• Visit The Therapy That Works Institute to learn more about her work and connect on Facebook, Instagram, YouTube, and LinkedIn.

Books mentioned in this episode:

Dr. Diane Gehart – Theory and Treatment Planning in Counseling and Psychotherapy

Dr. Diane Gehart – Mastering Competencies in Family Therapy

Dr. Diane Gehart – Mindfulness and Acceptance in Couple and Family Therapy

Dr. Diane Gehart – Mindfulness for Chocolate Lovers

Joe Sanok 00:00:00  Every single phase of private practice has its own unique challenges and its own unique opportunities. Whether you’re starting and growing a solo practice, getting a group practice going, whether you’re already a group practice boss or you want to go big and go national with the skills you have, every phase has its challenges. And, you know, doing that in community with people and learning from other folks and having that guidance is so, so important. That’s why we have a membership community for every phase of practice. Next level practice is for solo practitioners to help you get organized, fill up your practice, and get that solo practice rocking. We have small groups, we have accountability partners. We have live events every single week. And also if in the first three months and the first 90 days, you’re not satisfied, we have a 90 day money back guarantee. Next we have group practice launch. Group practice launch is a six month program specifically for you to launch a group practice. We have weekly meetings with that as well as well as guided courses, and you get full access to next level practice, and you’re guaranteed to hire someone in the first six months.

Joe Sanok 00:01:11  Or you could go through it again for free. Next we have group practice boss. Group practice boss is for people that have group practices and want to continue to grow. All those ups and downs of having a group practice of changing that mindset, being in community with other people and getting that support from us. We with that as well, have weekly meetings and you get to come to next level practice events as well. So that’s eight meetings a month that you could come to live to get extra help. Also, there’s a 90 day money back guarantee. Lastly, we have audience building Academy. Audience building Academy is specifically for people that are ready to level up and go national. Maybe you want to get a traditionally published book. I have a podcast launch, some products and courses, and scalable income. Audience Building Academy is specifically for you so that you can level up and go national. We’ll walk you through exactly how you go from having a solo or a group practice to going national. We’ll help you build your email list, get on podcasts, and really level up.

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Joe Sanok 00:02:39  This is the.

Joe Sanok 00:02:40  Practice of the practice podcast with Joe Sarna session number 1156. I’m Joe sound like your host. And welcome to the practice of the Practice Podcast. This month we are doing the Even Better Year series. We are so excited about this series. You know, small steps in the right direction rather than these giant things that we do for just a month. You know, that’s how we roll here at practice of the practice, whether you’re growing your private practice in one of our membership communities, or maybe you are improving your clinical skills, or maybe you’re just figuring out things outside of your business that bring you life. We want you to take steps in the right direction over time that we support.

Joe Sanok 00:03:25  So really excited to have you here as part of our Even Better Year series. you know, I’m really excited about our guest today, Doctor Diane Gerhart. Diane is an award winning author, educator, and TEDx speaker. She has trained thousands of licensed mental health professionals over the past 30 years, translating complex clinical theories into easily understood principles and practices. She’s the founder of the Therapy That Works Institute, pioneering a unifying framework for psychotherapy, and is a professor emerita at California State University, Northridge. Her authored works include Theory and Treatment Planning and Counseling and Psychotherapy, Mastering Competencies in Family Therapy, Mindfulness and Acceptance in Couple and Family Therapy, and Mindfulness for Chocolate Lovers a lighthearted way to stress less and savor more each day. Diane. Welcome to the practice of the Practice podcast.

Dr. Diane Gerhart 00:04:24  Thank you so much, Joe, for having me.

Joe Sanok 00:04:26  I got to start with chocolate. Do you love chocolate a ton? Is that why you wrote the book? Or tell us more about writing a whole book on chocolate?

Dr. Diane Gerhart 00:04:33  Hahaha.

