Portland Psychotherapy 2019 Year in Review

Hello colleagues and friends. Looking back on this year at Portland Psychotherapy we feel a tremendous sense of gratitude for being able to continue to do this meaningful work, and also excitement for what the future holds. We wanted to take this time to pause and share with you all, our friends and colleagues in the community, what we have been up to this past year. We also wanted to extend our deep appreciation for the relationships we have with you and all the encouragement and support we receive from you.

More staff means expanded access

With several new clinicians joining our team this year, we are a full house here at Portland Psychotherapy. Joanne Chan, Psy.D. and Brian Pilecki, Ph.D. join as the newest licensed psychologists in our anxiety specialty clinic. Dr. Chan works with adolescents and adults who struggle with anxiety-related difficulties, with a particular specialization in evidence-based interventions for OCD and hoarding disorder. Dr. Pilecki specializes in anxiety treatment and also brings clinical expertise and research experience in psychedelic integration and safety.

We are excited to have two new postdoctoral fellows, Priyadarshani (Priya) Loess, Ph.D. and Kati Lear, Ph.D. join us as well. Her strong background in DBT, compassion-based interventions, and ACT enables Dr. Loess to work with adults presenting with a wide range of difficulties and she has a particular passion for working with adults with trauma-related struggles using culturally-informed models. Dr. Lear has a strong interest in addressing pervasive self-criticism, shame, and non-suicidal self-injury. As one of our clinician-researchers, Dr. Lear spends about half of her time in clinical work and the other half working on research related to shame, self-criticism, and self-injury. We are also very pleased to have Tyree Dingle, M.S. join our team as a practicum student from the Ph.D. clinical psychology program at Pacific University. With an interest in ACT and FAP (Functional Analytic Psychotherapy), Tyree joins Drs. Loess and Lear in offering low fee services (as low as $20/session).

We have also expanded our administrative staff. We are so appreciative of being able to have Aspynn Oliekan and Heather Burkhardt join us as Administrative Assistant and Billing Manager respectively. While our clinicians and researchers may be the more visible face of Portland Psychotherapy, all of us here know that it is our administrative team of Aspynn, Heather, Alyssa Wong (Administrative Assistant) and Amy Forrer (Operations Manager) that really keep things running here.

New Directions for Portland Psychotherapy

Research and clinical services related to Psychedelic Assisted Psychotherapy – The growing empirical research on the possible benefits of psychedelic assisted psychotherapy is impressive and exciting, with particularly promising data on the treatment of trauma, treatment resistant depression, and distress related to life-threatening illnesses. While we can’t provide these services yet as they have not yet been approved by the FDA, we are starting to offer psychedelic harm reduction and integration services for people who want support in making informed choices about their use, strategies for reducing risks associated with their use, help in integrating what was experienced during psychedelic use into everyday life, or support in coping with negative experiences they may have had. We have various ongoing research projects related to psychedelics and hope to be able to offer these treatments once they are legal.

Expansion of the Portland Psychotherapy Anxiety Clinic – With three full time licensed psychologists (Dr. Brian Thompson, Dr. Joanne Chan, and Dr. Brian Pilecki) and a part time psychiatrist (Dr. Meghan O’Neil), we have been able to greatly expand the services we can offer in our anxiety clinic. In addition to the evidence-based clinical services for adolescents and adults, anxiety clinic faculty are also conducting research to contribute to the scientific literature on the most effective treatments for anxiety-related difficulties.

Release of Values in Therapy – For the past year and a half Drs. Jenna LeJeune and Jason Luoma have been working on a book for clinicians who want to develop their effectiveness in working with values and meaning in therapy. We are thrilled to say that Values in Therapy: A Clinician’s Guide to Helping Clients Explore Values, Increase Psychological Flexibility, and Live a More Meaningful Life has just been released. This book is based in ACT, but written to be relevant to clinicians from all theoretical orientations. If you read the book, we think you will see that this topic is a personal passion, especially for Dr. LeJeune, and she feels honored to be able to have had the opportunity to write this book and share her passion with others.

Current Groups and classes (complete list at: portlandpsychotherapyclinic.com/classes_and_groups/)

Upcoming training events (complete list at portlandpsychotherapytraining.com)

Research at Portland Psychotherapy

Portland Psychotherapy is the only research institution of its kind. Rather than relying on grants that make us dependent on the whims and priorities of funders, we use a social enterprise model in which profits from the income-generating activities of our organization are used to fund independent social science research. Over the past year, publications supported by Portland Psychotherapy include:

Luoma, J.B., Subucedo, P., Eriksson, J., Gates, N., & Pilecki, B. (in press). Toward a Contextual Psychedelic Assisted Therapy: Contextual Behavioral Science and the Third Wave of Psychedelic Research. Journal of Contextual Behavioral Science.

