GET TO KNOW ME: AN EXTENDED BIOGRAPHY

I was born and raised in a small town in Northwest GA called Dalton. Dalton is known as the "carpet capital of the world," because, well, we make a LOT of carpet. At one point ~96% of carpets in the US were manufactured in Dalton or by a Dalton-based company. Largely due to the influence of the carpet industry, Dalton became a great place for jobs during recent decades, and, as such, Dalton attracted numerous immigrants, mostly from Mexico and other Central America. In recent censes, Dalton has consistently maintained a majority Hispanic population (46.7% in 2013), followed closely by 42.3% White (non-Hispanic), and then 7.4% Black. Though as a whole things have improved, and though Dalton is by no means a bad place, one unfortunate result of the influx of non-white immigrants into my hometown was that the previous hegemony held by some of the White majority experienced a perceived threat to their well-being, and racial tensions began to develop. Thus, as I grew older during my time in Dalton (0-18 years old), I became increasingly aware of the overt and covert racism that was all too commonplace amongst some (but certainly not all) of the people in my hometown. The culmination of this mixture of overt and covert racism was exemplified recently in a national news story featuring some members of my home community who conducted a "parade" of sorts driving their trucks through town flying the Confederate flag. Most of the people who participated in this parade, in my view, were focused on making a statement of "heritage, not hate," and they hoped to call attention to the positive importance of the Confederate flag to communities from the Deep South; however, one of the unfortunate consequences of these activities was that, instead, it called attention to the relative lack of understanding that many people, including many of those who come from my very own hometown, still have about minority issues and social justice.

The reason I share all of the above is to draw a picture about one of the reasons I ended up in psychology. I learned from an early age that social injustice is real. I saw, throughout my life, social segregation of the non-white race from the White hegemony, and I came to feel that something just wasn't right about this. I thus found myself developing quickly into an advocate of social justice. As I continued to develop through high school, college, and even through graduate school, I developed a heightened awareness of other kinds of social injustices, not just limited to race, but also including socio-economic status, religion, ability (vs. disability), and other forms of privilege. I think it is this awareness of social injustice that led me, although indirectly, and discretely, to pursue psychology in college and graduate school.

I knew early on I wanted to be a therapist. In a similar way as described above, I was fortunate to have an innate gift for empathy, which I further developed through some of the experiences described above, combined with lessons learned from my family, friends, and mentors. This capacity for empathy made me feel early that the best career for me would be one in which I could engage in psychotherapy with others, getting to know them deeply, learning from them, and, with good fortune, helping them enjoy life to the greatest extent possible. I ended up going to college at the University of Evansville, in Evansville, IN, which is a small, private, liberal arts college smack dab in the middle of the Midwest. I loved every minute of it. I was blessed with a wonderful education, met the love of my life, and continued to grow in my exposure to multiculturalism, as I worked closely with international students throughout my time there.

 

 

 

 

 

 

 

 

 

While in college, I landed an internship, and then a job, working first as recreational therapy intern, and then as a psychiatric attendant at a small, approximately 30-40 bed state children's hospital, called the Evansville Psychiatric Children's Center (EPCC). EPCC housed children ages 6-14 years, both male and female, in two, locked units. The children who ended up at EPCC had serious mental illnesses, but, more importantly, all of them had experienced some level of very serious physical, sexual, and/or emotional trauma in their young lives. I learned quickly, in fact, that it was due to these traumas that these children had the symptoms they had, and it was because of these traumas (most often given to them by a parent or other supposedly loving family member) that these children built internal safety barriers to protect themselves from further abuse. In other words, they behaved in ways that made them hard to like, because, to them, being loved meant being hurt! Nonetheless, the more time I spent with these kids, the more I liked them, and I found that my personality was well-suited for making connections with these children who seemed to work so hard to push everyone close to them away. In the end, I made very close connections with these children - I lived with them for 8 hours a day, and some for over a year (typical hospital stay there was 6 months, though some stayed for 12-18). I knew from those experiences that I wanted to continue this work, to connect with traumatized children and to help children overcome mental illness and other adversity.

