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Episode Description
Your client finally gets close to the real work. Then the clock hits 50 minutes. “Let’s pick this up next week.”
What if the 50-minute hour is part of the problem?
In this episode, Ashley Charbonneau and Morgen Villegas talk with trauma therapist Alli Christie Disney, LPC. Almost all of Alli’s practice is now therapy intensives. She uses EMDR, IFS, and somatic experiencing to help high-achieving women heal in days, not years.
Alli explains what an intensive really is. (Hint: it means more time, not more emotional intensity.) She shares her “surgery vs. physical therapy” analogy for knowing when a client needs an intensive and when weekly therapy fits better. She also talks about EMDR 2.0 research that questions how long we spend on stabilization before trauma processing.
Then the conversation turns to the system. Why does insurance get to decide how long healing takes? And why is some of the most effective care so hard to afford?
IN THIS EPISODE:
What counts as a therapy intensive (and what doesn’t)
Why weekly sessions can leave clients with emotional whiplash
How many clients process their worst memory in 90 minutes or less
What EMDR 2.0 says about preparation and stabilization
How the insurance model shapes the way therapy is delivered
Alli’s thumbs up, thumbs down, and middle finger to the therapy field
GUEST BIO:
Alli Christie Disney, LPC, is a trauma therapist who helps high-achieving women heal through therapy intensives. Her clients are ready for deep, lasting change, and they don’t want to spend years getting there.
Alli has more than 18 years of clinical training. She draws on EMDR, Internal Family Systems (IFS), and Somatic Experiencing (SE) to get to the root of anxiety, self-doubt, old patterns, and unresolved trauma. Instead of short weekly sessions, she works in focused blocks of three hours or more, so clients can make real progress in days rather than months.
The result? Women who trust themselves, feel lighter, and move forward with more confidence and freedom.
Learn more about Alli and her work at www.allichristiecounseling.com.
Transcript
Welcome and Guest Intro
Morgen V.: Welcome back to The Art of Being a Therapist: The Space Between Training and Real Life. I'm Morgan.
Ashley C.: And I'm Ashley. This is the podcast where we talk about all the things that happen between what we learned in school and trainings, and what actually happens when you're a therapist in the real world.
Morgen V.: Today, we're joined by Ally. Ally is a licensed professional counselor. She is a trauma therapist specializing in therapy intensives for high achieving women who are ready for deep, lasting change. With more than 18 years of clinical training and extensive experience in EMDR, internal family systems, and somatic experiencing, Ally helps clients get to the root of longstanding patterns, anxiety, self-doubt, and unresolved trauma without spending years in traditional weekly therapy.
Her intensive approach is designed to create meaningful breakthroughs in days rather than months. What? That's incredible. Helping women cultivate unshakable self-trust, release the weight of the past, and move forward with greater confidence, freedom, and purpose.
Ashley C.: Ally, welcome. I'm so glad you're here.
Ugh, that intro just, oh, resonates with me. I wish I had found someone like you, you know- Oh, yeah ... many years ago.
Alli's Calling to Therapy
Alli D.: Same.
Ashley C.: Anyways, tell us a little about you and your career. Why did you become a therapist? What are intensives, and how did you get to where you are today?
Alli D.: I have always been a very meaning driven person.
I was raised in a, a very religious household where the mission, the purpose of what you're doing was always emphasized, and that is something that I've carried forward with me in a really meaningful way about purpose. And also, I've struggled a lot with some mental health things related to hormones and PMDD, and whenever I get really low, or before I had some medical support with that issue, I would have these periods of really deep, like, lowness.
And it's now just the moment my mind starts being, "Oh, what is the purpose of life? Why are we here? Why are we doing anything?" Usually in those spaces, it's heavy and hard and painful, but I've spent a- Probably years of my life, decades sitting with that question of like, what's the purpose? What gives life meaning?
Is there ultimate purpose? Is there not? When I was 15, I was roommates with a individual at a summer camp, and I had-- like we both worked at the summer camp. Before that, I was really like, "I need to find my purpose in life." Like, I really want to know the direction and I didn't realize it back then, but I've always been very visionary.
I didn't know that's what it was called or like anything, but I was just very motivated to, what's my calling? And I ended up working at this summer camp with a roommate who had tons of complex trauma, been through horrible things, and more than, like I grew up in a small town, protected, safe family system.
