Imagery rescripting & reprocessing therapy (with Samantha Duroska)

[00:00:05] Bronwyn: Hey, mental workers. You're listening to the Mental Work podcast, the podcast about working in mental health for early career mental health workers. I'm your host, Bronwyn Milkins, and today we are talking about moving to Australia to practice psychology and imagery, rescripting and reprocessing therapy. It's a mouthful and they seem unrelated, but as we'll see in this episode, they are very much tied together. Here to help us out is our wonderful new guest, Samantha Duroska. Hi Samantha.

[00:00:30] Samantha: Hi Bron. Thanks for having me.

[00:00:33] Bronwyn: Could you please start us off by telling listeners who you are and what your non-work passion is?

[00:00:38] Samantha: Yes, sure. So my name is Samantha Duroska and I'm a clinical psychologist and Board approved supervisor and the Director of Reprocess Psychology, which is my private practice, um, where focus on Imma imagery scripting and reprocessing therapy.

My non-work passion, um, is spending time outdoors, going to some of the beautiful beaches in Australia, going for a hike, um, going camping. But I also like playing the cello. Um, and as I'm German, I also got into bread making because I really do miss German bread.

[00:01:13] Bronwyn: Uh, is it different to Australian bread?

[00:01:16] Samantha: It is quite different. Yeah, I think, I mean, you can get really good bread here, um, from like good bakeries, like good sourdough bread, but I feel like the variety is bigger in Germany, it's quite dense bread at times. Lots of seeds in it. So, um, yeah, just trying to learn some skills and find the best recipe for doing that at at home.

[00:01:38] Bronwyn: Wow, that's so cool. It sounds like my kind of bread, because the only bread that I know that's German is pumper nickel, which I really like.

[00:01:44] Samantha: That's really, really dense. That's true!

[00:01:46] Bronwyn: Yeah.

[00:01:47] Samantha: Yeah.

[00:01:48] Bronwyn: I mean like I don't, it's not my main bread, but like I do enjoy it.

[00:01:52] Samantha: yeah. It's delicious. That's right. Yeah,

[00:01:55] Bronwyn: No, and Australia is so beautiful to be outdoors in. I find that a lot of psychologists often like being outdoors because our work is so indoors as well.

[00:02:04] Samantha: That's true. It's so, so restorative to be outside in nature.

[00:02:08] Bronwyn: Yeah, I totally agree. And so we've brought you on the podcast today because we're talking a little bit about your journey because you moved from Germany to Australia to become registered here. Is that right?

[00:02:20] Samantha: That's right.

[00:02:22] Bronwyn: Could you take us a bit through what motivated you to move internationally to Australia, and then what the process was like of undertaking your registration?

[00:02:30] Samantha: Yes, sure. So, um, to be honest, I never really envisioned myself, um, moving to Australia. It kind of fell into place because my partner is Aussie German. And we spent a couple of years together overseas and then he brought up the idea of moving to Australia. And I thought, well, yeah, actually, why not? Let's just do it.

Um, and then I started looking into it. I spent a lot of time, um, looking at the AHPRA webpage to understand what the process will look like. Started gathering heaps of documents, getting them certified and translated since they were in German and in French. Then eventually AHPRA, approved me as a provisional psychologist and I had to work under supervision for 12 weeks and I had to set the national psychology exam.

[00:03:21] Bronwyn: Wow. What a, that sounds like a huge administrative load. Like first off, getting all your transcripts, getting all the documentation, getting them translated, and I imagine certified as well. How difficult was that for you?

[00:03:33] Samantha: It was really nerve wracking, like I felt like I'm doing another degree, really?

[00:03:38] Bronwyn: Yeah.

[00:03:39] Samantha: It was really intense. It sounds so smooth. You tell people, yeah, I just moved here and got everything like transferred and I am a clinical psych now. But it's a lot of work and effort that goes into that.

[00:03:50] Bronwyn: Yeah, totally. And what was it like sitting the national psychology exam? Like, uh, did you pass, first try? Was it a bit harder? Was it okay?

[00:04:01] Samantha: Um, I did pass first try. Um, and I was really happy that it worked out because it's such a weird exam.

[00:04:10] Bronwyn: You think?

[00:04:11] Samantha: I, I thought, like, I felt like they're almost like trick questions and really unusual ones having to memorize different scores from tests. Like that's not really helpful knowledge to know. It was quite different to the test I had to do in Germany to become registered.

[00:04:27] Bronwyn: What was it like in general Germany? Just curious, like what was the exam like?

