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DR. CURTIS MATTSON: You know, I like working with people. I love the human element. And to me, that’s what drew me away from medicine and toward psychology.
RANDY: This morning on Sense of Community you’ll meet a “healer” who is not a medical doctor—he doesn’t “heal” with his hands or by prescribing medications. In fact, he doesn’t heal physical wounds at all, but rather helps lead his clients through the process of healing their psychological and emotional “wounds.” He is Dr. Curtis Mattson, who works in clinical assessment and therapy at the Burrell Center in Springfield. He’s a Springfield native, did his undergraduate work, majoring in psychology, at University of Missouri in Columbia. He returned to Springfield for grad school at the Forest Institute; did his doctorate-level internship with the Federal Bureau of Prisons facility near Tampa, Florida; and spent two years in post-doctoral work in Ohio before returning to Springfield less than a year ago. He came to the Burrell system after spending a brief time in private practice. And he teaches “Objective Assessment” at the Forest Institute. Dr. Mattson tells how he got into the field of psychology.
DR. MATTSON: I got into it about my sophomore year. I actually started out as pre-med, and realized that I didn’t like staying up all night studying genetic diagrams! And so for me, that was kind of the end of it. And then starting my sophomore year is when I went into psychology.
RANDY: Right before his junior year at MU Dr. Mattson did a summer internship with the “Shock Incarceration” program at the Boonville (MO) Medium Security prison… and had a revelation.
DR.MATTSON: There really wasn’t a big difference between the guys in Shock Incarceration and the problems that some of the people deal with every day. And I had kind of always placed the incarcerated individuals in this different compartment, the way that I looked at them, as opposed to an individual person who might come off the streets for therapy. And for me, that was kind of that moment of—I really enjoy helping people.
There are two different ways to approach working with the prison population that I’ve found. The first is: there is a lot of crisis management. You have a lot of guys who are either having difficulty coming in off the streets, adjusting to prison life; or, once they have family members start to get sick or they realize they’re missing kids’ birthdays---and that really starts to build up. And they run into those situations and they don’t know how to handle it.
The other thing—and this is one of the things that actually drew me to the field of correctional psychology or even forensics is—in terms of those long-term therapy cases like I might see here at Burrell, even in prison the guys deal with the same issues of fear, and rejection and depression, and just as many negative thoughts and problematic emotions as people that come in off the streets.
RANDY: Do you deal with any of the prison population around here now?
DR. MATTSON: I’m not currently. You know, it’s not something I would be opposed to working with in some capacity in the future. And that’s the nice thing about being here: I’m allowed to tailor some of the things that we do, within guidelines. But I would certainly be up for doing it in the future.
RANDY: At Burrell, Dr. Mattson concentrates in both clinical assessment and therapy.
DR. MATTSON: When we talk about “clinical assessment,” generally what I’m looking at is, someone is going to come in, we’re going to do a brief interview, and then it’s just basically testing that’s going to kind of give us some variables that describe their personality. There’s not a lot of rapport that you build with the client—you need to, obviously, develop some, but you don’t develop the relationship with the client like you would during therapy.
RANDY: You’re just doing an initial interview, basically.
DR. MATTSON: Exactly, with a little bit of testing on top—you know, things that are going to help us to find personality structure and things like that.
RANDY: So then, from there they go on to a therapist.
DR. MATTSON: Exactly. And the evaluation outcome will result in treatment recommendations that we would then send to their medical doctor (or) their psychologist, to help them tailor treatment in response to our findings.
And then with “therapy,” what we’re talking about is what people generally think or when they think of going to a psychologist, where you come in, we meet for an hour—hopefully every week—and we talk about things that are immediately going on in their life… but more specifically, how those things that re happening now have been influenced by what’s gone on in the past.
RANDY: So you’re doing both the “pre” and the therapy at this point?
DR. MATTSON: Yeah, and I wouldn’t do it on the same client. So if my client comes in that I referred for testing, somebody else would do the testing, and then send (the results) back (to me)—whereas someone else here down the hall, if they saw someone and referred for testing, they might come to me and I would do the testing and then send it back. It’s just a way of keeping the boundaries there, and it’s all tied up with the ethical obligations that we have. But yeah, I kind of do both sides of it.
RANDY: Is there anything you particularly specialize in when you’re working on the “therapist” side of the ledger?
