Embracing Therapeutic Complexity: Interview with Patricia Gianotti, Psy.D.

[Episode 138] Today's episode is an interview with Dr. Patricia Gianotti, Academic Director of The Institute for Advanced Psychotherapy at Loyola University Chicago. Patricia and I speak about the neurobiology of shame, why depth work is important, and how to think about human complexity in a therapeutic context. She emphasizes the impact of attachment failures on a person's sense of self and the role of shame in therapy. She explains the concept of loyalty contracts and how they shape individuals' beliefs and behaviors. She underscores the power of psychodynamic techniques in uncovering and addressing these dynamics. Throughout the conversation, she highlights the hope and resilience that can be found in therapy.

Download MP3 [41:17]

The Institute for Advanced Psychotherapy at Loyola University Chicago offers a yearlong certificate program for licensed professionals, aimed at enhancing clinical skills through an integrative training method. The program incorporates advances in trauma and neuropsychological research within a framework rooted in attachment theory. Participants engage in onsite residencies that last three full days each, featuring hands-on training by nationally acclaimed faculty. In between residencies, distance learning continues through monthly 90-minute case consultation meetings and bimonthly live webinars. The program is approved for CEU Credit by the APA and NASW, and awards a total of 72 credit hours. To learn more, please visit https://www.luc-iap.com/

Under Pressure (Part 2): Interview with Lisa Damour, Ph.D.

[Episode 123] Today's episode of the Social Work Podcast is the second of a two part-series about Dr. Lisa Damour’s 2019 text Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls. In today’s episode we talk about rape culture; the problem with the word "consent"; and how society's criticisms of the way girls speak is really just another way of criticizing girls. In Part 1, Lisa and I talk about the difference between stress, anxiety and trauma; what “good” and “bad” pressure look like; and how schools, parents, and providers can think about pressure.

Download MP3 [27:46]

Under Pressure (Part 1): Interview with Lisa Damour, Ph.D.

[Episode 122] Today's episode of the Social Work Podcast is the first of a two part-series about Dr. Lisa Damour’s 2019 text Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls. In today’s episode we talk about the difference between stress, anxiety and trauma; what “good” and “bad” pressure look like; and how schools, parents, and providers can think about pressure. In part two we move the conversation into issues of rape culture and how society criticizes the way girls speak as a cover for criticizing girls.

Dr. Damour and I first spoke in February 2016 about her book, Untangled: Guiding Teenage Girls Through the Seven Transitions into Adulthood. I thought Untangled was a fantastic combination of empirical insights and practice wisdom and I loved our interview.

Download MP3 [34:06]

Attachment-Based Family Therapy (ABFT) for Depressed and Suicidal Youth: Interview with Guy Diamond, Ph.D., and Suzanne Levy, Ph.D.

[Episode 96] In today's Social Work Podcast I speak with two of the three developers of Attachment-based Family Therapy (ABFT), Guy S. Diamond, Ph.D. and Suzanne Levy, Ph.D. The third developer Gary M. Diamond (no relation to Guy Diamond) lives in Israel and was unavailable for the interview.

ABFT is the only family-based psychotherapy with empirical support for reducing suicidal ideation in youth. In today's interview, Dr. Diamond and Dr. Levy discuss the theory and practice of Attachment-Based Family Therapy. Dr. Diamond mostly covers theory and concepts, and Dr. Levy addresses the question of "what does the therapist actually do in the therapy room."

Download MP3 [50:36]


If you're interested in learning more about ABFT, you can buy the treatment manual Attachment Based Family Therapy for Depressed Adolescents, watch a free webinar http://youtu.be/KcwHznzq-S4, or attend a workshop (details on their website: https://abftinternational.com/)

ABFT is listed on the National Registry of Evidence-based Programs and Practices, also referred to as NREPP. According to NREPP, 

"Attachment-Based Family Therapy (ABFT) is a treatment for adolescents ages 12-18 that is designed to treat clinically diagnosed major depressive disorder, eliminate suicidal ideation, and reduce dispositional anxiety. The model is based on an interpersonal theory of depression, which proposes that the quality of family relationships may precipitate, exacerbate, or prevent depression and suicidal ideation. In this model, ruptures in family relationships, such as those due to abandonment, neglect, or abuse or a harsh and negative parenting environment, influence the development of adolescent depression. Families with these attachment ruptures lack the normative secure base and safe haven context needed for an adolescent's healthy development, including the development of emotion regulation and problem-solving skills. These adolescents may experience depression resulting from the attachment ruptures themselves or from their inability to turn to the family for support in the face of trauma outside the home. ABFT aims to strengthen or repair parent-adolescent attachment bonds and improve family communication. As the normative secure base is restored, parents become a resource to help the adolescent cope with stress, experience competency, and explore autonomy. 