So being roommates with somebody who had experienced horrendous sexual assaults and was adopted and all, all kinds of stuff, and high levels of dissociation and different things, I was like, "Whoa, what in the world?" And she and I were super good friends, and I would just ask her questions all the time from this desire of, "You survived that.
You're here. How can I help?" We had this beautiful relationship, and I remember her telling me, "I don't know how you can help, but you asking me questions is helpful, so please keep doing that." And so, after that summer, I got home and was talking to my parents about my friend and all the stuff she'd been through and what we were doing and how she has fragmented memory, and except I didn't have words for it back then.
So I was telling them, "Yeah, we're gonna do a map of like what she is aware of and see how that is, and talk about these feelings and different things." And my dad was like, "Alli, you need to stop doing that. You're not a trained therapist." She needs a real therapist to help her with this stuff." And I was like, "How dare you?"
Internally I was very upset. My dad told me to stop doing that. But then it also landed of, oh, this is a thing. This is a whole area that People get trained in. And there are skills, there are tools, there's a world of awareness and knowledge that people learn how to help people navigate. So that was my answer back then to what is my calling, was to be a therapist.
And at the time I didn't think of it as complex trauma and dissociative disorders, but that did continue to be a thread all the way through. I don't know if I'd call it a calling or a mission, but I just get so excited and feel so honored to be a presence, be the presence that helps facilitate just the transformation so that people don't have to stay stuck.
And that really has been a through line, and not just for other people, like with myself and my own pain, and friends and family. And when I was little, I used to say I wanted to be a professional best friend. Can you do that? Can you get paid to be a professional best friend?
Healing Through Relationships
Ashley C.: I see what you're saying, how your dad was giving you feedback that this person needs to work with a trained professional.
But what also lands for me is there is so much that a lot of people offer to people- Mm-hmm ... after they experience a trauma like that. And a professional, or a, in this case a trained therapist, is often only one piece of how- Mm-hmm ... someone gets help or how they heal or move forward, or whatever they're conceptualizing for themself after such an event.
And I'm just sitting here thinking about how lovely it is sometimes to play a part in someone's life that's not the formal therapist.
Alli D.: Yeah. Yeah. And I think that just reminds me how many people are afraid to venture there with people they care about. They're like, "Oh, I can't-- They went through this terrible thing, should I just ignore it?
Ugh, they got, I gotta get them a therapist. I can't..." They're afraid of doing damage or something or making it worse. And just how naturally, I would say naturally healing it is, close relationships and people just being- Wow ... curious and wanting to understand and wanting to support. Anybody can do that.
What Therapy Intensives Are
Morgen V.: What are intensives? Ic an conceptualize what an intensive is, but I'd love to hear what you do specifically and what that might look like.
Alli D.: Yeah. Sometimes I wish it had a different name, because it makes it sound scarier than it is. W- the word intensive, it just more time, and so it's relating to intensive focused time, not- More emotional intensity.
So the word intensives, I think sometimes makes people think, "Ah, it's gonna be real scary or real intense emotionally." And it might be, but no more than regular therapy, no more than regularly doing your deep work. Some people call anything over a 60-minute session an intensive, and I don't think that's true.
I think maybe an extended session is what I've heard anything up to three hours called. In how I do them, an intensive is focused therapy in blocks of three hours or longer. My full days are like six hours, and we do an hour lunch. Some people do intensives up to eight hours a day. My nervous system does not do well with that long, so mine are pretty much five hours of therapy, but breaks all between.
And then we do that for a full day or multiple days in a row, usually up to three days in a week if somebody's coming from out of town. I might do more than that if they want to or if they're up for it. But in terms of capacity and nervous system, a lot of people don't do great with five days in a row.
Why Intensives Work Faster
Alli D.: So what I really, really love about intensives is how focused it is, 'cause oftentimes in like weekly therapy, especially with the insurance model and like you only get paid for 60 minutes or, and, or 50 minutes, so in your standard 50, 60 minute session, you're catching up, you're saying hello, you're getting refocused, you're trying to remember where you were.
By nature just of the container, the time gets taken up by just the ongoing stressors of life, because that's obviously what's like upfront in your mind when you come into therapy. So unless somebody is like super focused and super committed to a treatment plan that is very trauma focused or past event healing focused, it can take people way longer than it needs to heal things.
