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The Clinical Depth Principle: Why Therapy Cannot Be Reduced to Tools, Hacks, and Sound Bites

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The Clinical Depth Principle: Why Therapy Cannot Be Reduced to Tools, Hacks, and Sound Bites

Tools have their place. If a square breathing exercise keeps a client from throwing their phone across the room, that is a good outcome. But somewhere between handing out worksheets like Halloween candy and asking a brand new client to re-experience their deepest childhood trauma four minutes into session one, the profession has drifted away from something harder to name, harder to bill, and harder to fit into a 30 second video: actual clinical depth.

Curt Widhalm, LMFT, and Katie Vernoy, LMFT take on this month’s modern therapist principle, clinical depth over simplification, and the two extremes it sits between. On one side is a therapy culture shaped by medicalization, productivity pressure, and social media trends that flatten complicated people into one size fits all narratives. On the other is the overcorrection, where therapists chase catharsis before the relationship can hold it.

Transcript

Click here to scroll to the podcast transcript.

(Show notes provided in collaboration with Otter.ai and Claude AI.)

In this podcast episode: Clinical Reasoning, Case Conceptualization, and Doing Deep Work Without Flooding Your Clients

Curt and Katie start with the systems that quietly train depth out of clinicians, from documenting medical necessity and observable behavioral change to the productivity pressure that makes a worksheet the fastest route to a finished note. They look at how social media has become the most available and least expensive substitute for real consultation, then turn to the opposite failure, the therapist whose clinical ambition outpaces what the client is actually presenting. Both hosts describe what depth looks like in their own sessions, and what it takes to build the capacity to stay in the messy, unpredictable parts of the work.

Key Takeaways for Therapists on Clinical Depth, Case Conceptualization, and Pacing Deep Work

“We can use tools as therapists as our own defense mechanisms against the system, so that way any kind of justification can be done in documentation, but we’re not necessarily moving towards the more unpredictable parts of human suffering.”

— Curt Widhalm, LMFT

Simplification is usually a reaction to pressure, not a lack of care. Documentation demands and early career pressure to show that something is happening push clinicians toward whatever is easiest to justify on paper. Katie names the word lazy, then reconsiders it on air and lands on under-resourced.
Tools can become the therapist’s defense mechanism. A worksheet or a thought record gives both people an immediate sense of accomplishment while leaving the core inner workings untouched.
Content is not process. Depth work tracks patterns across sessions rather than moving through this week’s events, which is where a great deal of therapy quietly stalls.
Premature depth is not depth. Chasing a specific emotional response without pacing, conceptualization, or consent can push a client well outside the window of tolerance. Katie goes as far as calling it potentially violating.
Deep work has to be consensual, session by session. Clients need to know what they are agreeing to now, not just what they signed at intake.
Stabilization and skill building are legitimate clinical work. Tools build capacity and let the relationship develop without going deeper than it can hold. The problem is stopping there by default.
Depth means tracking capacity, not just story. Curt describes progress as clients recognizing their impulses and staying present with difficulty, rather than needing to leave the room or reach for another tool.

“When I was coming up, the way it was described is process versus content, and that’s such a simple concept, but for me, I took that to heart. Everything is process, everything is pattern.”

— Katie Vernoy, LMFT

What Clinical Depth Actually Looks Like

Rather than assigning depth to psychodynamic or trauma informed clinicians alone, Curt and Katie each describe it in their own terms. Katie works relationally, grounded in knowing the person in front of her, tracking the through line across sessions, and holding space for emotion instead of resolving it quickly. Curt, who came up in behavioral and directive training, focuses on helping clients recognize their own patterns and, in his words, track their capacity, not just their story. Practically, that means clients who can name their impulses and stay present with something hard rather than needing to run out of the room.

The research they lean on points the same direction. Curt cites Jonathan Shedler’s long running critique that when therapy focuses on symptom control and tool delivery, treatment gains tend to decay, while depth oriented approaches emphasizing emotional expression, avoidance, and interpersonal patterns show continued improvement after therapy ends. Dan Siegel’s window of tolerance supplies the pacing language, and Bruce Wampold’s common factors keep the conversation from collapsing into a single modality.

Building the capacity for this work starts with the therapist. Katie points to doing your own work so your distress tolerance can hold what shows up, getting back into consultation, keeping case formulations and treatment plans dynamic rather than written once at intake, and aiming past symptom control toward a different relationship to emotion and to self. Both hosts tie it back to last month’s territory: under-resourced, burned out clinicians cannot consistently do deep work, which makes career sustainability a clinical issue rather than only a self-care one.

