make in real life. If you attend a graduate program in an area you are not considering practicing in, you are depriving yourself of a head-start on building that important professional network.

Where You Want to Practice

This kind of goes along with networking. If you want to practice in San Diego, but you go to school in San Francisco, once you get to San Diego you will need to begin at square one in building your professional network. To some extent, this goes for whether you're looking for an agency job or thinking about opening a private practice. But if you begin practicing in the same area where you went to school, chances are a little better that your network can help boost you as you're starting out.

Of course, there's a flip side. If you live in an area that's low on mental health resources, you may benefit from attending school somewhere else for a couple reasons. First, you personally may benefit training-wise from having fieldwork opportunities in a higher-density area. And second, when you return to your home base, your credentials of having attended school and worked in a more metropolitan area may give you an advantage in getting work.

And finally, if you're planning on going to school in California but think there's a chance you may want to practice in another state, you will definitely want to investigate the accreditation of any school you're attending. The MFT is not a very "portable" license, meaning that it's hard to qualify for licenses in other states just by virtue of having qualified for an MFT license in California. Part of this is because of the graduate programs that qualify for licensure here versus other states. Some states (not California) require that a licensee's graduate degree be granted by a COAMFTE-accredited program, but there are only nine programs in California that currently have that accreditation status. If license portability is important to you, you may want to think about making attending a COAMFTE program a priority.

Personally, I had no intention of practicing out of state, and I hope to practice in the city I'm currently living in--Los Angeles. And there are plenty of MFT programs in Los Angeles to choose from. However...I didn't know about MANY of them. Some simply don't show up when you Google "MFT program Los Angeles."

I wanted to make things easier for you, if you're looking to narrow down your choices by location. So on my website, MFT California, I created a map that plots the locations of every MFT program approved by the BBS in California. 

I hope you'll find it a handy resource as you hunt down the perfect program for you!

 

 

Points of Interest:

Learn about the many benefits of membership in California's largest Marriage and Family Therapy Association, from unlimited access to our on-staff legal team, to our enriching educational and networking opportunities, and so much more. Become a CAMFT member and enjoy the many benefits that await you.

If You Want to Be an MFT, You Don't Want a Master's in Psychology (Probably)

Caroline Wiita Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

One of the horror stories I came across as I was researching MFT programs was the tale told by a young woman who had almost completed her master's program in psychology when she realized that the program did not qualify her to sit for the MFT licensing exam (which was her goal). She believed that to become an MFT, she just needed to get a master's in psychology! Unfortunately, this is only partly true.

This is critical: If, like me, you want to eventually qualify for the "marriage and family therapy" license in California, you need to attend a program that meets the requirements set forth by the licensing body, the Board of Behavioral Services (BBS). 

See, there's a broad spectrum of master's degrees in psychology. 

There are some schools that offer a masters in psychology that is intended to prepare students to pursue a doctorate (this is also sometimes the program that students drop down into when they are kicked out of the school's doctorate program). Most of the time, this program DOES NOT meet the requirements you would need to get your MFT license! They offer different classes, don't require the right direct client contact hours, etc. 

Let me make this super clear: If you accidentally enroll in a masters program like this, you WILL NOT be able to become a marriage and family therapist! You would need to RE-ENROLL in a qualifying program. So...do it right from the beginning, yeah?

If you want to become an MFT in California, you need to make sure you're enrolling in a qualifying program. Unfortunately, they come with a variety of different names:

M.A. in Marital & Family Therapy
M.A. in Clinical Psychology
M.S. in Counseling, Option in Marriage, Family and Child Counseling

M.A. in Psychology - Marriage and Family Therapy
M.A. in Counseling
M.A. in Marriage & Family Therapy

You get the point. Hilarious, right? Those are all very different names for essentially the same degree.

Luckily, almost every qualifying program declaratively says so somewhere on the website. So it should be pretty clear. Let's look at example.

The school I currently attend is California State University, Northridge (CSUN). CSUN has a College of Social and Behavioral Sciences, and this college has a Department of Psychology that offers an master's in Psychology with two different options--Clinical Psychology and General Experimental Psychology.

Click to enlarge!

Click to enlarge!

NEITHER OF THESE PROGRAMS QUALIFY. If you attend these programs, you are not qualified to get your MFT license. You would have to attend this program:

That is, the M.S. in Counseling, Option in Marriage & Family Therapy, offered through the College of Education.

