December 5, 2025 • 32 mins
Dr. Robert Rhoton is the Chief Clinical Officer of the Arizona Trauma Institute and President of the Trauma Institute International. A Diplomate of the American Academy of Experts in Traumatic Stress, he has spent decades advancing the understanding and treatment of developmental and family trauma.
Dr. Rhoton has supervised outpatient clinics, juvenile justice and substance abuse programs, day treatment centers, and child and family therapeutic services. Formerly a professor at Ottawa University, he trained counselors to work with traumagenic family dynamics using non-egoic, compassionate models of care.
Today, he consults with agencies and organizations across the globe, helping them strengthen trauma-informed systems and improve therapeutic outcomes for both individuals and families.
In This Episode
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Dr. Rhoton has supervised outpatient clinics, juvenile justice and substance abuse programs, day treatment centers, and child and family therapeutic services. Formerly a professor at Ottawa University, he trained counselors to work with traumagenic family dynamics using non-egoic, compassionate models of care.
Today, he consults with agencies and organizations across the globe, helping them strengthen trauma-informed systems and improve therapeutic outcomes for both individuals and families.
In This Episode
Become a supporter of this podcast: https://www.spreaker.com/podcast/the-trauma-therapist--5739761/support.
You can learn more about what I do here:
The Trauma Therapist Newsletter: celebrates the people and voices in the mental health profession. And it's free! Check it out here: https://bit.ly/4jGBeSa
———
If you’d like to support The Trauma Therapist Podcast and the work I do you can do that here with a monthly donation of $5, $7, or $10: Donate to The Trauma Therapist Podcast.
Click here to join my email list and receive podcast updates and other news.
Thank you to our Sponsors:
Incogni - Use code [traumatherapist] and get 60% off annual plans: https://incogni.com/traumatherapist
Jane App - use code GUY1MO at https://jane.app/book_a_demo
Journey Clinical - visit https://join.journeyclinical/trauma for 1 month off your membership
Therapy Wisdom - https://therapywisdom.com/jan/
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the Trauma Rivers podcast. My name is Guiming
Ferson and I interview incredible people who share the story
of how trauma has shaped their lives. And a big
thank you for sponsoring today's episode goes to my guest
and our sponsors. So five four, three, two and one,
(00:23):
Our folks, welcome back to the podcast. Very excited to
have my guest today, Doctor Robert Roten.
Speaker 2 (00:29):
Robert, welcome, Thank you for having me so.
Speaker 1 (00:36):
Doctor Roton is the chief Clinical Officer of the Arizona
Trauma Institute, one of our sponsors, and President of the
Trauma Institute International. A diplomat of the American Academy of
Experts in Traumatic Stress, he has spent decades advancing the
understanding and the treatment of developmental and family trauma. Doctor
Roton as supervised outpatient clinics, juvenile justice and substance abuse programs,
(00:59):
the Treatment Center, and Child and Family Therapeutic Services. Formerly
a professor at Ottawa University, he trained counselors to work
with trauma genetic family dynamics using non egoic, compassionate models
of care. Today, he consults with agencies and organizations across
the globe, helping them, strengthen trauma informed systems, and improve
(01:20):
therapeutic outcomes for both individuals and families. All right, Robert, obviously,
just a little bit about you, but before we go in,
share with our listeners where you're from originally and where
you are currently.
Speaker 3 (01:36):
Okay, Well, originally I was born in the Phoenix area,
and I've lived most of my adult life in the
Phoenix area. This last year, I moved to Cottonwood, which
is a couple of hours north of Phoenix. So I'm
(01:57):
I'm definitely an Arizona guy, and I don't plan and
moving out of the state.
Speaker 2 (02:02):
So you know, I like it here.
Speaker 1 (02:05):
Awesome, awesome. All right, So we're obviously going to talk
about the Arizona Trauma Institute, but before we do, how
did all this start for you? This this interest is
specialization in trauma and so forth.
Speaker 2 (02:21):
Wow, that's that's an interesting question. You know.
Speaker 3 (02:27):
There's the professional answer I gave is that I was
teaching college. But the true answer is that I started
kind of learning about this stuff to kind of make
sense in my own lived experience. Anybody that's familiar with
the ACE Scores, which is kind of a landmark study
(02:53):
in trauma, I have an a score of nine, and so,
you know, I was trying to figure out what people
were doing, why they were doing it, from as young
as I can imagine, you know, my youngest memories are
trying to figure out stuff about people. And as I
began to gain more knowledge and education, I realized.
Speaker 2 (03:19):
Nobody was really addressing that.
Speaker 3 (03:22):
And when I you know, of course, when I started
the college in nineteen seventy one, neuroscience was a baby
in the development, and now we have understanding a lot
of what's going on. So for me, it's been a
lifelong pursuit to unpuzzle the craziness that I experienced and
(03:42):
then helping other people be able to so tasel it
for themselves as well.
Speaker 1 (03:49):
Was that a conscious trying to figure out what was
going on because of what you'd experienced or you just
were drawn to that kind of subconsciously?
Speaker 3 (04:02):
I wanted to understand it, and it kind of drove
a lot what I did, And what I found was
that most people really didn't understand. I mean, talk therapy
as it was practiced, you know, up through the say,
(04:23):
the late seventies, was either cognitive behavioral or psychoanalytic in nature,
and you know, psychoanalytic tends to focus people back on
the misery and pain, and that never made sense to me,
because you know, you get more of what you focus on.
So having people go back and slog through pain after
(04:45):
pain after failure after misery.
Speaker 2 (04:48):
Just doesn't seem to be really very useful to me.
Speaker 3 (04:53):
And then the cognitive approaches, I realized most of my
clients didn't have the ability to really function that well,
and so gaining an understanding of what's going on in
the body and the nervous system and the hormonal system
of a person that has a trauma history completely changed
(05:13):
how I saw clients.
Speaker 2 (05:15):
It completely changed how I approached things.
Speaker 3 (05:19):
And you know, we for a long time a couple
of us that were friends that were doing this research
together were the only ones in the US using a
salutogenic approach, which is a wellness approach. And when we
talk about it with people, they would look at us
like what because for.
