Clinical Psychology

can be helped by therapy. Such persons may not be
raised to the level of independent functioning, but
with the advent of operant procedures and token
economies, their institutional adjustment can often
be significantly improved.
Not only the institutionalized have benefited
from behavioral techniques. Patients at lower socio-
economic levels with limited sophistication and
verbal skills can also experience anxieties and pho-
bias or lack necessary problem-solving skills. In
cases where lengthy verbal psychotherapies that
were highly dependent on insight, symbolism, or

the release of some inner potential were likely to

fail, a broad band of behavior therapies seems to

offer real hope.

Scientist-Practitioner and Clinical Scientist.

For those who support the scientist-practitioner or

clinical scientist model of clinical psychology, CBT

is an approach that seems to encourage a blending

of the two roles. The CBT tradition springs from a

heritage that is experimental and oriented toward

research. Many of the specific techniques of behav-

ior therapy have developed directly from the

BOX14-8 Psychologist Perspective: Rhonda Oswalt Reitz, Ph.D.

Dr. Reitz is a cognitive-behavioral therapist with a

specialty in dialectical behavior therapy. She is a psy-

chologist for the Missouri Department of Mental

Health, providing treatment, training, and consultation

in the state hospital and community mental health

centers statewide. Finally, Dr. Reitz is a trainer and

consultant for BTech, a company that provides training

and consultation in DBT to mental health professionals

in the United States.

We asked Dr. Reitz a number of questions about

her background, interests, and activities.

Describe your background and your clinical interests.

I began to focus on a career in psychology when I was

12 years old. I had a friend whose psychiatrist father

modeled effective compassion and respect in the

treatment of his clients and I was inspired to do the

same. Paired with this ideal of a mental health profes-

sional was my interest in the process and structure of

learning. I learned behavioral methods by training

dogs in high school, took as many courses in learning

theory as were available as an undergraduate, partici-

pated in brain autopsies on internship, and did neuro-

psychological assessment of clients with HIV/AIDS,

traumatic brain injury, and other impairments as a

master’s-level clinician and intern. While my graduate

training largely emphasized cognitive-behavioral ther-

apy, I found myself drawn to more pure forms of

behavior therapy in work with the organically

impaired, children and adolescents, and then with an

increasingly broad range of presenting concerns. This

has been made easier in more recent years as more

empirically supported protocols have been made

available.

Dialectical behavior therapy was a natural syn-

thesis of my interests in behaviorally based methods

and empirically supported treatments. This became a

dominant mode of treatment for me when I attended

one of Marsha Linehan’s workshops and for almost

15 years now I have worked primarily with clients who

meet criteria for borderline personality disorder.

What types of services do you provide and to whom?

I am the DBT Program Coordinator for the State of

Missouri. In this role, I train mental health providers to

do DBT, develop teams of providers across communi-

ties, consult on difficult cases across the state, and carry

a caseload of clients at a local mental health center.

In addition, I developed and manage a certification

process for DBT teams in the state of Missouri.

What are the things you enjoy most about your clinical

work?

The most rewarding part of my job is getting to know

each of the clients with whom I work. The DBT model

prescribes a“radically genuine”interpersonal

approach with clients and encourages staff to minimize

professional distance. While the therapy requires a

high level of attentiveness and cognitive flexibility, it

also allows for a more relaxed and personal relation-

ship, in which client impact on the therapist is overtly

considered important. It is a satisfying experience to

engage in behaviorally honest interactions with

another individual and to watch difficult behavior

patterns change as a result.

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