So, at CSUN, a master's degree in Clinical Psychology does NOT qualify you to become an MFT, but at Antioch, it DOES. It just has to do with how each school picks its degree names.

There is, of course, an exception that exists simply to screw with you.

At San Francisco State University, both the MS in Clinical Psychology, Concentration in Clinical Psychology degree (offered through the Psychology Department in the College of Science & Engineering) AND the MS in Marriage, Family, and Child Counseling degree (offered through the Department of Counseling in the College of Health & Social Sciences) meet the BBS requirements for MFT education.

Because sure, why not.

I wanted to make it easier to figure out which program at a given school was in fact an MFT-qualifying program. The site I created, MFT California, lists every single program in California that meets the BBS degree requirements--you can clearly see the name of the qualifying degree at the top of every profile page, and I've included links to the specific degree's program page.

I hope you find it helpful, and that it saves you the horror of enrolling in the wrong kind of master's program!

 

Points of Interest:

Learn about the many benefits of membership in California's largest Marriage and Family Therapy Association, from unlimited access to our on-staff legal team, to our enriching educational and networking opportunities, and so much more. Become a CAMFT member and enjoy the many benefits that await you.

Book Review: Saving Psychotherapy, by Benjamin E. Caldwell, PsyD

 ~ Benjamin E. Caldwell, PsyD,&nbsp; Saving Psychotherapy

~ Benjamin E. Caldwell, PsyD, Saving Psychotherapy

If you're a California MFT student or you're studying for the licensing exam, you're probably familiar with Ben Caldwell. I first became acquainted with his work through his excellent blog, Psychotherapy Notes. He's written an easy-to-understand textbook, Basics of California Law for LMFTs, LPCCs, and LCSWs, which is used in Law & Ethics courses as well as considered a must-have desk reference for practicing clinicians. He's also written a series of prep books for the various law and ethics exams in California, and his company, Ben Caldwell Labs, is now offering continuing education courses that meet the six hours of Law & Ethics content needed for license renewal in California. Somehow, he has also found time to be a frequent guest on some of my favorite podcastsadvocate for prelicensed MFTs, and teach at the graduate level, as well (full disclosure: I am currently a student in his Systemic Family Therapy Theories course at CSUN--the opportunity to learn from Dr. Caldwell was a major reason I wanted to attend this program).

What I'm trying to say is--if you're currently on the path to becoming a licensed MFT in California, you probably know this guy.

You've probably also gathered that he's passionate about the field of psychotherapy. If you've purchased his books before, you may have seen advertised a slim, unassuming volume entitled Saving Psychotherapy: How therapists can bring the talking cure back from the brinkIt hasn't been required reading for any of my classes yet, and I don't know why not. I think every future MFT should have to read this before embarking on the graduate school journey--it is a clear-eyed look at the current state of the profession and a clarion call to psychotherapy students and clinicians to take personal responsibility to improve the field.

The quote in the image above is from Caldwell's introduction to this book, and it sums up his underlying point--don't be intimidated by the size of the problem, because if we all pull together, we can achieve something great.

The problem, Caldwell argues, is that the field of psychotherapy is in danger. He points to research indicating that, though therapy has been shown to be effective, it is increasingly underutilized, it "isn't seen as competing well against other services, and [its] reputation as a profession is not as strong as it could be" (p. 28). Readers should not jump to scapegoat the usual suspects, however; while it may be easy to blame Big Pharma or doctors or the stigma associated with mental health services for psychotherapy's issues, it won't help anything (and it's not entirely fair).

Instead, Caldwell outlines a straightforward four-pronged plan of attack to advance the field, all underlined by the necessity of taking personal responsibility.

Task #1

He encourages us to clarify our purposes and values to ameliorate the problem of client mistrust. In this chapter, Caldwell makes an explosive claim: " Therapists who refuse to give advice are failing to fulfill their responsibilities as professionals" (p. 48). If you just re-read that sentence, I don't blame you--it runs counter to almost everything I've been taught about being a therapist so far. However, Caldwell's argument is so persuasive you just might exclaim out loud, as I did, "BY GEORGE HE'S RIGHT." 