Because if, I guess without getting into all the trauma therapy theories, a core foundation that I have is that most of our mental health struggle come from past painful experiences that are not fully resourced, except for things that are like biologically based, like me, like if your hormones are off or you don't have enough serotonin or something, or if it's a current active stressor that is Being supported.
But everything else, like ongoing depression, ongoing anxiety, flashbacks, PTSD, personality disorders, at root are trauma. Trauma experiences leads to all these things. So if we're trying to choke it out in teeny tiny bits, but the roots are really under there, and somebody's ready and able, has the capacity to just, "All right, let's just go process this stuff," it helps people feel so much better so much faster, and in fewer hours, fewer total hours, because you're not having to do all the transitions or dealing, "Oh, my boss was a jerk," or, "My kids are really over- overwhelming me," or, "I got in a car crash on the way here, and ah, I have to settle from that."
You get the focused time to really do the work, and then also not have to be cut off of, "Oh, I'm-- I did my 10 minute check-in and my 30 minutes of processing, and I'm really getting into it. Oh, session's up. Okay, bye, see you next week." Just whiplash, emotional whiplash all the time.
Ashley C.: And it's really hard for a therapist to develop either the art or the skill, whatever we wanna call it, of how long do I let this person go in terms of verbally processing what happened over the last week, and intervening- Mm-hmm
in that regard, versus, okay, you're here for the deeper stuff. I don't think there's necessarily a right or wrong answer, but we're often making those decisions in the moment with clients. It's often a split second decision. We're doing the best we can, and it's a very difficult decision. I want to heal trauma.
That's my goal. And like you said, if someone comes to me, and this is where they're at today, who am I to say, "Okay, stop there, and let's pivot on this bigger thing that you said you wanted to do." It's much more complex than that.
Alli D.: Yeah, totally. And almost disrespectful. I would feel disrespected if I came in and was like, "I'm really stressed out about X," and then the person was like, "Sorry, no, we're gonna go talk about your mom."
That, I'd just feel entirely missed. And also, "Screw you, I'm gonna do what I want. I'm paying you." Also, I would doubt myself, though. I'd be like, "Wait, part says I'm not supposed to do that, but I'm so distracted by that." So yeah, it really, it's a big push/pull. And now my practice is almost entirely intensives.
I have one person I might see every other week for just an hour. But when I was more in the middle, and would do some of each, the weekly sessions were so- Because we would circle, circle, yep, get to the point. We really should work on this past stuff, huh? Time's up. Next time. And because the manifestations of the old trauma show up in everyday life, but that awareness of, oh, this is rooted in the past, is not as upfront it's like we travel that every single week.
So I influence my clients now to, "Hey, let's just do three hours."
Ashley C.: It's the difference between treating a symptom versus the cause. I know it's not that simple ever, but the symptom is the stuff that shows up week to week and in patterns and in symptoms, versus if we can get to the core of what is causing this and do a lot of healing, which is very hard work.
And I know you said you didn't like the word intense, but it is, it can be very intense work. Then the symptoms are gonna subside. And again, that is where a lot of the art of therapy lies, and sometimes it puts a lot of pressure on us as clinicians to make those decisions either minute to minute in a session or week to week as we prepare or reflect on sessions, too.
Alli D.: For therapists, it, to me, it's so much more exhausting to have to reorient to a client's goals over, like the overarching where they wanna go, get into it, see if their past goals are what's up and wanting to be worked on today, and do that work for however long, whether it's the old stuff you already had a plan for or something new, and then to contain.
It is so much harder to do that six times in one day with six different clients than one client where you're just doing the whole thing. It also speaks to folks who might experience the world living with neurodivergence. There might be parts that really need to report back, like what happened during the week for a full hour, and then really feel safe with, "Okay, now I can go deeper.
Now I can talk about my mom." And that's what I found in my own personal work doing an intensive. I was like, oh wow, there's still, like, all these hours that I get to now do some of the actual trauma because I already checked in about all the things I needed to talk about. And it was just such a beautiful experience as a client, and I do intensives as a therapist, and I definitely can resonate so much, Ally, with what you're sharing about the open shut of the weekly therapy.
