Therapy on the Cutting Edge

In this episode, I speak with Nigel about his work with Integrative Attachment Therapy (IAT). He discusses how his studies with Dan Siegel, M.D. and his meditation training in the Tibet Bon Dzongchen, led him to be very interested in what is a “mind”, how it works, what its about, and how ti develops. He discussed how attachment is the basis for the development of the mind, which we create "bottom up in our relation to others. He explained that the key developmental processes for the mind include attachment, care and nurturance, social rank, sexual identify and safety. He said that the novel part of the work that Daniel Brown, Ph.D., the coauthor of Attachment Disturbances in Adults: Treatment for Comprehensive Repair, was using an ideal parental figure to repair what had or had not been established in development. Nigel talks about the three pillars of IAT, where the therapist and client are collaborating on the work they’re doing together at the beginning of the session, doing the imaginal intervention of the ideal attachment figure, and then using metallization to process the experience and gain new awareness. He explained that they are helping a client to connect with the felt experience of feeling safe, seen, being able to trust and other elements of experiencing a secure attachment with this imagined parental figure. He shared that the conditions for a secure attachment include embodied trust, felt safety, being good enough, that its ok to explore, being able to down regulate the nervous system, and knowing your a good person. He spoke about how transference is encouraged to be shared directly with the therapist, and discussed using metallization, rather than using the therapist to provoke transference and letting it build up and then be worked through. We also discussed his work with psychedelics and its ability to help clients to integrate experiences in a different interpretive map. Nigel Denning, M.Psych, MA is a Counselling Psychologist and Director of Integrative Psychology and Medicine in Melbourne, Australia. Nigel is Research Fellow at Australian National University. Nigel has been involved in developing the Three Pillars of Attachment Repair and Integrative Attachment Therapy with David Elliott and Traill Dowie and developing the IAT Training Program. Nigel is a nationally recognized expert in family violence, institutional abuse, trauma and attachment-focused practice. Nigel is also clinical lead in several psychedelic medicine trials and a trainer in psychedelics and holotropic breathwork, having studied under Stanislav Grof. In addition, Nigel is a long-term meditation practitioner and teacher in the Tibet Bon Dzogchen tradition. Nigel has a profound understanding of how Eastern practices affect the mind and their subsequent connection to psychotherapy. Nigel is a jovial and kind person who is passionate about improving the world one mind at a time.

In this episode, I speak with Chandra about her path into trauma-informed work with young children and their caregivers. Raised in San Francisco by parents who worked in child welfare, Chandra was exposed early to stories of trauma and healing. Before age 7, several of her friends lost their parents to cancer, which inspired her to become a doctor. In high school, during an internship on a pediatric oncology ward she noticed that while physical health was prioritized, children’s emotional needs were often overlooked. This realization led her to study psychology. After college, Chandra worked at a residential program with children aged 6–12. She found the children often opened up about trauma during informal moments—car rides, bedtime, or watching TV—highlighting the need to involve caregivers in the healing process. In 1998, Chandra interned with Dr. Alicia Lieberman at UCSF’s Child Trauma Research Program, where she trained in Child-Parent Psychotherapy (CPP), an evidence-based treatment for young children under age 6 who have experienced trauma. She later developed the CPP fidelity framework and co-authored the second edition of the manual. Chandra noted a key challenge: although many parents recognize their child’s trauma, few clinicians are trained to work effectively with young children. Many therapists also avoid discussing trauma directly with young children, which can leave them alone with their experiences. CPP begins with the therapist meeting alone with the caregiver to supportively explore the child’s symptoms, experiences of trauma, the caregiver’s own history, including how past experiences may shape the parent's responses. Then the therapist and caregiver gently acknowledge past traumatic experiences to the child—“speaking the unspeakable”—and help the child process their experiences using developmentally attuned pacing and modalities, including play and art. As children process their experiences they sometimes shift topics or activities or seek physical comfort when they begin to move outside their window of tolerance. Therapists help parents understand this process, attune to their child’s needs, and support their child. CPP has a strong evidence base, including five randomized controlled trials. It has shown positive outcomes for preschoolers exposed to violence and infants and toddlers who experienced maltreatment. Notably, a recent study found CPP is associated with lower epigenetic age acceleration in trauma-exposed children aged 2–6—suggesting a measurable impact at the biological level. Chandra Ghosh Ippen, Ph.D. is a child trauma psychologist specializing in working with families with children under age 6. She is co-developer of Child-Parent Psychotherapy, the associate director of the Child Trauma Research Program at the University of California, San Francisco, and a member of the Board of Directors of Zero to Three. She has spent over 30 years conducting clinical work, research, and training in the area of childhood trauma and diversity-informed practice. She is also an award-winning children’s book author and has written 5 children’s books as well as the free Trinka and Sam disaster series, which has been translated and distributed to over 400,000 families around the world.