Dr. Diane Gerhart 00:04:34  I do love chocolate. and you know, I’ve taught mindfulness now for decades, and the classic, the classic exercise was with raisins. And when I would travel around and try to present, those raisin boxes got crushed. And so I, I decided, you know what? Because I would mindfully eat chocolate all the time for myself. Yeah. I said, you know. You know what? I’m just going to bring chocolate. So that’s how it started. And I had a ton of I’ve had a ton of fun, teaching it that way because it just, it chocolate just opens itself up to every the lots of metaphors. So I had a lot of fun, meditating with chocolate.

Joe Sanok 00:05:17  yeah. My daughter and I, her name is Lucia. We went to Saint Lucia for her 13th birthday, and she got to pick, kind of different activities we did there, and it was so cool to see her, kind of organize it with a Trello board and all that. And one of the things we did was a chocolate making, thing where we had to grind the the cocoa nibs by hand in this, like, really hot, like Stone bowl.

Joe Sanok 00:05:40  and it just gives you an appreciation for how chocolate used to get made, because, you know, we’re making this and pounding it like crazy. And the final bar that we made was such a gritty chocolate, like, it’s it’s okay, but it just helps you understand just all that goes into like, you know, separating the butter from the nibs and then bringing it back together and adding the sugar. And, we’re doing this on this beautiful, like, you know, cocoa farm. and it’s just amazing all that goes into just this delicious piece of chocolate.

Dr. Diane Gerhart 00:06:08  That is sounds like so much fun. And it sounds like it can be a great meditation to. So awesome.

Joe Sanok 00:06:14  Yeah. Well, so you have, this unifying theory. You’ve been working on this for a while, and you’ve been training people. I mean, the books that that you’ve written. I mean, I feel like I probably have read many of them throughout my life without even realizing you were the author of them. Because especially early on in my career, I feel like I bought every single book that was on, like Theory and Treatment because, you know, you have like, you know, two years, three years of grad school and then you’re thrown into these sessions and it’s just like, oh my gosh, I do not feel ready to be in here.

Joe Sanok 00:06:46  And so I devoured a lot of that early career. tell me about the unifying framework. How did it come out, come about? and kind of what made you want to bring this framework together.

Dr. Diane Gerhart 00:06:59  Well, you know, it kind of evolved without my conscious, like, attempting to create it. You know, I’ve been a textbook author for almost three decades, and I’ve written books on both counseling theories as well as family theories. And so, you know, I’ve done a deep dive on at least 50 different theories. And when I write my my textbooks, I really tried to describe what people were doing in the room. not just, you know, kind of the theoretical concepts. And to really get as practical as possible and put it into really simple language. What began to happen as I did that is that I began to create this framework in my head to compare and contrast everything. And so over the years, slowly, this model kind of developed, as I’m trying to explain in very simple terms.

Dr. Diane Gerhart 00:07:54  But we all know that so many of these theories kind of sound alike. and like God, you know, didn’t someone say this ten years ago? And a theoretician or your professor. I was a theory professor. Right. Well, say no, no, no, that’s totally different concept. And let me tell you why. But you know what I’ve discovered over the years, and this is so ironic because I’m a textbook, I’m a theoretician. I’m a textbook author, for the love of God. But I’ve begun to realize, like, wow, we have way too many of these theories. It’s just creating a lot of confusion. And when you’re in the room, they actually can be a bit of a problem. For example, you know, solution focused therapists talk about finding exceptions to problems, and narrative therapists talk about finding unique outcomes or sparkling moments. And the truth is, like theoretically, conceptually, they truly are different things. But when you’re sitting in that room face to face with a client, it’s the same thing.

Dr. Diane Gerhart 00:08:50  You’re just looking for a time when the problem could have happened, but it didn’t. And having all of this jargon to have to sort through and stumble through, I think really makes us less effective in the room.

Joe Sanok 00:09:03  Yeah.

Joe Sanok 00:09:04  And so take us through what have you discovered with the unifying framework for psychotherapy.