And then, oh my gosh, when you're in intensive it's just we- you're just gonna keep this open for 12 hours, three days in a row for about four hours a day or something like that. I think you said you do about five. Mm-hmm. But for 15 hours we're gonna have this really deep, actually intense special focus, hyperfocus on this experience.
We're gonna honor it. We're gonna be with it. We're gonna really try to transmute it, try to heal from it.
Surgery vs PT Analogy
Morgen V.: Can you tell us your surgery analogy?
Alli D.: Sometimes I talk about intensive's more like a surgery than PT. So some things, some issues need more of a PT approach, like- Skills learning or somebody who is really wants to learn boundaries, that is great for weekly therapy where you're taking in your current life, you go out and practice, and then you come back, and then you, "Oh, this is what I worked on.
This is what I wanted to improve. This went well. This didn't we- get well. Let me get feedback and see how I feel about it," and all this stuff. But when someone is just at a spot where they are semi-aware, they don't have to be fully aware, but semi-aware that I have this ongoing pattern, whether it's a limiting belief about myself or these memories really come back negatively and I experience them negatively regularly, or this relationship from the past is still impacting me.
Once you have that awareness, then it's not something you have to chunk up. If you had a tumor, you don't go in and take it out. Tiny little piece at a time. That sounds terrible, and probably, I'm not gonna go into that. I was gonna make it more of a growth analogy It's just much more likely to have that like impact the rest of your life.
I was gonna say le- negatively impact the rest of your life while you're taking out little chunks of the trauma at a time than having the whole three hours, the whole six hours to go in, get around the whole thing, take it all out, move it all through all at once, and then you're done. And with some of the newer, like EMDR 2.0 and stuff like that, it's not even like, "Oh, this one painful memory, I have to spend six hours on it."
It's more like, and not for every person every time, but most people I work with, their worst memory of their entire life, we get through it in 90 minutes or less And that's crazy. Usually much less, but I would say the longest is 90 minutes. So for it to be like, whoa, I have these 100 worst or 10 worst experiences of my whole life, but in two days I could get through Six, eight of them, or at least the worst three, if even if- Yeah
I want to go slower and more titrated, 'cause that's... It's amazing. I love it. You're even alluding to complex trauma. This isn't just one time trauma. These are things that you absolutely can target some of the most distressing aspects of a trauma and get through it in 90 minutes. And as I'm hearing you say that, I have parts that are like, "But how is that possible?"
Even though I've actually witnessed it happen, and I know that there are studies that show that it actually works. But it's almost like an inexplicable witnessing, isn't it?
Research, Systems, and Access
Alli D.: It's crazy. And parts of me, 'cause I just got back from the EMDRIA conference, and I went to, I'm gonna butcher her last name, Dr. Susie Mathiason, who is one of the EMDR 2.0. Her whole model is intensives. That's what they do. They do two hours in the morning, two hours in the afternoon for two days one week, two days the next week, and yeah, they just are blasting through things. And she's like, "We all think we need this extensive preparation stage, but actually people have worse outcomes when you do a lot of stabilization and preparation than if you just dive in and start doing the work."
I'm still wrapping my brain around that, but I've seen it so often that it's like,
Ashley C.: I loved the surgery analogy, and it makes me ask the question out loud, why would we partially heal somebody? And this idea of weekly therapy, I know that's not the language you use, but you heal someone partially, and then maybe partially, and then maybe partially, whereas an intensive, the goal is much more than that, and how beautiful and inspiring that is.
The resourcing is hard to sit in, that preparation phase, 'cause you're like, "I'm ready to heal. I'm ready to heal. I'm ready to heal." And the therapist potentially is like, "Nope, they're not stable enough. They need more. They need more resourcing." And then there's this misfit between client motivation and therapist clinical judgment, and if that space lasts for too long, then the therapeutic alliance can shift drastically.
And if that shifts drastically, then outcomes, potentially are not what they could be.
Alli D.: I used to think it was safer to do intensives because I was the container or I was the stabilization while doing the work. I usually use like an EMDR structure, but if somebody really needs a more pendulated approach, then I'll do more IFS and somatic experiencing, which can be very, it's very gentle.