 

 

 

 

 

 

 

I applied to graduate school with this singular goal in mind, and I was offered the opportunity to study under Helen Benedict, Ph.D. at Baylor University in Waco, TX. Dr. Benedict (now retired) was a nationally renowned expert in childhood trauma and play therapy. She wrote the book chapter on "Object-relations play therapy," which focused on a model of care she developed specifically for treating the often very difficult manifestations of chronic, complex trauma in young children. Under Dr. Benedict, I learned even more about treating and connecting with traumatized children, and I learned about play therapy and all of the richness that play therapy could offer. I also learned about other treatment approaches - evidence-based treatment approaches - and was fortunate that Baylor offered me a varied exposure to numerous theoretical orientations. I found myself intrigued by the integration of these various theories and orientations into effective therapy. The more I learned about EBPs (evidence-based psychotherapies) the more I loved the science that they added to the field, but also the more I grew disillusioned with their non-integrative approach. I found myself feeling that EBPs and manualized therapies, though they had much to offer to the field, fell short of the richness of the art of psychotherapy, which involves a complex process of making connections with clients, evaluating needs, and adapting treatment to fit the needs of any given client. So, as a graduate student, I began to develop, in my mind, an alternative approach to the manualization of psychotherapy, where scientific principles were still followed, in order to lead to better evidence-based practice, but where the "art" of psychotherapy could still be adequately integrated into evidence-based practice. I also found myself disillusioned with the finding that too many children seemed to "drop out" of manualized treatment approaches when applied in the community. Logically, I thought that one reason for this must be that children don't seem to find the process of psychotherapy to be very much fun. And, generally speaking, successful psychotherapy isn't fun. It's work! Hard work! However, I felt like this perhaps did not necessarily need to be the case, and I thought that perhaps psychotherapy, if not fun, could at least be "palatable." Researchers and clinicians often talk about "tolerability" of treatment, but I believe that treatment is likely to work best when it is more than just tolerable, but also palatable. They don't make children's cough syrup taste really good for no reason - it's because kids are more likely to take it if the taste is palatable. The same principle should apply to psychotherapy. Hence, I became interested in increasing palatability by working to figure out how to incorporate the things that kids enjoy, and already do everyday, into the psychotherapeutic enterprise.

 

The model that I eventually came up with ended up (somewhat serendipitously) with a very "buzz-friendly" name - Fantasy-Exposure Life-Narrative Therapy (FELT). FELT became the culmination of all the experiences and interests I just described above. The idea was to develop a model of psychotherapy that could 1) be studied scientifically, 2) be applied widely to a large range of disorders and presentations, 3) tell therapists what characteristics, exactly, most facilitated therapeutic connection and therapeutic change, 4) inform therapists how to adapt their therapeutic approach based on the individualized needs of the client (which could include culture, SES, religion, ability, etc.), and 5) identify (and utilize) what types of play are both palatable to kids and therapeutic at the same time. I have since tested this model in a number of pilot studies, and the results have been extremely promising. Although the full FELT paradigm is too complex to summarize here, the images below demonstrate some of the concepts that can be communicated through play therapy.

 

 

 

 

 

 

 

 

 

Nurturing play can be very important. In the left image, my daughter is playing doctor, and I'm the patient. Through this play, the therapist may highlight that sometimes nurturance can hurt (e.g. shots, parents setting limits, etc.), but the long-term benefits outweigh short-lived pain. The therapist can also demonstrate how to tolerate pain or other unpleasant feelings through active coping (e.g. breathing techniques, singing a favorite song, etc.). In the right image, doctor play is achieved through toy characters. In this case, an anxious child is preparing for a medical procedure. In this scene, the doctor became so overwhelmed by the procedure that he fainted. For this child, the scene was an attempt to process her fear that the doctors would fail in healing her during the procedure. She alleviated this fear by having another doctor (bottom right of image) provide support to the main doctor to keep him from getting overwhelmed. The scene ended after the female doctor helped the male doctor and they both completed the procedure to success. In both cases, children can use play to process normal and/or frightening experiences, and therapists can model proper coping through play.

