Me, myself, and I:
The Basics
Renee Hoekstra, Psy.D.
Licensed clinical psychologist, Massachusetts
My Values
I give you the best content I have, including recent trainings and workshops. I keep content fresh and try my hardest to make the skills relevant and flexible to your learning needs. I think of my clients often and blog regularly to provide fresh content to my readers. I’m trying to think “bigger picture” by developing online programs for clients who are unable to drive to my office. I obtain consultation and I participate in online learning programs relevant to my area of practice.
I like to have a sense of who people are in my groups and where they are at- My DBT skills groups are generally small. I want people to feel included and have a sense of belonging, so I try hard to create optimal learning environments. I like to follow up with people on skill acquisition, application, and relevance of material- so feedback and discussion is often part of the groups.
I’ve never met a manipulative client. I believe there are people who behave in ways that are functional despite the fact that such behaviors may not be effective long-term solutions for solving problems. Figuring out why people behave the way they do makes a lot more sense to me than dismissing, blaming, or negatively labeling behavior that may not easily be understood.
I believe that clients can be their own best resources to each other when the setting is structured in such a way that encourages improvements in behavior. I believe clients should be able to receive clear, direction, and immediate feedback about the problems they bring to group; and that the group as a whole can provide insights and information based on experiences beyond what I alone can offer.
I don’t believe that diagnosis defines identity and I do not believe it adequately explains causes of behavior. While clarity about diagnosis may direct me towards certain treatment interventions, I don’t believe having or not having a diagnosis should inhibit or limit people from behavior (or even life!) changes. I really struggle with giving people a diagnosis of a personality disorder because it implies that people have a patterned and fixed way of responding to the world that can not change.
I take risks and I make mistakes. I’ve developed some really good ideas to help clients. I am creative and entrepreneurial and put my group leader “foot” forward when thinking through the implementation of treatments that have good research data for their effectiveness.
My Background
I’ve moved across the universe and back pursuing my education and career path. I’ve lived in 9 different states. I understand what it is like to be new in town and what it is like to be a professional in transition. Having lived in both extremely rural and urban places, I relate to struggles about “fitting in” and have many friendships with persons who are minorities and immigrants. When I finally completed all the steps towards licensure the only jobs that met my training background and interests were in Seattle or New York. I started my practice facing a great deal of discrimination from insurance companies because I was newly licensed.
I’ve worked in comprehensive DBT treatment programs. Not all of my experiences have been positive, and I’ve recognized a lot of pros and cons of what DBT clinicians often refer to as “adherent” treatment. I’ve come to realize that I work best when the clients who need my services find me- and they get better. I’ve worked in a wide range of settings including inpatient, outpatient, and residential eating disorders programs, inpatient psychiatric hospitals, community mental health centers, and crisis lines. My special training in FAP and my strong interest in groups make my services unique.
Having worked on crisis lines and an inpatient psychiatric hospital, I tend to be conservative about advocating intensive levels of care. Marsha Linehan herself has frequently reminded the mental health community no research evidence exists that hospitalization reduces self-harm and suicidal behavior. The clients I work with have to live in the real world- and the stressors, interactions, thoughts, feelings, and people that exist in the real world don’t tend to disappear when people get discharged from hospitals. Hospitalization (which can be a helpful intervention in some circumstances) can become an awfully expensive way of solving problems.
Education
Doctorate of Clinical Psychology/ Psy.D. (2007)
Pacific University, Forest Grove, OR
Master of Arts, Psychology (2001)
Seattle University, Seattle, WA/ Existential-Phenomenological program.
Short summary of relevant clinical training:
- Volunteer position audio taping Marsha Linehan’s individual therapy sessions and consultation team meetings (Spring, 2000)
- Dialectical Behavioral Therapy Seminar Class (Seattle, WA/ September-December 2000) Instructors: Kate Comtois, Ph.D., Andy Elliot, M.D., Marty Hoines, M.D., Amy Wagner, Ph.D., and Tony DuBose, Psy.D.
- Suicide Workshop (Seattle, WA/ Spring 2002). Marsha Linehan, Ph.D.
- Dialectical Behavioral Therapy for Substance Abusers (Portland, OR Spring 2002). Linda Dimeff, Ph.D., and Ruth-Herman Dunn, Ph.D.
- Emotion Regulation (Seattle, WA/ October 2005). Marsha Linehan, Ph.D.
- On-line Learning/ DBT Skills Training (Completed April 2007).
- DBT post-doctoral fellow/Harvard appointment. Massachusetts Mental Health Center (July 2007-June 2008). Supervisor: Dr. Elizabeth Simpson, M.D. (Clinical instructor of psychiatry, Harvard Medical School, DBT Trainer, DBT Director of MMHC).
- Treating Anxiety Disorders in Multi Problem Clients with Borderline Personality Disorder: How, When, and Why to use Exposure Procedures in DBT (Westborough, MA May 2011) Melanie Harned, Ph.D., Kathryn Korslund, Ph.D.
- Member of Practice Ground Learning Community with Kelly Keorner, Ph.D. Online learning community for persons in private practice focusing empirically based treatments. March 2011 to present.
- Functional Analytic Psychotherapy Online Course with Mavis Tsai, Ph.D. and Jonathon Kanter, Ph.D. Jan-Mar 2011
- Ongoing consultation with University of Washington clinical faculty and local DBT-trained clinicians.
Publications:
Hoekstra, R. (2008). Interpersonal process groups redefined: A behavioral conceptualization. International Journal of Behavioral Consultation and Therapy, 4,188-198.
Hoekstra, R., & Tsai, M. (2010). Functional Analytic Psychotherapy for Interpersonal Process Groups. In R. Kohlenberg, M. Tsai, & J. Kanter (Eds.), The Practice of Functional Analytic Psychotherapy, p. 247-260.
Professional presentations:
Hoekstra, R. (November 2009) Functional Analytic Psychotherapy: Thinking in groups. Functional Analytic Psychotherapy (FAP): New Frontiers in Awareness, Courage, Love and Behaviorism. University of Denver, CO.
Hoekstra, R. (November 2009). Borderline personality disorder: Towards understanding, change, and validation. Guest lecturer for undergraduate abnormal psychology class at Emmanuel College, Boston.
Hoekstra, R. (October 2009) Behaviorism: Theory, Application. Guest lecturer for graduate students at Boston University.
Hoekstra, R. (June 2009) The application of functional analytic psychotherapy (FAP) to prevent anti-therapeutic group behavior. Presented at the Northeast Society of Group Psychotherapy conference, Boston.
Hoekstra, R. (March 2011) Making therapy therapeutic with contingent responding. Inservice training for Emerson College Counseling Staff.
Where my work on the application of FAP to group is being presented:
Supercharging CBT with Functional Analytic Psychotherapy, London, March 2010
Association for Behavior Analysis International, San Antonio, TX, May 2010
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