Task #2

Fix the process of therapist training and licensure. Caldwell goes into great depth on the problems inherent in the training and licensure paradigms, both of which figure heavily in his advocacy work. The part of this section that most resonated with me was his exhortation to "let money be an explicit factor in decision-making" (p. 103), offered as a counterbalance to the general reticence on the part of most in the field to discuss financial matters.

Personally, I first ran up against this brick wall as I was attempting to determine just how much this whole "graduate school" endeavor was going to cost me. It started simply enough, when I was trying to compare tuition at different programs I wanted to apply to. THIS WAS NEARLY IMPOSSIBLE. Then, I wanted to discern the functional difference between the programs--each one seemed to toot their own horn for different reasons, and I had a hard time wrapping my head around what set each program apart. I became aware that, intentionally or not, many programs obfuscated the details of their programs. I had a lot of free time back then, so I meticulously researched until I had the answers I wanted, but then it dawned on me--there were probably A LOT of people researching these programs that did not have my levels of free time or tenacity (ok fine OCD tendencies). What were they going to do? Probably rely on advertising. That pissed me off.

Fortunately, I'm stubborn. And had a lot of free time back then. And a touch of OCD. So I researched every single MFT program in California and put it all in one place, MFT California. All the information looks the same between programs, so you can easily compare across different metrics. Most importantly? You can easily get a general idea just how expensive each program is. It's pretty enlightening. So yeah--I really liked this part of the book. 

Task #3

This idea is also near and dear to my heart--embrace science. Caldwell argues that discounting science as a therapist is a prime example "of cutting off one's nose to spite their face" (p. 37). His section on statistics in this chapter entitled "Bad Science" was incredibly helpful during my Clinical Research Methods class; if you're intimidated by the math-y-ness of the social sciences, please get this book if ONLY for this reason, because you won't be so intimidated once you're done with this section.

Incidentally, here Caldwell also touches on the issue of postmodern therapy, which is a special area of interest for me. He argues that:

Philosophically, postmodernism...does not discount science, it merely treats it as one of many ways of knowing... True postmodernism suggest that, like all ways of knowing, science can and should inform the social development of consensus around key ideas... [However,] some therapists take calls for a 'not-knowing' stance in therapy quite literally--approaching therapy as if they had never received any training, or as if it had no value in the task at hand. This is not what the developers of postmodern models had in mind. Those developers have attempted to differentiate the humility of a 'not-knowing' stance from the emptiness of a 'know-nothing' stance.  (p. 124-5)

Postmodernism's philosophical embrace of scientific knowledge as well as the more ephemeral ways of understanding really resonates with me, so I deeply appreciated how Caldwell addressed this concept.

Task #4

Finally, and perhaps most importantly, Caldwell encourages us all to accept accountability. He's a huge proponent of Scott Miller's work around clinical effectiveness. Bottom line, no model of therapy is more effective than any other, but there are clearly some therapists who are more effective than others. Miller's work centers on trying to figure out what makes those therapists better. Caldwell argues here that, as clinicians, we need to work to make ourselves better by getting our work evaluated and deliberately working to better our skills. If you really want your mind to be blown, check out this lecture from Scott Miller at the Evolution of Psychotherapy conference in 2013:

Take It Personally

Caldwell clearly articulates at the end of each chapter concrete ways you can personally take action to save psychotherapy. There are simple, common-sense measures we all can take to improve our field, such as becoming a supervisor, being a skeptic not a cynic, and gathering data on your practice. These may seem like insignificant ways to do something as monumental as "save psychotherapy," but if we each take up an oar and really put our backs into it, we can cross oceans.

And your very first step could be reading this book.

 

 

Points of Interest:

  Listen to Dr. Caldwell's podcast on iTunes!

Listen to Dr. Caldwell's podcast on iTunes!

Book Review: The Book of Joy, by the Dalai Lama, Archbishop Desmond Tutu, and Douglas Abrams

Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

I'm going to be honest with you--I downloaded this audiobook because I felt like it was something I should read. I've never read anything by the Dalai Lama, I just know he is on the path to enlightenment and probably a pretty good person. It had been recommended in some Reddit thread on books for therapists, so I figured, what the heck. There are worse ways to spend in hours of traffic than listening to the wisdom of the Dalai Lama.

I am so glad I did. This book far exceeded my expectations.

First of all, I do recommend listening to the audiobook first. Douglas Abrams, the journalist who narrates this extraordinary summit between the Dalai Lama and Archbishop Desmond Tutu, reads his part, and two voice actors read the parts of the two spiritual leaders in accents I assume must approximate the real thing. The effect is utterly charming.