[00:04:32] Samantha: They asked for more in-depth clinical knowledge in the exam, but the system is also very different, um, because you do the national psychology exam in Germany once you become fully registered, but you only become fully registered to be a clinical psych. So maybe that's just a different system, um, whereas here, like I think every psychologist, even if they're not clinical or they don't want to be clinical psychologist, they have to sit the same exam right? So I found there's a different, um, yeah. They ask for different skillset almost.

[00:05:06] Bronwyn: Yeah, it's such a, you're so right because I'm just looking back, thinking back to when I did the exam and you just reminded me of like how confusing the questions can be and you're just like, it seems contradictory here, what they are asking me, what is actually being asked of me. It's just really hard.

But yeah, you're right. It's... So for psychologists who gain general registration, who go through the four plus two or the five plus one path thread, then they have to do this exam. But those who do the two year masters do not have to do the exam. but most people need to do the exam.

[00:05:37] Samantha: Yeah. Yeah, it's quite painful. Um, like normally enjoys it, right? It's not a pleasant experience.

[00:05:43] Bronwyn: Yeah. Yeah. I don't think anybody looks back on it fondly. Yeah. Oh, what a time. I'd love to do the exam again!

[00:05:51] Samantha: Yeah.

[00:05:52] Bronwyn: Um, we could talk about like your boldness and being like, I'm just gonna move to a different country. Like I think that is pretty bold, but you sound like you're pretty self-assured and confident.

[00:06:02] Samantha: Yeah, like I was like, I'm really happy here now. Like obviously it's a huge process and also I've never been to Australia before I moved here, so it was a big adjustment, um, and with lots ups and downs. Um, so I guess it's pretty, pretty normal. It's, it's a big challenge, but today I feel pretty settled again. Um, and also pretty privileged, uh, and lucky that it was as easy as that. Like I'm a permanent resident now. I also applied for a skilled visa. I can practice as a clinical psychologist, so I'm really grateful for that as well.

[00:06:36] Bronwyn: Well, congratulations. Like that can be really, really hard in a long journey.

[00:06:41] Samantha: Yeah, thanks.

[00:06:42] Bronwyn: Yeah. And so, I mean, you've got your own practice here now. Is that as a solo private practitioner or have you got contractors or employees?

[00:06:50] Samantha: No, it's just me for now. Yeah. Yeah. It's just me focusing on my own clients. Um, that's what I enjoy most to keep it very simple and straightforward. Yeah.

[00:06:58] Bronwyn: Mm. And had you had a business overseas or was this your first go at it?

[00:07:03] Samantha: I did have my own private practice in Germany as well, and I think I knew that's what I kind of worked best in. That's the setting I enjoy the most. So it was also a goal of mine to work towards that at first. Um, though I worked as a contractor in the private practice to get some supervision to get familiar, um, with the Australian health system. And then I felt confident enough to open my own private practice again, um, to go back to the same level of independence that I was used to. Um, so yeah, right now I feel really, really happy running my own business again.

[00:07:41] Bronwyn: Oh, great. Fantastic. And you mentioned the health system in Australia. I'm wondering whether that was a key challenge for you as well, to work out the differences, say in Medicare as well.

[00:07:52] Samantha: Yes, for sure. Like, um, you know, on one hand I love the idea of universal healthcare. On the other, like, I struggle to wrap my head around how there are only 10 rebate sessions per year. How does, how is that supposed to work, right? I still don't really, maybe it just doesn't, it's not working. Um, but in Germany, clients can access as many therapy sessions as they need and they are fully covered, um...

[00:08:22] Bronwyn: Well that sounds like, how it should be.

[00:08:26] Samantha: Yeah, so that's really a luxury I think, uh, and really great to have. Wait times are super long though, so I guess that's another consequence of it. But therapy of around 30 sessions is considered shorter term there.

[00:08:39] Bronwyn: Yeah, it's, it's so nuts. I think you've hit the nail on the head there, which is that I don't think anybody is like 10 sessions is adequate unless you're doing like the shortest or short term therapy.

[00:08:50] Samantha: But yeah, I, I, I don't know, you know, like I had some clients they would see me for up to two years and attend maybe 80 sessions. 80, and they wouldn't need to pay anything for it.

[00:09:03] Bronwyn: Ah, that'd be so good.

[00:09:04] Samantha: Yeah, like you can really. Do good work and sustainable change and help them. Um, whereas here it's often more like patching things up and, and sessions get spread out throughout the year, so it's hard to really get going and have a good process. Um, and then only really privileged people can access mental health healthcare services in Australia.

