About Renee Hoekstra, Psy.D.

The Basics

Renee Hoekstra, Psy.D.
Licensed clinical psychologist, Massachusetts

I wanted to be a psychologist when I had a personal experience in high school of receiving counseling myself. I was intrigued by the power of an attentive audience, the ways in which I felt really “heard”, and the ways in which it really helped me at the time. Getting the help I needed at the time changed the projection of my future and my career. Because I also wanted to be a horse trainer, I spent a period of time working with horses before returning to school and reading every interesting article and book I could find about psychology and counseling. I went to graduate school in several different places before coming to Boston for a Harvard post-doctorate position. I decided to stay in Boston and create for myself the “perfect” job. Since then I have come to appreciate the charm of all New England has to offer.

The most helpful training and supervision experiences in my life have been personal and powerful- and have challenged me to practice what I preach.  I am actively involved in an international community whose core treatment components include awareness, courage, and love. In my own regular ongoing consultation group I am encouraged to take risks, to consider my role in group process, to increase my connections, and to identify the impact and consequences of my own behaviors with my colleagues and with clients. Sometimes this is painful and includes a few tears, but usually always results in growth and deeper connections. I try to attend conferences yearly with the Association of Behavioral and Contextual Sciences (ACBS) and an annual intensive training on Functional Analytic Psychotherapy (www.faptherapy.com). I have a strong interest in the Third Wave Behavior Therapies.

I tend to be creative in my treatment, approach mindfulness from many different angles, and incorporate my own material to enable clients to understand how my approach helps them solve their problems. I believe that people should have good information in order to make a decision about working with me, thus I offer a blog and website for people to review before making decisions about initiating services. When people leave my groups, I write them a personal letter of appreciation acknowledging what they have meant to group, ways in which they’ve grown and changed in the group, ways in which they have influenced myself or the group, what I will remember about them, and what I hope for them in the future. I read this letter out loud to them on their last day of group, and provide a written copy for them to take with them when they leave.

I managed to get all of your cartoon elephants into one big book. Everything you need to know about your cartoon elephants (emotions!) has been condensed into a graphic how-to self-help book. Clinicians are using this book to teach emotion regulation skills from Dialectical Behavior Therapy, and to start discussions about emotions with individual clients. If you need a playful conversation starter about extreme and intense emotions, you need to buy this book. Here is the link to obtain your Cartoon Elephants. 

How is the last name pronounced? You will do fine if you say it “Hook-stra”, but if you are feeling particularly Dutch you can say it more like “Whook-stra”. It is not Ho-EK-stra, Hoke-stra, nor Hockstra, although I am rather forgiving if you don’t get it right.


Doctorate of Clinical Psychology/ Psy.D. (2007)
Pacific University, Forest Grove, OR

Master of Arts, Psychology (2001)
Seattle University, Seattle, WA/ Existential-Phenomenological program.

Short summary of relevant clinical training:

  • Volunteer position audio taping Marsha Linehan’s individual therapy sessions and consultation team meetings (Spring, 2000)
  • Dialectical Behavioral Therapy Seminar Class (Seattle, WA/ September-December 2000) Instructors: Kate Comtois, Ph.D., Andy Elliot, M.D., Marty Hoines, M.D., Amy Wagner, Ph.D., and Tony DuBose, Psy.D.
  • Suicide Workshop (Seattle, WA/ Spring 2002). Marsha Linehan, Ph.D.
  • Dialectical Behavioral Therapy for Substance Abusers (Portland, OR Spring 2002). Linda Dimeff, Ph.D., and Ruth-Herman Dunn, Ph.D.
  • Emotion Regulation (Seattle, WA/ October 2005). Marsha Linehan, Ph.D.
  • On-line Learning/ DBT Skills Training (Completed April 2007).
  • DBT post-doctoral fellow/Harvard appointment. Massachusetts Mental Health Center (July 2007-June 2008). Supervisor: Dr. Elizabeth Simpson, M.D. (Clinical instructor of psychiatry, Harvard Medical School, DBT Trainer, DBT Director of MMHC).
  • Treating Anxiety Disorders in Multi Problem Clients with Borderline Personality Disorder: How, When, and Why to use Exposure Procedures in DBT (Westborough, MA May 2011) Melanie Harned, Ph.D., Kathryn Korslund, Ph.D.
  • Functional Analytic Psychotherapy Online Course with Mavis Tsai, Ph.D. and Jonathon Kanter, Ph.D. Jan-Mar 2011
  • Co-leader, Functional Analytic Psychotherapy Online Course with Mavis Tsai, Ph.D., Oct-Dec 2012
  • Ongoing consultation with University of Washington clinical faculty and clinical community.


Hoekstra, R. (2013). The Emotional Extremist’s Guide to Handling Cartoon Elephants: How to solve elephantine emotional problems without getting run over, chased, flattened, squished, or abandoned by your true cartoons.

Hoekstra, R. (2008). Interpersonal process groups redefined: A behavioral conceptualization. International Journal of Behavioral Consultation and Therapy, 4,188-198.

Hoekstra, R., & Tsai, M. (2010). Functional Analytic Psychotherapy for Interpersonal Process Groups. In R. Kohlenberg, M. Tsai, & J. Kanter (Eds.), The Practice of Functional Analytic Psychotherapy, p. 247-260. 

Recent Presentations:

Hoekstra, R. (2016). Navigating the Growing Pains of DBT Skills Groups with Functional Analytic Psychotherapy: Creative Adaptations to Help Your Groups Thrive. Association of Behavioral And Contextual Sciences, Seattle, WA.