 

 

 

 

 

 

 

 

After my training (described further in the About Me section of this website), I sought positions working in academic settings, where I could continue to research and refine my FELT approach to play therapy. I interviewed at several universities across the US, but I eventually landed at East Tennessee State University (ETSU), where I served as a full-time, tenure-track faculty member for 3 years. ETSU was an interesting and extremely valuable time in my life. As a faculty member, I grew to love teaching and mentoring students and other developing professionals. At ETSU, I not only worked to further develop FELT, but I expanded my research into other areas. Perhaps what I appreciated most about my position at ETSU was the freedom to pursue whatever research and clinical interests I wanted. So, it was at ETSU that I developed the CAPTVRE research lab, from which this website and Center gets its name. CAPTVRE initially stood for Childhood Anxiety, Play Therapy, and Virtual Reality Environments, and reflected my core research interests of anxiety, play therapy, and digital media. Fairly quickly, though, I moved away from researching anxiety alone and instead began thinking about the development of the Self in childhood. This research area came about in a somewhat interesting way. Because of the nature of my previous research, I was unable to transfer my FELT data from my previous university to ETSU, as doing so would have risked a violation of confidentiality (much of the FELT data were recorded therapy sessions, which are tightly protected by HIPAA law). I needed to get started on research productivity for work, and I did not have my FELT data, and I needed time to prepare to collect new data. So, in the meantime, I began thinking of other research areas. I had been given a graduate student by my department, which was a generous gift for a first-year professor. I sat down with him to look as his previous research and to see where our interests coincided. Interestingly, we eventually both came up with a similar idea. We wanted to study the development of the Self across childhood. Self-development is an important part of FELT, and in my more dynamic, object-relations approach to psychotherapy, how others influence the development of the Self is key. My grad student at the time (Michael Feeney) had done similar research previously in mentorship, and he had worked summers in North Carolina as a mentor for at-risk youth, where his job was to use his mentorship to shape and maximize the development and self-identities of youth. So, together, Mike and I built a massive, multi-year, cross-sequential study exploring the development of Self-Identity in youth ages 6 to 19. I continued this research throughout my time at ETSU, and now, Self-Identity is probably my favorite clinical area not only in my ongoing research but in my clinical work too.

 

For whatever reason, the CAPTVRE lab at ETSU quickly became one of the largest labs in the Department (at least with regard to the amount of students I had in my lab). Some of this may have been due to the experience of my colleagues knowing how difficult it is to mentor 15 students at a time while also fulfilling all other duties of a university faculty member, and so they wisely chose to keep their labs smaller. Nonetheless, I found a way to manage 15 students that worked well for me, and I built close relationships with my students. One of my proudest achievements always will be seeing my students succeed. I keep in touch with most of them even now and love watching all of the great things they are doing in their own careers. We were also a versatile lab, split across two primary research areas – Self-Identity, as described above, and Videogames/Digital Media. This was another reason I had such a large lab – I really ran two labs simultaneously.

 

Within the videogames/digital media portion of my lab, I conducted studies on anonymous social media (Yik Yak, for those of you that remember that app), on psychological reactions to videogames, and on videogames as tools to be used in psychotherapy. This latter area led me to develop a clinical trial investigating biofeedback gaming in treating anxiety. After the painstaking process of developing and getting the clinical trail approved and registered on clinicaltrials.gov, I regrettably never got a chance to start the trial.

 

Unfortunately, about 2 years into my job at ETSU, my wife, who had followed me throughout our marriage from Indiana, to Texas, to Connecticut, and to Tennessee, grew unhappy in her own job, and it became clear to us that the best thing for her would be to seek employment elsewhere. An opportunity presented itself in Chattanooga, and it was a perfect fit for her. It also didn’t hurt that Chattanooga was practically back home for me (being from Dalton, GA, which is about 30 minutes South of Chattanooga). So, after my wife got her new job, I alerted my department I would need to leave after my 3rd academic year, and so I did not complete data collection on my major studies mentioned above. Fortunately, I had collected plenty of data from other studies out of the CAPTVRE lab, many of the results of which are published or were presented at scientific conferences (see here for a summary).

 

And all of that brings us to the current day. After moving to Chattanooga, I began looking around for opportunities to work clinically here. I interviewed at several places, but the best fit for me was at my current one, at Chattanooga Peds. I found Chattanooga Peds out of luck, simply by searching pediatric offices close to my home. I didn’t know at the time that Chattanooga Peds was a 3-time recent “Best of the Best” winner or that my soon-to-be colleagues would be such awesome people. I pitched the idea of an integrated pediatric practice, and they loved it. We became the first in town to do it, and we’ve been doing it ever since, for over 2 years now. I still work to write and publish scientific articles when I can, and I maintain I diverse clinical practice that always keeps me interested and ready for new challenges.

 

Altogether, I love what I do, and I look forward to working in Chattanooga for a long time.

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