[00:09:28] Bronwyn: Yeah, it's really sad. And yeah, again, I completely agree with you. It's either we're patching things up and then the person without the 10 sessions gets worse in the meantime, then they come back again the next year. Um, or we're spreading things out so we never get that momentum needed to make the changes that people wanna see in their lives.

[00:09:47] Samantha: Yeah, exactly. And you know, I also think it has a massive impact on psychologists. Like I can't imagine how hard it must be for early career psychologists to try to help clients within such limited amount of sessions. That's just a lot of pressure. So I really feel for both clients and practitioners here.

[00:10:06] Bronwyn: Yeah. Me too. Yeah. It is a really sad state. Yeah. I always wish, I wish that we could go to that German model. It sounds like heaven. It's like, wow, people can get the healthcare that they need to help them sustain and make changes. That sounds great.

[00:10:19] Samantha: Yeah, that's how it should be. Right? I would say it also costs a lot of money. Like there's lots more taxes and stuff to pay, but then you get this, um, really great, um, mental or general like health services in general. Um, and you, you get help and it doesn't really depend on how much money you earn.

[00:10:40] Bronwyn: Which is how it should be as well. And like people who have mental health problems might be financially disadvantaged or vulnerable, so then they can get the help that they need to.

[00:10:48] Samantha: That's kind of painful, um, having to adjust to, to having just a different setting and wanting to see clients more often to help them better, but knowing at the same time, like I can't put more financial stress on them either by making them come in more often if they can't afford it. Um, so it's a, just money plays a big role in therapy here, whereas that's a topic I would never need to discuss with my clients in Germany.

[00:11:12] Bronwyn: I used to work in a service where we had free sessions. It was government funded, um, for up to six sessions. There's still not many sessions, but I still didn't need to think about money. Um, and it was really good not having to think about money and spacing out sessions. I could just be like, we're gonna do this amount of sessions and then moving into private practice and having that just at the back of my mind for every client. It, it actually does weigh pretty heavily over time.

[00:11:37] Samantha: It does, yeah. And you know, when I trained, my supervisors, they would tell me, you won't do any therapy before the ninth session because you have up to eight sessions for assessment only, and then the therapy is supposed to start. But those eight sessions, they're just to get your formulation right, to get to know the client, to assess it properly.

So you have like, a lot of time, right? Like if you did not ask a question in the first session, you have many more sessions to ask them. Whereas see, you have to kind of hit the ground running and get going pretty quickly.

[00:12:14] Bronwyn: You do? Wow. That sounds like a luxury as well. Like that would've alleviated so much pressure for me, because literally I also used to work in another service where it was expected that you would do your assessment in session one, and then only if you had really crucial questions to ask in session two further assessment questions, would you ask them at the top and then you're hitting the ground running exactly as you say. So it's one session for assessment and that put a lot of pressure on me.

That sounds quite nice. Having eight sessions for formulation assessment. It's what you need, really.

[00:12:43] Samantha: It's, it's so hard, and I think once you get more experience, maybe you, you have enough time in one or two sessions to do an assessment, right? Like you, you have more experience and you see things more clearly and quicker, and you ask different questions. But when you first start out, it's just so overwhelming.

[00:13:01] Bronwyn: It is absolutely, and it's so hard to tease things out and it's like, oh, this person is telling me about this family. How do I interpret that? How do I work that in into what they're coming to see me for? How do I make sense of this? It's a lot of questioning going on for yourself.

[00:13:15] Samantha: Yeah, it is. It's, yeah... So I really feel for Australian practitioners and I can't really imagine training here, but I'm very glad to be practicing here now. And I think it's just an adjustment, um, to having less sessions, um, and lower frequency. Yeah.

[00:13:30] Bronwyn: Yeah, it does sound like an adjustment. And I guess one other thing that we wanted to talk about today, which is perhaps a difference between therapeutic approaches in Germany compared to Australia, is that you mentioned to me that imagery rescripting reprocessing therapy is quite common in Germany. Is that right?

[00:13:48] Samantha: Yes, it is. It's quite common and most psychologists would know about it or, or use it in their, uh, sessions. Um. But I, yeah, moved to Australia and I realized, well, no one really knows about it. It's not very common. Um, there's almost no content in English either, so it's really hard to kind of train in it, um, or just access any knowledge about, it's quite baffling really.

[00:14:16] Bronwyn: Yeah, literally the only time I've come across it is because I did a deep dive into social anxiety, and I remember reading an article about imagery rescipting reprocessing therapy for social anxiety for people who have had like bullying experiences that.

[00:14:28] Samantha: Yeah. Ah, interesting. There you go. Interesting.