In this episode, I speak with Karen Sprinkel Ancelet about her path to integrating trauma-informed, psychedelic-assisted therapy into her clinical practice. Karen shares how, early in her career, she worked with families whose loved ones had been murdered by a serial killer. She found that the models she had been trained in were not enough to address the profound spiritual trauma her clients experienced as they struggled to make sense of such horrific loss. This realization led Karen to begin practicing Buddhism and eventually to live in Asia, where she deepened her understanding of human suffering. While working with people from Thailand and Tibet who had endured trauma, she witnessed how cultural perspectives shape the ways we make meaning out of tragedy and resilience. She also facilitated group therapy for child sexual abuse survivors, where she discovered that while some approaches were effective for certain individuals, they were not universally helpful. From these experiences, Karen came to conceptualize trauma as impacting the mind, body, and spirit, all of which must be addressed in healing. She describes her initial skepticism toward psychedelic therapies, coming from a place of purism, but shares how her perspective shifted as she learned more about their effectiveness. Immersing herself in advanced training and certification, Karen began working with clients using psychedelics in therapeutic contexts. Karen also discusses the breadth of her training across multiple trauma-healing approaches. She highlights Somatic modalities such as Somatic Experiencing, Hakomi, and Sensorimotor Psychotherapy; Desensitization-based methods like Eye Movement Desensitization and Reprocessing (EMDR) and Brainspotting; and Parts models including Internal Family Systems (IFS), Voice Dialogue, and Ego State Therapy. She explains how client factors often determine which approach is the best fit for a given individual. Throughout our conversation, Karen emphasizes her commitment to helping clients heal from PTSD as efficiently as possible. This integrative vision inspired her book, The Thriving Self: A New Paradigm for Healing the Mind, Body and Spirit and Moving Beyond It, which offers clients a framework to move toward healing without spending years in therapy. Karen Sprinkel Ancelet, LMFT is a licensed psychotherapist with more than 30 years of clinical experience, practicing in California, Colorado, Oregon, Washington, and Michigan. She specializes in trauma-informed care and integrates a broad range of evidence-based modalities, including EMDR, Brainspotting, Somatic Experiencing, Internal Family Systems (Level 3), and HeartMath. Karen is also a Ketamine-Assisted Psychotherapy (KAP) provider with advanced psychedelic training through MAPS, Fluence, and Three Cups. She graduated with a Certificate in Psychedelic-Assisted Therapies and Research from CIIS. In addition to her clinical practice, she serves as a consultant, educator, Certified Clinical Trauma Professional, and Continuing Education provider. A pivotal chapter in Karen’s life was her time living in Asia, where she conducted her master’s research on trauma healing following violent crimes in Tibet, Southeast Asia, and the United States. Deeply impacted by these findings, she returned to Asia for several years to further her exploration. Today, Karen weaves together the ancient wisdom of meditation and mindfulness with contemporary approaches such as EMDR, Brainspotting, Flash, EFT, IFS, and Somatic Experiencing to guide and support her clients in their healing journey.

