Case Consultation.

 As a clinician, do you ever find yourself unsure of how to best respond in the moment to your client’s difficulties? We all know how common and frustrating this experience is. Oftentimes, we don’t really know what to do, and many therapists attempt to solve this dilemma by “shooting from the hip”: hoping what they say to their clients will be productive.
 
In treating our clients successfully, it’s not only important to have a theory in mind that helps you conceptualize your case, but it’s also crucial to know how to intervene, in the moment, where you can observe the immediate impact of your intervention. Does your client become more defensive when you speak or offer help to them? Or, does the person become more active in session, spontaneous, alive, and insightful? Is the client better able to experience feelings and relinquish automatic habits that perpetuate suffering and problems?

I am trained in an evidenced-based (scientifically researched) psychotherapy technique called ISTDP that helps clients solve the internal problems that keep them from leading their most satisfying, productive lives. I have helped many clients break through internal barriers, such as lack of motivation and difficulty with assertion and learn how to think, feel, and behave differently in a shorter amount of time than with most traditional psychotherapies.

​Currently, I offer individual and group case consultation to psychiatrists, psychologists, licensed marriage and family therapists, licensed clinical social workers, and career counselors. I have taught an all-day introductory workshop on Intensive Short-Term Dynamic Psychotherapy (ISTDP) at Stanford University’s Vaden Counseling Center. This workshop focused on establishing both the conscious and unconscious therapeutic alliance, including how to recognize and intervene effectively with client defenses. Participants in this workshop also learned how to help clients regulate anxiety and approach avoided feelings. The learning and teaching of ISTDP is typically done through lectures, PowerPoint presentations, discussion, experiential exercises, and video demonstrations of work with clients. Participants will initially observe videotape of their teacher and other teachers in ISTDP.

Later, in learning, participants will present their own videotapes. Although many clinicians are initially anxious about videotaping their own work, this method is a more-effective way of knowing what actually transpires moment-by-moment between therapist and client than the therapist’s self-report of what happens in session. The viewing of video tape and the practice of experiential exercises is always done in a safe, supportive and respectful environment. Being able to review the videotapes helps us form a dynamic case conceptualization and understand how your client is responding to the particular interventions you employ.  (continued​→)
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I have done consultation with Diane for more than 10 years. I have found that her obser­va­tions about my clients have opened doors to inter­ven­tions I never would have dreamed of on my own. She sees things in a few min­utes that point out what the most helpful next in­ter­ven­tion should be. Her ded­i­ca­tion to and mastery of ISTDP is obvious and a real resource. At the same time, she has the capacity to inte­grate the best of other models into her work. And through it all her care and com­pas­sion shines through.

— David L. Mineau, Ph.D., MFT

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My approach to helping you with your case is to best support your particular learning needs. For instance, do you need help with getting a clear, mutual understanding of your client's problem? Or, is your client so anxious during session that he/she cannot focus on the content of the problem effectively? Does the client not seem motivated to work on what they tell you they want to accomplish in session? Or, perhaps your own reactions are getting stirred up by a client who may devalue you or your work in session. Some clients make us feel sleepy. Why is this?
 
By understanding the problem you are having in your work with your client as well as the client’s problem, we can support you to do your best counseling with clients and help make the therapeutic enterprise a relationship for real change.

​Learn more about my evidenced-based approaches to treatment.
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If you are looking for a supervisor who is devoted to you and your de­vel­op­ment as well as that of your patients, Diane Byster would be an excellent choice. Diane will create a safe but chal­leng­ing en­vi­ron­ment in which you can stretch and grow, as well as struggle and occa­sion­ally fail. She will be both in­spir­ing and sup­port­ive. Diane is highly trained, bright and com­mitted to clinical ex­cel­lence.
 
— Patricia Coughlin, Ph.D.
     Author, Intensive Short-Term Dynamic Psychotherapy: Theory and Technique
     Author, Maximizing Effectiveness in Dynamic Psychotherapy

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I have worked with Diane Byster for more than seven years. She is per­cep­tive and clear in her case consultation, and always leaves me with a better under­stand­ing of the core dy­nam­ics of a case. She is compassionate and caring in the way she does con­sul­ta­tion — leaving me as the therapist feeling good about the work I’ve done. When she teaches, she prepares pains­tak­ing­ly and effectively illu­mi­nates the points she is teaching.

— Monica Stone, MFT

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Diane provides high-qual­ity super­vision with clin­ical excel­lence and deeply com­pas­sion­ate under­standing for the super­visee and clients. Her inter­ven­tions make beau­ti­ful sense and help me see how to forward client progress in a way that feels like a breath of fresh air to a stuck or con­fused ther­apist super­visee.

— Leslie Auld, LMSW, ACSW

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I have had many super­visors and col­leagues over 25 years of prac­tice in psy­chi­atry. Diane is def­in­itely at the top of the group! She taught and con­sulted with me on many cases — com­pas­sion­ately devel­oping my skills as an ISTDP ther­apist and as the best person I could be in my role as ther­apist. Diane does this through a firm under­standing of theory and tech­nique, but not at the expense of the indi­vid­ual and their hu­man­ity. I highly recom­mend her as a ther­apist, teacher, and super­visor/con­sultant.

— Ronald C. Albucher, M.D.
     Staff Psychiatrist, Vaden Health Center
     Former Director, Coun­seling and Psy­cho­log­ical Services
     Clinical Associate Professor, Depart­ment of Psy­chi­atry, Stanford Uni­ver­sity Medical School

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Supervision with Diane has been really helpful. I was begin­ning to feel dis­cour­aged and burned out in my clin­ical work, and Diane has done a great job of meet­ing me where I’m at and helping me focus on the most im­por­tant fun­da­men­tals of ISTDP. Only five meet­ings in and I feel I’m help­ing my clients much more quickly and deeply.

— Matthew McCall, Psy.D.

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