Dr. Diane Gerhart 00:09:10  So you know this this evolved I mean I’ve been supervising folks for over 30 years. I’ve been writing about these theories and trying to, you know, train folks on how to become a highly effective clinician, as quickly and easily as possible. There’s actually some fascinating research that about 15% of mental health professionals are just simply more effective across the board then, than everyone else. It doesn’t matter whether they’re, you know, they’re early in their career, later in their career. Does it matter if you give them a manual treatment or just tell them, do whatever the heck you want to do in there? So there are certain things, that we know kind of work better. And so that’s really what this therapy that works unifying framework is about.

Dr. Diane Gerhart 00:09:56  Like let’s just focus on what gets results in the room right and and be a little less attached to all of our theory that tells us how things should be going and what should be happening. And let’s just focus on what actually does happen in the room.

Joe Sanok 00:10:14  so walk us through, kind of some of the key bullet points or pillars of it.

Dr. Diane Gerhart 00:10:20  Absolutely. So there’s six components, so to speak. and the first one is self of the clinician. And if you look at all the different, you know, I think of there being streams of research on specific theories on common factors on highly effective clinicians. We actually have multiple streams of research in our field. But when you look across all of them, the who the person is and how they relate in the room is consistently, the most, you know, the top predictor of whether or not they’re going to be positive outcomes. And so I start training folks in this unifying framework by looking at themselves and, you know, not just saying, go get some therapy or do some mindfulness, you know, do some self-care, but really looking about how do you how do you live your life day to day when you do this type of work? And I think that’s a real important thing to look at.

Dr. Diane Gerhart 00:11:15  And so, the self, the clinician we start looking at, you know, how how are we doing as humans emotionally relationship wise, health wise, you know, financially even and looking at the 360 self of the therapist and learning how to set a personal development plan that you can use across all of your life, and setting small little goals and moving towards them. So we start kind of just looking at who you are as a human. The the next piece is kind of the therapeutic relationship. And, you know, most of us were all trained in empathy and the Rogers core conditions, which are absolutely necessary. But when you start looking at the current research, there’s so much more to what these highly effective clinicians are doing. And so we we really look at how you enter the client’s kind of lived reality. I guess I’ll share real quickly the metaphor I use to teach this, and it is, is that we have to enter their meaning making system. And so this kind of is grounded in some social constructionist approaches and also some interpersonal neurobiology.

Dr. Diane Gerhart 00:12:28  and so in terms of entering a client’s meaning making system, I like to think of it. And the best metaphor I can think of is, comes out of Star Trek and it comes out of an old version of Star Trek where there was the starship enterprise, and there was a room called the holodeck, and the holodeck was a room that the user programmed. And you could create, you know, an island Paradise, you know, another planet, your your home when you were a child, right? But the user programs the characters and the logic of that world. And so this is different than a VR headset where you’ve got an app that someone else’s programmed. And so I think the best metaphor for understanding how to talk with a client is you are blindfolded in their holodeck. You are blindfolded in their meaning making system. And that the the first step in helping a client is to try to step out of all of your meaning making systems which are assumptions, are biases which we can never fully let go of.

Dr. Diane Gerhart 00:13:27  But to as much as you can step out of that and realize that you were blindfolded in someone else’s meaning making system. And so in their holodeck, you know, lions can be prey animals who are grazers and gentle, and the gazelles can be the apex predators. You just don’t know until you ask. And, you know, clouds could be found on the ground and rivers can float through mid-air. You just don’t know until you stumble through their world and ask questions. And so, so as you relate in this way, there’s this very much getting in tune with the clients. And Dan Siegel talks a lot about, how that you can they can actually now in their interpersonal neurobiology research, they’re looking at something called neuro resonance. And where when two people are connecting and communicating, they can actually have a measurable neural resonance. They feel in sync with each other. We all know that feeling when someone gets you, you know, and you’re kind of like in sync. There’s actually a neurological piece to that.

