Angela Klein

Angela Klein, Ph.D., earned her doctorate in clinical psychology from the University of Missouri, Columbia, in 2009. Prior to this she began her study of eating disorders and psychology through the honors program at Kent State University, completing her B.A., with a minor in women’s studies, as valedictorian, in 2002. As both a researcher and practitioner, Dr. Klein has extensive experience delivering and conducting treatment trials emphasizing effectiveness in the real world, including her development and investigation of the mindful eating program presented in her book “Mindful Eating from the Dialectical Perspective: Research and Application.” She began specializing in dialectical behavior therapy (DBT) in 2004. She also now practices radically open (RO) DBT, becoming one of the first intensively trained RO therapists in the U.S. in 2015. Her evidence-based approach incorporates CBT, including exposure therapy. She has multiple journal publications in the field of eating disorders and has presented both nationally and internationally. She founded and directs her private practice, Centered Ground, providing individual therapy, family therapy, group skills training classes, and coaching support to adolescents and adults, as well as preteens, in the greater San Diego area, with her main office in Carlsbad, offering her expertise in DBT, RO, and mindful eating from the dialectical perspective. With her DBT and mindfulness specialties, she focuses on comorbid presentations, including emotion dysregulation, self-harm, suicidality, mood and anxiety disorders, and personality disorders (borderline; avoidant; obsessive compulsive), as well as disordered eating, eating disorders, and body image. You can find more about her practice at https://www.centeredgroundtherapy.com

First, we would like to know a little about your practice.

What are your personal strengths as a practitioner?

Perseverance is definitely one of my main personal strengths as a practitioner, relentlessly persisting through complicated comorbid pathology. Likewise, I am extremely committed to my clients and passionate about my practice, embodying what I teach: dialectical living, finding balance between extremes, and embracing discomfort, not just habituating to it through exposure but also seeking it out for the sake of learning. As a DBT therapist, I have essentially been on call 24/7 for the past 15 years, while also pursuing my own adventures outside of the office, modeling how to live bravely, overcoming.

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

Perhaps this goes without saying with this audience, but I would definitely recommend specializing and emphasizing empirically based treatment. In this era of self-help gurus and social media influencers, let alone all the diversity in academic degrees and training, the public gravitates towards what stands out above the crowd. Often this is not necessarily what is effective-and yet, clearly offering expertise in what is supported by evidence will draw clients.

I would also say that you have to absolutely love this work and be able to balance sensitivity with the fortitude to bear the emotional and mental toll of this vocation. Depending on your clientele, hour after hour, day after day, year after year, you will be faced with the darkest accounts of human experience and despair, sometimes truly terrifying, and need to greet each one with full presence and exactitude, even if a session nearly knocks you off your feet, even if there are multiple crises in the background.

I would also recommend starting small, then growing. For example, I first rented a small room without air conditioning in a quirky shared space along the coast here in Southern California, conducting both groups and individual sessions in the room. I will forever hold dear those clients, their good-natured spirit and gratitude, sweating and squeezing together as if in a clown car! And then I added a second larger room for groups. Then I held groups in a larger, separate space. Then I expanded to my current beautiful, modern new location. The clients could see the value through this journey, and it is such a gift to be able to provide them the current setting, designed specifically for my practice.

How do you remind your patients of their strengths during the therapy process?

Before solution analysis, I reinforce skillful behavior and insights. I also balance validation of their experience with reframing to acknowledge their more positive attributes.

Are you involved in other types of professional activities in addition to your private practice?

In addition to my practice I remain active professionally through presenting and writing, with aspirations of further book projects and research.

We would also like to know a little about you personally.

Who was your mentor?

I have been fortunate to have many mentors. I completed my Masters under the mentorship of Anna Bardone-Cone, examining the differential influence of perfectionism, self-efficacy, and stress in various domains on restrictive versus bulimic behaviors. Informing my treatment trials with her expertise in effectiveness, my dissertation mentor was Kristin Hawley, along with integral clinical supervision from Jeremy Skinner. I also completed my latent transition analysis projects in the lab of Kenneth Sher. On internship at the University of South Carolina Counseling and Human Development Center, I received invaluable mentorship from Pete Liggett, as well as Rhea Merck and Russell Haber. My postdoctoral mentor, on her randomized trial of emotion regulation group therapy, was Kim Gratz, with clinical supervision from Matthew Tull, at the University of Mississippi Medical Center. Most recently I can thank Thomas Lynch for my training in radically open DBT.

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

I love enjoying the beach, travel adventures, cuisine, and the arts. My recent trips include hiking in Ireland and the Camino de Santiago, sailing in Greece, and traversing museums in Paris. At home I especially appreciate the sand and waves with my morning runs before sessions and ocean sunsets as I end my clinical weeks. In my spare moments I also write poetry and play my baby grand piano.

We are also interested in some of your views of CBT.

What do you think is the single most important thing CBT can do for your clients?

That is a great question. I would say resilience: the ability to realize and choose empowerment over suffering, to face whatever painful experience we encounter without succumbing, to ultimately find our way to balance and joy no matter our circumstances.

How do you use the local or social media to educate your community on the benefits of CBT?

I maintain an Instagram account curated from my life and practice, along with my writing, to demonstrate and share CBT and, in particular, DBT concepts, including mindful eating, mindfulness in general, dialectics, radical openness, and exposure therapy. Perhaps in a way I am thus offering both education and my own journey as a case study, capturing the benefits of CBT in action in a compelling and accessible way. You can follow me: @dr.angela_klein .

Finally, we would like to know your opinions about ABCT.

How long have you been a member of ABCT?

I began attending ABCT as a postdoc in 2009; I remained active and became a member following this.

How has ABCT helped you professionally?

ABCT has allowed me to remain connected to the research community that is my ongoing commitment and background, even as I have moved beyond academia, more primarily into the clinical world.

What services do you consider the most valuable from ABCT?

The annual conference is invigorating and enriching with its energy and gathering of cutting-edge research to enliven practice upon returning to the therapy room.

What service(s) are missing from ABCT in your role as a practitioner?

Tangible research support for the private practice setting seems lacking. This includes adequate time at conferences for practitioners to connect with researchers in meaningful and lasting ways to establish the seminal and necessary groundwork for truly bringing collaborations to fruition. More intentional space for this and even funding resources could exponentially increase the yield of such potentially powerful collaborations. I would absolutely love to maintain an ongoing research program in my practice, and ABCT seems exceptionally poised to contribute to this endeavor for those practices like my own especially, the culmination of rigorous research training in behavioral and cognitive therapy.

Thank you very much for taking the time to answer our questions!