The Power of Change: Spotlight on Ben Caldwell, MFT

The individuals that make up our SimplePractice community come from incredibly diverse backgrounds and experiences. Our Spotlight series is our chance to share their stories with you, and shine a light on life as a behavioral health professional. Through these interviews, we learn about their specialties, struggles, and the epiphanies that come with experience.

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Ben Caldwell isn’t your average Los Angeles MFT.

His practice is located in the Miracle Mile area of Los Angeles, where he shares a wing of an office building with his wife and a couple of other independent therapists. One of his favorite things about this cluster of offices is the fact that it also contains a conference room where he and his colleagues can gather in between sessions — it’s a true sense of community which is hard to come by in private practice.

His waiting room includes a water feature that sets a calm tone the moment you walk in. It also features a jar of cookies that Emily and I may or may not have been a little too excited about.

Ben has written multiple books on Law and Ethics which makes him an expert in the field. He’s also contributed to a groundbreaking piece of legislation that’s going into effect next year. The main thing that really sets Ben apart from the rest of the MFT world is the fact that he is an active advocate and change-maker for his profession.

Natasha: Hi Ben! Thanks for inviting us to come hang at your office. Tell us a little bit about your space.

Ben: I run a non-profit practice called Caldwell-Clark. Next door to me is my wife Angela who runs the Self-Injury Institute. We have three other offices that are used by renters, often people we’ve known for a while. We’re not under one business entity. So many of our good conversations happen in our conference room. Typically, unless we’re working on stuff, we’ll all hang out in that room when we’re between clients. It’s really nice to have a shared space.

N: That’s really interesting! So, how did this all come to be? Tell us about your journey as a therapist.

B: I grew up in the Midwest and moved out to California in 1998 for graduate school, which feels like forever ago now. I went to what was then the US International University in San Diego (now Alliant). I stayed and continued school there, and got my Master’s in 2000 and my doctorate in 2004. As soon as I finished with my doctorate degree, I was hired to teach full time.

N: Wow, convenient!

B: Yes. The hiring was conditional. It was basically, “we want to have you on our faculty here. But we also want you to expand our program up at the Sacramento campus where we don’t have the MFT program at the time.” So, I accepted and I moved up to Sacramento in 2005, and was the only MFT faculty there for three years.

I moved back to LA in 2008 and have been here ever since. I helped start the MFT program at Alliant as well, and left about a year ago. Mostly, because I was starting a family and because I needed and wanted more time for practice.

My specialization in private practice now is in working with couples. I really fell in love with EFT, Emotionally Focused Therapy, which is Susan Johnson’s model. It has a lot of research behind it and is really effective for working with couples. I like taking on couples who are sort of on the brink or have had difficult experiences with other therapists. I usually do pretty short term work — about three to six months is the common time frame for how long I’ve got my couples in therapy.

N: I’m really interested in your career in academia. What made you pursue it and how did you get into writing books?

B: I taught Law and Ethics at Alliant for many years. I got really frustrated because so much of that class was simply, “here’s what the rules are”. There wasn’t really any singular book or singular resource to help people understand what the rules are for Master-level therapists in California. I was just doing a lot of lecturing. My students were learning a lot, but it wasn’t an especially enjoyable class for them or for me for that reason.

I wrote Basics of California Law with the intention of allowing Law and Ethics instructors to say to their students, “Go read this chapter. Then let’s talk about what it means when you come back next week.”

My classes immediately got better for the students and for me. Instead of being so much rote memorization, now it was, “Wait a minute. Are we okay with this? What does this mean when we try to apply it to real cases? What if we want to change some of these rules? How do we go about doing that?”

I got to talk more about advocacy. I got to talk more about really difficult ethical and moral choices that we make. The book has really facilitated that. I’ve been happy. It’s gone beyond my expectations. We have about 30 programs around the state now that have adopted it as a required text in their Law and Ethics class. It’s better than I ever expected.

N: How do you practice advocacy? Are there any campaigns you’re working on right now?

B: Quite a bit is changing on January 1st of 2018. First and foremost, on January 1st, 2018, the title “Intern” officially becomes “Associate” for MFT counseling interns in California. That is a big deal. I am very happy to have played a significant role in making that happen.