Resources on Clinical Depth, Case Conceptualization, and Deep Clinical Work

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

Jonathan Shedler, PhD, on depth oriented psychotherapy and the durability of treatment gains
Bruce Wampold, PhD, and the common factors, including therapeutic alliance and goal consensus
Dan Siegel, MD, and the window of tolerance
Concepts discussed: process versus content, case conceptualization, medical necessity, stabilization, premature depth

Relevant Episodes of MTSG Podcast

Meet the Hosts: Curt Widhalm & Katie Vernoy

Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at: http://www.curtwidhalm.com

Katie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at: http://www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

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Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements)

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist Survival Guide, where therapists live, breathe, and practice as human beings. To support you as a whole person and a therapist, ere are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 0:16
Welcome back, Modern Therapists. This is Modern Therapist Survival Guide. I’m Curt Widhalm with Katie Vernoy, and this is the podcast for therapists about the things that we do in our practices, the way that we approach our professions. And look, I love a good coping skill as much as the next guy. If a square breathing exercise keeps a client from throwing their phone across the room, fantastic. You know, tools have their place, but somewhere between handing out worksheets like they are Halloween candy and asking a brand new client four minutes into session one to re-experience their deepest childhood trauma, we seem to be in a place in our profession where we’ve maybe lost some actual clinical depth. We’ve somehow created a therapy culture that swings wildly between two extremes: either acting like human PDF generators who dispense 30 second hacks that we learn on TikTok, or wildly diving off the deep end before building a container that can actually hold the wreckage. So today we’re turning off the fast forward button. We’re setting down on laminated thought records and talking about what real relational clinical depth actually looks like, without flooding your clients, without hiding behind tools. So we are talking once again about the principles that make us the Modern Therapist Survival Guide.

Katie Vernoy 1:43
It’s so interesting because when we get started, I never know what jokes you’re going to do, or…

Curt Widhalm 1:50
Sometimes I don’t either.

Katie Vernoy 1:53
…or how you’re going to show up, and so it’s always interesting to see that. And part of what I do is is I hold the space for whatever you you want to bring and rely on the relationship to guide us through. But anyway, to the topic at hand. So the principle we’re talking about this month is clinical depth over simplification. It’s acknowledging that therapy is complex, nuanced, and relational. It can’t be reduced to tips, hacks, or sound bites. We want to make sure that we’re looking at clinical reasoning and case conceptualization. Critically evaluate any of the trends or pop psychology that are greatly influencing how we are seen, at least if not how we see ourselves as well, and honor the complexity of human behavior and therapeutic change. So we’re not looking for quick fixes. We’re not looking for reductive mental health advice. We want to make sure that although some of us may even be influencers, that we’re honoring that things are way more complicated than can fit in a three-minute or 30 second video on your social media feed. And to tie this back to last month and and to not go too deep into what we’ve been talking about for quite some time, to do clinically deep work, we need to have a sustainable career. We need to have the ability to take care of ourselves, take care of our supervisees, and and fight back on systems that would would make us do work that’s either morally injurious or leads to all kinds of burnout and empathy fatigue, and all of those things. So, we’ll probably mention it. We are the Modern Therapist Survival Guide, and one of our biggest survival issues is this burnout and and difficulty in sustaining the career. But I think we should start with some of the other pieces as well. The the the parts of this that are probably more relevant to this topic than just “Hey, do your own work, keep yourself well, so that you can do this work.”

Curt Widhalm 4:18
So a lot of the backdrop of this has been more and more about the trade-off that we have made as professionals to be seen as more professional, to have our services covered by insurance, to have a lot of the things that we do be taken more seriously within the larger healthcare system has involved some trade-offs that unfortunately put some of this stuff at risk. And I’m really kind of talking about the medicalization of therapy that doesn’t necessarily make things better or in depth in the ways that we want, and this has only gotten more and more heightened over the course of my career. But this has led us to have a therapy culture that, on one hand, is based on insurance demanding short-term fixes, getting to symptom reduction rather than necessarily healing, and this ends up pushing us into all kinds of you know, whether it be the work that that we do if you’re paneled with an insurance company, whether it be MBA bean counters pushing DMH services in order to have clients be able to move through to justify funding, that ends up kind of making it to where therapy having to follow this medical model isn’t necessarily adding any of the clinical depth and insights and oriented processes that help to actually move things forward. In addition to that, over the last decade plus, we also have more and more of therapy on social media, and whether it be therapists themselves talking about the ways that things need to fit into those 30 second or three-minute sound bites that you were referring to, Katie, or whether it be clients talking about their therapy experiences, or other therapy aficionados who aren’t necessarily therapists trying to make things fall into sound bites that aren’t necessarily the relational aspects that make the transformation end up happening. That really, kind of within clinical depth is creating an effective space that allows for growth to end up happening, and this really kind of comes at odds with a lot of where the influences, both in the financial and the reimbursement realm of things, but also on the pop culture ideas of what therapy ends up needing to be, that makes it to where it gets more likes and follows and reposts than it does to actually get to something beyond any kind of superficiality.