Speaker 1 (05:39):
What was that not that important? What was the term salutogenic?
Speaker 2 (05:46):
Salutogenic?
Speaker 1 (05:48):
Salutogenic?
Speaker 3 (05:48):
I say it is, Yeah, it's a it's a wellness approach. Basically,
instead of seeing, oh man, this person has gone through
all the misery and they've had all of these failures
and they've had.
Speaker 2 (06:03):
All of these challenges.
Speaker 3 (06:06):
Oh pour them, We look at them, Look at what
they survived.
Speaker 2 (06:11):
How did they do that.
Speaker 3 (06:13):
They have competencies, they have capacities, and we focus on
helping them discover those, operationalize them, and use them. And
so it's really a different mindset. I can clearly give
you an example. If you're working with particularly intense trauma histories,
(06:34):
you're probably going to deal with people that tend to
dissociate or avoid. And from a psychoanalytic point of view,
that's a problem that needs to be fixed. From a
cognitive behavior approach, they say, that's irrational thinking.
Speaker 2 (06:49):
It needs to be fixed from our perspective.
Speaker 3 (06:53):
From a pseudogenic perspective, what you really need to do
is teach them how to use it with some intentionality,
because it's a tremendous skill if they can use it
when they want and avoid it when they don't want.
And so, you know, instead of having people feel a
sense of shame because this is what they do, we
(07:15):
teach them how to use it to help them.
Speaker 2 (07:18):
And it's just so much more compassionate and kind of people.
Speaker 3 (07:23):
Right.
Speaker 1 (07:23):
A whole paradynamic shift in a sense. So at what
point did you realize treatment needed to change to shift
as you were referring to CBT and psuchodynamic fair, how
did you realize that? When did you realize that?
Speaker 3 (07:48):
I realized that because almost everything I was taught in
school didn't work right, and it particularly didn't work with
people that had trauma historyes, toxic stress histories, or severe
mental health presentations. And you're kind of going like, well,
you know, here is all the stuff I was taught
(08:10):
and it's not working.
Speaker 2 (08:12):
And you know, then I was kind of in that
place where.
Speaker 3 (08:16):
A lot of therapists find that they panic and they
run to somebody else to say, what do you do?
And that person tells them what they do, and they
come back and they do that, and now we have,
instead of a true information base being shared, we have
opinions being shared, and the quality of characters doesn't, you know,
doesn't really grow very well. This is not something that
(08:39):
you know, this really I became firm in this probably
in the mid nineties because I realized that, you know,
all the stuff that I'd been taught really didn't prepare
me to help people much, and I was actually kind
of resentful of that fact.
Speaker 2 (08:59):
They taught what it has state licensure exams.
Speaker 1 (09:03):
Right, right, So let's let's talk about this. So one
of the things you wanted, I want to make sure
we talked about was what students, what students are being taught,
how they're how they're being taught. Let's kind of talk
a little bit about that. You mentioned. They're not really
being taught how to how to heal.
Speaker 3 (09:29):
No, they're taught theories and the history of the development
of those theories. And then they do they're required to do,
you know, an internship, but most of them it takes them.
Their internships run from four to six months. It takes
them four months just to learn how to do the paperwork.
(09:52):
And you know, they're they if if they're working for
if they're doing an internship at a place that's worthwhile.
Speaker 2 (10:01):
The only cases they should be getting as.
Speaker 3 (10:03):
An intern are the most easy cases because you know,
they don't have the skill set to take on anything
that's really serious.
Speaker 2 (10:13):
And when you and then.
Speaker 3 (10:15):
We we turn them loose to the public, and we
you know, the supervision is universally poor. You know, how
do people become supervisors is that they happen to be
licensed and they've worked for a company for a while
and so, but there's supervision is its own scientific field.
Speaker 2 (10:41):
There's a real skill to it.
Speaker 3 (10:42):
And most supervisors are not trained to be supervisors. They
just happen to be senior you know, counselors that are licensed,
that are willing to do it. So you you really
don't have a set up where professional development is really
(11:03):
taken seriously. And the consequence of having poor supervision and
having companies that are set up for efficiency is that
it destroys the relationship, which is the thing that provides
the most healing and the most stability for staff. So
you know, it's it really is a problem the way
(11:26):
we educate, the way we educate people to become therapists.
And I have conversations with universities all over the place
around this issue, and what they tell me is, well,
you know, the people attracted to being counselors aren't interested
in science. But I said, you require that they take
(11:49):
a human development course, but you don't require them to
understand any anatomy, any hormonal or nervous system work, which
seems kind of like, you know, a missed opportunity because
we have a lot of people that go into mental
health services seeking help when it's not actually a mental
(12:10):
health issue.
Speaker 2 (12:10):
At all, it is a biological issue.
Speaker 3 (12:13):
You know, we don't teach therapists to screen for the
difference between having a thyroid disorder and chronic depression. And so,
you know, if somebody is not aware that there are
medical conditions that can that can generate these things and
we need to kind of check those out, they just
(12:34):
you know, happily go about treating them for depression. Well
that no treatment's going to work if there's an underlying
physiological issue. So, you know, we really really don't prepare
therapists well and in most university settings to really know how.
Speaker 2 (12:52):
To help the folks that they are going to be helping.
Speaker 1 (12:56):
And when you say they're students, aren't really taught how
to heal. They're basically taught how to basically regurgerate, regurgitate
these theories. What do you mean by healing?
Speaker 3 (13:16):
Let me give you a simple example, based on what
I was just talking about. I got a this has
been what two thousand and eight or nine. I got
a referral from a little gal who was thirteen and
just made her third suicide attempt. She had been attending
therapy for almost two years. She'd had four different therapists,
(13:39):
she'd had a host of medications, and when I visited
r her the very first time, I said, there's something else.
Speaker 2 (13:46):
Going on here.
Speaker 3 (13:48):
And I began to ask her parents, you know, she's
been having this for the last two and a half years,
tell me what was going on six months prior to that,
and they just looked at me, like, well, but the
problem is this.
