COMMUNITY Psychology clinic serves needy clients,
offers lower rates
Friday, April 8, 2005
Christopher Heredia, Chronicle Staff Writer
Psychologist Robert Reiser recalled the story of a suicidal 21-year- old
patient who visited Reiser's low-cost therapy clinic in Los Altos several
months ago after the man had had several doors shut in his face.
"He was very depressed," said Reiser, director of the Kurt and Barbara
Gronowski Psychology Clinic. "He is a nice kid, but someone who had had
legal problems probably resulting from poor judgment. His family had thrown
him out. He was unemployed. He was really in a high-risk situation.''
After seeing a counselor at the clinic once a week for several months,
the man found a job and is doing better emotionally, Reiser said.
"He is working on his depression. He is less immobilized. To me, this is
going to be a success case. The fact that he found a job should be a major
benefit to his self-esteem. Not only will he benefit from him getting
therapy, but society will benefit because he's not on welfare.''
The client paid only a few dollars per session, Reiser said. People in
need of mental health care without insurance are often left out in the cold,
Reiser said.
The Kurt and Barbara Gronowski Psychology Clinic, which offers low-cost
therapy, opened in 1987 on the campus of the Pacific Graduate School of
Psychology in Palo Alto. It moved in the fall to its own office space in Los
Altos.
One of the clinic's namesakes, Kurt Gronowski, said donations and
ingenuity are what enabled the school to open a clinic in the first place.
Allen Calvin, the Pacific Graduate School of Psychology president,
approached Gronowski, a Pacific Heights resident, in the late 1980s about
joining the school's board and helping to open a clinic.
"It is very necessary that the school has a clinic where students can
practice and get their first wings in psychology,'' said Gronowski, the
owner of a successful clothing business in San Francisco. He said the clinic
started with a few faculty members seeing clients in a small room at the
graduate school when it was in Menlo Park.
"It was not a large investment of money,'' Gronowski, 81, said. "Most of
it was the result of good will and our commitment to treat people charging
low fees. We've been able to keep it up for many years.''
Gronowski, a Jew who fled Germany with his family shortly before Nazis
began their deadly pogrom, said the suffering he and his family endured
helped him empathize with the plight of the poor and downtrodden.
"We were poorer than many of the homeless people here in the Bay Area,''
he said. "We were kicked out of our home country. Once you've tasted
poverty, it's always with you. Now that I'm in better circumstances, I've
made a commitment to help those who have less. Psychological care is an area
that is tremendously underserved."
In addition to founding and supporting the clinic, Gronowski donates
money to the San Francisco Education Fund, which supports public
schoolteachers, and Meals on Wheels. He also sits on the boards of St.
Francis Foundation, which supports St. Francis Hospital, and Marin Academy
in San Rafael. Barbara Gronowski, his wife of 46 years, is involved in a
variety of health-related philanthropic causes.
Therapy at the Gronowski clinic usually costs $45 for a 50-minute
session. Private therapy sessions can cost from $125 to nearly $200, and
some health insurance companies don't cover one-on-one therapy. Other
insurance companies restrict the number of sessions a patient can have per
year.
Clients meet with second-year graduate psychology students, who are
supervised by faculty -- five of whom are licensed psychologists and one who
is a licensed marriage and family therapist. There are about 35 student
counselors and faculty members seeing about 100 clients, Reiser said. Twenty
percent of the slots at the clinic are reserved for clients who cannot pay a
dime.
"Our students have extremely low caseloads; usually they see two to three
clients each. We also videotape the sessions. Our goal is to provide close
supervision and monitoring. It's in my interest to see that each client
receives the best care possible. That said, one of the ways we keep the cost
of service lower is because students are providing the services.''
The clinic operates on a shoestring budget, relying heavily upon support
from the graduate school and donations from the community. Reiser said he
plans to ask Santa Clara County to give the clinic financial support for
working with the severely mentally ill. The clinic held a fund-raiser on
April 2 to offset the cost of providing services and raised $20,000.
"We're providing a service to people that they can't get elsewhere,"
Reiser said. "We have an expensive private mental-health care system. The
county rations service because of budget constraints. If you're ill, you
can't be seen by the county unless you meet strict criteria, and then you
get minimal treatment."
Clinic helps people overcome shyness
Kathleen Acuff, Town Crier Staff Writer
Shy persons are Lynne Henderson's favorite people. And, like Powder milk
Biscuits, she gives them the "strength to get up and do what needs to be
done."
Of course, she doesn't look at it that way. The head of Los Altos' new
Shyness Clinic would say she only helps shy people find their own strength
and maintain it.
"I call it social fitness training," the doctor of psychology said. "Just
as you have to work out to be physically fit, you have to work out to be
socially fit. It's really like sports or anything else. It's not the lessons
that make you a tennis pro - it's the practice."