[00:14:32] Bronwyn: But other than that, I never heard of it. Never knew it existed. And so maybe for listeners who are unfamiliar with it, could you please explain what it is?

[00:14:41] Samantha: Yes, of course. So, imagery, rescripting and reprocessing therapy, in short IRRT, was originally developed in the nineties, um, to help people who experienced childhood sexual abuse and physical abuse. Um, and this therapy really helped them to deal with flashbacks and nightmares. Um, and they actually stopped.

And then over time, psychologists realized how versatile this method really is. So today it's been used for social anxiety, but also for trauma, for grief, depression, anxiety and personality disorders, so it's no longer tied to a certain diagnosis. Um, it's more a tool that you can, uh, use for ulcer assessment and to help clients access emotions from a different angle, like a different access point, um, to understand what their inner emotional landscape might look like. And IRRT also offers a unique approach to inner child work to help people improve their ability to self-soothe.

[00:15:48] Bronwyn: And so what does it look like? Like, uh, yeah. How does it work?

[00:15:53] Samantha: Yeah. Yeah, it's quite hard to imagine, right? So obviously it's imagery based. You work with imagery. I think most people know what that might look like. Um, and there is a protocol on how to do that. And different protocols, depending on the issue really, or what you're trying to look at, and the language in those protocols is very nuanced, um. because IRRT is based on this value of being Socratic, meaning I as a practitioner will only facilitate this imagery process, but I won't insert any of my own ideas or content into it. So I think that's a difference to other approaches of imagery work.

[00:16:34] Bronwyn: So like let's say that a client might be filtering out positive information, only focusing on the negative, and from a CBT perspective, you would be like, oh, the cognitive distortion here is filtering, and you might try and work with that. In IRRT you don't do that.

[00:16:49] Samantha: I would guide the client through the imagery, but I wouldn't say, oh, I think he only noticed the negative things here, so I would never correct him. I would maybe mention that as an OB observation afterwards and to see what. Their thoughts are about it, and maybe even record the session so that they can listen in again and kind of reflect back on it and be like, ah, true. And then notice their distortion themselves. So it's more like this guiding. It's not like I have all the wisdom and I know what to do here, and you should be doing A, B, C to feel better. It's more like, well. Where do you get stuck? Let's move through this process and discover new things that we might not be able to access just by talking about it in our sessions and being quite cognitive while doing that.

[00:17:37] Bronwyn: So the therapist approach, it sounds like it's non-directive, like pretty curious, helping the client, uh, be curious about their inner world?

You.

[00:17:45] Samantha: That's right. Yeah. Like it's, it's the client's process. We, as psychologists, we don't need to understand everything quite yet. It's their process. We move through it, we trust the process, and then we can, afterwards, we can maybe share some interpretations with our clients and see if they resonate. Maybe they won't. And that's it really. Like, it's not about me saying, oh, you should be saying this to this person in your imagery, and to encourage them to say this specific thing. So I think that's, that's the main difference. And also I think quite helpful for clients because often they might come up with something completely different from what I would envision them doing, right?

So to really, it's sometimes quite hard to hold back as a, as a therapist and be like. Okay. I'm not gonna say anything. I just, I'm just gonna resist putting my own ideas in there, and it's my job to just facilitate it and hold the space for them.

[00:18:44] Bronwyn: Yeah. It's so interesting as you're talking about that I'm like, relating to that urge to try and insert my own things into imagery. It's like I might be like, oh, I think you could use a hug right now. Like in the imagery, and the client's like, I wanna eat ice cream. And I'm like, okay. Yeah. And I'm like, and I'm like, no, you need a hug. But it's so hard to, like, hold back from that.

[00:19:07] Samantha: Yeah. I think you can really notice how impatient we can get, right? Like if we wanna get a good result for the client and move forward. But to really sit back and sit tight and let them do their own work in their own pace and find their own solution, which I think is much more sustainable than encouraging them to do something. And then they might feel maybe forced to do something even though it doesn't feel right. And it's not the effect, or not the, it's not, it's not the pro- progress or process that they needed.

[00:19:37] Bronwyn: Yeah, absolutely. And I think one aspect that I wanted to pick up on as well, because I mentioned off air too, that I'm a certified schema therapist, so I use imagery re scripting and schema therapy, and I just wanted to check if it's similar in this way.

So one way that I might use imagery re scripting and schema therapy is that I get the client to go into an image as a younger version of themselves, and then I get them to explore the image from the perspective of their young child self. And then I might get an adult version or a current version of them to go into the image and provide what the younger version of themselves needs.