Speaker 2 (14:03):
I said, well, I'm not sure that's the problem.
Speaker 1 (14:06):
And.
Speaker 3 (14:08):
Found out that really her life had been pretty simple.
The only thing that had been really different was that
they had done a two week long camping trip with
family in Tennessee. And I said, you know, it feels
like it's not depression to me.
Speaker 2 (14:27):
It feels like something else is going on. I said,
would you.
Speaker 3 (14:30):
Mind if I would consult with a physician friend of
mine and they said no, So I did and he said, well,
you know the syndots are describing if I was back East,
I would consider having her checked for Lymes disease, and
so I said, well, you know, so I suggested the
family get her checked for Lymes disease.
Speaker 2 (14:50):
At that time. They did two separate tests.
Speaker 3 (14:52):
She came back positive for both, and when they started
treating the Lyme's disease, guess what happened to the depression?
Speaker 2 (15:00):
Wow, So you know, you know, we really have to
pay attention.
Speaker 3 (15:06):
And the fact that we don't educate counselors on what's
going on in this body is a real problem because
they are left to think, well, it's a mental health problem.
It's you know, it's a you know, the there's mental
illness there. Well, there may not be mental illness there.
We may be dealing with a physical problem. And if
(15:28):
you don't have the education to kind of distinguish the difference.
And I, you know, I lecture at medical schools all
over the place, and it's really funny because I had
to teach myself all that stuff because I didn't get
any of it in college classes.
Speaker 1 (15:46):
So enter Arizona Trauma Institute. You folks offer a lot
of different trainings and so forth. How did you become
associated affiliated? First off with ATI?
Speaker 3 (16:04):
Well, I founded ATI. I started it, and I can
tell you the reason I started it was because I
was irritated that I was, you know, constantly running into
people that wanted to do good work.
Speaker 2 (16:23):
And not knowing how.
Speaker 3 (16:27):
So my original concept was just to form this to
train people in the Phoenix metropolitan area.
Speaker 2 (16:33):
I mean, I really wasn't looking to go past that, and.
Speaker 3 (16:40):
You go forward, you know, fifteen years, and now we've
trained people in one hundred and thirty countries, and we
have active partnerships and in a number of countries that
you know might surprise people. So it's grown way past
what I initially initially thought. I just wanted therapists locally
(17:03):
to have good training. And in one of the things
we've done traditionally, if people take training from us, they
can join open mentoring sessions, which we don't charge for,
is to learn how to put these things into practice
and have a you know, have a community to get
(17:24):
support from.
Speaker 2 (17:26):
So it's really fun. We have people that attend.
Speaker 3 (17:30):
From these things from probably currently about twenty different countries
and hearing how they're.
Speaker 2 (17:38):
Putting these things into practice.
Speaker 3 (17:40):
I find that a lot of times they're resourcing each
other and it's really been kind of a fun project
to do.
Speaker 2 (17:47):
But almost all of them.
Speaker 3 (17:50):
Have suffered under that same idea is why am I
not being effective with what with what I was taught
in school? And the turnover rate for counsel in organizations
is huge. The standard in the in the US or
mental health agencies is seventy percent turnover of their clinical staff,
(18:15):
and that a lot of clients, a lot of people
that become therapists get out of the field within five years. Well,
why because we haven't. They're not adequately prepared to help
the people. And you know, the cases that I saw
in starting, you know, in the eighties.
Speaker 2 (18:37):
Were not nearly as.
Speaker 3 (18:39):
Severe as the cases that are pretty common nowadays.
Speaker 2 (18:43):
And so the education system is lagged so far behind
the current.
Speaker 3 (18:51):
Population that presents for therapy that the.
Speaker 2 (18:56):
Gap between what.
Speaker 3 (18:59):
These people know graduating and what they need to know
is a gulf.
Speaker 1 (19:06):
So, having listened to this interview, you know, the fifteen
or twenty minutes that we've already done so far, I
think people could have an idea of what goes on
what you teach at the Arizona Trauma Institute. But let's
get more specific. What are you offering in terms of
(19:27):
courses or education there?
Speaker 2 (19:34):
We do multiple things, but let me just talk about
the classes.
Speaker 3 (19:38):
Most of our classes, and I think we have almost
sixty that are online, are mostly clinically related.
Speaker 2 (19:46):
They're for counselors, psychologists, social workers, case managers.
Speaker 3 (19:52):
We have several courses that are designed for the layman,
and those courses that are designed for the layman. We
actually work in partnership with the Americopa County Community College District,
(20:13):
which is a eleven college system in the Phoenix metropolitan
area with over two hundred thousand students. We've written curriculum
for their courses. We endorse certain classes and provide micro
credentials for people that have completed specialties so that when
(20:36):
they finish up, we know they can do these things.
Speaker 2 (20:41):
And so that's you know, some of the things that
we do.
Speaker 3 (20:46):
But most of our trainings that are available either live
or in person, are really targeted to the mental health culture,
and we have.
Speaker 2 (21:00):
We start with a basic.
Speaker 3 (21:01):
Three day training just to introduce people to the foundation
of you know, what trauma care really is and what
it really means and how to begin to apply it.
Most of the mental health culture out there is driven
by business models of efficiency, so you know, you have
(21:25):
I'll give you an give you an example. Just talk
with an agency in the southeast US. They have one
hundred and eighteen therapists. They serve almost seven thousand clients,
but their average caseload for their mental health professional is
(21:48):
close to ninety clients, and there's no way anything any
therapist can be effective with ninety clients. And I was
kind of talking about that, and this is what the
leader of that organization told me, Well, as long as
we can build, as long as we can prove that
we provided a service and that we can build for it,
(22:11):
we don't need to worry about anything else.
Speaker 2 (22:13):
And I'm saying no, No, you want.
Speaker 3 (22:15):
To build your organization to drive clinical outcomes. What is
your client benefiting from this? You are in an efficiency model.
You don't even screen, you know who gets what client is.
Speaker 2 (22:29):
Just the next counselor in rotation gets the client, whether
they're ready for it or not.
