With traditional clinical assessment, clinicians are often guided by the question, “What do I want to know?” As psychologists, we can tend to prioritize own interests and goals when determining an assessment’s purpose as well as the questions we attempt to answer. In doing so, we can overlook the client’s interests and priorities. It’s much less common for a clinician to revise the question of “What do I want to know?” to “What do you want to know?,” and focus the assessment around what is personally meaningful to the client. Additionally, traditional clinical assessment tends to prioritize the identification of what’s “wrong” with the client. However, our client’s interests are often not limited to insights into what is wrong; they also have an interest in identifying their strengths and adaptive traits.

Moreover, it can be easy for clinicians to overlook what it is like to be “in our client’s shoes,” and recognize just how unnerving and intimidating an assessment can be. Think about it—some mysterious person is asking several mysterious questions, administering a series of mysterious measures and tasks with mysterious activities and items–all the while, providing limited feedback along the way. This uncertainty can make assessment a frightening and overall negative experience for our clients, which can potentially have an adverse impact the on the quality and accuracy of the collected data as well as the quality of the relationship with the client.

In light of this, Collaborative/Therapeutic Assessment (C/TA) offers a refreshing change to the traditional clinical assessment approach. C/TA is a brief, collaborative intervention that helps clients gain insight about themselves as well as how they might address their problems in living. C/TA is co-directed by the clinician and client and prioritizes the client’s experience and observations. This type of intervention can elevate traditional assessment and build collaboration with our clients, ultimately fostering healing and personal growth.

I was first exposed to C/TA during my doctoral training, and was instantly intrigued and excited by the approach. What I particularly appreciate about C/TA is that it is a highly collaborative, client-centered approach that facilitates rapport building between the assessor and the client. This positive relationship can enhance the overall assessment experience and outcomes. It also identifies and leverages the client’s strengths along with identifying problems. This provides a much more balanced feedback for the client as well as additional ways the client might address their problems in living, and it can enhance client outcomes.

That said, C/TA can potentially be challenging to incorporate into one’s practice. For instance, C/TA can be time-consuming and requires training and skill development to effectively utilize. Additionally, I know for me personally, the thought of navigating how to bill and be reimbursed for C/TA was quite intimidating, and I was uncertain on how I could realistically incorporate C/TA into my practice on a regular basis. As a result, my use of C/TA decreased significantly after graduate school, when I no longer had the resources and freedoms that came with practicing in a training clinic.

As one can imagine, when IPA revealed the theme for the fall 2023 conference, I was thrilled to learn that its emphasis would be C/TA. Having drifted away from using C/TA in my clinical work, I hoped that this training would reinvigorate my interest in C/TA as well as inform me on how I can practically better incorporate C/TA into my practice. I am pleased to report that the conference was a complete success on these fronts.

In her training, Following the Breadcrumbs: The Basics of Collaborative/Therapeutic Assessment and How it Can Enhance Clinical Practice, Dr. Krista Brittain provided invaluable insights into the essence and significance of C/TA, explained and demonstrated how C/TA can be incorporated into one’s practice, and also empowered attendees to enhance their clinical practices, and ultimately, benefit their clients through the use of C/TA. I especially appreciated how well Dr. Brittain introduced and explained the basics of C/TA in a clear and straightforward manner as well as how she reviewed the empirical literature supporting C/TA. I also enjoyed how she guided the attendees through each of the steps of C/TA in an engaging and interactive way. Ultimately, I left the conference with a renewed understanding of, and enthusiasm for, C/TA, and I was excited to see such a powerful and effective approach be introduced to the IPA community. I now have a much clearer vision on how I can effectively utilize C/TA.

I would also like to highlight that, in addition to engaging and useful trainings and workshops, I sincerely appreciate the fantastic opportunities that IPA conferences provide to connect and network with other clinicians, researchers, and students. It is always wonderful to catch up with friends and colleagues as well as meet new people. I’m excited about, and look forward to, attending future IPA events.

Check out other upcoming IPA trainings and events here. 

When was the last time you got a new referral who had seen five therapists in recent years but didn’t feel like any of the clinicians really “got” them or helped them feel better? Or how about  worked with someone who checked their symptoms with Dr. Google or was taking some “classes” at TikTok University? We see folks with these types of experiences every day, and it might seem tempting to roll our eyes or sigh deeply at yet another person who has lived with their pain for so long or hearing about another self-diagnosis/TikTok-diagnosis of autism, DID, or another diagnosis de jour. Through the lens of Collaborative/Therapeutic Assessment (C/TA), these presenting concerns provide a chance to invite data from all sources into the room…believe it or not, even TikTok. When clients/patients come in seeking care, we can create a rich opportunity to deepen a person’s curiosity, increase their ability to understand their strengths and problems in living, develop new narratives about themselves and their life, and support meaningful change in just a few sessions.