And so from a schema perspective, that helps us identify what the younger child missed out on and what they need and it helps them to reparent themselves. So that's the schema language of that and help them self soothe. And I just wanted to check, is that similar to IRRT or is there a difference?

[00:20:27] Samantha: Um, it can be similar. So when you look at traumatic events, it would be a similar script, I think. So, um, in IRRT there are three steps. The first step would be the client recalls the traumatic event and relives it. So that's the, the imagery part.

Um, and then the scripting part starts where. The adult self would enter the scene, for example, and confront and disempower the perpetrator. Then again, it's Socratic, right? Like I just guide them through it. That's where the language is quite, um, nuanced, um, to not put any content and it was quite hard at times not to influence the, the progress while still holding the space. So to be quite neutral in what, what we are saying and also to deepen the emotional experience. Um, so that's step two.

Um, and then in step three, they would as well, um, soothe their past self and provide what they need and what their intuition might tell them. What then often happens, and maybe. That's also, uh, a bit different is that sometimes clients then enter a different kind of conversation, which no longer has anything to do with the specific situation.

[00:21:47] Bronwyn: Interesting.

[00:21:48] Samantha: So that's where IRRT says they also do separate in a child work., where they work with the metaphorical child instead of the biographical child. So I think it's quite unique because it's not about, not depending on the situation and the protocol, but it's not always about the actual situation back then. Sometimes it can be about connecting with your inner child today. So, so it's more of a, of a metaphor.

[00:22:15] Bronwyn: That is unique because in my training for schema, after we've got the corrective emotional experience that the adult has given the child, I was told in my training to cut it off. Okay. And we exit the image. So we don't have that space like you just mentioned, to go on to a different scenario that might be unrelated.

[00:22:34] Samantha: Yeah. And, and like the, the founder of IRRT says he did not, um, how did he say it? He did not invent this method, he found it because, doing this work with, um, trauma patients or people with PTSD, he just noticed at the end they often enter a different, different area, different scene, and there's like some, like some deeper conversations with themselves that is detached from the actual traumatic event.

And then they started doing more inner child work and used that as a tool in itself to deepen this, this experience. So we wouldn't cut it off. We would see like, is there anything else, like what else comes up? Like once now we might feel safe and secure. Is there any, any impulse to do anything or say anything? So it's completely open.

And also in IRRT, there's no goal. Why then you say you reach a certain emotional goal in imagery scripting, we wouldn't have any specific goal really for a client. I think that's maybe also what makes it a bit more relaxed for clients and practitioners. Because there's nothing you need to achieve. There's nothing specific you need to prove or show. It's more of an exploration and being curious and taking your time, which doesn't mean it takes longer, I don't think it takes longer than doing it guided, but it's just finding their natural pace to access certain emotions or to understand certain things they couldn't previously understand.

[00:24:08] Bronwyn: Yeah, that sounds nice as well because in schema it's definitely goal focus. So the goal of the imagery rescript might be that I really want the client to develop further self-compassion for themselves or develop more courage, um, or to use their wise part of themselves to draw them out in this situation. Um, so yeah. That's really nice. It's exploratory. It's really the client, yeah, sorting out and having a look inside themselves.

[00:24:33] Samantha: Yeah. And you know, previously I did do schema therapy with my clients a couple of years ago, and it felt really good. Like, I really like this aspect of encouraging them like, let's do this or say this and get going, right? Like it's really, um, empowering to be able to do that. So. I get that.

But then again, it's about our clients and sometimes I thought, well, maybe it's more sustainable to actually hold back and let them do the work to find their, their own words, their own actions, instead of kind of giving them the solution. Then they end up doing it, but there's still something else, maybe. Like quite often you can be very surprised what people come up with.

[00:25:17] Bronwyn: Yeah, absolutely. Well, I think it's very, um, a very complimentary to the EMDR model, actually like the AAP model, which says that people who are traumatized, they have what's already in them to heal and EMDR sometimes is, is facilitating that inner healing, but they're capable of doing that themselves. And sometimes we have to help remove those blocks. But otherwise, like the brain can heal itself is the kind of theoretical basis.

[00:25:42] Samantha: Exactly. It's, it's the same approach. It's similar. Yeah. It's like the client can be trusted, that they can find their own path. We also don't need to protect them from the worst parts of the experience.

[00:25:54] Bronwyn: interesting.

[00:25:55] Samantha: They're able to face it, they're able to work through and reprocess it, which is the first part, right? Like reprocess things and then re script things if they need with scripting.

Um, so yeah, clients are very capable and they always carry trauma around with them. Like it's always there. So we don't need to protect them in our sessions and stabilize them... Stabilize them for a long time. They're quite resilient, if you think about it.