Dr. Diane Gerhart 00:14:31  And so that’s what you’re trying to do as the therapist when you’re first connecting with the client. So this who you are in the room, how you show up and how you enter and listen to your client. it’s very attuned. And this is this kind of connects with those that research on the highly effective clinicians. There’s this attunement that’s very subtle. It’s moment to moment in terms of relating to your client and understanding, you know, how they are making sense of whatever situations they’re describing to you in the room. I’m just going to stop there and make sure that that’s all making sense to you. Before I go too much further.

Joe Sanok 00:15:14  Yeah. Keep going, I love it.

Dr. Diane Gerhart 00:15:17  So. Yeah. So. So you entered the client’s world. You try to understand, you know, and you want to get a basically what I call the movie, which is a behavioral description of what happened. And then they how they interpret it. And then where the kind of unification or synthesis comes in is in terms of case conceptualization, we use a framework.

Dr. Diane Gerhart 00:15:37  And a framework is not a theory. A theory explains why people do what they do. And then we come up with, you know, ideas for how to help them. a framework is this is simply a system for doing so. When you’re in the room working with the client, how can you draw on, you know, all of the theories that we have. So we have over 500 psychotherapy theories with 50 major theories taught in like universities, across our various disciplines. And so the unifying framework synthesizes. It’s not integrative because integrative is like cognitive plus behavioral. You get cognitive behavioral right. Or an emotionally focused couples therapy. It’s attachment theory plus systems plus humanistic. They’re clearly identified. But what we’re doing is is boiling down all the theories, trying to get away from as much jargon as we can to just get at some of the key concepts. And so the framework for conceptualization is not going to shock anyone listening. it is looking at what’s going on behaviorally, looking on what’s going at the emotional level, which includes that secure attachment as well as expressed emotions, looking at what’s going on cognitively, which is of course our beliefs and schemas, but also our identity narratives like who we tell we ourselves that we are right so we can string all your beliefs together.

Dr. Diane Gerhart 00:16:55  You get your your identity narrative. And then finally, the top level is the societal level. So the societal discourses, social location, what people say about, you know, people who have problems, like, you know, our clients. And so we look at these four different levels in terms of conceptualizing the problem. And what’s truly fascinating is that you can really map, you know, every major theoretical approach that we have onto this. And most theories will, you know, address maybe two of these levels. And so what happens when you use this unifying framework? All of a sudden you’re able to pull from so much more of the knowledge in the field to kind of understand what’s going on with our clients. And this really enables you to have a very rich, conceptualization that’s much more nuanced than any one theory can do on its own. And then after you have that, then you filter it through the evidence base. And this is something that we really don’t have a great way to access in our field.

Dr. Diane Gerhart 00:17:57  You know, in terms of the practicing clinician knowing, you know, what the research says about each of the major, you know, disorders and the DSM. So using a template to help filter through, you know, what’s my client’s problem and what does the research say should work best for that. So for example obsessive OCD, obsessive compulsive disorder, we now know that 95% of people, some kind of an exposure behavioral therapy is going to be most effective. And just using cognitive interventions typically doesn’t work. And that’s real important to understand. You know, similarly we know for generalized anxiety another form of anxiety. Most approaches are going to work well for that. And so understanding what’s going on with your client and with the research says, and then finally, you know, the same process we use to conceptualize the problem, we use to conceptualize health and the solution in terms of kind of thickening those with, identity narratives and those positive narratives around wellness is as well as promoting lifelong wellness with what we call the five pillars of wellness, which, again, this is not surprising.

Dr. Diane Gerhart 00:19:10  but it’s, you know, making sure our clients have healthy life habits like sleep, exercise, healthy eating, a strong support network, and, you know, healthy coping skills that involve more than just a margarita on the beach, things like mindfulness or journaling, but to have real skills, so that once they’ve, you know, left treatment, they’re able to maintain whatever they’ve their gains that they’ve learned with us.

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Joe Sanok 00:20:29  Hello, alma. Com forward slash Jo. That’s hello alma.com/jo to learn more. How do new therapists kind of screw this up? Or what are some traps of newer therapists in regards to how they enter into those therapeutic relationships?