If you haven’t completely written this off based on my generous acceptance of so-called “TikTok data,” thank you. And I’ll take this opportunity to remind you of the chance to learn more about C/TA at IPA’s upcoming fall conference, Following the Breadcrumbs: The Basics of Collaborative/Therapeutic Assessment and How it Can Enhance Clinical Practice. You may be thinking, “I do therapeutic assessment!” or wondering what C/TA is and how it’s different from traditional assessment. You may also be curious about how this semi-structured assessment method could enhance your practice, especially if your practice is more (or entirely) therapy focused. Or, if you’re a carb-lover like me, you may even have noticed your stomach rumbling at the mention of bread. While I can’t help you with a snack in this moment, I’m delighted to share a bit about my presentation at the upcoming conference, C/TA, and why (besides the snacks) it might be worth your while to spend the day together, learning and connecting as we engage our curiosity together. 

As a basic introduction, Therapeutic Assessment (TA) just celebrated its 30th birthday and is the only assessment method with empirical support as an efficacious stand-alone intervention resulting in many positive outcomes, including decreased ODD, personality, relational, and emotional symptoms; decreased distress; increased hope; better compliance with future treatment (Finn, Fischer, & Handler, 2012). In practice, or C/TA uses traditional assessment tools in both typical and creative ways. We use all kinds of techniques to do therapy (e.g., sand trays, walk-and-talk, movement, art) and C/TA embraces a similar creativity and diversity in the assessment process. Imagine having a teen and their parents play with blocks during an assessment appointment! Sounds fun, right? During the conference, you’ll see many examples of how tests, data, and a few new techniques that extend the potential of traditional assessment tools can be used to invite clients to follow the “trail of breadcrumbs” they’ve left behind throughout the assessment process. This can range from exploring perfectionism through an Extended Inquiry of the WAIS’s Similarities subtest to re-reading a person’s Rorschach responses in search of meaningful imagery. I hope you will be moved, as I often am, to discover how following the breadcrumbs in these ways can produce deeper, richer self-understanding and begin to inspire new narratives for the people we meet in the work. 

Because becoming curious together allows for new ways of seeing and being through the assessment process, the values and tools of C/TA can be applied in so many of the contexts in which we are engaged: therapy, assessment, supervision, outreach, etc. So, what does this look like in “real life?” Well, for example, each C/TA begins by working with the client(s) to create a list of assessment questions, the questions they are hoping to answer and the things they are hoping to learn through the assessment process. Thus, this approach can also be applied (quite helpfully!) to both therapy and supervision processes. Additionally, through a C/TA lens, it is possible to creatively utilize assessment tools as tools for therapy as we half-step clients toward meaningful psychological change. Furthermore, C/TA provides a framework for multicultural and cross-cultural assessment practice (Rosenberg, Almeida, & Macdonald, 2011), which is a must-have in your clinical tool-belt. Especially in this way, the values and practices of C/TA extend past the assessment arena and into all areas of practice and everyday life to support more affirming relationships.

So, if you think it might be nice to have tools for welcoming data from Dr. Google and TikTok University into the room, look no further! (Perhaps data is data?) And if you like the idea of spending a day connection, learning, shifting, exploring, playing, and leaning into curious, creative, vulnerable assessment journeys, the IPA fall conference is for you! (If you’re into other things, don’t despair, it may still be for you!) Through the conference and C/TA, I hope that you will find a sense of inspiration and renewal—of skills, ideas, relationships, and much more. I’m so looking forward to sharing the time and experience with you, snacks (more than breadcrumbs) included. 

This story begins in Iowa in the spring of 2021. I had white knuckled my way through the darkest days of the pandemic, doing my best to hold space for and support my clients’ fears, frustrations, anger, and depression while also navigating my own fears, frustrations, anger, and depression. My schedule was booked solid 11 weeks out, which felt suffocating. Many of my clients seemed to be just treading water, which left me feeling ineffective. My mind wandered during sessions. I procrastinated writing my session notes, and they piled up such that there was a mountain of them to do on the weekend. I was easily annoyed by, well, basically everything. I was completely exhausted when I got home at the end of the day. I had no emotional energy for my spouse and family members. I started to dread going to work. I had all the signs of burnout. This worried me because I was less than two years into my career. I was afraid that the career I had been working toward for many years was going to leave me feeling miserable. Something had to change; my future in this profession depended on it.