So, um, yeah, it's quite, it's a quite empowering technique to use, and that's what most clients say after a session. They're like, oh, it was more intense than I thought, but I feel lighter in some way. I feel more empowered. Uh, and it felt pretty, pretty good actually. So quite surprised, like how different they feel about this experience now.

[00:26:46] Bronwyn: Yeah, I do resonate with that as well, like with the schema and when we use imagery re scripting, I usually tell clients like it's simultaneously, um, the most emotionally intense thing that we'll probably do in therapy together, but it's also usually the most rewarding, um, in terms of like that emotional lightness. And people are just like, wow, I just think and feel differently about this.

[00:27:07] Samantha: Yeah. And it feels so real, right? Like it's, it's just imagery work. It's just in our imagination. But it's so impressive how real it is and what, like it provides real change for clients. So it's such a powerful tool.

And when I first discovered it, I was like, oh wow, like. That was the missing piece. I had no idea there was a missing piece. But now I feel like I have a complete toolkit and I can use imagery sessions and kind of enhance their progress or understand things together with them. Like if we get stuck to kind of say, oh, let's use a different access point to get to the core of this. Um, so I think often we might get stuck in sessions by just talking about things.

[00:27:53] Bronwyn: Yeah.

[00:27:54] Samantha: And instead we have to get uncomfortable, do some imagery work, for example, and really explore what is this about? Like why doesn't it help to talk about it in therapy or maybe with friends and family, and it's still an issue. Like what exactly is it?

[00:28:09] Bronwyn: Yeah, it's so true. I just like, um, whenever I do my schema supervision, sometimes I go in a bit guiltily because I'm like, to my supervisor, I've just been talking too much rather than doing the techniques. I'm sorry. And I don't, because it's uncomfortable for me a little bit to sit with that discomfort. And so, but it's so much easier to talk and I'm like, I'm sorry, I've been talking about the things. I'm like, I'll do better. Yeah.

[00:28:37] Samantha: And I think I did a similar thing and that's I think why over time I stopped doing schema therapy, but 'cause I often find myself talking about different modes.

[00:28:47] Bronwyn: Yeah. It's so easy to get stuck in that.

[00:28:50] Samantha: And it's so interesting. It's fascinating and it's a great model and it works so well. Um, but then again, like having used rt, I was like, oh, actually that's all that I need in therapy to plug it in into my sessions. Um, and you can use it with psychodynamic therapy with CBT. Like it works very well. Um, and to kind of enhance the process a bit with it.

[00:29:13] Bronwyn: Yeah, absolutely. So what drew you into specializing, I guess, in this therapy in particular? Like were you drawn to it for, for the reasons you just mentioned, like the missing ingredient or was there something else?

[00:29:25] Samantha: Yeah, I think a supervisor introduced it to me. And then I started reading the books and kind of learned more about it and started using it. And I was really fascinated by it in sessions, but like, oh, now, now we get talking. Now we can see things that we were trying to understand, but we couldn't quite get there just by talking about it. So I was like, really, really, really fascinating. I read all the books and, uh, had supervision on it, did the workshops to kind of learn more about it.

And I think what I love is, um, having a clear structure on how to do it. Having a protocol while still having enough room for creativity and curiosity, um, are really love the Socratic approach as well. Like there's no expectation and I, I don't know the answer and, and to trust the process. To trust the client and to guide them through it. I think that's just a wonderful tool to have both for clients and for practitioners.

Um, and it's, so in some ways it's also so simple. I think maybe that's where I, at some point thought of schema therapy is so bulky and complicated and sometimes I feel like, oh, I just kind of fail at it. Like there are so many different things I should consider. Um, whereas IRRT is very forgiving. Like even if you say, maybe say a question during the imagery work that's not perfectly correct. It doesn't really matter, like it's very forgiving and clients still follow their own path and process. Um, and that's also the attitude of the founders of this technique. Like it doesn't need to be perfect and the clients will find their own way. Like it's just about opening up this room and guiding them through it.

Um, so yeah, I really enjoy using it and I wish that it could be more popular in Australia as well.

[00:31:20] Bronwyn: Yeah, like I said, I've never heard of it, like aside from an article or two or an or a mention in a textbook, but now what is popular in Australia is Schema therapy and EMDR. So I mean, I heard you mention the IRRT is really good for trauma, so it's a trauma modality in itself. Is that right?