ABFT is typically delivered in 60- to 90-minute sessions conducted weekly for 12-16 weeks. Treatment follows a semistructured protocol consisting of five sequential therapy tasks, each of which has clearly outlined processes and goals:

1. Task 1: The Relational Reframe Task, with the adolescent and parents (or parent) together, sets the foundation of the therapy. After an assessment of the history and nature of the depression, the therapist focuses on relational ruptures. This shift pivots on the therapeutic question, "When you feel so depressed or suicidal, why don't you go to your parents for help?" The progression of this conversation leads parents and the adolescent to agree that improving the quality of their relationship would be a good starting point for treatment.
2. Task 2: The Adolescent Alliance Task, with the adolescent alone, identifies relational ruptures in the family and links them to the depression. The adolescent is encouraged and prepared to discuss these often avoided feelings and memories with his or her parents.
3. Task 3: The Parent Alliance Task, with the parents alone, explores their current stressors and their own history of attachment disappointments. These conversations activate parental caregiving instincts to behaviorally and emotionally protect their child, which helps motivate parents to learn and use new attachment-promoting parenting skills.
4. Task 4: The Attachment Task, with the adolescent and parents together, creates an opportunity for the adolescent to directly express his or her thoughts and feelings about past and current relational injustices. Rather than defending themselves, parents help the adolescent fully express and explore these emotionally charged topics. This conversation helps the adolescent work through trauma, address negative patterns in the relationship, and practice new conflict resolution and emotion regulation skills.
5. Task 5: The Autonomy Task, with the adolescent and parents together, helps consolidate the new secure base. In solving day-to-day problems, parents provide support and expectations and the adolescent seeks to develop autonomy while remaining appropriately attached to his or her parents." (http://legacy.nreppadmin.net/ViewIntervention.aspx?id=314)

Shared Trauma: Interview with Carol Tosone, Ph.D.

[Episode 91] Today's episode of the Social Work Podcast is about shared trauma, one in which the provider and client experienced the same traumatic event simultaneously. If you're not familiar with the concept of shared trauma, no worries. It is a relatively new concept, but one that has been experienced as long as there have been helpers and... helpees.

In order to better understand shared trauma, I spoke with Dr. Carol Tosone, one of a handful of scholars whose writings and research have defined shared trauma. Dr. Tosone is Associate Professor at New York University Silver School of Social Work. She is a Distinguished Scholar in Social Work in the National Academies of Practice in Washington, D.C.

In today's episode, Dr. Tosone unpacks the concept of shared trauma. She uses her personal experience of being in a therapy session on September 11, 2001, when the first plane flew over her building, and how sharing the trauma of 9/11 with her client affected her professional and personal life. During our conversation she answered many questions: How does a concurrent experience of the same traumatic event as your client affect the treatment relationship? In what ways is it beneficial to the treatment relationship? How do you know when it is detrimental? We end our conversation with recommendations for practitioners.

Identifying and Responding to Sex-Trafficking Victims in Social Service Settings: Interview with Rebecca J. Macy, Ph.D.

[Episode 81] In today's social work podcast I spoke with Rebecca J. Macy, Ph.D., ACSW, LCSW. Rebecca is the L. Richardson Preyer Distinguished Chair for Strengthening Families and the Associate Dean for Academic Affairs at the UNC at Chapel Hill School of Social Work.

I started our conversation asking Rebecca how she became interested in identification of sex trafficking victims in human service delivery. Most of our conversation focused on how to identify and respond to victims of sex trafficking. We talked about the interdisciplinary nature of sex trafficking; how it involves representatives from law, medicine, social services, and how social workers can and should take the lead in coordinating efforts to help victims. And, as is the custom, we ended our conversation with resources for social workers, the Polaris project in particular. Rebecca was kind enough to send me a list of references and resources that I have posted to the socialworkpodcast.com website.

Since 2004 there has been a 150% increase in the number of searches for the term "sex trafficking." During the same period, there has been no appreciable change in the number of searches for the terms "modern day slavery" or "labor trafficking."

An Overview of Trauma-Informed Care: Interview with Nancy J. Smyth, Ph.D.

Today's episode of the Social Work Podcast looks at Trauma Informed Care, one of the most promising approaches to working with people without causing additional trauma. And I had the honor of talking about Trauma-informed care with Nancy Smyth, professor and Dean of the School of Social Work at the University at Buffalo. There are three reasons why Nancy was the perfect guest for today's topic. First, she understands what it means to address trauma at the micro, mezzo, and macro level. She has worked in both mental health and addiction treatment settings for over 35 years as a clinician, manager, educator, researcher, and program developer. Second, she's what we like to call a “content” expert. She is a Board Certified Expert in Traumatic Stress.  Her research, teaching, and practice focuses on trauma, substance abuse, and on working with people recovering from those experiences, including the use of innovative treatment approaches like EMDR and mindfulness meditation. In today's episode, we talked about Nancy's interest in Trauma-Informed Care. She identified the basic assumptions behind Trauma-Informed Care. She clarified the relationship between a trauma-informed approach to working with clients and specific empirically supported treatments for people with trauma histories, and treatment for people with PTSD. She talked about some of the ways that she has translated trauma-informed principles into micro-level treatment practices. We ended with resources for people who are interested in learning more about Trauma-Informed Care, including a bunch of episodes on the inSocialWork podcast series.