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Featured Therapist Interview
Chris Maguth Nezu has been in private practice as a licensed psychologist for over 25 years. She received her Ph.D. in clinical psychology from Fairleigh Dickinson University in New Jersey and completed her residency at Beth Israel Medical Center and Mount Sinai School of Medicine in NYC. She has been a board-certified psychologist since 1998 with the American Board of Professional Psychology (ABPP), in the designated specialties of clinical psychology and cognitive behavioral psychology. In addition, she is a certified cognitive therapist with the Academy of Cognitive Therapy. Dr. Nezu is a tenured Professor in the Department of Psychology and also a Professor of Medicine in the Department of Medicine at Drexel University in Philadelphia. At Drexel, she teaches in the undergraduate and graduate programs, including an accredited PhD program in clinical psychology, and collaborates with Dr. Art Nezu and other colleagues in clinical research at Hahnemann University Hospital. She is currently developing clinical prevention interventions through the Department of Veterans Affairs, for returning military veterans, and has consulted with universities and organizations in other countries. She has authored/co-authored over 125 scientific publications, including books, book chapters, and articles in professional journals. Dr. Nezu is a past President of the ABPP and actively participates in many organizations and conferences in the USA and abroad. These include the American Board of Cognitive and Behavioral Psychology, the American Psychological Association, American Board of Clinical Psychology, the Academy of Cognitive and Behavioral Psychology, the Association for Behavioral and Cognitive Therapies, and the World Congress of Cognitive and Behavior Therapies. In addition, she was elected to be designated as a Distinguished Scholar/Practitioner of Psychology by the National Academies of Practice. Dr. Nezu has collaborated with Dr. Art Nezu regarding the continued evolution and application of contemporary Problem-Solving Therapy (PST) to many different clinical problems.
First, we would like to know a little about your practice.
When did you begin your practice?
I began my practice over 25 years ago. Although I have been a tenured professor of psychology and medicine for a long time, I have always believed that to be an effective clinician and clinical teacher of the next generation of psychologists, it is important to maintain a hands-on approach to treatment. This allows our clinical practices and the journey we make with our patients to guide meaningful clinical research and scholarship.
Do you have a specialty?
My practice is focused on adults in both individual and couples treatment. My assessment and therapy services are grounded in an evidenced-based approach to treatment. This means that I have a strong commitment to the preferential use of mental and behavioral health interventions that are grounded in research and scientifically supported theories. The psychotherapy interventions that we use in our practice are under the broad cognitive and behavioral umbrella; however, my approach also incorporates emotionally focused interventions within the context of respect for an individual’s social, cultural, ethnic, and spiritual background. I have found an integrative approach to behavior, cognitive, and emotional experiences combined with individualized applied case formulation to best define my therapeutic work. Populations with whom I frequently work experience a range of mood, personality, relationship, developmental, and health problems over the lifespan.
What are your personal strengths as a practitioner?
I view my commitment to lifelong learning and continued professional development, coupled with a respect for the individuality of each patient, to be among my greatest strengths as a practitioner. However, a compassionate heart and my focus on the therapeutic relationship as an important vehicle for change within the context of a strong evidence base regarding the interventions I choose are also important components of my professional identity.
As a professor in an established PhD program in clinical psychology I participate in clinical research and have co-authored many manuals concerning contemporary Problem Solving Therapy (PST). Manuals are very important to the fidelity of controlled outcome studies. However, my clinical work is based upon a case-formulation model and prescriptive treatment derived from an individualized assessment for each patient. Therefore the actual interventions in which I engage patients often have components of many different therapy strategies in order to target an individual’s unique constellation of symptoms or comorbidities.
What is one method you use to promote your practice?
I have found that having an up-to-date website, as well as a collaborative network of professionals from various disciplines, including psychologists from multiple orientations to treatment, is essential to promoting my practice.
How important are board certifications and/or credentialing programs to your practice?