Katie Vernoy 7:25
I have a choice here. I can continue on this surface level discussion, or I can go deeper. Which way you want me to go?

Curt Widhalm 7:33
Go deeper. Deeper.

Katie Vernoy 7:35
All right, Curt, we’ll go deeper. So, looking at the medicalization, I want to I want to sit there for just a second, if that’s okay with you. And he nodded for people who…

Curt Widhalm 7:44
Noticing what’s going on in my body.

Katie Vernoy 7:50
I worked for a very long time and supervised for a very long time in community mental health, and so I want to I want to speak to this because I feel like there is what is encouraged, and then there’s what can be done. And I think, as we typically do, we’ll talk about what can be done. But when we look at the medicalization, whether it’s a private practitioner with insurance, although I feel like that’s less relevant, although maybe just I was a bad insurance taking therapist and just did what I wanted to anyway, but when you’re in community mental health, when you’re when you’re aligned with Medicaid contracts and all of the documentation and all of the things, there is this push to show medical necessity, which not as hard as it seems, but I think some folks feel daunted by that because they’re supposed to be very focused on symptomatology and symptom reduction based on that model, and then it’s also about behavioral change, things that can actually be seen. Talking about what happened in a session? What can I bill for? What is the specific change I’m going for? And what are the things that are still needed? So you, you know, medical necessity. You show that there’s progress towards the goals, and that there’s still ongoing need. So you’ve not met it, and and to a certain extent, as long as you keep doing that, you can you can actually keep clients for fairly long time. But to me, I think some of it becomes this shortcut to trying to get the work done that happens when you’re overburdened, and so I know I’m already going into the overburden system and the overburden clinicians, which is what we talked about all of last month.

Curt Widhalm 9:46
Right, right.

Katie Vernoy 9:47
But the outcome is I just need to get this documentation done. I just need to have something to put in my notes, and I’m exhausted. And this client is so overwhelmed, and so I’m going to do a worksheet, or I’m going to do a specific protocol, and I’m going to do it as quickly as possible, so that I can then go do my note and be done and meet productivity. Right? It can be that exhausting, or it can be from the supervisor angle. You have to be doing something. You have to prove that there is both medical necessity and you’re doing an intervention, and so that becomes really tough because that’s what’s encouraged, but it’s not necessarily what’s solely what’s allowed. But the same is is true for pop psychology and social media. The same is true for all of these things. If we stick there and we get, I hate this word, but I can’t think of another one, if we get lazy and we allow the conversations to stay there, we we allow the the work to stay at that level where it’s just about symptom reduction. It’s just about content instead of process. Time passes. There is some incremental progress, but it’s not the deep work that we’re talking about, and it it requires a lot more of therapists. And so, I think I just wanted to acknowledge that what we’re talking about isn’t easy. It’s not even necessarily easy to prove that it’s more effective sometimes, and it requires more of you, and so this is we’re saying, hey, this is what modern therapists do, and we’re saying it’s not that easy. It’s it’s not going to be a simple switch. It’s it’s actually a lot of understanding yourself and how you want to be in the room. There’s a lot of the person of the therapist stuff that I think needs to be here as well, and maybe that’s the next thing we can talk about.

… 11:43
(Advertisement Break)

Curt Widhalm 11:45
Well, as I’m sitting here listening to you, I am kind of, I know you weren’t wanting to settle on the word lazy, but I don’t necessarily want to assign that that’s the intention. It might be more of kind of a reaction to these pressures that, especially early on in our careers, that we can feel to the system around us, to be able to move clients forward, and so a lot of times there can end up being this reaction to just do something in order to justify what’s going on outside of the room, and so giving a client a worksheet or a grounding exercise or a thought record gives the therapists and the clients an immediate idea of accomplishment, but it doesn’t necessarily address any kind of the core inner workings of things.