Speaker 3 (22:36):
And so when you have an efficiency based system, you
strip away the very thing that therapists need to stay
vital in their work and the things that clients need
to be successful, and that's relationship. Because efficiency doesn't operate
well in a relational model.
Speaker 2 (22:56):
And what most people don't realize is that.
Speaker 3 (22:58):
Trauma informed care is a relational structure. It's a it's
a structure to give dignity, to to help people see
that they have value, that they have worth, that they
that they you know, and to lift them that is
not what most mental health agencies are structured around. They're
(23:20):
structured around documentation, billing, and lack of complaints.
Speaker 1 (23:27):
It sounds to me as though someone who's interested in
becoming a therapist of any kind should go straight straight
to straight to you. Unfortunately, it seems like a lot
of people are gonna have to go through go through
(23:47):
the system, and then find out that they need to
get to what you're offering. And that's very it's that's depressing,
that's depressing. But enough you mentioned something I want to
John Robert, which was your your mentoring model and offering
talk a little bit more about that. That's unded fascinating.
Speaker 3 (24:11):
Well, when again, we use a solugenic model, which really
we're looking at four things almost always, is it comprehensible
to the to the person you're working with, Can they
understand it? Does it make sense to them? The next
is is it something that they could actually manage in
(24:32):
the state that they're in now? You know, asking somebody
to do cognitive behavior work when their whole system is
disregulated and their bodies being filled with stress hormones which
takes the prefrontal cortex right offline, is not something that
they can manage, So you wouldn't use it until they
can manage it. So it can they understand it as
(24:56):
it comprehensible, is it manageable? And then finally, does what
you're asking them to do personally meaningful for them? Because
if it's not meaningful for them, they're not going to
do it.
Speaker 2 (25:07):
None of us will do something if we don't feel
it's personally meaningful.
Speaker 3 (25:12):
And then the fourth is what are the resources that
they already have had to use to survive. Let's identify
those and help them use them with intention. So those
are very different because it's not a focus on, oh,
how giving them a label. It's not focused on, you know,
creating a diagnosis and thinking.
Speaker 2 (25:34):
That now I have a diagnosis, I know what to do.
Speaker 3 (25:36):
Because the reality is if you have ten clients that
are bipolar, you have ten different ways bipolar is going
to present. So having a diagnosis does very little for
you in to actually bring healing or relief into people's lives.
And so since most people are trained in that idea
(25:57):
that we need a diagnosis and we need to treat
the diagnosis, well, it's kind of like you know that
you're high on the top of a mountain and they say,
don't look down.
Speaker 2 (26:12):
What do you do? You look down?
Speaker 3 (26:14):
And you know then it triggers all of this. Why
would we do that to somebody? Yet in mental health
we do it all the time. We focus on negative,
painful emotions and we light up the amiglatist system. And
when you light up the amiglative system, you put the
person in survival mode.
Speaker 2 (26:33):
And when they're in survival.
Speaker 3 (26:34):
Mode, they can't think clearly, they can't plan, they can't
follow through. Why in the world would we ever do
that to somebody. Imagine you're a child and every interaction
with your parent is a criticism for you or a
fault finding with you.
Speaker 2 (26:53):
There's something wrong with you.
Speaker 3 (26:56):
We have created a mental health world that is like
a critical parent. Well, this is what's wrong with you,
and this is what you need to be fixed, instead
of what is wonderful about this person? What is amazing
about that? Why am I not uncovering that? Why am
I not utilizing that? And that's the primary flaw that
(27:18):
I see out there is that this point of view,
the traditional mental health point of view, underserves people, and
it underserves them badly.
Speaker 1 (27:31):
Robert, you're really good at this, do you do a
lot of interviews. I am very inspiringly, you're very inspiring.
So all right, as we kind of wind down here,
I think our listeners have a good idea, but specifically,
(27:53):
who who's the Arizona Trauma Institute. Who are the classes
for any therapist, anyone interested? You mentioned lay audience as well.
Speaker 3 (28:07):
Sure, we have people that take a lot of our
classes that are not therapists because they just want.
Speaker 2 (28:13):
To know the information.
Speaker 3 (28:15):
Strange enough, we have a good number of parents that
are struggling with children that want to understand, particularly if
they've adopted children and didn't realize what was going to.
Speaker 2 (28:25):
Come with that.
Speaker 3 (28:27):
But most of the most all the courses are designed
for therapists, you know, social workers, psychologists and you.
Speaker 2 (28:36):
Know other human service workers.
Speaker 3 (28:40):
We have a few that are designed for educators, but
the bulk of what we do is really targeted towards
the mental health world. And but we have we even
have clients from from that will take those and then
we get nasty notes from their therapists. They take this
(29:01):
information back and say why aren't why aren't you doing this?
And so every once in a while I'll have somebody
call me and say, you know, I'm I'm I live here,
I'm having trouble finding a therapist, and I will comp
them a basic training so they know what to look for.
Speaker 2 (29:21):
And that always.
Speaker 3 (29:25):
Seems to put pressure on the people that they go
visit with. So so that's kind of but our main,
our main focus is on clinical programming.
Speaker 1 (29:38):
Okay, as we kind of wind down here, Robert, what's
the best way for people to learn more about the
Arizona Truma Institute.
Speaker 3 (29:50):
Go to our website, do a search on Google for
Arizona Trauma Institute. You're going to pull it up. You
can spend some time on it. We also have a
LinkedIn page, Facebook page. I don't particularly monitor the Facebook page,
but I usually am monitoring the LinkedIn page. So, and
(30:14):
we we really do respond pretty well to people, and
you know, we we do a lot of public service
kinds of things. I spent the hour before I joined
you today, I spent with a group of people that
are working with trauma survivors that through the from the
(30:35):
hurricane in Jamaica. Oh well, you know, it's just some
you know, they had some questions on so I do
kind of explain the difference between crisis and trauma and
that they're really doing with crisis, and this is what
you need to do in crisis. And when people get
through with crisis, maybe they'll need trauma therapy. But you know,
(30:59):
so those kinds of things. But yeah, we really, we
really do try to build a community wherever we are
working because it's really tough for therapists to go to
work with people that don't have any idea what we're
talking about and use a different kind of language or
get supervision. So we do the mentoring, we offer the
(31:22):
classes to support them so that they can have some
help in actually putting these things into practice.
