The Practice of Therapy

Carolyn Solo
Hi, I'm Oh, should I go ahead?

Gordon Brewer
Yeah, go ahead.

Carolyn Solo
Hi, I'm Carolyn solo LCSW. I have a small private practice outside of Philadelphia. And I'm an EMDR, therapist and consultant.

Gordon Brewer
Well, hello, everyone, and welcome again to the podcasts. And I'm really happy for you to get to know kale and solo. Welcome, Carolyn.

Carolyn Solo
Thank you. I'm so happy to be here. Yes. And

Gordon Brewer
so the Carolyn has outside of Philadelphia, and then practice there. And really kind of your niche is helping people with EMDR, intensives, and that sort of thing. But as I start with everyone, why don't you tell folks a little more about yourself and how you've landed where you've landed?

Carolyn Solo
Sure, well, I am an EMDR, therapist and consultant. And like you said, Gordon, I'm outside of Philadelphia. I specialize in working with all sorts of complex trauma, but also with the perinatal and maternal mental health population, and dissociative identity disorder, actually, and the primary format I use for my therapy is what's called the MDR intensives, which is, if you haven't heard of it, sort of a longer version of your average 50 minute therapy session, sometimes up to, you know, three or four days, over the course of a couple of weeks with the aim to really move through stuff really quickly and efficiently. And I also do some business coaching to help other therapists get going with intensives. So that's something else I've started doing recently, I have a podcast about intensive, just started the future template parent podcast, if you no EMDR future template will make sense to you. And the best part is that I'm a mom of three girls. And I think a lot about how parenting impacts the way that we show up in the therapy room. Especially given that I work with a lot of parents. And also that I feel like the intensive model gives parents a lot of freedom in their in their scheduling. So it's sort of that come combined, kind of it. I'm also a doctoral student at Bryn Mawr School of Social Work, and I'm hopefully graduating next year. So

Gordon Brewer
awesome. Awesome. Got a lot going on.

Carolyn Solo
I do probably too much. But yeah,

Gordon Brewer
yeah, well, good. That's good. Well, I'm really excited to talk with you about this topic. So let's just start with if folks that might not be familiar with the concept of doing intensives, what, what do they need to know? So

Carolyn Solo
most of your audience probably knows that EMDR is a trauma therapy modality. And you know, our standard model in our field for a while has been the 50 Minute therapy hour, right? But EMDR is a very intense experience where you're really going deep into a specific, traumatic episode. And often in a 15 minute session, you have that open up? How are you how is your week, but a lot, and then you have the closed down, you might only get in about 2030 minutes of that processing time. So I don't know how long ago this was, but people started talking about intensives. What if we did, what if we did EMDR for longer, and it really lends itself to for like a longer time, just the way it's structured. And so essentially what I do now with my clients, my model is usually a 90 minute intake, and then three to four days of four to five hours each over about two weeks. And the idea for me, I usually like to have clients come in with a kind of specific goal, like postpartum depression, or if they had a traumatic birth, maybe their baby ended up in the NICU, or repeated pregnancy loss is something I worked with medical traumas specific medical event that was very traumatic. So it's sort of boundaried because that really lends itself well to working through something in a short amount of time. I always like to tell new clients that I think of intensives as the Disney Fastpass of therapy, jumping the line, because I really think that every hour of an intensive it's almost like two hours of weekly therapy because you don't have that open up and closed down thing. And I would say the other thing I really liked about it is my schedule flexibility. That's huge. You know, obviously I said I'm a parent of three young kids under seven. And I need flexibility like if my kid gets sick, I can't work and it's much easier to reschedule one day of one person that IT people and it's financially I find more lucrative so I can take a week off and feel fine about it. You know, and I'm not leaving people hanging because I don't have that many weekly clients anymore. I have a lot of people who just come for an intensive and then they send them back to the Your therapist.

Gordon Brewer
Wow. So you're doing so you're doing intensive just exclusively?

Carolyn Solo
Not exclusively, I still have clients from my okay. You know, but I would say that 60% of my practice now is intensive.

Gordon Brewer
Okay. Okay. Yeah.

Carolyn Solo
People are finding out about them. Yeah. Getting around. Yeah,

Gordon Brewer
yeah. Yeah. And I think, you know, I think the concept of even though it might be a little bit of a myth, but kind of the concept of a quick fix is appealing to people.