Dr. Diane Gerhart 00:20:50  Well, so newer therapists are often, one of the common mistakes I see with newer therapists is that they try to look and sound professional, and they try to have this expert stance.

Joe Sanok 00:21:05  And I just pause you there and tell you when I first graduated. as soon as you said that, I’m like, oh my gosh, I was totally that. And I just got to jump in with this story. I was 25. I was asked to teach a parenting class that was court mandated, not as a parent. And I grew a beard so I would look older and would act all like I. I would say, I don’t have kids. I want you to know that I am just a professional teaching you and you have to apply it. But it was like, so like, if I grow a beard, then I look more professional.

Joe Sanok 00:21:36  So yeah, so I had to jump in there. So. So they try to act all professional.

Dr. Diane Gerhart 00:21:40  Yeah. And they try to sound professional. Like you know, they’re so worried about not you looking like they don’t know anything that they come off kind of aloof. And then they have this imposter syndrome and the paradox the irony is, okay, that clients actually like newer therapists better because usually they’re more likable. but also because, you know, if you go back to the holodeck, this not knowing, this openness is curiosity, just willingness to truly listen from an open position without judgment. Newer therapists actually do that better than experienced therapists who are like, after the first three minutes, we’re like, oh, I know this. I’ve heard this before. Oh, I know exactly where this is going, right? No one wants to talk to someone who thinks they know where you know. Know knows my story better than me, right? So, so newer therapists are really trying to look a certain way or think that an expert sounds or does or like you’re saying, grow a beard, look a certain, you know, look a certain way that they often totally mess up, that that one piece of how you connect in a really authentic way, because it’s really that that quality of your connection unlocks everything else.

Dr. Diane Gerhart 00:22:50  When people come through my course, I’m like, if you don’t get this, what I call collaborative connecting correctly. If you don’t get this, it’s the key to unlocks everything else. You can have the best research in the world. You know the evidence based treatment. But if you don’t have that really attuned communication where clients feel like you are right there, nothing else works. And that’s really what matters the most.

Joe Sanok 00:23:14  Now what about kind of like, seasoned therapists that have been around a bit like, you know, when you’re not maybe in grad school have things fresh in your mind. you know, you’re obviously doing continuing ed and things like that, but are there habits that you see that when it comes to psychotherapy that seasoned therapists like, what are the missteps maybe they’re making?

Dr. Diane Gerhart 00:23:36  Well, I think sometimes, you know, when you’ve been doing this for a while, you begin to think you, you know, it all. You you kind of you think you know where it’s going. You know what? You’re you know how this is going to end with your client.

Dr. Diane Gerhart 00:23:51  And the one thing I would challenge a seasoned client and a seasoned clinician to do is to really slow down. And yes, it is true. You, you. Your hypothesis is probably correct. Okay. Seasoned clinician, you’re probably correct. However, you are going to be a lot more helpful if you can just slow down, be curious, look for the unique elements of this client’s story. and to just really force yourself to slow down and be more curious, because usually what you get are these little gems that open up possibilities that you didn’t see because you kind of jump to conclusions. And so the one thing I will say is when you’re really listening to how your client is making sense and interpreting their lived experience, that should take 99% of your brain power. You know, my mind never wanders. It’s like I’m just following this breadcrumb trail and meaning, this happened. They understood this way. And then they said this. And so, you know, and their partner responded this way, and this is how they interpreted that.

Dr. Diane Gerhart 00:25:02  And, and if I’m going to understand from their meaning making system and not mine, that should take like 99% of your brainpower so that you’re always engaged. Your brain should never your mind should never be wandering if you’re really trying to understand how they see things. But when you work that way, it is amazing how how everything kind of unfolds naturally and the clients start putting all those new dots of meaning together and our job becomes so much easier.

Joe Sanok 00:25:36  Yeah.