In this episode, I sit down with Zenobia Morrill, Ph.D., who shares her journey into psychotherapy—from a personal confrontation with existential truth to navigating her family’s intergenerational pain. Dr. Morrill reflects on her early experiences as a therapy client, where she encountered traditional frameworks that often fell short, approaches that pathologized pain while ignoring the broader systemic and historical forces at play. Grounded in liberation psychology and critical theory, Dr. Morrill offers a compelling critique of mainstream psychological models that individualize suffering and overlook the impact of power, politics, and culture. We explore how psychotherapy can become a tool for liberation, not by reinforcing institutional norms, but by creating space to challenge and reimagine them in service of opening up possibilities for personhood. Dr. Morrill shares how critical-liberation psychotherapy offers practitioners a framework to question how therapeutic practices may either reinforce alienation or open new paths toward freedom, healing, and fuller participation in society. She reflects on the importance of broadening our range of being, reclaiming repressed parts of the self, and bridging individual pain to collective emancipation. Therapy, she argues, must move beyond static formulations and recognize that social, political, and cultural forces are already present in the room—they are not “add-ons” but essential to the client’s lived experience. This approach does not suggest liberation occurs solely within the therapy room, but asks how the institution of therapy itself—its theories, method, and practices—can be used to support liberatory outcomes. Ultimately, Dr. Morrill calls on therapists to resist objectification of clients and of therapy itself—and to reimagine psychotherapy as a dynamic, relational, and contextually grounded space for transformation. Zenobia Morrill, Ph.D., is a critical-liberation psychologist and psychology professor at William James College. She received her doctorate from the University of Massachusetts Boston and completed her pre- and post-doctoral fellowship at the Yale School of Medicine and at Yale Health, Mental Health & Counseling, respectively. Inspired by her personal and professional experiences with the mental health system, Dr. Morrill emphasizes the power in psychological frameworks as the stories we use to understand ourselves, and the risks presented when these frameworks cannot capture the complex existential, sociocultural, familial, physiological, and tacit dimensions of humanity. Her work centers on the belief that psychological healing must account for these broader meaning systems and political structures that shape individual experience. Her research and clinical interests include psychotherapy process, global mental health, qualitative methodology, theory and philosophy, and critical and liberation psychologies. A recipient of the American Psychological Association’s Sigmund Koch Award for Early Career Contribution to Psychology, Dr. Morrill’s work and Critical-Liberation Psychotherapy model have been recognized and presented internationally.

In this episode, I speak with Alex about his career working with addiction. While there are countless resources for substance-related issues—such as drug, alcohol, and sex addiction—he noticed a striking lack of support when it came to process addictions related to technology use. He shared how he connected with and learned from Dr. Hilarie Cash, founder of reSTART, a pioneering treatment program for technology addiction. Alex discusses his work with parents, helping them implement comprehensive behavioral strategies to support children and adolescents in developing a healthy relationship with technology. In an age where digital exposure is unavoidable and children grow up as digital natives, he explains how we can encourage balance and moderation from an early age to prevent problematic or addictive behaviors from forming. He delves into the unique challenges of treating process or behavioral addictions, which can involve greater complexity than substance-related ones. Alex emphasizes the difficulty of establishing structures that foster intrinsic motivation for self-regulation in children and young adults. He highlights the importance of helping young people connect with their values, become more intentional with their screen time, and take a holistic approach to balance—not just with technology, but across all areas of life. The conversation also explores how parents can coordinate across households to create consistent expectations around technology use and how they can impose meaningful limits even when school-issued laptops have minimal built-in safeguards. Alex concludes by discussing how screen use can become a mechanism for emotional avoidance, which can significantly block personal growth. He underscores the need to prioritize self-care and emotional awareness to prevent this from becoming a long-term negative coping strategy. Alex Basche, LMFT is a psychotherapist based in the SF Bay Area. He works mainly with adolescents and young adults, specializing in the treatment of tech-related behavioral addictions such as gaming, social media, pornography, online gambling & shopping in addition to substance use disorders, as well as frequently co-occurring conditions such as anxiety disorders, ADHD, depressive disorders, OCD, Autism Spectrum, and identity formation issues. In 2017, Alex helped create and found the first in-network Intensive Outpatient Program in the state of California treating technology addiction in adolescents. He has written many therapy groups’ curricula and leads trainings and workshops on topics related to Assessment & Treatment for Process Addictions, Parenting in the Digital Age, Adolescent Anxiety & Depression Treatment and more. Alex serves as a Subject Matter Expert (SME) on the Mental Health Workgroup Advisory Board for Fairplay’s Children’s Screentime Action Network and on the Board of Directors for local nonprofit Adolescent Counseling Services. He continues to co-author and present research on digital addictions and related topics.