For psychologists, I consider board certification by the American Board of Professional Psychology (ABPP) to be the gold standard of clinical practice, as well as supervision and clinical training. Especially with the growing evidence base and scientific studies that inform cognitive and behavioral interventions, it is important for the public to know that a therapist has demonstrated competency in clinical assessment and interventions beyond the recognition of a degree or written licensing exam. Board certification is the only way to document evaluation of competency by one’s peers. As a former president of ABPP, I view board certification as important to the future of our profession in a similar way that board certification is considered essential for physicians in various medical specialties. As a cognitive and behavioral psychologist, I know that it is a tradition of this specialty that a written exam or scholarly article is not always an accurate approximation of actual behavior. Therefore, it is my view that a competency-based, board certification process should be viewed as fundamental to a CBT approach. I believe that, in the future, psychologists who are active as clinical training program faculty members, hospital supervisors and practitioners, and expert witnesses for court, will be required to have specialty board certification though ABPP. The ABPP specialty in cognitive and behavioral psychology has a great presence at the annual ABCT convention and it is wonderful to see the synergy between ABPP and ABCT. For psychiatrists, board certification in their medical specialty as well as additional certification through cognitive and behavioral multi disciplinary organizations, such as the Academy of Cognitive Therapy, can help the public to identify individuals who have completed a peer review of their competencies.
What tips can you offer to colleagues just opening a practice?
I am in a unique position as a university professor to be able to maintain a small private practice in addition to my university work. As such, I have focused more on providing advanced clinical training opportunities to our doctoral students through our practice and less on building the hours required by full-time private practice. With that caveat, there are several tips that I believe contribute to the satisfaction and rewards of private practice:
- Develop an inviting and informational website. I have found that people who have received several names for therapy referrals have called our office after visiting www.nezupsych.com.
- If you are a psychologist, get board-certified through ABPP. I promise that this will not only be one of the proudest moments of your career, but will increase your national presence as a board-certified practitioner and inform your colleagues of your expertise.
- Attend continuing education workshops, seminars, and webinars. This provides a renewed commitment to lifelong learning and increases the half-life of your training.
- Reach out to colleagues in the area who can provide you with referrals. These include colleagues in university and research settings who are frequently looking for referrals for individuals who do not meet criteria for an ongoing study, as well as other practitioners who want to refer people they know personally, or appointments that they cannot accommodate in their practice or typical office hours.
- Reach out to other professionals, such as physicians, nurses, social workers, lawyers, and teachers. Many of these individuals get frequent requests for referrals.
- Work with insurance companies to recognize your value and apply for a national provider number that can be integrated with the insurance plans with which you work.
- Develop a good working relationship with a primary care, psychiatry or neurology group that you trust regarding referrals for needed medical evaluations, and negotiate a reciprocal relationship to receive referrals from them.
- Provide pro bono community talks at municipal, community, and church organizations and donate at least one hour per week to an underserved population for free. This is simply a decent and ethical thing to do. My personal choice is the “Give an Hour” project for returning military and their families.
What sorts of literature that describe evidence- based therapy do you make available in your waiting room?
I actually make the waiting room as friendly and low key as possible. Most of the reading that I provide is more related to leisure or pleasure. However, I do provide information on our website regarding my assessment and treatment approach and a take-home pamphlet that describes the assessment and treatment that folks can expect as one aspect of informed consent. Finally, after several assessment sessions, I share my case formulation and treatment prescription with each patient. I provide a visual handout as an aide to this process, and many patients have found this useful to take home with them.
What self-help books do you suggest to your clients/patients?
Due to the case formulation approach that defines my practice, the self-help and popular books I recommend are very much tied to an individual’s prescriptive treatment. In addition to books, I have recommended various digital audio or video recordings, iTunes downloads, and You Tube videos that may be applicable to a given situation. Additionally, I have a biofeedback computer program that I have used in conjunction with other stress management strategies. Because of the ubiquitous application of various problem-solving (PST) strategies in my work, I have found it useful to provide patients with a copy of Solving Life’s Problems, by Nezu, Nezu and D’Zurilla (2007), to support treatment. Additionally, when working with individuals for whom integration of spiritual and cognitive-behavioral strategies make sense, I have provided patients with a book that I co-authored entitled Awakening Self-Esteem: Spiritual and Psychological Techniques to Enhance Your Well-Being, published by New Harbinger in 2003. Finally, for patients managing medical issues, I co-authored a book entitled The Emotional Wellness Way to Cardiac Health: How Letting Go of Depression, Anxiety, And Anger Can Heal Your Heart, along with my colleagues Art Nezu and Diwakar Jain (2005). I participated in writing these books for the general public because, while there are a vast array of excellent books on the market, these projects represented what I believed was a needed niche.