I gave a presentation to the BBS (Board of Behavioral Sciences) about this in spring of last year. In advance of that presentation, where I knew I was going to talk about the possibility of doing a title change. I did some informal research. I surveyed some therapists on Facebook and other places, and asked questions like, “What’s your experience with the intern title? How is it understood among employers, and supervisors, and clients, and even friends and family?” I looked for word frequency just to see what things come up most often.  One word that I didn’t expect to come up a lot, but did, was the word”coffee.” I thought that was a little odd, so I went and looked back through all of the responses where that came up. Every single one of those references to coffee was somebody saying that we socially understand “Intern” to mean somebody who goes and gets coffee for the people who are doing the real work.  

It’s a big, big problem in the therapy world where you have people who have Master’s degrees, who are very good at what they do. The “Intern” title makes everyone think of them as someone who’s still in school, who isn’t getting paid and maybe shouldn’t get paid. In my research, I learned that Medical Schools stopped using the intern title decades ago — they now call these individuals First Year Residents!

The BBS were fantastic and very receptive. It’s been signed into law and takes effect January 1 of next year.

N: Congrats on helping foster that change! Can you speak more to your role as a change maker? How did you get to this point in your career?

B: This is a funny story, actually. It was 2005 and I’d been elected to the Elections Committee for AAMFT California. I went to their retreat in San Diego where they were planning the year out. They mentioned that the Chair of the AAMFT Advocacy Committee was stepping down and that they need more people to be a part of that work. I mentioned that I was moving to Sacramento. And that even though I didn’t know anything at all about advocacy, I was interested in helping out. They responded with, “Great! You’re going to be our new Chair.” I thought, “All right!”

After that, I started going to BBS meetings. I started getting involved in the legislation. Slowly learned and built relationships with the BBS, and with lawmakers, and really liked it. I really liked the influence that I could have on the work that we’re doing on the larger field, and was impressed with what I was learning about all of those decision makers.

Our country is very politically polarized right now. One of the things I found in the state legislature is that every legislature and staff person I’ve talked with, Republican, Democrat, they all genuinely seem to be interested in doing what is best for their constituents. Everybody has been open and makes sure to ask the question of, “Is this going to be helpful for the people I serve?” That’s awesome.

N: Wow, yes. Would you say there’s a large percentage of therapists involved in the law and ethics surrounding their profession?

B: Actually the opposite, very few therapists are involved. All the BBS meetings are open to the public but there are about five people who show up to each of them.

It’s frustrating for me in a couple of ways. Part of it is just that I’m a member of the therapy community. These rules impact me too. The ones that don’t work, I would like to see changed. It’s helpful to have more voices involved in those conversations. If you’re talking about a rule that was set by the BBS or set by the legislature, it can be changed. There are open meetings happening all the time that you can go to and say, “Hey. These things aren’t working in my practice. Why do we have this rule? And is it possible to change it?”

I worry that it starts to look bad for us as a profession. We help our clients learn to deal with things directly. But then we’re not doing that ourselves.

N: Right, I think that speaks to a larger culture of people feeling that they, as an individual, have no chance of influencing the law making process or helping to create change.

B: There’s a tendency to think of the BBS as this big, faceless government agency that you sometimes mail stuff to. It’s all run by robots and people with hammers who only get mad at therapists and discipline them when they’ve don’t something wrong. While discipline is part of what the BBS does, the board itself is made up of people, about half of whom are therapists themselves. All of their meetings are open to the public and they use those meetings to try to find out from the profession what’s happening. What do they need to look at changing? What needs to be done differently? That’s why in my California Law book there is actually a chapter on advocacy that talks about how you can change the rules if you don’t feel like they’re working for you. That’s not something I got in my Law and Ethics class when I was a student. It is something I think is really valuable.

For every good argument you can make about changing a rule, there is a meaningful counter argument about why that rule is in place to begin with. You need to be able to address that counter argument, give it your best effort, and understand that sometimes you’re going to lose. That’s how change happens. If you are simply going to sit back and wait for somebody else to do something, you’re in turn modeling that for your clients. You are in some way, shape, or form showing them that rather than going and directly pushing for the kinds of changes that they way that it’s okay to sit back, and wait, and hope that somebody else does the hard work. I don’t think that’s what we’re here for.

N: What would you say is your favorite part of academia?

B: The research and presentation part I’ve always really loved. It’s just that I like the pursuit of knowledge. I’m a nerd that way, I’ll happily wear that label. It’s been interesting to me from the beginning what it means to be a therapist and how we develop as therapists.