[00:31:37] Samantha: It was first developed to help with PTSD, but today it's been used similarly to EMDR and schema therapy for very wide range of issues. Um, and interestingly enough,. Um, there are even clinics in, um, in Germany that specialize in this technique because it works so well and they're mainly focused on trauma. So they're trauma hospitals. So it's really, really popular and very common and well known. And there's also research that shows that it is as effective as EMDR. So the evidence is there. Um, I just think the main downside is that all the literature is in German.

[00:32:17] Bronwyn: That would be, that would be the barrier because I would be like, I'm like, why isn't it more popular? I'm like, why are people learning this? Because it should be, it's like, it should be on parity, if something is just as evidence-based, then we should hear about it. And then I feel like it offers clients more choice and control about the type of treatment they enter when we've got those options available to them. Um, so yeah. Okay. That sucks. 'cause most of us, I mean, if, if all Australians were bilingual and German, it wouldn't be a problem.

[00:32:44] Samantha: Yeah. But you, it's too much to ask for, right? Like you can't accept people to read a book about trauma therapy in German. That's just, um, quite hard.

[00:32:53] Bronwyn: That's such a shame though, that it's um, that it might be inaccessible in that way. Given that we've got Schema therapy and EMDR, and I think a lot of early career psychologists and a lot of early career practitioners feel quite pressured to specialize in these therapies, and I wondered what your perspective on this was.

[00:33:10] Samantha: Yeah. I noticed that, and I again feel like it's not necessary, right? Like there's enough pressure already on early career psychologists especially. Um, and I would, I would like to tell 'em, you can just take your time. And you can experiment and you can also change your preferred technique if you need to. Um, you also don't need to upskill right away. Like you definitely also don't need to be certified in every other modality just to be qualified enough and to be a good enough therapist.

Like you can delve into some different techniques. Use them, try them out. See what suits you as well, um, and what suits your personality. I think that's also a good burnout prevention to choose something that really suits your own perspective on things that really clicks with you. So don't feel pressured, take your time and explore what else there is besides from schema therapy and EMDR.

[00:34:13] Bronwyn: I think that's such a nice and reassuring perspective to hear because I think a lot of listeners who are early career will definitely resonate with that feeling of pressure to get trained in all the therapies, get them all straight away, um, I gotta be certified in this and this and this. And it's like, you know, speaking from personal experience as well, it just feels like you need more tools in your toolkit straight away.

[00:34:35] Samantha: And from research we know it's not really about having all those different toolkits. We know it's the therapist that makes a difference.

[00:34:42] Bronwyn: So true.

[00:34:42] Samantha: Right. So to kind of... sit tight and remember, you're skilled enough as a registered psychologist. There's no need to spend so much money on those trainings as well. At least it's my point of view. Um, and to just take your time and if you want to specialize and focus on something, go for it. But like you can also take your time and just see what works best for you.

[00:35:07] Bronwyn: Yeah, absolutely. I, I think it's really important as well. So like, for Australian psychologists, we've just gotten these new code of ethics and one of the competencies that's been added is deliberate practice. And I think that's really good because it speaks to what you're saying about like, you can improve how you are as a practitioner by focus on these these skills that you already have, like you don't need to spend $5,000 on the latest, most expensive training.

[00:35:32] Samantha: Exactly. I think that's so important to remember. I guess once you finish uni, you kind of feel like you just keep going, right? Like you chase the next decree, the next certification, but it needs to end at some so you need to sit in your therapy room, slow things down, and feel what is actually going on here, and maybe practice some soft skills as well. Deliberate practice is the perfect example for that to really work. Like small things out step by step instead of buying into all those marketing strategies that you need to straight away.

And also, maybe it's also quite competitive between psychologists and you might feel like you have to, because otherwise they all have their certifications and I will miss out on it, but I don't think it's true.

[00:36:23] Bronwyn: Yeah, it, you're right. I think there can be a perception of pressure that maybe, maybe doesn't necessarily match up to reality. And I know from like my own personal experience, like early on in my career, I saw a huge leap I think in my practice when I focused a lot on attuning with my clients.

So something that I really tried to focus on was trying to get on the same page with my clients about what was happening for them and what they hoped to get outta therapy and just really getting into their inner world about what was painful for them and what was making things difficult for them to get to where they wanted to be. And I found that focusing on that, like consistently maybe three to six months, I saw, you know, I didn't learn a single technique, but I just tried to get on the same page and I think I saw massive improvements.

[00:37:08] Samantha: Yeah, and I'm sure your clients felt a difference as well, because there's someone who's actually really listening and tuning in instead of someone thinking about, Hmm, which tool could I use next now? Right.