Luoma, J.B., Chwyl, C., & Kaplan, J. (in press). Substance Use and Shame: A Systematic and Meta-analytic Review. Clinical Psychology Review.  Download pre-print here.

Luoma, J.B. & LeJeune, J.T. (2020). Incorporating Affective Science into ACT to Treat Highly Self-Critical and Shame Prone Clients. In M. E. Levin, M. P. Twohig & J. Krafft (Eds.), Innovations in ACT. Oakland, CA: New Harbinger.

LeJeune, J.T., & Luoma, J.B. (2019). Values in Therapy: A Clinician’s Guide to Helping Clients Explore Values, Increase Psychological Flexibility, and Live a More Meaningful Life. New Harbinger: Oakland, CA.

Guinther, P. M. (2018). Contextual influence over deriving another’s false beliefs using a relational triangulation perspective taking protocol (RT‐PTP‐M2). Journal of the Experimental Analysis of Behavior, 110(3), 500-521.

Your support, in all of its forms, is essential in the work that we do and our ability to fulfill our mission. Thank you and we look forward to seeing you in the year to come.

Portland Psychotherapy 2018 Year in Review

Hello friends and colleagues. As we usher in a new year, we pause to take a look back at 2018, an exciting year of growth and new beginnings for us here at Portland Psychotherapy.

Expansion of clinical staff means more specialized services and an increased ability to serve our community

We just celebrated the one-year anniversary of the three newest members of our full-time clinical team: our Director of Clinical Operations, Kyong Yi, LCSW, and licensed psychologists Angela Izmirian, Ph.D. and Bryce Doehne, PsyD. Although they have only been with us for a year, Kyong, Angela, and Bryce have already made huge contributions to our organization. In addition to seeing clients, they have been meeting with members of our broader community to explore ways Portland Psychotherapy can better support underserved and disenfranchised populations, including immigrant communities and gender minorities. We are excited for how these partnerships will allow us to have a broader positive impact on our community in the years to come.

We are also fortunate to have Debesh Mallik, M.S. join us as an advanced practicum student this year. Debesh earned his master’s degree in psychology from the University of Louisiana at Lafayette, where he studied under Emily Sandoz, Ph.D., one of the foremost experts in ACT and RFT and who also happens to be coming to do a two-day training for us in Portland in April (see below). Debesh is pursuing a Ph.D. at Pacific University with a focus on substance use, mood, and anxiety disorders under the mentorship of Dr. Sarah Bowen. We are excited to have such a skilled and well-trained clinician as Debesh offer low fee therapy services at Portland Psychotherapy.

Books and other creative endeavors coming out of Portland Psychotherapy

With our wonderful and expanded team of clinicians onboard, Portland Psychotherapy founders, Jenna LeJeune and Jason Luoma were able to take a step back from the day-to-day operations of the clinic to spend the first half of 2018 abroad on sabbatical. This sabbatical allowed them more focused time to work on various research and writing projects including a forthcoming book entitled Values in Practice: A Clinician’s Guide to Helping Clients Develop Psychological Flexibility and Live a More Meaningful Life (Jenna and Jason, due out later this year by New Harbinger Press) and an RO DBT skills workbook (Jason with Tom Lynch, Ph.D. and Nicole Little, Ph.D.). Jason also worked on his soon-to-be released podcast, Research Matters in which he interviews established psychology researchers from around the world. Through the podcast, listeners, especially students and aspiring researchers, will be able to learn from the wisdom of these amazing researchers as they deconstruct the strategies that have worked for them for conducting meaningful social science research.

Research at Portland Psychotherapy

Portland Psychotherapy is the only research institution of its kind. Rather than relying on grants that make us dependent on the whims and priorities of external government funding sources, we use a social enterprise model in which profits from the income-generating activities of our organization are used to fund independent social science research. We also collaborate with other researchers around the world to help fulfill our mission of contributing to the wider community through scientific research. Over the past year, the publications that have come out of those research endeavors include: (see tinyurl.com/ppcscience for a complete list, with some available to download):

Guinther, P. (2017). Contextual influence over deriving others’ true beliefs using a relational triangulation perspective-taking protocol. Journal of the Experimental Analysis of Behavior, 108(3), 433-456.