Speaker 2 (31:29):
And if you're curious, you're welcome to join one if
you want.
Speaker 1 (31:32):
Guy, I tell you, you know, obviously I interview a
lot of people, but what sets you apart what you've
talked about, really the difference in what people are actually
are learning and what actually needs to be done and
how you are kind of transferring that into your education
(31:54):
and your courses is really inspiring. So I appreciate that,
and I'll take you up on that offer. For our listeners.
The website is azitrauma dot org and we'll have that
linked up here at the show notes page at the
Trauma therapist podcast dot com doctr roten awesome, super inspiring.
Appreciate you, We'll be in touch. Thank you, all right, sir,
(32:19):
all right,
Welcome to the Trauma Rivers podcast. My name is Guiming
Ferson and I interview incredible people who share the story
of how trauma has shaped their lives. And a big
thank you for sponsoring today's episode goes to my guest
and our sponsors. So five four, three, two and one,
(00:23):
Our folks, welcome back to the podcast. Very excited to
have my guest today, Doctor Robert Roten.
Speaker 2 (00:29):
Robert, welcome, Thank you for having me so.
Speaker 1 (00:36):
Doctor Roton is the chief Clinical Officer of the Arizona
Trauma Institute, one of our sponsors, and President of the
Trauma Institute International. A diplomat of the American Academy of
Experts in Traumatic Stress, he has spent decades advancing the
understanding and the treatment of developmental and family trauma. Doctor
Roton as supervised outpatient clinics, juvenile justice and substance abuse programs,
(00:59):
the Treatment Center, and Child and Family Therapeutic Services. Formerly
a professor at Ottawa University, he trained counselors to work
with trauma genetic family dynamics using non egoic, compassionate models
of care. Today, he consults with agencies and organizations across
the globe, helping them, strengthen trauma informed systems, and improve
(01:20):
therapeutic outcomes for both individuals and families. All right, Robert, obviously,
just a little bit about you, but before we go in,
share with our listeners where you're from originally and where
you are currently.
Speaker 3 (01:36):
Okay, Well, originally I was born in the Phoenix area,
and I've lived most of my adult life in the
Phoenix area. This last year, I moved to Cottonwood, which
is a couple of hours north of Phoenix. So I'm
(01:57):
I'm definitely an Arizona guy, and I don't plan and
moving out of the state.
Speaker 2 (02:02):
So you know, I like it here.
Speaker 1 (02:05):
Awesome, awesome. All right, So we're obviously going to talk
about the Arizona Trauma Institute, but before we do, how
did all this start for you? This this interest is
specialization in trauma and so forth.
Speaker 2 (02:21):
Wow, that's that's an interesting question. You know.
Speaker 3 (02:27):
There's the professional answer I gave is that I was
teaching college. But the true answer is that I started
kind of learning about this stuff to kind of make
sense in my own lived experience. Anybody that's familiar with
the ACE Scores, which is kind of a landmark study
(02:53):
in trauma, I have an a score of nine, and so,
you know, I was trying to figure out what people
were doing, why they were doing it, from as young
as I can imagine, you know, my youngest memories are
trying to figure out stuff about people. And as I
began to gain more knowledge and education, I realized.
Speaker 2 (03:19):
Nobody was really addressing that.
Speaker 3 (03:22):
And when I you know, of course, when I started
the college in nineteen seventy one, neuroscience was a baby
in the development, and now we have understanding a lot
of what's going on. So for me, it's been a
lifelong pursuit to unpuzzle the craziness that I experienced and
(03:42):
then helping other people be able to so tasel it
for themselves as well.
Speaker 1 (03:49):
Was that a conscious trying to figure out what was
going on because of what you'd experienced or you just
were drawn to that kind of subconsciously?
Speaker 3 (04:02):
I wanted to understand it, and it kind of drove
a lot what I did, And what I found was
that most people really didn't understand. I mean, talk therapy
as it was practiced, you know, up through the say,
(04:23):
the late seventies, was either cognitive behavioral or psychoanalytic in nature,
and you know, psychoanalytic tends to focus people back on
the misery and pain, and that never made sense to me,
because you know, you get more of what you focus on.
So having people go back and slog through pain after
(04:45):
pain after failure after misery.
Speaker 2 (04:48):
Just doesn't seem to be really very useful to me.
Speaker 3 (04:53):
And then the cognitive approaches, I realized most of my
clients didn't have the ability to really function that well,
and so gaining an understanding of what's going on in
the body and the nervous system and the hormonal system
of a person that has a trauma history completely changed
(05:13):
how I saw clients.
Speaker 2 (05:15):
It completely changed how I approached things.
Speaker 3 (05:19):
And you know, we for a long time a couple
of us that were friends that were doing this research
together were the only ones in the US using a
salutogenic approach, which is a wellness approach. And when we
talk about it with people, they would look at us
like what because for.
Speaker 1 (05:39):
What was that not that important? What was the term salutogenic?
Speaker 2 (05:46):
Salutogenic?
Speaker 1 (05:48):
Salutogenic?
Speaker 3 (05:48):
I say it is, Yeah, it's a it's a wellness approach. Basically,
instead of seeing, oh man, this person has gone through
all the misery and they've had all of these failures
and they've had.
Speaker 2 (06:03):
All of these challenges.
Speaker 3 (06:06):
Oh pour them, We look at them, Look at what
they survived.
Speaker 2 (06:11):
How did they do that.
Speaker 3 (06:13):
They have competencies, they have capacities, and we focus on
helping them discover those, operationalize them, and use them. And
so it's really a different mindset. I can clearly give
you an example. If you're working with particularly intense trauma histories,
(06:34):
you're probably going to deal with people that tend to
dissociate or avoid. And from a psychoanalytic point of view,
that's a problem that needs to be fixed. From a
cognitive behavior approach, they say, that's irrational thinking.