I wrote a piece with Scott Woolley who was Alliant’s Program Director, and my brother, Casey Caldwell,  who has an MBA and Law degree. We looked hypothetically at what would the impact be cost-wise if we just went out and did screening of the general population to see if marriages were in distress. There’s good assessment tools for that. Then, offered a course of therapy to those marriages that were in distress.

If insurance paid for it, would insurance get their money’s worth out of it? If the public paid for it (if it was a government investment) would government get their money’s worth out of it? In both cases, we found the answer to be yes. That couples therapy is actually a really good investment for insurers and is also a really good investment for government. There continues to be growth and development on that front. Building on this case for insurers, who in many cases already do, to pay for couples therapy. They’re actually going to get their money back and then some.

We know that in relationship therapy there is what’s called an “offset effect.” That means, at the end of therapy your future medical expenses go down because relationship distress tends to make us sicker. That reduction in ongoing health care expenses more than pays for the couples therapy.

What a cool thing to know right? To be able to make the case to insurers and to others that not only is this hopefully going to help your relationship, it’s actually a good investment. It’s not a cheap process, but if you spend a couple of thousand dollars on therapy to help your relationship, there’s actually a good chance you’re going to make that money back.

That kind of stuff I love learning about. I did not come recently to geekiness. That’s been around forever I think.

N: What are three things that you wish you knew starting out as a therapist?

B: Let’s see…

1. I wish I knew how powerful each of us individually is and can be. We have a lot of influence with our clients. We also have larger influence than that. I’ve been able to get some things done policy-wise not because I’m anybody special. I’m a pretty ordinary MFT, but I spoke up because I saw where there was possibility and necessity for change.

2. I wish I had known about the differences in graduate programs. Which differences matter and which ones don’t. When you’re looking for a job, your prospective employers and your prospective supervisors may care what program you went to. I’m a supervisor and I care what program somebody went to because that tells me about their level of education. One of the big differences between graduate programs that I did not know about when I was looking at grad programs is cost. It is so expensive to go to a private graduate institution. While those institutions often do great work, so do the public programs.

3. I wish I had known at the beginning how small the therapy world really is. Your professional network is critically important. You can build that network from day one, when you’re in graduate school. Stay on good terms with them. They can have ongoing influence on your career for the better or for the worse.

N: What’s the deal with continuing education?

B: As it is right now, continuing education is a matter of sitting in a seat for a certain number of hours. Then checking off that box on your application for license renewal. It is assumed that you have somehow learned something or grown from that time when the overwhelming majority of evidence says you probably didn’t. A lot of therapists when they are coming up against license renewal time, and they think, “Oh no! I haven’t done my 36 hours yet.” They go online. They find whatever cheap online program they can that will allow them to do a “6 hour course” in about an hour and a half.

N: Why is it important for therapists and clinicians to pursue further education?

B: The therapy field is maybe the only field in healthcare where you can continue practicing the way that you practiced 30 or 40 years ago and not get sued all the time. On one hand, yeah, the work that therapists were back then was very effective. It’s still very effective now. On the other hand, we’ve learned an awful lot since then. About how to keep clients from dropping out of therapy. How to make sure that we are being effective in the work that we do. How to do therapy on a short term basis. How to work with a wider variety of clients than we had a good knowledge base for decades ago. All of those things are important in not being seen amongst colleagues as out of date. Really in being able to service the population that you are trying to serve today.

I don’t blame people for wanting to just check off a box on their continuing education for license renewal. I also would wish for people, that if you are going to be spending that money anyway to pay for something that you’re going to get real value out of. Pay for something that you are really going to learn from that is actually going to influence your work where both you, and hopefully the CE provider, are going to be accountable for your learning. Make sure to act on what you’ve learned!

Ben’s recommended resources:

1. Psychotherapy Notes blog
2. Scott Miller’s website
3. Professional associations:
   1. AAMFT
   2. CAMFT
   3. ACA
   4. NASW
   5. APA
4. Evolution of Psychotherapy conference
5. AAMFT’s new Best Practice Guidelines for Online Therapy
6. A book I like on HIPAA compliance in mental health

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Ben uses SimplePractice to help streamline his practice so that he can spend more time with his clients,  writing books on Law and Ethics, and advocating for those in the behavioral health field.

We would love to help you spend more time on the things that matter. If you’re interested in building a stronger practice and joining the SimplePractice community just use Ben’s referral link to get started with a 30 day free trial.