Luoma, J. B., Codd, T. R., & Lynch, T. R. (2018). Radically Open Dialectical Behavior Therapy (RO DBT): Shared Features and Differences with ACT, DBT, and CFT. The Behavior Therapist.

Luoma, J.B., Guinther, P., Lawless DesJardins, N. M., & Vilardaga, R. (2018). Is Shame a Proximal Trigger for Drinking? A Daily Process Study with a Community Sample. Journal of Experimental and Clinical Psychopharmacology, 26(3), 290-301.

Luoma, J.B. & LeJeune, J.T. (in press). Incorporating Affective Science into ACT to Treat Highly Self-Critical and Shame Prone Clients. In M. E. Levin, M. P. Twohig & J. Krafft (Eds.), Innovations in ACT. Oakland, CA: New Harbinger.

Osborne, T., & Luoma, J.B. (2018). Overcoming a Primary Barrier to Practice-Based Research: Access to Independent Ethics Review. Psychotherapy, 55 (3), 255–262.

Appreciating where we have been and looking towards the future

During their sabbatical, Jason and Jenna were also able to pause to reflect on next steps for Portland Psychotherapy. It’s been more than 10 years since they launched this dream of developing a social enterprise in which the profits from providing exceptional, specialized therapy services could be used to increase the social good by funding important social science research and sliding scale services. There have been bumps along the road and at a lot of learning along the way, but we are proud of what our team has been able to accomplish thus far. If you’re interested in learning more about Portland Psychotherapy’s model of using social enterprise to make a positive difference you can read more at: tinyurl.com/ppcsocial.

Looking to the future, Portland Psychotherapy will focus on 1. Having a broader positive impact through partnerships with other like-minded colleagues and organizations, 2. Expanding our research program by hiring more clinician researchers and strengthening our research collaborations with colleagues around the world, and 3. Continuing to expand our clinical services by bringing on new therapists who are experts in their area of specialty and are interested in our mission. To help meet these goals, Portland Psychotherapy hopes to hire at least one new full-time therapist, a full-time postdoctoral fellow, and a full-time research psychologist (see: http://portlandpsychotherapytraining.com/employment-opportunities-at-portland-psychotherapy/).

Groups and classes

We continue to offer a variety of groups and classes for members of the public. Our current offerings are (see portlandpsychotherapyclinic.com/classes_and_groups/ for a complete list):

  • ACT for Depression Group
  • ACT on Life for Women
  • Radically Open Dialectical Behavior Therapy Skills Classes

Upcoming training events

To support our training mission, we will continue to host workshops based on a variety of topics within Contextual Behavioral Science and related fields. Upcoming trainings include (see portlandpsychotherapytraining.com for a complete list):

  • Evoke, Reinforce, Repeat: Enhancing the Creativity and Sensitivity of your ACT work with a Plain Language Behavioral Perspective to Clinical Work – April 12-13, 2018 with Emily Sandoz, Ph.D.
  • Helping Patients Forgive: REACH Forgiveness as Evidence-Based Practice in Psychology – September 28, 2019 with Everett Worthington, Ph.D.

In looking back on this year, and the more than 10 years Portland Psychotherapy has been serving our Portland community, we are humbled by all the support we have received from friends and colleagues around the work. Your support, in all of its forms, is essential in the work that we do and our ability to fulfill our mission. Thank you and we look forward to what lies ahead.

New RCTs: Acceptance and Commitment Therapy is effective for treatment resistant clients

New RCTs: Acceptance and Commitment Therapy is effective for treatment resistant clients

Two recent randomized control trials seem to indicate that acceptance and commitment therapy (ACT) is a good option for people who have no benefitted from prior treatment. A lot of people don’t respond to their first round of treatment, so this is good news for a lot of people. This research adds to a growing list of studies showing that ACT is helpful across a large range of conditions and life difficulties.

ACT outperforms CBT for people who had not previously responded to therapy

 

In a study published in July of 2014 the investigators compared group-based ACT to group-based CBT (treatment as usual) for 61 participants.  These participants came to the study with a range of diagnoses and all had participated in previous psychotherapy for which they did not receive a significant beneficial response.  The results of the study showed that both groups showed initial benefit, however in the group that received ACT treatment the benefits were completely sustained at a 6 month follow up assessment.

 

ACT works for people with panic disorder that didn’t respond to previous treatment

 

Another RCT published in March of 2015 tested ACT as an intervention for “treatment-resistant patients” struggling with panic disorder and/or agoraphobia.  There were 43  participants in this study and they all had received evidenced-based, standard of care treatment (mean number of previous sessions = 42) with unsuccessful results.