I think part of my eye-roll resistance to reading anything by "spiritual leaders" is that I find self-righteous seriousness insufferable. In my experience, a sense of humor is necessary to weather what life can throw at you. And I assumed the Dalai Lama and an Archbishop talking about anything would be mind-numbingly dull, even in something called The Book of Joy.

WRONNNNNG.

These two spiritual leaders are SO FUNNY. They crack jokes with each other, tease each other, and playfully slap each other. The Dalai Lama insists, "laughter is good for the heart."

Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

What makes their humor so charming, though, is their warm-heartedness. They are so loving--with each other and with literally all of humanity.

Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

Additionally, they emphasize how to be loving to yourself. Another thing I have resisted for a long time is meditation. However, there's a section at the end of the book with suggested practices if readers want to try to take action to increase their joy, and I was pleasantly surprised at how grounded the exercises are. There's nothing uncomfortably esoteric--rather, there are lovely suggestions for things like meditating in the morning to set an intention for the rest of the day. The Dalai Lama admits that sometimes, even he can't come up with an intention; on those days, he simply resolves to do his best to help others, and if he can't, at least he will try to bring no harm to others.

Perhaps the most encouraging conclusion these two great men come to in the book is that joy comes from not pursuing things but from living in community and helping others. This resonates with what has called me to pursue therapy at this point in my life--I have found it to be true, the most joyous moments in my life have come when I could be of service to others. Abrams, the narrator of sorts, includes some fascinating asides about why, scientifically speaking, we are hardwired to find service so satisfying.

No matter what else I tell you about this book, I can't possibly do it justice. I just really hope you'll read it. Its effects have been rippling through my life ever since I closed the cover, and I love how its impact is shifting my perspective. Do yourself a favor and spend some time with some of the most joyous humans on the planet.

 

Points of Interest:

What is Grad School Like?

Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

When I first started researching MFT master's programs, one of the questions that kept gnawing at me was, "what is it really like to be in one of these programs?" Each program seemed so different, and I didn't have a great idea of what "perks" I should be prioritizing over others. Should a flexible schedule at multiple campuses be the deciding factor? Or should I shoot for a rigorous "lockstep" program that would get me out in the least amount of time? Would I be missing anything if I did an online program? And what's the deal with "fieldwork sites," anyway??

I've successfully completed my first semester in graduate school and have begun my second--which includes the fieldwork/traineeship process. I wanted to give you a breakdown of what I've experienced so far. Bear in mind, this is one experience, and I'm basing all of my judgments on my one experience. I'll be honest about what I think, but you may think and feel differently from me, and ultimately come to different conclusions, and that's ok! I just wanted to illuminate the whole thing a little.

For many reasons, I decided to attend California State University, Northridge (CSUN) in Los Angeles, CA. First, I'm going to address the various factors that influenced this decision so you can see my thought process and how it panned out. Then, I'll give you a look inside what my classes were like.

Deciding Factors

Location was the most important part of the decision for me . The school I attended had to be in Los Angeles, because I couldn't relocate. That being said, I didn't feel like I needed to attend the closest campus to my place--I didn't mind driving under an hour, but I couldn't attend school in Santa Barbara or anything. I wrote a whole post on why location of your grad program is important if you'd like some more information.

After that, cost was an enormous factor. I'm still paying off student loans from my undergraduate years, so I didn't want to take on another huge chunk of debt. It seems like you can make a solid living as a marriage and family therapist, but you're probably not going to be a millionaire, so it didn't make sense to me to take on $100,000 of debt just for a master's degree. That ruled out programs like Pepperdine and USC. The CSU schools, however, were remarkably affordable.

Once I narrowed down my choices based on location and cost, I started to consider the less-easily-quantifiable factors. I wanted to get a good education, be taught by good professors, have exposure to diverse populations, and have some flexibility to make my experience personal to me.

Trying to determine the quality of the education and professors at different programs was difficult. What worked best for me was doing some Google and library research on whatever professor names I could find. Some were easy--CSUN, for example, lists its full-time faculty on its website. Others, like Alliant, don't have a full list of faculty members, just a sampling of professors in the program (and information was scant on the Los Angeles ones).