The Shyness Clinic is not a structure but a new program at the Pacific
Graduate School of Psychology's clinical training center, the Kurt and
Barbara Gronowski Psychology Clinic, which relocated to Los Altos from Palo
Alto in the fall. Both a training facility and a community mental health
center, the Gronowski Clinic specializes in evidence-based,
systematic
treatment of a range of psychological and emotional problems, from shyness
to bipolar disorder, for all ages.
Henderson has incarnated the Peninsula's shyness program for 22 years,
starting as a volunteer in Philip Zimbardo's shyness clinic at Stanford
University in the late 1970s and taking over the directorship in 1982. She
said she likes to work with shy persons because they tend to be "very
genuine, often conscientious, sensitive, kind, very decent, very honest and
generous with themselves."
Shyness is an ordinary temperament like any other, said Henderson. A
point she stresses is that shyness itself is not a problem; usually it takes
a negative event to turn it into one.
"You can't always tell when someone's shy," she said. "It isn't the same
as being introverted - 40 percent of the population is introverted. The
hallmark of shyness is being so worried about being evaluated that you don't
do what you want to do."
Henderson said she used to believe shy people when they told her they had
no social skills. But she has found that when they don't feel
self-conscious, they show themselves to be quite skilled socially.
Self-consciousness, she said, preoccupies people with negative thoughts
about themselves that cuts off their ability to connect with others.
Shyness often depends on environment, so it's important that shy people
find environments that suit them, Henderson said. She calls that process
"niche picking," and encourages parents to help their shy children "niche
pick."
"The kids who do best have parents who accept their temperament, help
with niche picking and maintain expectations of them," she said. These
parents give their children empathy, but they also help them do things
they're scared to do - and do them in their own style."
Henderson herself treats the Shyness Clinic's clients - persons with
social phobia, anxiety or shyness problems. She takes the cognitive approach
to shyness: looking at clients' beliefs about themselves and at the
undermining thoughts that underlie them. She teaches clients to restructure
those thoughts and develop coping skills. Her clients practice in group
role-play and integrate their growing skills into their daily life.
Chronically shy persons are mildly depressed, and the Shyness Clinic
helps them change the negative thought patterns that tie them down. Persons
with more severe depression, or with other emotional or psychological
disorders, can consult with one of the Gronowski Clinic's 40 second- to
fourth-year graduate students or one of the five other doctors or licensed
master's level therapists.
Students range in age from the mid-20s into the 40s and work in the
clinic under close supervision on nine-month rotations after a year of
preparatory coursework.
The directors of the Gronowski Clinic feel their unique contribution to
the community is their use of the systematic, evidence-based treatment
selection system developed by Larry Beutler, Ph.D., the well-known clinician
on the Pacific Graduate School faculty who wrote the book on the system. The
program assesses clients in an initial 90-minute interview followed by their
completing an online questionnaire, then matches them to a treatment
procedure that allows measurement of their progress against established
norms.
Outcomes are not routinely evaluated and measured in private practice,
said Robert Reiser, Ph.D., director of the Gronowski Clinic.
The National Institutes for Health has issued best-practice guidelines
for treating depression, for example, but found that only 25 percent of
practitioners follow them, Reiser said.
"You improve your outcomes when you follow guidelines you know to be
effective," he added. "My belief is that therapy needs to be systematic,
structured and agenda driven."
The director said the Gronowski Clinic trains students to practice to
approved science, which includes tailoring treatment to the individual -
there is no one-size-fits-all plan.
Reiser specializes in treating bipolar disorder and schizophrenia. The
theory behind the cognitive approach is that thoughts produce feelings. When
those thoughts are negative, feelings spiral downward - and when people are
depressed, they tend to look at things negatively.
"It's about how people interpret events, the beliefs they have about why
things happen, the assumptions that are not based on reality. We look at how
their beliefs filter their view of the world," Reiser said.
To aid this systematic process, clients keep a record of their thoughts.
Because depressed persons experience a significant loss of positive events
in their daily life, they also keep an activity schedule. Some clients are
too young to do either of those things, but even the 3-year-olds can
participate in the therapeutic process in the play room.
The small but well-stocked room reflects the Gronowski Clinic's
developing child and family therapy practice, the specialty of Sandra
Macias, Ph.D., assistant director. Much of Macias' 10 years of clinical
experience is with children who have been neglected or abused and have
developed attachment problems. Macias was unavailable for comment, but
Reiser said she includes families in the treatment process.
The clinic charges clients on a sliding scale of about $25 to $135 per
visit and donates about 20 percent of its services. In addition to
individual therapy, group therapy is already available in most treatment
programs, and Reiser wants to start a group-based program for bipolar
disorder. |