[00:37:20] Bronwyn: Yeah. 'cause I had so many clients be like, please don't gimme a worksheet. So I was like, okay, I'm just gonna focus on this. Yeah./

[00:37:28] Samantha: I can relate to that. yeah.

[00:37:29] Bronwyn: Was there something in your practice where like you didn't need further training and you were just like, I'm just gonna focus on this like, air quote, soft skill and that really helped you?

[00:37:39] Samantha: Yeah. I think also something like how to start a session, right? Like how to end the session, how to be on time... That's super important and I think maybe more invisible skills that we can't put on our homepage as a shiny fancy therapy technique are just as important as knowing your techniques, because obviously it's just not just about listening, it's also about having enough knowledge and tools. But I think we might need way less tools than we think we need. So to kind of choose the right ones for you and to maybe stick to them for number of months or maybe years, and then to see what else. Is there anything else you struggle with? How could you go about it? But to really slow things down and make things simple.

Like it doesn't need to be complicated. No one wants to go to therapy and do something super complicated, right? Like it needs to be simple both for clients and for practitioners.

[00:38:38] Bronwyn: Yeah, absolutely. Gosh, I bet your supervisors just love your chill approach. It's like, I'll go to Samantha and I feel better about myself.

[00:38:48] Samantha: I hope they do. I hope they do.

[00:38:52] Bronwyn: Do you think that IRRT training could be more accessible in Australia? Like are you working on German translations for us?

[00:38:59] Samantha: I'll say like, I recently started, uh, my first Instagram account to share more insights into IRRT and to make it more popular. And then I hope that the, the books will be published in English sometime soon. I'm not sure when that will be be, but, um, we'll see.

And I guess if enough, um, Australian psychologists are curious about IRT, hopefully I can offer some training in the future. My dream is to build a community of IRT therapists so we can learn from each other and to also make this therapy more accessible for our clients.

[00:39:35] Bronwyn: I think that would be entirely possible because I think like one of the huge shifts to EMDR was, in Australia, I think there was, before EMDR, there was a big movement in prolonged exposure therapy, and then I think we, we all got trained in it. I think I just missed that boat. But before me, I think a lot of people got trained in it.

And then clients don't respond to it very well. They don't really like repeating and repeating again, the precise details of their traumatic events over and over again. And so I think a lot of people went off it and that contributed to the huge swing to EMDR. Um, but like I feel like IRRT could be a good, a good side or like a good accompaniment. Good alternative.

[00:40:16] Samantha: I, I think so too. I think it's, um, it's something that's just missing here. Like it's quite accessible. It's quite straightforward. Should be quite easy to learn as well. Um, so I think that's why I maybe also like, um, IRT it's not as, as bulky or there are less gatekeepers. Um, so yeah, we'll see what the future will bring. Um, and yeah, maybe we'll see a lot more IRRT therapists in the future.

[00:40:46] Bronwyn: Yeah, well do get back in touch with me if you'd ever do training in the future, and I'm happy to promote it. I'd love it to be more accessible as well.

[00:40:54] Samantha: Yeah. Thank you. I'll let you know.

[00:40:56] Bronwyn: Yeah, please do. And Samantha, what do you hope listeners will take away from our conversation today? What would you like to leave them with?

[00:41:03] Samantha: I think I would really like to encourage listeners to find a tool that suits their personality and that they actually enjoy using, like something that clicks with them something. That just feels quite natural to them, because that's so important. Not just for effectiveness for our clients, but also to help prevent burnout in the long run. So that's really important, I think.

Uh, and if everyone, around you is talking about one technique and arriving about it, um, and it doesn't resonate with you, that's completely fine as well, right, to kind of accept that and look into something else. And if RRT sounds like something that might fill a gap in your toolkit, feel free to reach out and see if it's a good fit.

[00:41:47] Bronwyn: Yeah, and if listeners do wanna get in contact with you, Samantha, where can they find you?

[00:41:52] Samantha: So they can find me on my brand new Instagram account, which is called Samantha Duroska. Um, but they're also welcome to send me an email to samantha@reprocesspsychology.com.au or visit my homepage for more information.

[00:42:04] Bronwyn: I'll pop all those links in the show notes and thank you so much, Samantha for being on the podcast. It's been so lovely to have you on. I really enjoyed our chat.

[00:42:11] Samantha: Thanks, me too. It was so much fun. Thank you.

[00:42:14] Bronwyn: Great. And listeners, thank you so much for listening to the Mental Work podcast. If you enjoyed today's episode, do make sure to share it with other people. Chuck it in their ears. It's the best way to get the word out about the podcast. That's a wrap. I'm Bronwyn Milkins. Have a good one, and catch you next time. Bye.