Once I had some names, I could see if they were actively practicing, researching, publishing, presenting at conferences, speaking on panels, etc. Quickly I determined that the faculty at CSUN was very active in all those activities, which gave me a sense that the program was probably academically rigorous rather than geared simply towards meeting accreditation requirements.

Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

Accreditation was another thing I considered but was far from the deciding factor. The only Los Angeles-area COAMFTE school while I was applying was Alliant; CSUN had CACREP accreditation, which seemed to be not as "great" as COAMFTE but better than nothing. However, I found out after I applied that CSUN had in fact been actively pursuing COAMFTE accreditation and was awarded it right before I enrolled--by the time I started, CSUN's program was, in fact, COAMFTE-accredited. You can read about why that is (sort of) important in my blog post on accreditation and why it matters.

Finally, the program format was important to me. CSUN's MFT program meets two days per week in the evenings. You are placed in either the Monday/Wednesday cohort or the Tuesday/Thursday cohort, and for the entirety of the program you stay in those groups. I figured this would give me the flexibility to work during the days and go to school in the evenings (I will get to how that worked out in just a second).

The program has been described as a "lockstep" program--the cohort moves through the program together, and all classes and the order in which they are taken is prescribed. So first semester, everyone takes the same classes, though you may have different professors; the second semester, you all move on to the next set of classes as a group. This differs from a program like Pepperdine's evening format program, where they tell you what classes you need to graduate, and then you figure out what order you want to take them (and where). If you would like to know more about different program format options, check out my blog post on that subject.

So, how did it all work out?

What Grad School is Really Like

Honestly, I feel like I made the perfect decision for me. The commute to CSUN is not bad, and parking isn't that great a challenge for evening classes. It costs a good chunk of change to go to grad school, but my program is significantly more affordable than most other programs in the area so every time I have to pay my tuition I remind myself it could be lots worse!

The professors are, as I'd hoped, incredible. For the most part, each is brilliant and on the cutting edge of his or her particular area of expertise, and every single one is so supportive and caring--they truly do want students to succeed.

Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

But the x-factor in my experience has been my classmates. I'd hoped that by going to a cohort-model program, I would be able to form stronger bonds with classmates (my future colleagues) than I might be able to attending a program where you have different classmates for every class, and I definitely think that is true. Within the first few weeks of class, I'd met and formed friendships with some really amazing people, and as the semester went on, those bonds deepened and even more bonds were made. Even this semester, I'm still making new friends and adding to this incredible support system that I'm not sure I would have found elsewhere. It is for this reason alone--my classmates--that I would urge anyone considering an online program to take a look at on-campus programs one more time. I'm sure you can probably learn a fair amount of material via online delivery, but I think my experience would have been far less valuable without hearing my classmates' perspectives during in-class discussions or being able to engage with them outside of class. It really is the thing that will push your grad school experience from sufficient to transformative.

My Classes

First semester, our cohort had to take Counseling Theories, Practicum, Law & Ethics, and Clinical Research Methods. There were two different instructors for Theories, four for Practicum, and then the same instructor taught two different sections of Law & Ethics, and another instructor taught two different sections of Clinical Research. 

COUNSELING THEORIES
I had Dr. Stan Charnofsky for Counseling Theories, and there were about 20 students in the class. On the first day, he gave us an overview of what we would be doing in class--every week, a group would present on a specific psychotherapeutic theory for about an hour, and then after than Dr. Charnofsky would add a little bit of information from his own perspective. A sign-up sheet was passed around and we signed up for whichever theory we wanted to present on (I picked postmodernism). We had one textbook, and every week our assignment was just to read the chapter out of the book that applied to the upcoming presentation.

The class was an interesting overview of all the theories that make up the field of psychotherapy. We covered everything from Freud to gestalt to person-centered to choice theory to an overview of family systems. It was really easy, which was a nice way to ease into graduate school (because my other classes were not easy). We had no exams during the semester, and the final was a group discussion with Dr. Charnofsky--he presented a case vignette, then we brainstormed different ways we could approach the case from different theoretical perspectives. Dr. Charnofsky was always very supportive and very kind, and he really encouraged us to do our presentations in whatever way we felt inspired to do (most of us did PowerPoints but he was open to anything if you wanted to be more creative).