Speaker 2 (06:49):
It needs to be fixed from our perspective.
Speaker 3 (06:53):
From a pseudogenic perspective, what you really need to do
is teach them how to use it with some intentionality,
because it's a tremendous skill if they can use it
when they want and avoid it when they don't want.
And so, you know, instead of having people feel a
sense of shame because this is what they do, we
(07:15):
teach them how to use it to help them.
Speaker 2 (07:18):
And it's just so much more compassionate and kind of people.
Speaker 3 (07:23):
Right.
Speaker 1 (07:23):
A whole paradynamic shift in a sense. So at what
point did you realize treatment needed to change to shift
as you were referring to CBT and psuchodynamic fair, how
did you realize that? When did you realize that?
Speaker 3 (07:48):
I realized that because almost everything I was taught in
school didn't work right, and it particularly didn't work with
people that had trauma historyes, toxic stress histories, or severe
mental health presentations. And you're kind of going like, well,
you know, here is all the stuff I was taught
(08:10):
and it's not working.
Speaker 2 (08:12):
And you know, then I was kind of in that
place where.
Speaker 3 (08:16):
A lot of therapists find that they panic and they
run to somebody else to say, what do you do?
And that person tells them what they do, and they
come back and they do that, and now we have,
instead of a true information base being shared, we have
opinions being shared, and the quality of characters doesn't, you know,
doesn't really grow very well. This is not something that
(08:39):
you know, this really I became firm in this probably
in the mid nineties because I realized that, you know,
all the stuff that I'd been taught really didn't prepare
me to help people much, and I was actually kind
of resentful of that fact.
Speaker 2 (08:59):
They taught what it has state licensure exams.
Speaker 1 (09:03):
Right, right, So let's let's talk about this. So one
of the things you wanted, I want to make sure
we talked about was what students, what students are being taught,
how they're how they're being taught. Let's kind of talk
a little bit about that. You mentioned. They're not really
being taught how to how to heal.
Speaker 3 (09:29):
No, they're taught theories and the history of the development
of those theories. And then they do they're required to do,
you know, an internship, but most of them it takes them.
Their internships run from four to six months. It takes
them four months just to learn how to do the paperwork.
(09:52):
And you know, they're they if if they're working for
if they're doing an internship at a place that's worthwhile.
Speaker 2 (10:01):
The only cases they should be getting as.
Speaker 3 (10:03):
An intern are the most easy cases because you know,
they don't have the skill set to take on anything
that's really serious.
Speaker 2 (10:13):
And when you and then.
Speaker 3 (10:15):
We we turn them loose to the public, and we
you know, the supervision is universally poor. You know, how
do people become supervisors is that they happen to be
licensed and they've worked for a company for a while
and so, but there's supervision is its own scientific field.
Speaker 2 (10:41):
There's a real skill to it.
Speaker 3 (10:42):
And most supervisors are not trained to be supervisors. They
just happen to be senior you know, counselors that are licensed,
that are willing to do it. So you you really
don't have a set up where professional development is really
(11:03):
taken seriously. And the consequence of having poor supervision and
having companies that are set up for efficiency is that
it destroys the relationship, which is the thing that provides
the most healing and the most stability for staff. So
you know, it's it really is a problem the way
(11:26):
we educate, the way we educate people to become therapists.
And I have conversations with universities all over the place
around this issue, and what they tell me is, well,
you know, the people attracted to being counselors aren't interested
in science. But I said, you require that they take
(11:49):
a human development course, but you don't require them to
understand any anatomy, any hormonal or nervous system work, which
seems kind of like, you know, a missed opportunity because
we have a lot of people that go into mental
health services seeking help when it's not actually a mental
(12:10):
health issue.
Speaker 2 (12:10):
At all, it is a biological issue.
Speaker 3 (12:13):
You know, we don't teach therapists to screen for the
difference between having a thyroid disorder and chronic depression. And so,
you know, if somebody is not aware that there are
medical conditions that can that can generate these things and
we need to kind of check those out, they just
(12:34):
you know, happily go about treating them for depression. Well
that no treatment's going to work if there's an underlying
physiological issue. So, you know, we really really don't prepare
therapists well and in most university settings to really know how.
Speaker 2 (12:52):
To help the folks that they are going to be helping.
Speaker 1 (12:56):
And when you say they're students, aren't really taught how
to heal. They're basically taught how to basically regurgerate, regurgitate
these theories. What do you mean by healing?
Speaker 3 (13:16):
Let me give you a simple example, based on what
I was just talking about. I got a this has
been what two thousand and eight or nine. I got
a referral from a little gal who was thirteen and
just made her third suicide attempt. She had been attending
therapy for almost two years. She'd had four different therapists,
(13:39):
she'd had a host of medications, and when I visited
r her the very first time, I said, there's something else.
Speaker 2 (13:46):
Going on here.
Speaker 3 (13:48):
And I began to ask her parents, you know, she's
been having this for the last two and a half years,
tell me what was going on six months prior to that,
and they just looked at me, like, well, but the
problem is this.
Speaker 2 (14:03):
I said, well, I'm not sure that's the problem.
Speaker 1 (14:06):
And.
Speaker 3 (14:08):
Found out that really her life had been pretty simple.
The only thing that had been really different was that
they had done a two week long camping trip with
family in Tennessee. And I said, you know, it feels
like it's not depression to me.
Speaker 2 (14:27):
It feels like something else is going on. I said,
would you.
Speaker 3 (14:30):
Mind if I would consult with a physician friend of
mine and they said no, So I did and he said, well,
you know the syndots are describing if I was back East,
I would consider having her checked for Lymes disease, and
so I said, well, you know, so I suggested the
family get her checked for Lymes disease.
Speaker 2 (14:50):
At that time. They did two separate tests.
Speaker 3 (14:52):
She came back positive for both, and when they started
treating the Lyme's disease, guess what happened to the depression?
Speaker 2 (15:00):
Wow, So you know, you know, we really have to
pay attention.