What one book do you recommend as a “must read” to improve your practice?
Because of the availability of so many effective treatments, I believe that a comprehensive case-formulation book is an essential “must read” for clinical practice. The book that I use for my advanced case formulation course in our doctoral program is The Handbook of Psychotherapy Case Formulation (T. D. Eells, Ed. 2nd edition), published by Guilford Press. The book contains several chapters devoted to cognitive and behavioral case formulation as well as case formulations based on alternative orientations.
Are you involved in other types of professional activities in addition to your private practice?
As I mentioned earlier, I am a university professor and very active in clinical research, supervision, and training in that role. I am a strong believer in the importance of promoting psychology as a profession. I am a member of the ABPP served as a past president of the ABPP. With regard to professional activities at ABCT, I served on the board of directors as the Coordinator of Academic and Professional Issues, as well as the Chair of the International Affiliates Committee, and Deputy Representative to the World Congress Committee. With regard to professional advocacy, I have trained with the American Psychological Association as a federal advocate to lobby for funds for psychology education and clinical training.
I hold a position as a Health Sciences Specialist for the Department of Veterans Affairs (DVA) and serve as a program consultant for the DVA’s Office of Mental Health Services. My current activities involve the development of interventions for prevention of mental and physical health problems for returning veterans, many of whom have experienced traumatic events and injury associated with combat.
I have recently assumed the role as Chair of the ABPP Foundation, a charitable and educational non-profit organization. The aims of the foundation are to provide continuing professional education opportunities for licensed professional psychologists for the purpose of improving the health of the general public.
Next, we are interested in your continuing education activities.
How do you stay current with new research or advances in the field as applied to your practice?
I am fortunate in my work as a professor of psychology and medicine to engage in research, training, education, and scholarship as a requirement of my academic role. I am also very fortunate to have professional colleagues, motivated students and trainees, and rich university library and laboratory resources available to me to support my continued development.
Where do you earn your continuing education credits?
In addition to my university resources, my continuing education experiences are usually through ABCT conventions, ABPP continuing education conferences, and APA conventions, books, and DVD resources.
We would also like to know a little about you personally.
Who was your mentor?
I have had so many people responsible for my mentorship and professional growth over the years. My dissertation chair, Michael Petronko, provided me with the clinical expertise in working with individuals with developmental disabilities, a commitment to professional ethics in private practice, and an advocacy for underserved populations. My life partner and most trusted colleague, Art Nezu, has provided me with thoughtful advice, honest feedback, and a supportive ear for 30 years. We continue to collaborate in much of our day-to-day work. The individuals who influenced me though their work and ignited my enthusiasm for both clinical psychology as well as cognitive behavioral psychology include George Kelly, Fred Kanfer, Michael Mahoney, Don Michenbaum, Walter Mischel, Thomas D’Zurilla, Arnold Lazarus, Marvin Godfried, Alan Kazdin, and David Barlow. With regard to clinical training, during my internship I was supervised by an interpersonally oriented psychologist, Joan Sadow. She taught me the healing power of the relationship, regardless of one’s theoretic orientation.
What is the last book you read?
Although I enjoy political books and documentaries, I confess that I am a “neuroscience junkie” and search out all that I can read with regard to the continually emerging field of affective neuroscience. The most recent books that I have enjoyed include The Handbook of Emotional Regulation (edited by James Gross), The Feeling of What Happens (Antonio Damasio), The Emotional Brain (Joseph LeDoux), and You Are Not Your Brain (Jeffrey M. Schwartz and Rebecca Gladding).
How do you avoid burnout?