PRACTICUM
This class is where I made the strongest bonds with my classmates. I had Dr. Mark Stevens and I don't think I've made a luckier choice in my entire life--I just randomly chose to be in his practicum because I'd seen him speak at orientation and he seemed nice. He's great. He really got a feel for our class's comfort level, didn't let preconceived class structure get in the way of us getting to know each other, and was just a gentle supportive presence at every turn.

In this class, we began doing role-plays, which is a mainstay of therapist training. GET USED TO THIS IDEA NOW! It seems to be a go-to tool in training beginning therapists. One student plays "the therapist," and the other plays "the client." Sometimes you do the role-plays privately, but you will also be expected to do them with the whole class watching.

Dr. Stevens made a really great choice in letting us create a character when we played the client at first--I think this gave us all time to get comfortable with each other. Then, after awhile, if we wanted to bring in personal issues during role-plays (like friend drama or family problems etc), we could. 

I cannot stress enough how important it is that you go into this class with an open mind and a collaborative spirit. Try your best to set a tone that encourages the rest of your class to approach this as a team. You really don't want it to descend into a competition, where you're trying to win the title of Best Therapist when you're in the therapist seat or trying to trip up your classmates by playing Problem Client when you're in the client seat. This is a class for introspection and muddling through the newness of it all, not for trying to demonstrate how amazing you are. You should also get in the frame of mind to receive feedback, because you'll get a lot. I highly recommend Brené Brown's book Daring Greatly, and you can read my review for my thoughts on what she has to say about giving and receiving feedback--it should be required reading before Practicum!

There were no exams in my practicum class; instead, we had some writing assignments, turned in weekly journals, and had a couple role-play projects where we paired up and filmed role-plays for submission, and for one of them we had to write out a transcript of the session. There was also a final PowerPoint presentation about our experience over the semester.

LAW & ETHICS
This may seem like a dry, boring class, but I promise you, it's really important with a lot of real-world applications. I had Dr. Ian Russ, who used to be Chair of the Board of Behavioral Sciences (the MFT licensing board in California) and has also been involved in CAMFT, one of the main professional organizations for MFTs in California. He has extensive personal experience with many of the issues covered in this course.

Most of each class is taken up with a lecture by Dr. Russ; he uses the Socratic method, so he'll pause his lectures frequently to ask the class a question (and he will wait for an answer, so don't think he'll move on if no one says anything!). In almost every class there is also a group presentation on a specific theme--you'll sign up in the first couple weeks of class. These cover things like Tarasoff situations as well more broad categories like eating disorders and child abuse; each group is expected to cover both the legal and ethical issues associated with their topic and present with a PowerPoint. There were two quizzes during the semester that were pretty hard (you really need to learn everything, so try to listen for the details that Dr. Russ thinks are especially important), but the final was really based on the quizzes so it wasn't brutal.

I feel like this class did a great job preparing me for the gray areas of this profession, but it was definitely designed more to encourage critical thinking and evaluating your personal ethics rather than preparing students for the Law & Ethics licensing exam that must be taken in order to practice. Dr. Ben Caldwell also teaches this class, and he has written a prep textbook for that exam, Preparing for the California MFT Law and Ethics Exam, that I highly recommend. I bought it the first week of class and followed along as we moved through the semester, so I feel like I learned the material with an eye towards the exam.

 

CLINICAL RESEARCH METHODS
I was not a psychology major as an undergraduate (I studied English literature), so this class was the most challenging but also my favorite. I learned so much! I had Dr. Deborah Buttitta, who is really smart and kind. I loved her teaching style--mostly she lectures, but she's very open to questions and discussion if anyone is confused about anything. Her PowerPoint slides were crucial for preparing for the quizzes during the semester.

The course, as its name implies, covers research methods used in the field of family therapy. Dr. Buttitta emphasized that even if you have no intention of doing research yourself, it's very important that as a clinician you understand research (and what makes research good), as one of our ethical obligations as therapists is to be up-to-date on the latest research that can help our clients.

The major component of this class was the literature review. I had never done one before--my classmates who were psych majors were familiar with this project so I don't think it was as intimidating to them. But even though it was intense, I do think this was an excellent assignment to practice coming up with a question, finding literature that could help answer the question, and synthesizing all the material into a usable form. I would definitely take another class with Dr. Buttitta.