The participants were grouped into the conditions of treatment, short-term wait-list and delayed treatment and each offered 8 sessions over 4 weeks of manualized ACT treatment.  The results show a medium-to-large effect sizes with sustained and improved results a 6 month follow up assessment.

The authors conclude that this data suggest that ACT is a viable treatment option for panic disorder and agoraphobia treatment-resistant patients.

Research into treatment recommendations and factors concerning non-responders to psychotherapy is a clear gap in the current literature.  However, these studies are building evidence that ACT is a robust treatment that appears to offer patients something useful that other treatments were not able to provide.

Newest Data on Shame and Drinking Published at Western Psychological Association Conference

Newest Data on Shame and Drinking Published at Western Psychological Association Conference

Last Friday, Portland Psychotherapy research assistants Monica Bahan, Megan Cheslock, and Jackie Potter presented a research poster at the annual Western Psychological Association convention, which took place in Portland. Their poster detailed findings from one of our ongoing studies exploring the relationship between shame, guilt, and drinking behavior. The findings were based on the first 88 participants in the study, all volunteers from the Portland area.

Congratulations to Monica, Megan, and Jackie on their first presentation!

Jason Luoma, Ph.D.

Author: Jason Luoma, Ph.D.

Jason is a psychologist who researches ways to help people with chronic shame and stigma and also works clinically with people struggling with those same problems.

A Meta-Analysis Comparing Psychotherapy and Medication for OCD

A Meta-Analysis Comparing Psychotherapy and Medication for OCD

This post was featured on our client-centered blog The Art and Science of Living Well, but I thought it would be of interest to therapists as well.

The post is about a finding from a meta-analysis by Cuipjers and colleagues that looked at studies comparing medication against psychotherapy in the treatment of anxiety disorders and depression. For obsessive-compulsive disorder, the researchers found a clear advantage of evidence-based psychotherapy for OCD above medication.

You can read the post by clicking here, and it includes links to the original article, which you can download for free.

UPCOMING TRAINING EVENTS

January 31, 2020, 8:30 am – 4:30 pm · Portland, OR · Details

This workshop is intended to be part 1 of a two day workshop, but can also be taken on its own. This workshop is useful for therapists who want an update on the current clinically applicable research on how shame functions, including an overview of how and when shame tends to be adaptive versus maladaptive. This day has two primary goals: 1. To provide an overview of research on shame and self-criticism that can guide clinical practice and 2. To allow therapists to experience the model from the inside-out so as to develop greater personal self-compassion and a deeper intuitive understanding of compassion-based intervention strategies. Read more

February 1, 2020, 8:30 am – 4:30 pm · Portland, OR · Details

This workshop is intended to be part 2 of a two day workshop, but can also be taken on its own. If you already have a thorough understanding of the functions of shame and a good understanding of Acceptance and Commitment Therapy, then it is you will probably be OK taking just the second day of this workshop. The workshop proceeds to discuss how ACT processes can be focused on addressing chronic and pervasive shame-based difficulties, with a particular focus on flexible perspective taking. Demonstrations of how to use perspective taking and compassion-fostering strategies with clients will be provided and attendees will also practice in small groups. An overview of chair work in the context of ACT will be provided. Read more

February 29, 2020, 9:00 am – 12:15 pm · Portland, OR · Details

Exposure is one of most the effective treatments for anxiety, trauma, and obsessive compulsive and related disorders (e.g., OCD, PTSD, panic disorder). A transdiagnostic intervention, exposure involves the repeated and systematic engagement with avoided stimuli that cause anxiety. Unfortunately, exposure remains underutilized by clinicians (e.g., Scherr, Herbert, & Forman, 2015), mostly due to misunderstandings of how exposure works and perceived difficulty of using it with clients. This half-day workshop will address these gaps by drawing from research on enhancing clinician understanding of and ways to overcome barriers to delivering exposure therapy (Farrell et al., 2016). Using didactics, role-play, and experiential exercises, participants will learn flexible application of exposure for a variety of clinical targets. Read more

April 17 and 18, 2020, 9:15 am – 5:00 pm · Portland, OR · Details

Do you ever “get stuck” as a therapist? Do some of your clients press your “hot buttons”? Do you ever find yourself struggling and thinking about “what do I do next” or feeling anxious, scared or stressed in therapy? In this workshop we will work on clarifying your therapist values and defining what is “difficult” about “difficult” clients. Through discussions, demonstrations and roleplays we will then work on these difficult clients and look at the processes from a compassionate ACT perspective. Read more