Speaker 3 (15:06):
And the fact that we don't educate counselors on what's
going on in this body is a real problem because
they are left to think, well, it's a mental health problem.
It's you know, it's a you know, the there's mental
illness there. Well, there may not be mental illness there.
We may be dealing with a physical problem. And if
(15:28):
you don't have the education to kind of distinguish the difference.
And I, you know, I lecture at medical schools all
over the place, and it's really funny because I had
to teach myself all that stuff because I didn't get
any of it in college classes.
Speaker 1 (15:46):
So enter Arizona Trauma Institute. You folks offer a lot
of different trainings and so forth. How did you become
associated affiliated? First off with ATI?
Speaker 3 (16:04):
Well, I founded ATI. I started it, and I can
tell you the reason I started it was because I
was irritated that I was, you know, constantly running into
people that wanted to do good work.
Speaker 2 (16:23):
And not knowing how.
Speaker 3 (16:27):
So my original concept was just to form this to
train people in the Phoenix metropolitan area.
Speaker 2 (16:33):
I mean, I really wasn't looking to go past that, and.
Speaker 3 (16:40):
You go forward, you know, fifteen years, and now we've
trained people in one hundred and thirty countries, and we
have active partnerships and in a number of countries that
you know might surprise people. So it's grown way past
what I initially initially thought. I just wanted therapists locally
(17:03):
to have good training. And in one of the things
we've done traditionally, if people take training from us, they
can join open mentoring sessions, which we don't charge for,
is to learn how to put these things into practice
and have a you know, have a community to get
(17:24):
support from.
Speaker 2 (17:26):
So it's really fun. We have people that attend.
Speaker 3 (17:30):
From these things from probably currently about twenty different countries
and hearing how they're.
Speaker 2 (17:38):
Putting these things into practice.
Speaker 3 (17:40):
I find that a lot of times they're resourcing each
other and it's really been kind of a fun project
to do.
Speaker 2 (17:47):
But almost all of them.
Speaker 3 (17:50):
Have suffered under that same idea is why am I
not being effective with what with what I was taught
in school? And the turnover rate for counsel in organizations
is huge. The standard in the in the US or
mental health agencies is seventy percent turnover of their clinical staff,
(18:15):
and that a lot of clients, a lot of people
that become therapists get out of the field within five years. Well,
why because we haven't. They're not adequately prepared to help
the people. And you know, the cases that I saw
in starting, you know, in the eighties.
Speaker 2 (18:37):
Were not nearly as.
Speaker 3 (18:39):
Severe as the cases that are pretty common nowadays.
Speaker 2 (18:43):
And so the education system is lagged so far behind
the current.
Speaker 3 (18:51):
Population that presents for therapy that the.
Speaker 2 (18:56):
Gap between what.
Speaker 3 (18:59):
These people know graduating and what they need to know
is a gulf.
Speaker 1 (19:06):
So, having listened to this interview, you know, the fifteen
or twenty minutes that we've already done so far, I
think people could have an idea of what goes on
what you teach at the Arizona Trauma Institute. But let's
get more specific. What are you offering in terms of
(19:27):
courses or education there?
Speaker 2 (19:34):
We do multiple things, but let me just talk about
the classes.
Speaker 3 (19:38):
Most of our classes, and I think we have almost
sixty that are online, are mostly clinically related.
Speaker 2 (19:46):
They're for counselors, psychologists, social workers, case managers.
Speaker 3 (19:52):
We have several courses that are designed for the layman,
and those courses that are designed for the layman. We
actually work in partnership with the Americopa County Community College District,
(20:13):
which is a eleven college system in the Phoenix metropolitan
area with over two hundred thousand students. We've written curriculum
for their courses. We endorse certain classes and provide micro
credentials for people that have completed specialties so that when
(20:36):
they finish up, we know they can do these things.
Speaker 2 (20:41):
And so that's you know, some of the things that
we do.
Speaker 3 (20:46):
But most of our trainings that are available either live
or in person, are really targeted to the mental health culture,
and we have.
Speaker 2 (21:00):
We start with a basic.
Speaker 3 (21:01):
Three day training just to introduce people to the foundation
of you know, what trauma care really is and what
it really means and how to begin to apply it.
Most of the mental health culture out there is driven
by business models of efficiency, so you know, you have
(21:25):
I'll give you an give you an example. Just talk
with an agency in the southeast US. They have one
hundred and eighteen therapists. They serve almost seven thousand clients,
but their average caseload for their mental health professional is
(21:48):
close to ninety clients, and there's no way anything any
therapist can be effective with ninety clients. And I was
kind of talking about that, and this is what the
leader of that organization told me, Well, as long as
we can build, as long as we can prove that
we provided a service and that we can build for it,
(22:11):
we don't need to worry about anything else.
Speaker 2 (22:13):
And I'm saying no, No, you want.
Speaker 3 (22:15):
To build your organization to drive clinical outcomes. What is
your client benefiting from this? You are in an efficiency model.
You don't even screen, you know who gets what client is.
Speaker 2 (22:29):
Just the next counselor in rotation gets the client, whether
they're ready for it or not.
Speaker 3 (22:36):
And so when you have an efficiency based system, you
strip away the very thing that therapists need to stay
vital in their work and the things that clients need
to be successful, and that's relationship. Because efficiency doesn't operate
well in a relational model.
Speaker 2 (22:56):
And what most people don't realize is that.
Speaker 3 (22:58):
Trauma informed care is a relational structure. It's a it's
a structure to give dignity, to to help people see
that they have value, that they have worth, that they
that they you know, and to lift them that is
not what most mental health agencies are structured around. They're
(23:20):
structured around documentation, billing, and lack of complaints.
Speaker 1 (23:27):
It sounds to me as though someone who's interested in
becoming a therapist of any kind should go straight straight
to straight to you. Unfortunately, it seems like a lot
of people are gonna have to go through go through
(23:47):
the system, and then find out that they need to
get to what you're offering. And that's very it's that's depressing,
that's depressing. But enough you mentioned something I want to
John Robert, which was your your mentoring model and offering
talk a little bit more about that. That's unded fascinating.