What I Have Learned

The biggest lesson I learned about graduate school is that even though my classes only meet two evenings per week, it is in fact a full-time class load. There is SO MUCH reading, and there really are a lot of group presentations and projects that take up a lot of time. So while it was possible for me to continue to work part-time while I was in school, it was a delicate balancing act. My classmates who have full-time jobs were much more stressed, so I would really say that if you must continue working a full-time job while you're in school, you may want to only consider programs that allow you to go part-time (CSUN is a full-time program).

The other major lesson I have already addressed above--I think my classmates are an integral part of why my experience so far has been so incredible. I simply cannot imagine doing these classes online and not having my classmates to discuss things with. Also, hearing my classmates' perspectives in class discussions but also outside of class has truly expanded my experience and understanding of the world, which I think is vital both as a therapist-in-training as well as a person in general. I feel so lucky to have met such compassionate, inspiring, funny, smart people. I hope your experience is as transformative!!

If you have any questions about the grad school experience, don't hesitate to contact me

 

Points of Interest:

Learn about the many benefits of membership in California's largest Marriage and Family Therapy Association, from unlimited access to our on-staff legal team, to our enriching educational and networking opportunities, and so much more. Become a CAMFT member and enjoy the many benefits that await you.

Book Review: Daring Greatly, by Brené Brown, PhD, LMSW

Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

A wise teacher I once had said this about pursuing excellence:

"Whenever you're trying to get better at something, there's where you are at your starting point, and then way far ahead of you is where you want to be--mastery, the flow state, whatever. In between there is the field of suck. There is no way around the field of suck, and no one gets to skip the field of suck. We all have to wade through the field of suck before we get to mastery."

The field of suck is a frustrating place. It's disappointing, wanting to do something well and being unable to do it. To compound the problem, we frequently have to muddle through the field of suck under observation. While you're trying and failing and disappointed that you're not there yet, there are usually people WATCHING you try and fail.

For many of us, it is so humiliating to fail in front of others that we may give up. We look up from our struggle, wondering how much more we must endure, eye the distance between where we are and where we want to be, calculate how much more humiliation may be in store--and decide it's not worth it.

Does this sound familiar? Have you given up on a dream because you couldn't bear to spend one more minute in the field of suck?

Then I beg you to acquaint yourself with Brené Brown. Surely you've heard of her--the TED talk she gave in 2010 has over 30 million views:

A researcher and bestselling author, Brown focuses on courage, vulnerability, empathy, and shame. She believes "that vulnerability – the willingness to be 'all in' even when you know it can mean failing and hurting – is brave." 

You need a lot of courage to enter the field of suck, and even more courage to stay in the field of suck when the going gets rough. Brown argues the only way to muster such courage is to get comfortable with vulnerability. My wise teacher says you can't get to mastery without wading through the field of suck; Brown, in her book Daring Greatly, says that "you can't get to courage without walking through vulnerability" (sorry I haven't cited page numbers, I listened to the audiobook!).

Daring Greatly is a roadmap for cultivating courage. Even if you've seen every Brené Brown YouTube clip ever posted, getting the Full Story from the researcher/storyteller herself is another experience entirely, so I really do recommend the whole darn thing. But I'm going to focus on just one piece.

The part of the book that most resonated for me at this moment in my life--as I've just completed my first semester of graduate school--is the section on feedback.

In life, we have to deal with feedback all the time. At work, we get performance reviews; at home, we get in fights over how well we washed the dishes. Handled poorly, feedback can be hurtful. But handled wholeheartedly (Brown's big buzzword), feedback moves you forward through the field of suck. Or as Brown puts it, "without feedback there can be no transformative change."

My master's program in marriage and family therapy relies heavily on feedback as part of a learning-centered educational design. Rather than relying on grades alone, feedback in this MFT program consists of discussions about strengths and "growth edges." This means that you can't just get your report card and go hide in your car--you offer your work in class, and then you have to sit there and get feedback from your classmates as well as your professor.

I'm not going to lie, it's tough. Brown uses the word "uncomfortable" to describe these hard conversations. Sure. If you've got straight-A tendencies like me, it's "uncomfortable" like having a sharp rock in your shoe is uncomfortable. That is to say, it can be excruciating. But Brown emphasizes that the goal is not to simply become comfortable with the feedback process--the way through, she argues, is to normalize the discomfort.

This struck such a deep chord with me because, at this point in my life, I've tried all the other ways to dissipate the uncomfortableness of receiving feedback, and they don't work. It never gets easy. And what I've realized is that if I can let go of my defenses and really take in constructive feedback, I move forward through the field of suck. Other people know things I don't, and learning from them is how I can make the transformative changes I'd like to see in myself.