Katie Vernoy 12:37
Yeah.

Curt Widhalm 12:37
And so, what you and I are kind of both talking about here is that we can use tools as therapists as our own defense mechanisms against the system, so that way any kind of justification can be done in documentation, but we’re not necessarily moving towards the more unpredictable parts of human suffering, and for clients, getting tools can feel like something is being done. At least at first, like it’s kind of this hit of we’re accomplishing something. So it almost sometimes helps to create kind of this intellectualization of the early parts of therapy, without necessarily being able to move into something.

Katie Vernoy 13:30
And to be fair, some of that work is really needed. It’s part of stabilization. It’s part of capacity building. It’s allowing the relationship to develop while not going deeper than the relationship can allow. So we’re not saying, “Hey, do deep work in this way all the time.” But it is something where maybe the word shortcut was better, or maybe maybe it’s more about having something specific and having guidance. But to go back to your addressing my use of the word lazy, I think I’m actually reflecting on some some of the work that I’ve done. So I’ll claim the the lazy word, and and that I don’t like it. I think it’s self judgmental. So maybe I’ll switch it to under resourced, and…

Curt Widhalm 14:19
Yeah.

Katie Vernoy 14:19
And not having the capacity to do the deep work because of how under resourced and overwhelmed I was, and recognizing that I needed to then get back into consultation, I needed to get back into some of the trainings that I’ve started doing, and so to me, it’s it’s jumping forward into clinical effectiveness is what was needed versus sitting in complacency and and just a lack of capacity.

Curt Widhalm 14:51
And I think that that ends up making what we’re talking about here. And I promise, at some point in this episode, we’re going to talk about what actual good clinical work looks like rather than just laying out problems, but I think that reaction that you’re talking about, as far as getting more training, getting more consultation, with so much stuff readily available through social media, whether it be from the client’s end, whether it be from the therapist end, but if we’re talking about all of the pressures that go on to a therapist to be effective; consultation’s expensive, especially early career when your wages aren’t necessarily supporting your ability to go and get more consultation stuff. So, where is therapy flavored speak readily available? Social media and…

Katie Vernoy 15:42
Facebook groups.

Curt Widhalm 15:43
Exactly, and so what that makes us sensitive to is relying on social media trends to reduce complex human beings in front of us into simplistic one size fits all narratives, and it doesn’t really develop kind of the skills around clinical nuance to be able to help our clients move beyond kind of the very same information that they’re receiving from potentially the very same social media trends. So it’s helpful to look at some of the you know clinical vibes that are happening on social media as the entry point, but it’s being able to go beyond that that is really what we’re trying to talk about as being beyond this aspirational part of what we want for modern therapists, but to actually do good clinical work. Now, admittedly, when I am reflecting back on the earlier parts of my career, when I have seen students, when I’ve been supervising people, I see the tendency to want to be able to have some answers to know what happens next and to be able to plan for anything beyond just kind of the discomfort that comes with not knowing what what might happen next, but being able to sit with that discomfort, being able to know that something is going to happen in in those moments of discomfort, those moments of silence. The moments of, oh my God, we’re we’re in the crap, and this could go any direction right now. That’s where the clinical work can really end up developing. But it takes your own being able to sit in that discomfort to be able to help move you forward.

Katie Vernoy 17:38
And the the converse is the reassurance and the moving out of discomfort quickly, which the client likely would like to a certain extent. Some of them know, but some of them are ready to do the deep work. But some of them are like, “Please, I don’t want to feel these feelings.” And a lot of therapists, I think, are also also sit in that place of my client is hurting. I want to bring them. I want to help them get out of it. I want to help them feel better, and I feel like that that need to find a solution to know what to do, but also to to remove suffering can be another reason why we don’t go deeper. And I think that’s something I’ll claim that one as well because I like to to make my clients feel better. I like them to be able to come out into the world and be able to to manage the things, you know. Even if then now they need to get another hit next week, right? Like I think there’s that that element of recognizing your own patterns in this of why why might you be avoiding depth? That is, I think, an important thing. When you talked at the beginning, you put the flip side as flooding or trauma dumping. I don’t know the right word there, but the the diving into depth before the container can hold it. And so maybe you can speak to what you were talking about there.