In this episode, I speak with Bill Miller about his road to developing Motivational Interviewing. Bill explained that he started off heading into pastoral ministry but instead chose to be trained as a clinical psychologist. His behavioral PhD program required a two-semester course on how to work with clients before engaging in behavior therapy, and that's where he was introduced to Carl Rogers and a person-centered approach, which significantly influenced his career. He mentioned watching Gerald Patterson doing behavior therapy with families and seeing how he was with clients: warm, engaging, empathic, and funny, which was not covered in published descriptions of the method. On a sabbatical leave in Norway, Bill was asked to demonstrate his own therapeutic approach through role plays in which the clinicians would stop him and ask good questions: "What are you thinking just now? "Why did you ask that particular question?" "How did you decide what tor reflect from all that the client said?" These interactions helped him reflect on what he was doing and why he was doing it, and he wrote down a description that became the first description of motivational interviewing. Seven years later, on sabbatical leave in Australia, he found himself officed next to Stephan Rollnick who would become his career-long co-author. Rollnick had already been teaching motivational interviewing based on Bill's first article and they decided to write together the first book about motivational interviewing that was published in 1991. When they began teaching the method they noticed that some trainees seemed to be using MI techniques “on” rather than “with” clients. What had they left out? They began writing and teaching about the underlying spirit or attitude with which MI is to be practiced. Therapists also shared with them that this way of practicing seems to prevent burnout. In a later book with Theresa Moyers, Bill discussed eight clinical skills that characterize more effective therapists, which are: accurate empathy, genuineness, positive regard, acceptance, hope, evocation, giving advice, and having shared goals or direction. Bill and I explored the term “resistance” and how it is something that happens between people yet is often attributed to client pathology. In yet another book he argued that ambivalence is natural human nature and even a virtue, as it means the person is weighing the options. He and Rollnick reformulated "resistance" as sustain talk (a natural part of ambivalence) and/or discord in the therapeutic relationship. We discussed how in motivational interviewing the therapist is a guide rather than an expert-director. Lastly, he touched on his work on quantum change, which is transformational change that that can occur within a matter of moments or hours and tends to be both permanent and benevolent. Dr. William R. (Bill) Miller, Emeritus Distinguished Professor of Psychology and Psychiatry at the University of New Mexico. He is the author of 67 books including four editions of Motivational Interviewing, Effective Psychotherapists: Clinical Skills That Improve Client Outcomes, Listening Well: The Art of Empathic Understanding , and On Second Thought: How Ambivalence Shapes Your Life. He has been teaching the skill of accurate empathy for over 50 years.

In this episode, Haim discusses his extensive experience providing group and being an early adopter of group therapy in 2006, which lead to his work on the effectiveness of telehealth. He discussed how in 1995 he started an internet forum called GP Listserv which now consists of 400 group therapists from all over the world who join together to discuss group therapy. Haim talked about his group analytic relational approach to therapy and discusses the difference between psychodynamic and relational approaches. He talked about how the research has found clinicians experience four obstacles to online therapy, and discusses the various ways one can address them. He explained that these obstacles include (1) Setting (2) Disembodied Environment (3) Presence and (4) Ignoring the Background in Online Settings. He discusses the body of research surrounding online therapy which is very promising and explains how a meta-analysis concluded that for individual therapy, there is no difference in the results for online vs in person therapy. According to research, the best predictor of success in individual therapy is the therapeutic alliance and goes on to list the three components of the therapeutic alliance which are agreeing on goals, agreeing on tasks, and bonding. While online group therapy is less researched, Haim’s experience suggests that it is very effective. He explained how in group therapy, the factor that is most predictive of success is the cohesion of the group, rather than the therapeutic alliance. He goes on to discuss how the preference of modality –such as having an auditory or visual preference– influences one’s ability to effectively do online therapy. He talked about how in groups, time, space, and attention are always shared, which can create turmoil for group members. He also discussed how keeping attention can be difficult online because there are more distractions and people may feel more unnoticed, which can promote disengagement in an online group setting. He recommends that small group therapy should consist of group sizes between six and ten people and for people who are not as skilled or experienced, groups should not exceed eight people. In 2018, Haim created an online training process group for therapists, and these groups consist of therapists from all over the world where they discuss their experiences with group therapy and learn how to improve their practice, but also use them to work on their personal issues, thus providing professional and personal growth. Dr. Haim Weinberg is a licensed psychologist in California (PSY 23243) & Israel and has a private practice in Sacramento, California, with more than 40 years of experience. He is also a group analyst and Certified Group Psychotherapist. He is past President of the Israeli Association of Group Psychotherapy and of the Northern California Group Psychotherapy Society, and list-owner of the group psychotherapy professional online discussion forum. Haim was the Academic Vice-President of the Professional School of Psychology in which he created and coordinates an online doctoral program in group psychotherapy and marital therapy. He published books on Internet groups and about Fairy Tales and the Social Unconscious, and co-edited a book about the large group and a series of books about the social unconscious. He is on the clinical faculty of Psychiatry at UC Davis Medical Center and Fellow of the American Group Psychotherapy Association and of the International Group Psychotherapy Association, as well as a Distinguished Fellow of the Israeli Group Psychotherapy Association. He has received several awards including the Harold Bernard Group Psychotherapy Training Award and the Ann Alonso Award for Excellence in Psychodynamic Group Therapy. He also co-edited the books: 1. Theory and Practice of Online Therapy: Internet-delievered Interventions for Individuals, Groups, Families, and Organizations. 2. Advances in Online Therapy: Emergence of a New Paradigm. 3. The Virtual Group Therapy Circle: Advances in Online Group Theory and Practice with Arnon Rolnick and Adam Leighton.