Carolyn Solo
It is it is. And yeah, it is a bit of a myth. And I never promised anything, of course. Right. Right. Good. All right to say is, I guarantee you will move more through a lot more stuff more quickly, than you would over six months of regular therapy. And some people are like, this is an issue that I need to work on. Now. I don't have nine months. That's a great for people that are really busy. Like, I'll come in for three days, and then I'm not gonna have to carve out like an hour for therapy every week, you know? So it's, I feel like it's appealing to a lot of people. Yeah, yeah. Behind it, too.

Gordon Brewer
Yeah. Yeah. So maybe walk us through a little bit of the structure of how you do sessions and that sort of thing?

Carolyn Solo
Sure. So like I said, I have this 90 minute intake. And that's after I've done like a quick console call to make sure they know what an intensive is, you know, because sometimes people get my name and don't realize that I'm only taking intensive clients, you know. So first eye contact, I'll make sure they get that. And then we have a 90 minute intake where I get you know, basic history, what do you want to work on? Do you have questions about EMDR. And then part of what I do during the 90 Minute intake is or console is I talk them through this workbook that I have, that basically gives me really good history so that we don't have to do it in the session, Prime's them to be like, Oh, this is what we're working on. So I have some like attachment interviews in there. I have some, like, Parks work kind of that. I don't call it that. But like, I asked him some questions about that, I ask them some questions about positive memories that they have, so that we can call on those if we need to. So I really condensed the time that we would spend in like weekly sessions, talking through all that stuff. And I haven't filled it out, I get it a day before, that helps me start a treatment plan. And then usually I do I, most people, I recommend three days to start. And then two hours, hour long lunch break two hours. And usually the first two hours are some prep work, let's really get the treatment plan organized, it's really figured out we're working on. And then EMDR is all about certain target memories that you're focusing on. We also use that time to pick what our targets are going to be for the intensive. Come back from lunch, just starting with the targets and see how far we get. Yeah, I do.

Gordon Brewer
Yeah, yeah. So is this following a particular EMDR model that you've run across before? Or is this something you've kind of come up with yourself?

Carolyn Solo
Oh, no, I cannot take credit for coming up. It's interesting, though, because Francine Shapiro who invented EMDR, when she designed it, or her her initial her like intention was for 90 minute sessions, always. That's kind of how she conceptualize it. But of course, insurance reimbursement and all that, you know, and people's just expectations of what they would be is kind of forced it into the shorter time. And so people I don't know, I don't know who first started doing this. But I'm a rookie, Greenwalt maybe. Anyway, I started hearing about three or four years ago, I did trainings with some people who are kind of the original, like, there's my organization called Scaling up the trains on this. And then zero disturbance is another organization. And they I trained with both of them. And then I just was like, I think I'm ready to do this. And so it was intimidating at first for sure. Because it's so different than how we think about therapy. And I think people worry like, is it going to be really tiring? Am I going to feel so drained? Like there's a lot of fears I think that come up around it. Writing is another fear right? Um, but now that I've been doing it for a while I feel really grounded it as the way that I really enjoy practicing you see so much progress in a short time.

Gordon Brewer
Right, right. Yeah. So when we again that kind of the marketing of this and then what you charge and all of that sort of thing, how did you come up with all those different things?

Carolyn Solo
I mean, I certainly pulled on these trainings I went to they helped a lot and then I don't know if you're familiar with

Gordon Brewer
Kelly McKenna. Do you know her she's not not familiar. No,

Carolyn Solo
she may have if you follow Instagram at all she does this Instagram reels membership where she teaches therapists how make real marketing and like she built she built her entire caseload doing this. And now she tells teaches people how to do it. So I took that on as part of my marketing, and that's really gone well, like it's one, I feel like it's very educational, like people are learning about intensives. But also, because with an intensive, you can come like some people can come from somewhere else come for the leave. So it's not quite the same limitations in terms of location, have you gotten have found out that at that I certainly network with a lot of local therapists and say, like, Hey, this is a great adjunct to what you're offering. I have a whole page on my website. And this is part of what like the coaching package I offer does is like teach people how to do all this. And then pricing, I priced the hours there. So my hourly rate for regular therapy is $200 an hour. And I price intensives at 250. Because I don't schedule anybody else that day. There is prep work involved. And I think it's kind of value for money. And people don't push back on it once I kind of give the rationale. I know that's a lot. But it feels like it reflects the value to me.