My relationship with my family is my remedy for burnout. My life partner and best friend, Art Nezu, my grown children Frank, Ali and Linda, and my grandchildren Alex, Jacob, Elle, and Maxwell, all give my life laughter and love. Additionally, exercise and spiritual practice keep me gratefully aware of life’s blessings even under the most stressful times.
When not practicing CBT, what do you do for fun?
Whenever I have the opportunity, I enjoy traveling, scuba diving, body surfing, and urban activities, like the theatre, opera, museums, comedy clubs and good restaurants. Because relationships are important to me, a get together with friends or family in which we are all participating in one of the activities described above, is blissful. I am most happy when sitting next to Art near an ocean at sunset (often with a chilled glass of wine in hand).
Do you have any other “talents?”
My undergraduate degree in fine arts/theatre afforded me the opportunity to understand and appreciate the arts, as well as to benefit from learning to play an instrument and sing. I have been given the feedback that I have a talent for learning other languages, and although Spanish is the only other language I know, I try to speak a little of the local language whenever I travel. I also think I’m a pretty good cook.
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?
My definition of CBT includes the very wide range of cognitive and behavioral interventions and the multiple learning theories upon which they are based. As I indicated previously, it is my view that no one approach defines the field, as much as the theories and methods on which they are based. Given that caveat, I believe that the single most important thing that all cognitive and behavioral interventions can do is to provide patients with a new learning experience and hope for a future that is more consistent with their life dreams and values.
Where do you see the field of cognitive and behavioral therapies going over the next 3 to 5 years?
I am delighted that I was asked this question! As the overarching field of cognitive and behavioral therapies continues to grow, the number of specific evidenced-based treatments that address the same or similar clinical problems also increases. Clinicians are often faced with the dilemma of what treatment or set of techniques they should implement in any given case. I believe that the field of cognitive and behavioral therapy will focus less on “brand names” in the next 3-5 years and call for what David Barlow refers to as a unified approach that seeks to understand the key mechanisms of action that are common to effective treatments. I am delighted to be chairing a clinical panel presentation at the 2012 convention in November that will include Dr. Barlow as a discussant and the leading ABCT clinical experts from various cognitive and behavioral treatments who will identify some of the common ground among these leading psychotherapy systems.
How do you use the local media to educate your community on the benefits of CBT?
We frequently receive requests through the university to respond to topical stories that are relevant to psychology and cognitive behavioral intervention. When possible, I try to respond to these requests in order to advocate for evidence-based treatments for common problem areas that are highlighted in the popular press such as mood disorders, obesity, aggression and violent behavior, and most recently post-deployment problems for returning military troops.
Finally, we would like to know your opinions about ABCT.
How long have you been a member of ABCT?
I have been a member (and very rarely missed a convention) for 25 years.
How has ABCT helped you professionally?
ABCT was a welcoming and nurturing home while I was still a student. I remember that at one of my first ABCT conventions, I shared a cup of coffee with Dr. Fred Kanfer following one of his workshops. I couldn’t believe that someone so prominent in the field gave the time to a student and answered my clinical questions with support and enthusiasm. It is my hope that I am able to pay this forward when trainees ask me clinical questions. Through the years, ABCT has provided a supportive and professional meeting place where new ideas can be discussed and shared (sometimes collegially argued) and disseminated.
What services do you consider the most valuable from ABCT?
The conventions, the continuing education, and the journals are top notch and provide excellent resources for clinicians. The central office staff are an incredible group of professionals.
What service(s) are missing from ABCT in your role as a practitioner?
It is my view that ABCT, as well as other professional organizations, could have a greater impact with regard to the media and professional advocacy. Although ABCT is in no way responsible for the lack of focus and misinformation that the media has promulgated with regard to psychotherapy treatment, trauma intervention, and childcare/parenting practices, I believe it provides a powerful means of remedying the misinformation that is out there, and advocating for greater reliance on evidence-based care in the areas of media dissemination and health care legislation. I know this is a challenging area. However, the public would benefit greatly from greater advocacy in these areas.
How do you see the future of ABCT?
As you may guess from my answer to the previous question, it is my hope that ABCT would take a greater role in advocacy and dissemination of evidence-based treatment.
Thank you very much for taking the time to answer our questions!