… 19:02
(Advertisement Break)

Curt Widhalm 18:47
If you are listening only to the minutes that we’ve been talking about this so far and saying, “I don’t want to be that, I’m going to do not that, and you overcorrect to the other side, is then needing to check your own clinical ambition against what your clients are actually presenting. And you know this is cautioning against premature depth.

Katie Vernoy 19:30
Yes.

Curt Widhalm 19:31
That you want deep work to be consensual. You want to be something that you’re doing in conjunction with your client, and this is really where a lot of the Common Factors Work by Bruce Wampold comes in. That being able to have a good therapeutic alliance that works with a, not a fixed system where you kind of lay out everything from the beginning as far as here’s what treatment’s going to be, and telling your client exactly what it’s going to be, but more along the lines of, hey, we are agreeing on what we’re working on, we’re agreeing on how we’re going to solve those problems, and we’re going to openly talk about how well we’re doing that. Ends up being really kind of the core basis to have effective therapy, and it allows for both you and your client to have a good input on that. And you know, going into the modern therapist archives, we’ll link into an episode that really gets into that piece of it a lot more in our show notes over at mtsgpodcast.com.

Katie Vernoy 20:41
Consent is really important, and I know we’ve talked about it in more depth, so we don’t have to go into it here. But I think the the idea of consent and clients knowing what exactly they’re consenting to, and even what are they consenting in this session, what are they consenting to in this moment, is really important because if you really dive into clinical depth, do we still call it clinical depth if it’s flooding or chasing outcomes or chasing emotional responses? But that that really deep out of the window of tolerance stuff that can happen, I think that clients may not know what they’re actually consenting to, and so it’s making sure that not only are clients consenting to do this deeper work, but also that you have the capacity to keep them regulated enough and activated enough in order to to have change happen, and we talk with Jules Taylor Shore, I think it’s going to be next week about some of this. So, and and she has some great work, and so we’ll link to that as well in the show notes over at mtsgpodcast.com. But I think there’s this this element of seeking that specific outcome or seeking that specific emotional response, the catharsis, the whatever it is, whatever you’re talking about, without placing it very specifically within the treatment conceptualization and planning, without pacing it properly, without making sure that you’re you’re navigating and helping the client to stay within the window of change is too much, and it’s not-it’s not real clinical depth. It’s-I’m going to use another word that I don’t think is exactly right, and maybe a little bit controversial, but it can be violating.

Curt Widhalm 22:39
Yeah, and so I want to kind of take this episode now and make that shift into what good clinical depth work…

Katie Vernoy 22:46
Sure, sure, sure.

Curt Widhalm 22:47
…ends up being. And so I think maybe starting with some of the ideas from Jonathan Chedler that he has spent a lot of his career, a lot of his critiques about what makes therapy effective that largely boils down to when therapy focuses on symptom control and tool delivery, treatment gains decay. They they don’t stick, and in contrast, depth oriented therapies focus on emotional expression. They focus on exploring avoidance. They focus on identifying interpersonal patterns that show continued improvement after therapy ends. And I think that this is really where, when we identify our own part of that process, so our own reactions to the systems around us, the agencies that we work in, the insurance panels that we’re trying to justify medical treatment to, that looks at what our own role is in helping clients to be able to get to their own clinical depth. Now, I was talking with you before we push record today, as far as you know, how do we necessarily define what good clinical depth is? And I’ve you know preparation for this episode was looking at various places online, and there was a couple of Reddit threads that more or less said that clinical depth comes from either trauma-informed therapists or psychodynamic-informed therapists. And my question to you beforehand was: What does actual clinical depth look like for you when you’re doing deep work with clients, what does that look like in your sessions?

Katie Vernoy 24:44
I am so relationally based that I I feel like the clinical depth for me is grounded in the the treatment relationship, the clinical relationship. And so understanding the person in front of me, at great depth, is important to me. For other folks with different formulations, some folks want to understand and get experiential. Some folks want to, you know, understand somebody’s their relationship with their body or relationship with with other people. I think it’s for me really knowing the person, knowing how they fit into the the world around them, and all of those those patterns, and being able to continue to look at the through line. When I was coming up, the the way it was described is process versus content, and that’s so simple. It’s such a simple concept, but for me, I took that to heart, and it’s everything is process, everything is pattern. I think this is my neurodivergent brain. So, being able to connect with someone deeply, human to human, understand them in a way that has a lot of depth to it, a lot of complexity to it, and then being able to sit with them in space that we’ve created together, and allow them the room to deeply feel their emotions, which is a newer skill I’m developing because I know that at times I’ve been more an intellectualizer as well. But being able to sit with them and hold space for all that is theirs, and looking at ways to create experiences or create insight together that will help them to make different choices or to interact with the world differently. And so, I feel like that’s a very broad explanation of it, and I feel like it comes from working in systems that required behavioral change, growing up psychodynamic or trauma informed, or those types of things. And so I think it it is all of those things, but for me, it so deeply goes to being in relationship and really seeing my client and seeing their patterns and being able to hold for them what they value and help them to reach those those things. What is clinical depth for you, Curt?