Gordon Brewer
Right? Yeah. Yeah. Well, that's yeah, I was remember several years ago, I was talking with someone on the podcast just about intensives for couples. And that, you know, I think the appeal is is that a person? Has this extended, devoted time to working on a particular issue? Totally. And I think they're probably more engaged. Doing it that way, as well.

Carolyn Solo
100%. And I think the financial investment, underlines that right there their work, they're paying a lot of money they're taking a lot of time they want to do this. You don't get people are like, Oh, I don't know, I don't really know what to talk about, not who this is for. And so yes, people come in, they're ready to work and they want, they want the experience, they want to just focus. And so VR works nicely in that way, because it's so focused on specific issues. So yeah, it works. Well. Yeah.

Gordon Brewer
That's good. That's good. So if somebody wanted to start doing intensives, what are the starting places? And what do they need to think about?

Carolyn Solo
Well, I think they can, I think first you want to think about your schedule. What do you schedule to look like? Because it is different than a weekly client load. Right? So thinking about how are you going to kind of transition your schedule, right? You could even think about just offering extended sessions to start to current clients and see how they respond to that. I think thinking about marketing, for sure. Like, I definitely would think about talking to your network. Reaching out to other EMDR therapists, you know, reaching out to other just other kinds of therapists, you know, and sort of saying, this is a service I even connect. My dentist sends people to me, because there's a lot of people that have dental anxiety. Oh, well, yeah. And it actually benefits him because it's easier to work with these people if they've worked through some of this. Right. Yeah. So thinking about who the referral sources are, that would I also network a lot with like doulas, and birth centers and midwives, because I do a lot of that work. And selling it to these people as like it benefits them. Benefits The other practitioner, right? It comes to you work through this stuff, it's much easier for them to go back to whoever else they're working with. Right, kind of gotten over this stuff point, you know, yeah. So I think there's clinical skills you need to develop as well, too.

Gordon Brewer
Okay. Yeah. I was just wondering if somebody were trained in EMDR, making the transition to doing intensives. What, what else would they need to know?

Carolyn Solo
I mean, I think, you know, everyone says this, but it's true. It's a lot of it's like mindset work. Certainly, I think, recognizing you can do this, it's not impossible. Recognizing that a lot of the skills you already have, you'll just continue to use. But I think there are some other clinical tools that I use pretty regularly. That, you know, will have meaning to people in EMC and Dr. Rowe, but like certain kinds of protocols that I think are really helpful. Having a lot of comfort with dealing with sort of like early life trauma is very important. I think knowing how to handle dissociation is very important. Having something like this isn't essential, but I find it very helpful. Having some familiarity with Parks work or ego states work or ifs, whatever you Call it because that comes up a lot. Really being comfortable being flexible, and kind of feeling like you can think on your feet be creative. I think there's the standard protocol for EMDR that you all everyone learns in their basic training. You really have you really want to have that internalized, I think, because once you've done that, you can become creative. You can become flexible, like any therapy modality. Right, right. Yeah. So I think those are some important things. I find the workbook super helpful, frankly, like, I think it's it Prime's the client and it Prime's you. And it gives you a lot of information. It's not essential, but I have found it really, really helpful. And that's, that's an idea I got from the zero disturbance training I did, she gave us a workbook as part of the training, but I'd like adapted it to make it my own. But I think it's I find that people really like it and really respond well to it. Getting comfortable with just saying how much something costs out?

Gordon Brewer
Yes.

Carolyn Solo
That work? You know, yeah, yeah. These are all things I talked about in the podcast, like all these issues, all this stuff,

Gordon Brewer
right. Yeah. So So in thinking about just your work with dissociative disorder, what are some things that you've learned that might be helpful to other other therapists just around that particular clinical issue?