DR. MATTSON: I generally come from a cognitive and behavioral background. A lot of people will refer to it as “CBT”-- just “cognitive behavioral therapy.” And it’s this idea that our thoughts help create our feelings, and the idea that if we can change around a person’s thoughts, if we can understand the process that gets you thinking in a certain way, then we can change the resultant feelings… just because feelings are hard to change. I mean, there is sadness in life, there is stress, there is anger—those feelings exist. It’s about getting people to kind of reprocess how they approach those situations. Generally, what I see right now is kind of a broad range—so I have everything from pretty severe mental illness to more characterological issues. So really, right now I see the gamut. I see mainly adults; I have a few adolescent clients. But for the most part I deal with adults and geriatric populations.
RANDY: IS the approach markedly different with adolescents vs. adult patients?
DR. MATTSON: Well, at least from what I’ve discovered with the adolescent-- and this is just my experience—but there is a little bit of difference in that, a lot of times the kids…. You can work with them quite a bit in treatment… and as soon as they leave your office and go home with Mom, Dad, caretaker, whoever it is, you always kind of run this risk, and you worry about it before the next session, of “How much of what we worked on is potentially being undone with their environment, with their surroundings that got them to that point?”
RANDY: Of course, that can happen with adults too.
DR. MATTSON: Absolutely. The difficulty is, with kids, they are not always in control of their environment like an adult may be. So there are some things that you work with, with the adolescents that I’ve had, that you know, you just have to realize that there are factors that they’re going to go home and have absolutely no control over.
RANDY: There has historically been a lot of debate about the efficacy of psychotherapy, and which forms of therapy are more effective or less effective. Bruce Wampold wrote an entire book on the subject a decade ago called The Great Psychotherapy Debate. He concluded that: yes, therapy is effective, and the methodology doesn’t matter. More important are the therapist’s belief in the methods he or she uses, and the rapport and relationship the therapist is able to build with the client. Dr. Mattson weighed in on this subject.
DR. MATTSON: There’s a big push for “evidence-based” practice right now. And “evidence based” practices are those practices that have been shown through the research, and through different means, to be effective in dealing with either specific classes of disorders, or with clients in general. You know, I think one of the main problems why no one’s really been able to come out with a definitive study that says, “Here is THE therapy that works!” is—the exciting part of psychology, (which) is the “human element.”
RANDY: Everybody’s different.
DR. MATTSON: Everybody has a “problem,” but really, nobody’s problem is exactly the same (as someone else’s). So there are certain types of treatment that have been shown to be effective with certain things. But to say that one is obviously better than the other—I don’t necessarily agree with (that). And the biggest factor to me is how a therapist can relate to their client. And a lot of clients feel like they don’t have a lot of power.
RANDY: People entering therapy for the first time often have unrealistic expectations—or don’t know what they hope to achieve.
DR. MATTSON: Clients will come in either expecting that “I’m never gonna be sad again” or “I’m never gonna be angry again”—
RANDY: Good luck with that!!
DR. MATTSON: --and they don’t really have this realistic idea that those emotions are a part of life. Then you have the other client, when you ask “What do you expect (out of therapy)?” and they say things like “I don’t know,” because they’ve never really been given an opportunity to take part in their treatment. And you’d be surprised how much just asking a question like that can influence the client’s perception of how helpful treatment is going to be. Generally, working with clients now, I think what they want to hear is, “This is going to be a collaborative relationship.” If they feel like they have a voice, I’ve found that, in general, I get people to come back more often; I get fewer no-shows once people actually come in, and I feel like clients work harder. I find that people do the things that we work on in treatment more outside of (the office) because they feel like, “I’m doing this because I’ve been allowed to have a say in what happens in treatment.” So to me that client-therapist relationship, and building that rapport, is by far the biggest individual factor.
RANDY: He says one of the toughest things to learn in this profession is when to dismiss a client from therapy.
DR. MATTSON: You cut it off when the client is clearly not benefiting anymore, but exactly when you decide, as the therapist, to draw that line? I mean, that’s kind of the million-dollar question. You know, if the client’s “ready,” and I’m not seeing it, it’s going to keep coming up until it “dings” in my head that, “Hey, they’re ready!”
RANDY: Ultimately, what do you hope to accomplish in the field?
DR. MATTSON: You know, ultimately I’d like to be in a place where I feel happy with the mark that I’ve left on the world in helping people achieve their potential. That’s going to mean that I’m “successful.”