In this episode, Carmen discusses her work in family therapy and her Socioculturally Attuned Family Therapy. Carmen shared that she entered the field when there were feminist critiques of family therapy and a focus on power in the therapeutic relationship. She explained that she went to Loma Linda University to direct the family therapy doctoral program, and worked with Douglas Huenerardt, Ph.D. doing cotherapy. They invited students to observe, and their goal was to be able to articulate the work they were doing, and later finalized it into a research study. She explained that the model that evolved out of that work was named Socioemotional Relationship Therapy. Later, she moved to Oregon to teach at Lewis and Clark College, and worked with Teresa McDowell, EdD, LMFT, and wrote the textbook, Socioculturally Attuned Family Therapy, with Teresa and Maria Bermudez, Ph.D., LMFT. We discussed how Carmen’s background in sociology led her to always be thinking about sociocultural aspects and how they play out in relationships. She explained that Teresa introduced the idea of Third Order Thinking or Third Order Change to her, which goes beyond the Systemic concept of Second Order change, to bring awareness to the therapist and client of how the sociocultural system the relationships are embedded in and influence their experiences. She also discussed how this helps therapists be aware of how they are accountable for possibly unknowingly reinforcing and repeating larger societal patterns. Carmen discussed the Socio-Emotional Relationship Therapy Model and how it is influenced by experiential, structural therapy, and social constructionist theory and technique, while centering sociocultural awareness. She discussed how emotions are the window into the larger context by helping us see the thinking that is happening and how that thinking may be a product of social-cultural influences. She also discusses the role of power in the model, and being aware of how that determines what is important, what is valued and the meaning of things, and seeing how power plays out in the couple or family dynamics. She explained that they operationalize relational equity as the Circle of Care, which consists of four parts: 1) Mutual Vulnerability - openness and willingness to admit mistakes, safe to express one’s sensitivities, 2) Mutual Attunement - that each person is aware of the other person and their needs, as often the person with more power is less attuned, 3) Mutual Influence - whose interests are organizing the relationship and whether there is a willingness to be influenced, and 4) Shared Relational Responsibility - where both are taking responsibility for the wellbeing of the relationship. Carmen discusses how when these are balanced, there is a more equitable relationship, and by the therapist’s awareness of power, they can support the changes in the relationship to be more equitable and mutually supportive. Carmen Knudson-Martin, Ph.D., LMFT is a professor emerita in the Marriage, Couple, and Family Therapy program at Lewis and Clark College. Her scholarship focuses on how the larger social context influences health and well-being and how therapists can address the inequities that result. Carmen especially loves working with couples and is widely recognized for her work regarding gender, marital equality, and relational health. She is a founder of Socio-Emotional Relationship Therapy, an approach that attends to the ways couple interaction, emotion, and socio-cultural context come together in clinical process. Carmen’s teaching and practice are based on her conviction that how therapists conceptualize client concerns is an ethical issue and that clinical practices have consequences that are never neutral. Carmen is an AAMFT approved supervisor and licensed MFT. She served as an associate editor of the Journal of Marital and Family Therapy, vice-president of the Family Process Institute, board member of the American Family Therapy Academy (AFTA), and president of the California Division of the American Association for Marital and Family Therapy (AAMFT-CA). She is currently editor of the AFTA Springer Series in Family Therapy. Prior to coming to Lewis and Clark, she directed family therapy programs at Loma Linda University in Southern California, Montana State University, and Valdosta State University in Georgia.