Normalizing discomfort, then, is how we all settle in to feedback. And according to Brown, you have a responsibility to help normalize discomfort for those around you and lead the way with the following declaration:

“We believe growth and learning are uncomfortable so it’s going to happen here, you’re going to feel that way. We want you to know it’s normal and an expectation here, you’re not alone and we ask that you stay open and lean into it.”

Letting people know that the uncomfortableness is normal, Brown argues, reduces anxiety, fear, and shame--those things that drive us out of the field of suck before we've reached our goals.

Leaning into the discomfort is, in my mind, wallowing in the field of suck. Settling in, deciding to stay awhile--opting out of surrender, no matter how unpleasant the experience. Because there is no way around the field of suck.

Making the conscious decision ahead of time to lean into the discomfort of receiving feedback has perhaps been the best thing I've done for myself in this entire graduate school process. I so passionately want to become a therapist, but I recognize I have a whole field of suck ahead of me. Wasting any energy fighting the field of suck would be counterproductive. Instead, recognizing the inevitability of discomfort has freed me to really hear feedback, to incorporate it into my own growth process. Feedback doesn't mean I've done something wrong--it means I have taken another step through the field of suck.

"Vulnerability," Brown reminds us, "is at the heart of the feedback process... [and it] never goes away, but experience gives us the knowledge that we can survive the exposure and uncertainty, and that it's worth the risk." This, I think, is a powerful argument for "[cultivating] the courage to be uncomfortable and to teach the people around us to expect discomfort as a part of growth."

I hope you've been inspired to cultivate the courage to be vulnerable and wallow in the field of suck--if you need a little help finding your way to that courage, I highly recommend Daring Greatly.

P.S. Brené Brown was on Oprah's podcast and it was soooooo good, I've posted the episodes below if you're interested!

 

Points of Interest:

My Favorite Therapy Podcasts

Caroline wiita Marriage and family therapy therapist psychotherapist graduate student masters degree doctorate phd MFT licensed prelicensed clinical social worker trainee intern associate

I spend an unreasonable amount of time in my car, so podcasts have been my saving grace. There are several great therapy podcasts I have stumbled across that have really broadened my understanding of the mental health field and introduced me to the huge variety of different paths you can take as a practitioner. Most podcasts release new episodes regularly, so I feel like they help me stay current even though my studying for school has been more focused on theoretical foundations, but I also recommend diving into the archives!

Talking Therapy, RJ Thomas, MFT & John Webber, MFT
This is one of my favorite ones. Long-format (each episode is around an hour). The hosts' media/entertainment industry experience shows--it's not overly-scripted but the interviews always flow. They also aren't selling anything, so you just get a lot of great information. They cover a wide variety of topics and always have quality guests. I appreciate how the hosts are mindful of explaining terms that "future therapists of America" might not understand yet. My only complaint is that I wish there were more episodes!

Psychotherapy Notes Podcast, Ben Caldwell, PhD, LMFT
Very short format (under 10 minutes). Part of how I decided to become an MFT was by reading every single thing posted by Dr. Caldwell on his excellent blog, Psychotherapy Notes. Dr. Caldwell is a passionate advocate for the profession with a clear and engaging style that's both easy and invigorating to read--he really wants the reader to understand what he's saying. He just launched his podcast, and I'm really excited to see where it goes from here.

YouTube LecturesDr. Diane Gehart, LMFT
OK this is not actually a podcast, but still I think the sooner you check these out, the better off you'll be. Dr. Gehart has several lectures posted on YouTube that cover various orientations and also more nuts-and-bolts things like APA style and BBS hour logging (for California trainees/associates). They're very popular with people studying for the licensing exam, but I found them to be an invaluable adjunct to my introductory counseling theories course in my first semester of grad school.

Hidden Brain, Shankar Vedantam
Medium format (25-50 minutes). Not strictly about psychotherapy, but it is so fascinating! And really, really well done (it comes from NPR). I can't explain it any better than they do on their website: "Hidden Brain links research from psychology and neurobiology with findings from economics, anthropology, and sociology, among other fields. The goal of Hidden Brain isn't merely to entertain, but to give you insights to apply at work, at home and throughout your life."