They'll, they're still deep, they're still powerful, but very gentle approaches. But I used to think, "Oh, it's because it's me," or, "It's the therapist who is keeping the person in their window or in that zone of I'm not being re-traumatized." And part of that is true. And also, 'cause last week I learned that the research shows it's more effective just to dive in, even if you have space in between, or even if you have more...
Yeah, I'm probably gonna get negative feedback about that, because it's definitely not the American system, and it's not the original system I was taught in the phase m- model of treating trauma.
Morgen V.: I think that you would see each client in their own circumstances and their own capacity to be able to gauge what is possible in...
That's the art of therapy in a way, is that we get to determine what feels right for each person. And I think one of the criticisms of their work, those two authors of 2.0- Yeah ... is that their studies are done in an ins- in a system in Europe where everyone has nutritious meals, exercise, access to meditation, access to gyms, access to, like, all these different kind of scaffolded experiences.
And so, yes- Hmm ... going to lend itself well to do quick EMDR work. I don't know enough about 2.0. I am trained in it, but I don't know enough about it to really provide such a deep critique. But you're onto something here, though, where we get to reconceptualize a little bit about some of the standard protocol.
Ashley C.: And I think part of the art is integrating new research, seeing what other countries do better than what we do. And of course, staying within our lane and adhering to ethical practice, but also recognizing there's a lot out there that works better than what we do, whether it's we as individual practitioners, no offense to Sari critiquing ourselves right now, but also we as in what we do in our certain location or our state or our country.
I really believe that is part of the art, is keeping up to date on research and inspiration and new ideas and not getting quote unquote stuck in how protocols were created. EMDR was created, what, 20, 20, 40? 40 years ago now, over 40 years ago now, and life looks differently than it did 40 years ago. Life in America for sure looks very different than what it did 40 years ago.
And I've seen the protocol work for sure, and I've seen the protocol not work. And I've veered away and brought in my own art, and it's worked, and in some cases it doesn't work. That's the reality, though, I think sometimes.
Alli D.: Something you were saying, both Morgan and Ashley, about why don't we do more of this?
Like- When you're talking with a friend, you don't just say, "Okay, my 50 minutes is up. Bye," like when they're in their middle of their story. And so why do we do this thing that feels so unnatural in relationship? And I think, this is not based on research, but I think it's the insurance model has limited people, and it says, "Okay, we're only gonna pay for 60 minutes or 50 minutes."
So then it's poor boundaries if we are like, "Sure, I'm just gonna go longer and not charge you." The system is what is defining what's helpful and not, but the system is not actually reflecting What works the best. And Morgan, what you said, I do think in 2.0, I would say don't quote me, but I did hear Dan DeYoung, he is the other guy, he said they don't end the session until you wrap up the target.
So that is so different than what we do here. They're not going five hours, but they'll take the extra 30 minutes to wrap up and land, I think, in a safe spot, 'cause their model is different, and the-- you're right that the government pays-- or the insurance companies pay for, like, the full time. So structurally, it's not even a concern there, whereas here it completely changes how care is being delivered to people.
There's part of me that's been looking how to get insurance companies to adopt an intensive model for therapy and pay for it. Everybody can do intensives. Every therapist who does any kind of trauma healing work would be better served if they could do, offer 90-minute, three-hour sessions. Like, everybody should do that, because once people get there in the work, then it's just the best way to do it.
Morgen V.: It's so true, and I just love how you're speaking to this. It's creating, like, such a dissonance for me because it's like I s- I do both. I do the intensives and the 60-minute, and my heart is just pounding because I'm just like, the system is just in the way, you know what I mean? And I'm just so appreciative of you naming that because it's like there's, there's certain ways that we can impact the system, such as, like, changing it into a completely intensive-- like, almost an intensives only model that, like, you did.
Or we get to just maybe figure out, yes, how insurance might be able to somehow pay us for certain intensive time.
Ashley C.: But how mind-blowing is it that a system that tells us that 60-minute therapy is the standard tells us that if we veer outside of that, we have poor boundaries? There's a lot more to that, of course.
Exploring boundaries is often someone's lifelong work, including if we're helpers. But that really stuck with me. My brother's in the tech space, and I asked him one day, "What if I have a ChatGPT and I'm fighting with an insurance company who is also using a ChatGPT? Who wins?" Right? What AI system wins?
And he basically said, "At some point it'll short out." And, like, that's my goal in our field, is to get AI to short out.