Joe Sanok 00:25:37  I like that idea of seasoned therapists like, you know, kind of cautioning them to be like, I’ve seen this before. I know this narrative. Here’s the direction we’re going without fully engaging with like what is the story and the mindset that that person is entering into.

Dr. Diane Gerhart 00:25:51  Yeah. And it’s a discipline, I would say. It requires discipline.

Joe Sanok 00:25:58  Yeah.

Joe Sanok 00:25:59  Now

Joe Sanok 00:26:00  When you look at people that are kind of implementing this unified theory, like what does that look like? kind of an ongoing assessment of the approach. what sort of, kind of ongoing tools do people need to be thinking about?

Dr. Diane Gerhart 00:26:15  Well, so what’s nice about the framework? It’s a system for what you’re doing in the room.

Dr. Diane Gerhart 00:26:20  And so even, you know, like I when I train newer clinicians, with what they find, like one of my they all will often find that, they’re one of the, you know, I, one of my students got pulled in by the, clinical director going, what are you doing? You have the highest retention rate of anyone here. And they had licensed people. And she was like, in her first six months of doing counseling, right? And she goes, I don’t know. I’m doing therapy that works. But it is this attuned, communication that really transforms things. but it’s easy. You can bring in almost any therapeutic model and language to use to help, you know, guide your work. So. So there is this, ability to have this framework that just is a very streamlined system for doing in the room that helps you use all the theories and to use all the research available to you, but then you can start integrating your own, you know, favorite approaches or way of looking at things or interventions, you know, on top of it.

Joe Sanok 00:27:28  Well, the last question I asked Diane is if every private practitioner in the world were listening right now, what would you want them to know.

Dr. Diane Gerhart 00:27:36  So I would say is that your work should be life giving. It should fuel you. I mean I’m hoping when you drive home at the end of the day you feel like, wow, that’s awesome. I can’t believe I get paid to do this work.

Joe Sanok 00:27:53  And that hopefully.

Dr. Diane Gerhart 00:27:55  you feel and experience just the, the difference you make in people’s lives. It’s really a privilege to do this work. And so hopefully, you know, my hope is that, that you find the work, this life, life giving to you as well as you’re giving life to others and to if you’re not doing that, if you’re starting to feel burned out, to definitely look at ways of addressing that, connecting with others, so that the, it’s really magical work. What I have to say, and I hope you feel that every day.

Joe Sanok 00:28:30  so awesome. If people want to follow your work, they want to read more about the Unified theory.

Joe Sanok 00:28:36  If they want to get your books, where should we send them?

Dr. Diane Gerhart 00:28:38  Oh, do I have a website called The Therapy That Works institute.com, and I have online courses where I teach this. My books are there. I have lots of free resources, for all of my textbooks, clinical forms, ironically, on all the different theories, because I’ve studied a lot of different theories. So, but yeah, therapy that works. institute.com.

Joe Sanok 00:29:00  thank you so much for being on the practice of the practice podcast.

Dr. Diane Gerhart 00:29:04  Thank you so much for having me.

Joe Sanok 00:29:14  Well, we have a packed schedule this month of helping you continue to have an even better year. If you’ve missed any of the episodes earlier in the month. we had one on 25 clinicians serving 50 countries, 100% online. We had one on a sexual health with Canadian researcher Laurie Bravo. we had best practices with attorney, employment law attorney, John Gardner. We had writing compliant progress notes. We had a healing journey, from Jordan to domestic violence and into leadership.

Joe Sanok 00:29:48  So really interesting stories that we’ve had this month and ways that people can help you have an even better year. So go back and check out some of those. also, we couldn’t do this without our sponsors. Alma is our sponsor for today’s episode, and alma provides clinicians a rewarding private practice through simplified insurance credentialing in under 45 days. They help with reimbursement rates and guaranteed two week payback. So you can check more over at. Hello alma.com/jo again that’s. Hello al McCombs. Jo, thank you for letting me into your ears and into your brain. Have a great day. I’ll talk to you soon. Special thanks to the band Silences Sexy for that intro music. And this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers or guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.