Carolyn Solo
Well, for one, it's so much more common than you think. I mean, dissociative identity disorder. And it's true, like DSM five form is one end of the spectrum. But dissociation exists on a spectrum. First of all, this dissociated, right? That's just a normal human coping strategy. But it's more, it's likely that if you deal with trauma, and honestly, who in our practices is not dealing with trauma to some degree, right, right. We have people who dissociate in certain ways, you know, and so becoming aware of what that looks like, knowing the kinds of questions to ask, in a really compassionate way, get a sense of like, what's the, what's the depth of what's going on here? Like, what's the impact this dissociation is having on this person's life? What's their awareness of it? And then really, I mean, there's some really good trainings out there about how to work with dissociation in a really competent way. And I think those are quite important, because it's a very complex symptom presentation. Certainly, especially when you get to like the big end of the spectrum, like, I've worked with people that have had, like, you know, ritual religious trauma for many, many years. And have, you know, 12, not co conscious personalities. So that is a lot. Right? And you can't just do that being like, Oh, I'm going to try some CBT on this person. Like, that's not what they need. Not that would be helpful to some degree, but that's not going to get them moving towards some. I don't really like to use the word integration, because that has a stigma and the idea that like some sense of more coherence, you have parts work US states work in a competent way. So Right. And I think one of the ways I like to do that in an intensive, we don't do the same level of trauma processing, because they might not be stable enough, right. But you can do intensive parts work sessions, where you're speaking with four or five different parts or aspects of their personality in a four hour day. That's huge. Take it two months,

Gordon Brewer
right? Yeah. And I would, I would guess, to just getting getting down to what are their desired outcomes with all of that?

Carolyn Solo
Absolutely. Well, on sometimes they don't even realize what's going on. Right. psychoeducation peace, and mindfulness and being more connected to their bodies, a lot of people who are very dissociated, don't feel pain. Hmm, that can be hard for us to imagine. But it's and so some of the early things you have to work on is like how do you connect what you're feeling in your body? You know, like, that's a real piece of the work. And a lot of that can be done beautifully in an intensive format, you're just maybe you're not doing traditional EMDR trauma processing, but you can do beautiful intensive work. You know, it could take a lot longer if you split it up.

Gordon Brewer
Well, it sounds like fascinating work. And I can I can tell that it's just something you're really passionate about. Yeah,

Carolyn Solo
because I feel like there aren't enough people who train in it because it feels intimidating. Yeah. Yeah. Some of my most cherished clients have been clients with the ID, the relationships I've formed with these people and the change I have seen, you know, brings tears to my eyes even thinking about it now. You know, so, I wish I want to tell people don't be afraid of working with those people. Right? They need people who know what they're doing, and there's great trainings out there. There's consultation out There, you can do it. But it's Yeah. Yeah. That's great. I'm very passionate about it.

Gordon Brewer
Yeah, yeah. Well, well tell folks how they can get in touch with you and learn more about the trainings that you're doing.

Carolyn Solo
Sure. So I do have this coaching package that I call my VIP day, which is get your intensive up and running in one day, and I teach you everything I know. And I like to say you can do it in your pajamas, because virtually, you don't even have to change and you write your web copy, we talked about who your referral sources are, where all the clinical tools, I give you access to all the stuff I use as part of the package. So that's one way, I also have this podcast that I'm only on episode 10. But I'm really excited about it. And I have all these episodes mapped out in my head, people have been liking it. So it's called The Future template parent podcast. And you know, you can find that on every place that you would find podcasts. And I have an Instagram, which is more associated with my private practice now, but I I also talked about the other stuff. And it's kind of a mouthful. It's integrity TAs. And I'll write that down for you. So for wellness underscore recovery, it's my practice name. And integrity is is the Latin word for integrity, or wholeness. I used to be a Latin teacher votes. That's awesome. And in the ID we talked about integration. So it's all kind of like a fitting

Gordon Brewer
name. That's awesome. That's awesome. Well, Carolyn, under gotta be respectful of your time, and I'm so glad we connected. Well, yeah, we'll have links in the show notes in the show summary for everybody to connect with you easily and that sort of thing. So any parting thoughts before we kind of close things down here?

Carolyn Solo
Just that I think intensives are kind of the way of the future to some degree, I think people really want them and the word is getting out. And you can do an intensive with whatever modality you use. I mean, think about Freud and psychoanalysis, right? So I think, if it's something you feel like you have the capacity for and the bandwidth for it's totally worth exploring. And also don't be afraid of dissociation takeaways.

Gordon Brewer
Right, right. Well, that's great. That's great. Well, Carolyn, I hope we can have another conversation here soon. Yeah, and I'm so glad you are with me on this journey.

Carolyn Solo
Yeah. Thank you so much.