Alli D.: I love that. I want to optimize. I don't wanna create new modalities, 'cause I think we have brilliant modalities. I don't need a new EMDR, a new IFS or something like that. But I am very interested in the structure of like, all right, how do we change the landscape or influence the landscape in the direction of whatever the structure is that is most effective?
'Cause I am, I'm expensive. I would have to save up for a very long time. If you wanna do intensives, it's always a private pay thing, even if you wanna work with somebody who takes insurance, because insurance will not pay that therapist. So it's a very inaccessible treatment. Only the rich get well. Yeah.
Yeah, and that's stupid, and I've had multiple patients, not patients, clients, patients, come in and say to me, "Why did I not hear about this before? Oh my gosh, you changed my life, and oh my goodness, I am so grateful I have the privilege to come see you, but what about everybody else?" And so what I wanna do with AI or people or a center or whatever is really Let the bots do the pieces that bots are good at to optimize or make it more streamlined or something so that the people are still over- overseeing.
Ashley C.: There's an opportunity here for the art, right? Mm-hmm. Mm-hmm. Like, how do we creatively work with technology, creatively and ethically work with technology to help people and help to m- help more people quicker.
Alli D.: Yeah. And have access to the genius and the presence of, not calling myself a genius, but anybody could get the training I have.
And there's a lot of buts in front of that because of all the privilege that I've had to be able to get the training I've had. And people are amazing. Therapists are amazing. People are amazing. We're just magical. People are divine. And, but matching that with each other Seems to not be easy to make happen.
Final Takeaways and Wrap-Up
Morgen V.: We're already almost at the end of our time today. Before we let you go, do you have anything else that you'd like to add just around your experience or just around any kind of perspective that you can offer to other therapists?
Alli D.: You're doing good work
You're already good enough Trust yourself. That's probably what I would wanna say.
Morgen V.: I love that. The last question that we've started asking guests is, what is one thumbs up, one thumbs down, and one middle finger to the therapy field right now?
Alli D.: Ooh. The thumbs up is There are, like, so many good therapists doing so much good work from a genuinely wonderful place, and it's so congruent and so just beautiful.
And any time I go to a conference, I like conferences. I like in-person trainings, probably 'cause I have a hard time focusing on computers and things, or making myself do the trainings outside of an in-person context. So I just met a bunch of therapists, and it's wow, this is so cool, and we're trying to change the world, and trying to unify, to, ah, progress.
I'm gonna say my middle finger is more at insurance companies. Based on everything that we've talked about, I have a love-hate relationship with insurance companies, because obviously, out of a major surgery, I didn't have to pay for the whole thing. That's wonderful. That is wonderful. And everything we've talked about with the limitations and how I-- it's better, like insurance coverage of mental health is better than it was 30 years ago when it didn't exist.
There wasn't insurance covering mental health stuff. But yeah, I... They still need to catch up. So that's my middle finger.
I guess a thumbs down... since I do, my three primary modalities are all trauma healing modalities, but they all feel so siloed. Like EMDR does EMDR, somatic experiencing does somatic experiencing, IFS does IFS, and like those are all even under the trauma therapy umbrella. When I think of the overall mental health field
I told a friend last year at the EMDRIA conference that if I was to do a training, I would wanna do, like, the universal principles that underpin all trauma healing. Just to really unify. You don't have to be all of them. Like, all these therapies work, but there's something about that, the silos, that I don't love because it's like everybody thinks, I don't know, maybe I'm just talking about myself, everybody thinks they're reinventing the wheel and, "Oh, this is what's gonna change the world, and this is what's gonna change the world, and this is what's gonna change the world."
And that's great. I wanna change the world, but it feels like we're just all talking to our own silo. I wonder if there is a broader unification that can happen to move the field forward faster and better, and create more change.
Ashley C.: Alli, thank you so much for being here and for sharing your perspective on intensives and what it can look like to do therapy in a different way than what we were taught.
Morgen V.: And thank you to everyone listening. If you enjoyed this conversation, please follow or subscribe, leave us a rating or review, and share the episode with someone who might appreciate it. It really does help more people find the podcast.
Ashley C.: Take care of yourselves.
Morgen V.: And take care of each other. We'll see you next time on The Space Between Training and Real Life.