Speaker 3 (24:11):
Well, when again, we use a solugenic model, which really
we're looking at four things almost always, is it comprehensible
to the to the person you're working with, Can they
understand it? Does it make sense to them? The next
is is it something that they could actually manage in
(24:32):
the state that they're in now? You know, asking somebody
to do cognitive behavior work when their whole system is
disregulated and their bodies being filled with stress hormones which
takes the prefrontal cortex right offline, is not something that
they can manage, So you wouldn't use it until they
can manage it. So it can they understand it as
(24:56):
it comprehensible, is it manageable? And then finally, does what
you're asking them to do personally meaningful for them? Because
if it's not meaningful for them, they're not going to
do it.
Speaker 2 (25:07):
None of us will do something if we don't feel
it's personally meaningful.
Speaker 3 (25:12):
And then the fourth is what are the resources that
they already have had to use to survive. Let's identify
those and help them use them with intention. So those
are very different because it's not a focus on, oh,
how giving them a label. It's not focused on, you know,
creating a diagnosis and thinking.
Speaker 2 (25:34):
That now I have a diagnosis, I know what to do.
Speaker 3 (25:36):
Because the reality is if you have ten clients that
are bipolar, you have ten different ways bipolar is going
to present. So having a diagnosis does very little for
you in to actually bring healing or relief into people's lives.
And so since most people are trained in that idea
(25:57):
that we need a diagnosis and we need to treat
the diagnosis, well, it's kind of like you know that
you're high on the top of a mountain and they say,
don't look down.
Speaker 2 (26:12):
What do you do? You look down?
Speaker 3 (26:14):
And you know then it triggers all of this. Why
would we do that to somebody? Yet in mental health
we do it all the time. We focus on negative,
painful emotions and we light up the amiglatist system. And
when you light up the amiglative system, you put the
person in survival mode.
Speaker 2 (26:33):
And when they're in survival.
Speaker 3 (26:34):
Mode, they can't think clearly, they can't plan, they can't
follow through. Why in the world would we ever do
that to somebody. Imagine you're a child and every interaction
with your parent is a criticism for you or a
fault finding with you.
Speaker 2 (26:53):
There's something wrong with you.
Speaker 3 (26:56):
We have created a mental health world that is like
a critical parent. Well, this is what's wrong with you,
and this is what you need to be fixed, instead
of what is wonderful about this person? What is amazing
about that? Why am I not uncovering that? Why am
I not utilizing that? And that's the primary flaw that
(27:18):
I see out there is that this point of view,
the traditional mental health point of view, underserves people, and
it underserves them badly.
Speaker 1 (27:31):
Robert, you're really good at this, do you do a
lot of interviews. I am very inspiringly, you're very inspiring.
So all right, as we kind of wind down here,
I think our listeners have a good idea, but specifically,
(27:53):
who who's the Arizona Trauma Institute. Who are the classes
for any therapist, anyone interested? You mentioned lay audience as well.
Speaker 3 (28:07):
Sure, we have people that take a lot of our
classes that are not therapists because they just want.
Speaker 2 (28:13):
To know the information.
Speaker 3 (28:15):
Strange enough, we have a good number of parents that
are struggling with children that want to understand, particularly if
they've adopted children and didn't realize what was going to.
Speaker 2 (28:25):
Come with that.
Speaker 3 (28:27):
But most of the most all the courses are designed
for therapists, you know, social workers, psychologists and you.
Speaker 2 (28:36):
Know other human service workers.
Speaker 3 (28:40):
We have a few that are designed for educators, but
the bulk of what we do is really targeted towards
the mental health world. And but we have we even
have clients from from that will take those and then
we get nasty notes from their therapists. They take this
(29:01):
information back and say why aren't why aren't you doing this?
And so every once in a while I'll have somebody
call me and say, you know, I'm I'm I live here,
I'm having trouble finding a therapist, and I will comp
them a basic training so they know what to look for.
Speaker 2 (29:21):
And that always.
Speaker 3 (29:25):
Seems to put pressure on the people that they go
visit with. So so that's kind of but our main,
our main focus is on clinical programming.
Speaker 1 (29:38):
Okay, as we kind of wind down here, Robert, what's
the best way for people to learn more about the
Arizona Truma Institute.
Speaker 3 (29:50):
Go to our website, do a search on Google for
Arizona Trauma Institute. You're going to pull it up. You
can spend some time on it. We also have a
LinkedIn page, Facebook page. I don't particularly monitor the Facebook page,
but I usually am monitoring the LinkedIn page. So, and
(30:14):
we we really do respond pretty well to people, and
you know, we we do a lot of public service
kinds of things. I spent the hour before I joined
you today, I spent with a group of people that
are working with trauma survivors that through the from the
(30:35):
hurricane in Jamaica. Oh well, you know, it's just some
you know, they had some questions on so I do
kind of explain the difference between crisis and trauma and
that they're really doing with crisis, and this is what
you need to do in crisis. And when people get
through with crisis, maybe they'll need trauma therapy. But you know,
(30:59):
so those kinds of things. But yeah, we really, we
really do try to build a community wherever we are
working because it's really tough for therapists to go to
work with people that don't have any idea what we're
talking about and use a different kind of language or
get supervision. So we do the mentoring, we offer the
(31:22):
classes to support them so that they can have some
help in actually putting these things into practice.
Speaker 2 (31:29):
And if you're curious, you're welcome to join one if
you want.
Speaker 1 (31:32):
Guy, I tell you, you know, obviously I interview a
lot of people, but what sets you apart what you've
talked about, really the difference in what people are actually
are learning and what actually needs to be done and
how you are kind of transferring that into your education
(31:54):
and your courses is really inspiring. So I appreciate that,
and I'll take you up on that offer. For our listeners.
The website is azitrauma dot org and we'll have that
linked up here at the show notes page at the
Trauma therapist podcast dot com doctr roten awesome, super inspiring.
Appreciate you, We'll be in touch. Thank you, all right, sir,
(32:19):
all right,
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