I reflected on my behavior. There was no question that I had overextended myself. In effort to help as many people as possible during a crisis, my caseload had grown too large. I had agreed to take on too many clients with concerns that were at the edge of my scope of practice. I was stuck in a pattern of people-pleasing that was harming my well-being. I had to start saying no. I had to start taking care of myself so I could better help my clients and be a better human to my loved ones. In service of this, I tried a few new things at work. I stopped doing intakes. When a client cancelled, I started blocking that time rather than filling it from someone from my waitlist. I looked a few months out in my schedule and decreased the number of clients I would see in a week. I got dictation software to expedite my note writing. When I eventually resumed doing intakes, I was more selective in the clients I chose to bring on board. I referred folks with whom I would not be able to do my best work to other providers who would be a better fit.

Slowly, very slowly, things started to feel a little better at work, but I still felt emotionally drained at the end of the day. That was the case for much of 2022. I found myself thinking that I needed a retreat. I needed some time to just slow down, be quite, and reflect. In looking for retreats, I stumbled upon information for a retreat that one of the mental health professional associations in Arizona (I think it was) was holding for its members. I thought this was a fabulous idea—I doubted I was the only mental health provider in Iowa who had been feeling this way. I brought the idea to the Triad and Program Planning Committee. It was well-received by all and the plan for the 2023 Spring Conference was launched.

The theme for the 2023 Spring Conference (April 28-29^th) is Taking Care of Us. The goal is to provide IPA members and other Iowa mental health providers an opportunity to rest and recharge while also learning how they can care for themselves to make their professional practices are sustainable. The conference will include didactic and experiential learning so attendees will not only earn CEs, but also actually practice new skills that promote wellbeing and burnout recovery and prevention.

Friday, April 28^th, will feature Dr. Fadel Zeidan’s talk, “The Neuroscience of Mindfulness-Based Meditation: A Day of Practice and Science.” He will provide instruction on a variety evidence-based mindfulness practices, as well as the science behind how mindfulness impacts the brain and body. Dr. Zeidan is an Associate Professor of Anesthesiology at UC San Diego. He currently serves on the Mind and Life Institute Steering Council, the UCSD T. Denny Sanford Institute for Empathy and Compassion Executive Council and the Neuroscience Director at the UCSD Center for Psychedelic Research.

Saturday, April 29^th, will feature Dr. Jenna LeJeune’s presentation of “Values, Burnout, and Finding Work-Life Integrity.” She will take an ACT-based approach to examining how reconnecting with our personal values can support burnout recovery and prevention and promote a relationship between our work lives and personal lives that is healthy and sustainable. Dr. LeJeune is president and co-founder of Portland Psychotherapy Clinic, Research and Training Center in Portland, Oregon. She is a peer-reviewed ACT trainer and first author of the book Values in Therapy: A Clinician’s Guide to Helping Clients Explore Values, Increase Psychological Flexibility, and Live a More Meaningful Life.

To support a “self-care retreat” vibe, we wanted to provide attendees opportunities to be outside in nature and chose to hold the conference at the Honey Creek Resort on Rathbun Lake in Moravia, Iowa late in April (to increase likelihood of better weather). We have 30-minute self-directed movement breaks scheduled in the afternoons. A brief guided chair yoga session will be held on Friday right before lunch, and a 30-minute gentle guided floor yoga session will be held on Saturday morning before the day’s presentation. Please bring a yoga mat or a towel if you’d like to participate in Saturday’s practice. Lunch on Friday is free of any other programming to allow time to reconnect with friends and colleagues. To further promote a relaxed atmosphere, we encourage attendees to dress in athleisure or activewear or whatever feels most comfortable to them.

I recently came upon this article by Salyers et al. (2011). It describes a one-day (6-hour) intervention for burnout among mental health providers that was associated with significant decreases in emotional exhaustion and depersonalization, as well as improved views of clients at follow up six weeks later. The intervention featured didactic and experiential learning activities on contemplative practices, body practices, and values clarification. I’m thrilled that these aspects will be a part of our Spring Conference. My sincere hope is that attendees will find the Spring Conference to be a restorative experience and that they will leave with new information and skills they can use to promote wellbeing in their lives, as well as in of those they treat and care about. I look forward to seeing you there!

Links to register for either or both days of the conference here. The discounted room rate is good through March 28^th, so don’t wait to make your reservation!