Reid Wilson

Featured Therapist Interview

Reid Wilson, PhD, is a clinical psychologist who is Director of the Anxiety Disorders Treatment Center in Chapel Hill and Durham, NC. He treats individual adults and children with any of the anxiety disorders or OCD. He also conducts two types of two-day intensive group treatments, one for OCD and the other for panic disorder and social anxiety.

Reid has a long history of learning-by-doing. At age 19, while a sophomore in college, he created a free peer counseling service for those in need, the first ever on a college campus. By age 20, he had published his first book on how to help those who are suffering and with limited resources. The first peer-review journal article on his work was published when he was 21. Since then, he has devoted his career to advocating and innovating within the field of self-help. In the 1980s he helped construct what is now the Anxiety and Depression Association of America (ADAA) and then chaired three national conferences on anxiety disorders and OCD. He is Founding Clinical Fellow of ADAA and a Fellow of ABCT. By 1990 he had built American Airlines’ national program for the fearful flier, using a 2-day intensive intervention. By 2003 he had launched the internet’s largest free self-help site for anxiety disorders and OCD. Today that site – www.anxieties.com – serves 110,000 people per month. The six self-help books he’s authored in the last 30 years have been published in nine languages, and his free self-help videos have been viewed by tens-of-thousands. In 2014 he received ADAA’s highest service award, and this month he receives the International OCD Foundation’s 2019 Service Award.

Reid received his Master’s degree in counseling psychology from Antioch University in 1977 and his Ph.D. from Fielding Graduate University in 1980.

Clinically, Reid is a cognitive therapist who continues to focus on brief treatment strategies and rapid change. His work, like his writings, uses a stepped care model that explores the synergistic effect of combining a self-help model with CBT. His office website is www.anxieties.com/office

First, we would like to know a little about your practice.

What are your personal strengths as a practitioner?

Even though I’ve never had such a disorder – I feel an affinity with those who struggle with anxiety and OCD. That enables me to relatively quickly establish rapport regarding what their life must be like. As a cognitive therapist, I lead with belief change, not technique. Within the first session, my intent is to not only gather diagnostic information but to give back to the client as much as I can. I will personify the disorder and outline the strategy it uses to dominate them. With that understanding, I then outline the broad strategies they will need in order to take back control of their life. This builds the all-important ingredients of placebo and hopeful expectancy. If at all possible, my goal is to collaboratively create a behavioral experiment, accepted in session one, to be fulfilled prior to session two.

Since I have a specialty practice, most clients I see have been in treatment with more than one previous therapist. Often, they feel like they have failed in their attempts to implement past treatment directives. Therefore, I work to show them how our approach is different, not the same. (Who wants to start over with a new therapist and yet be expected to engage in the same protocol?) Most of these clients are overcontrolled, so I try to counterbalance that through modeling. I present a relaxed atmosphere and laid-back body language. I use less formal language, and I frequently use humor. At the same time, I’m quick to disagree with them and challenge their beliefs.

Most importantly, I convey that I serve them, and I am going to work quickly and efficiently on their behalf.

What “tips” can you offer to colleagues just opening a practice?

Here are a few:

First, I hope you will have been learning on someone else’s “dime” before you launch your own enterprise. Spend a few years working in someone else’s practice or within an institution. Take advantages of all the opportunities for supervision and training. Study how others make their practices cost-efficient. Interview those who run practices.

Consider starting your private practice part-time, while you continue to earn a paycheck elsewhere. This takes the financial pressure off.

You must have ways to pull in referrals. Make yourself useful to those who will become sources. If physicians are a referring source, offer to take on one or two of their difficult patients, and do it for a reduced fee (but not gratis). If they don’t know you, then you have to serve them to show your usefulness. And always send a clinical evaluation and follow-up notes to any referring health professional. Show them that you’re working on their patient’s behalf.

Lastly, don’t rely only on training in CBT. We all see clients with a complicated set of psychological conditions, environments, and family histories. If you’re not versed in them, take continuing ed courses in family therapy, motivational interviewing, psychodynamics, and the humanistic therapies (client-centered, gestalt, existential), for a start.

We would also like to know a little about you personally.

Who was your mentor?

I have a relatively diverse background, beginning my career in the sexuality field and studying directly with Masters and Johnson. I then shifted my specialty to the treatment of chronic pain patients within an intensive therapeutic community hospital setting at the Boston Pain Unit. I was fortunate enough to have Aaron (Tim) Beck as my external advisor for my PhD dissertation on the cognitive approach to treatment of pain and depression, and I view him as a significant mentor. But I was also mentored by other schools of treatment, starting in 1970, as a college sophomore, when I taught myself biofeedback with one of the first biofeedback machines in the country, built by the Duke University Engineering Department. In 1976 I started studying Transactional Analysis, then later enrolled in a one-year intensive in gestalt with the Boston Gestalt Institute and after that a one-year intensive in family therapy with the Cambridge Family Institute. This work was complemented by my intensive study of strategic treatment and Ericksonian hypnosis.

Back when I was in school, the study of anxiety disorders was incredibly limited. Systematic desensitization and relaxation for phobias was about all we got. So, in 1978 I began my own self-study of the field. Every major clinical researcher became my mentor-from-afar, as I had a voracious appetite as a student of the field. Who’s work influenced me most of all: David Barlow’s.

When not practicing CBT, what do you do for fun?

I am a charter member of CHaOS Rowing, a masters crew team. I work out of the 3-seat in the Stämpfli 4x. I cross-train with a road bike and get tortured in the gym by my personal trainer twice a week. We live in the countryside of the beautiful piedmont area of North Carolina, so you’ll find me walking the trails on our land several times weekly with my wife and German shepherd puppy, Raina. Live concerts and music festivals with my son are my joy, as are my daughter’s two girls and my wife’s three grandboys.

We are also interested in some of your views of CBT.

What do you think is the single most important thing CBT can do for your clients?

CBT gets clients to work quickly on skills, backed by a simple-to-understand logic. Trained CBT therapists are confident in the skillset needed to get clients back to equilibrium, and they convey that confidence to the client.

Where do you see the field of the behavioral therapies going over the next 3-5 years?

We must focus on briefer therapies. They support a stepped-care approach; they allow skilled therapists to see more clients; they entice more people into care; they reduce attrition rates; and they reduce several major barriers to treatment, including time cost and financial strain.

Thank you very much for taking the time to answer our questions!