An Interview With George Wing

MEET ABCT'S FEATURED THERAPIST

An Interview With George Wing

George Wing Here is a recent photo of me in front of my cow calendar. This animal, the cow, is symbolic of the acronym COW that I use in my practice. It stands for the Courage to face one's most difficult personal problems, the Optimism that one has that he or she can solve his or her most difficult problems and the Willingness to the Work that one needs to do, to successfully solve his or her problems. The calendar with the cow serves as an ongoing reminder and motivator for patients to face and solve their problems.

When did you begin your training and practice?

I was lucky to have had B.F. Skinner as one of my teachers during my undergraduate education at Harvard College. At George Washington University School of Medicine, we had many guest lecturers from the National Institute of Mental Health, which was located near the medical school, to teach us some of their latest research findings. My psychiatric training was at the Brooklyn Health Science Center, State University of New York, where I completed my general psychiatry residency and child psychiatry fellowship. As Clinical Assistant Professor of Psychiatry, I taught behavior therapy to medical students and psychiatric residents there for a few years. I began my private practice in adult and child psychiatry in Brooklyn and started attending AABT conventions, beginning in the 1960s and continued when the organization became ABCT. I enjoy practicing in Brooklyn, with its population of almost 3 million, it is the biggest borough in New York City and its population is from all over the world, with each group having its own attitudes and customs but, in general, they all respond to the techniques of Cognitive Therapy and Behavior Therapy. Each group may need some slight modifications in their understanding and using the techniques of CBT to be effective.

Who were some of the people you learned CBT?

The first person was B. F. Skinner, from whom I learned about operant conditioning and the power of positive reinforcement. I have been fortunate to have lived through the birth of Behavior Therapy and then Cognitive Therapy and finally the combining of Cognitive and Behavioral Therapy. I learned from the early pioneers including Joseph Wolpe, Albert Ellis, and Aaron Beck. My current favorites include Arthur M. Nezu for his Problem-Solving Therapy and Judith S. Beck for her Cognitive Therapy.

What are your personal strengths as a practitioner?

First, I can touch-type while watching and listening to the patient, so that I can have a brief summary of ideas for each patient to remember and some leads for each patient to do homework between sessions, all typed up and ready for use shortly after the end of each session. Second, having a medical degree and having concurrently practiced in hospitals all my professional life, I have a background and knowledge of medicine and psychopharmacology, which continues to be helpful to my understanding of the biological or medical aspects of each of my patients and the judicious use of medication when helpful. I constantly remind my patients that "Pills do not teach skills." Third, by attending ABCT meetings and subscribing to various CBT journals, I can use some of the latest techniques of CBT with my patients.

What is one innovative method you use in your practice that you would like to share with the reader?

Consistent with my early background in Behavior Therapy, I give many of my patients two cards, "My Action Card" and "My Reaction Card," both 3x5 cards that my patients and I jointly prepare for their use. "My Action Card" is what each patient reads each morning and lists the actions they plan to carry out that day. "My Reaction Card" is a short list of some common situations that they may encounter and for which we have developed an appropriate way of thinking about and method for handling for each situation as it may come up. This card is also to be read every morning and before or during or right after an occurrence of one of the situations for which we have created a reaction plan. Also, with new learning based on learning from experience, new Action Cards and Reaction Cards are made, and these are added to the old cards or they may replace some of the old cards, as they are revised periodically to increase their effectiveness.

How important are board certifications and/or credentialing programs to your practice and where do you earn you continuing education credits?

Having board certification in Psychiatry by the American Board of Psychiatry and Neurology and getting the required number of Continuing Medication Education (CME) credits every year allows me to continue to work in accredited hospitals. I earn my CMEs from the various medical and psychiatric facilities and from the annual meeting of the American Psychiatric Association along with attending ABCT meetings.

What tips can you offer to colleagues just opening a practice?

The use of the Motivational Interview is very important when seeing a new patient. Also, the readiness to use the Motivational Interview again later in therapy is important when an ongoing patient starts to develop resistance to therapy.

How do you avoid burn out?

I find that constantly leaning something new about my professional work keeps me interested and even fascinated with my work.

When not practicing CBT, what do you do for fun?

I enjoy traveling. In the Spring of 2008, I spent 3 weeks visiting China. I also enjoy studying languages. In recent years, I have been learning Spanish. Also, since I was born and raised in Boston, I like to follow some of the Boston teams including the Boston Red Sox.

Where do you see the field of the behavioral therapies going over the next 3-5 years?

With America's demand for better health care reaching a climax, I see CBT coming to the forefront to help meet this demand. I am always amazed each time I attend an ABCT convention, to see so many new, innovative, and effective treatments being developed. America needs us now, more than ever.

How has ABCT helped you professionally?

I find the annual meeting as the most valuable. I learn a lot from all the parts of the meeting, from the courses to the panel discussions to the poster sessions to the book exhibits. Also, talking to various people from all parts of the country and with so many different backgrounds is very helpful. Finally, the newsletters and journals add to my learning and keep me abreast of my profession.

How do you see the future of ABCT?

I see it as very bright. The coming together of so many professional disciplines, including psychiatry, psychology, and social work, as well as others, allows everyone to participate in this great adventure of developing new and effective therapies. CBT has never belonged to one professional discipline and will always be richer from the contributions from many different disciplines.

George Wing, M.D.