… 27:11
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Curt Widhalm 27:12
In reflecting back on my career, I came from a background where it was very behavioral in my early training and very directive, and a lot of that was entirely based on the systems and the reimbursements that were around me. And what I’ve learned across my career is the benefit of that for early kind of work. But when clients are asking for things beyond just tools, and even when clients are now asking for: “I just want tools. I don’t want to talk about my childhood,” or “I don’t want to talk about my my background.” A lot more of it is being able to help clients recognize what those patterns are. Now, that still leaves us very open to any kind of theory. I don’t want anybody in this part of the episode to be listening and saying, “Well, my theory doesn’t fit that. I think that this still very much fits across a number of theories, and again, comes back to Wampold’s common factors. But I think a lot of it is being able to help clients track their capacity, not just their story. And so, a lot of this does come out of trauma-informed trainings that I have been in, whether it be EMDR, whether it be DBT, building distress tolerance aspects. That seeing clients be able to handle more and more of the things that used to push them outside of their window of tolerance. You know, let’s credit Dan Siegel’s impact on this too. Is that being able to recognize where in their process they are, where their reactions to new and ongoing stimuli in their environment, in their stories, seeing that they don’t get flooded, seeing that they are able to operate in a new and better way. Now, what does that look like practically? What it means is clients don’t feel like they need to run out of the room when they are faced with things that are difficult for them. They’re able to talk about, “I’m still having reactions to things in my life. My life is not perfect in any way, but I can recognize where my impulses are, and I can recognize that I can do something about them.” Rather than “I just need tools to be able to manage myself in these situations when it comes up.” So to me the depth is being able to kind of what I said Cheddler was talking about earlier is being able to emote, being able to explore where their reactions are, and to do it in a way that has insight into their ability, not just with me as their therapist reflecting that to them.

Katie Vernoy 30:23
So as we’re getting closer to the end, I think probably getting to a little bit more of the the solutions, I guess. Although this is not a quick fix or hack situation, but where I started with it in my mind on how you build the capacity to do this is that you want to make sure you’re doing your own work, that you have shored up your own distress tolerance, that you are able to be present when this is happening, doing consultation and making sure that you’re thinking deeply about your cases, having full case formulations that are dynamic that continue to play out. Treatment planning is also really important with consent. That’s that’s also dynamic, and making sure that you’re moving beyond symptom control into more of the things that create lasting change, a different relationship to emotion, a different relationship to self, an understanding of what makes them tick, and and how they accommodate the things that make them special or or the challenges that they face. So we also have talked with some folks, and and we’ll continue to to come back to this because I feel like this is a really important topic, and it’s it’s part of where we sit when we interview folks on things that we weren’t necessarily taught in grad school. But the episodes we chose for this month that epitomize a little bit of what we’re talking about here is we’ve interviewed Jules Taylor Shore on showing up as a therapist. We’ve talked to to Nikki Rubin as kind of a way to think about case conceptualization, and then we also talked to Alex Iantaffi around messiness, thinking non binary, and and looking at that, we’ll we’ll have a CE episode at the end of the month that’s going to talk about being able to understand when we move into when we can move into clinical depth with our clients when we move past stabilization. So that’ll be our CE episode. But but we’re wanting to to talk a little bit more broadly, and then we’ll over the years, so for the continuing years, we’ll continue to to bring in more specific clinical populations. But we wanted to give an overview at this point because I feel like it’s it’s such an important foundation for how we operate, and so I I’m excited for the upcoming episodes. All of those interviews were really fun to do.

Curt Widhalm 33:01
You can find our show notes over at mtsgpodcast.com, and we’d love for you to jump into the Modern Therapist community on Facebook to help move on with this conversation as well as any others. Let us know how you practice in your clinical depth, follow us on our social media. Join that Facebook group. I’m in the habit of just saying whatever it is that I normally say at the end of the episodes. And until next time, I’m Curt Widhalm with Katie Vernoy.

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Announcer 33:36
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