Frontiers of Psychotherapist Development

At the Bleeding Edge of Development, Reaping Benefit for Our Clients.

Author: darylchow (page 2 of 4)

Signs That Therapists are Barking Up the Wrong Tree in Our Professional Development 

 

Signs That Therapists are Barking Up the Wrong Tree in Our Professional Development

Sometimes you climb the ladder to the top,
only to discover that you’ve placed it against the wrong wall.

~ Joseph Campbell

 

I’m going to re-look at some deeply held truths  we were taught to believe about professional development in the field of psychotherapy.

Actually, if these truths are closely examined, they are perpetuated lies.

 

What’s worse than falsehood is a distorted truth.

 

This is not an attempt to put up a straw man about our field. Rather, I hope we can

a) Stop digging ourselves into a deeper hole, and

b) Get ourselves out of the entrenchment.

Before you read on, answer the following question:

Do you consider yourself a person who is open to challenging your own assumptions

If you are, read on. If not, the following list is going to cause you some discomfort.

Here it goes:

In no particular order, here are signs that we are barking up the wrong tree in our professional development:

Continue reading

Mastery Learning for Therapists: Figure Out the What Before the How

“I always wanted to be someone. Now I think I should have been more specific.”

~Comedian Lily Tomlin

One of the most rudimentary, yet the most difficult thing to do in your professional development is to be specific.

As a culture, we are obsessed with “How to’s” . Do a search on Amazon, and you’d yield close to 100,000 self-help books like “How to Change Your Life in the Next 15 minutes,” the classic “How to Win Friends and Influence People,” and “How to Be Happy,” etc.

The unresolved problem is, we fail to identify What to work on before the How

Skipping this step of well-defining and specifying the component parts of what to work on that has leverage on improving our situation is like trying to be a writer without knowing how to spell. Sal khan, founder of Khan Academy shines a light at the inherent issue:  We go after complex techniques and so-called advanced skills, and lose sight of  working at the grammar i.e., fundamentals.

Sal speaks on this issue regarding standardised testing in education:

On that test, maybe I get a 75 percent, maybe you get a 90 percent, maybe you get a 95 percent. And even though the test identified gaps in our knowledge, I didn’t know 25 percent of the material. Even the A student, what was the five percent they didn’t know? 

Even though we’ve identified the gaps, the whole class will then move on to the next subject, probably a more advanced subject that’s going to build on those gaps. It might be logarithms or negative exponents. And that process continues, and you immediately start to realize how strange this is. I didn’t know 25 percent of the more foundational thing, and now I’m being pushed to the more advanced thing. And this will continue for months, years, all the way until at some point, I might be in an algebra class or trigonometry class and I hit a wall. And it’s not because algebra is fundamentally difficult or because the student isn’t bright. It’s because I’m seeing an equation and they’re dealing with exponents and that 30 percent that I didn’t know is showing up. And then I start to disengage.

To appreciate how absurd that is, imagine if we did other things in our life that way. Say, home-building

So we bring in the contractor and say, “We were told we have two weeks to build a foundation. Do what you can.”

So they do what they can. Maybe it rains. Maybe some of the supplies don’t show up. And two weeks later, the inspector comes, looks around, says, “OK, the concrete is still wet right over there, that part’s not quite up to code … I’ll give it an 80 percent.”

In our field of psychotherapy, with over 400 models therapy, there are so many aspects to learn and get distracted by. Again, here is the problem : We lose sight and remain vague, abstract, and overwhelmed in our definition on what to work on. Instead, we go broad, and sacrifice deep. And when we go deep, we go into rabbit holes that make us none the wiser.

I worry we are barking up the wrong tree. We work on things that have suboptimal leverage on impacting our interpersonal therapeutic skills. Instead, we think that content knowledge will get us to there.

Here’s what Carl Rogers has to say about this, almost 78 years ago:

“The experience of every clinic would bear out the viewpoint that a full knowledge of psychiatric and psychological information, with a brilliant intellect capable of applying this knowledge, is of itself no guarantee of therapeutic skill.” (Rogers, 1939, in The Clinical Treatment of the Problem Child)

NO GUARANTEE of therapeutic skill?? Good grief. Then what should I be working on? Here’s my best estimates at this point in time. It’s not in the domain of content or clinical knowledge. It’s got something more to do with process knowledge and conditional knowledge. (See my previous post on this topic, Three Types of Knowledge).

~~

Before we can adopt a philosophy of mastery learning, we first have to learn the art of being specific.

I remember during my primary school days, when we were first introduced to science lessons, we were given a little magnifying glass. Armed with this little contraption, I took it around with me during recess. We ended up skipping meals, and ran to the edge of the fences to burn things. Leaves, paper, even our textbooks or whatever we could get our hands on. The simple trick, as we applied our science lesson, was to find the sweet spot and focus the sun’s rays and slowly ignite the object. To discover smoke and fire. What a primitive delight.

magnifying glass

Figure out what to work on that has the biggest leverage to improve your performance before you begin working at your craft.

Fast forward a few decades, we are still playing with a different sort of magnifying glass. Scott Miller and I to created what we call a “Taxonomy of Deliberate Practice Activites (TDPA; Chow & Miller, 2015*). This is aimed at guiding practitioners and supervisors in the art of leveraging and being specific. Stay tuned. In an upcoming APA book, edited by David Prescott, Cynthia Maeschalck, and Scott Miller, I’ve got a chapter related to the topic that speaks about the taxonomy, as well as  issues on the practice and the practicals of deliberate practice.

 

Here’s a question you can begin to ask yourself: “At this point of my professional development, What is the one thing I can to work on to get better at my craft?” Hint: Seek the advice of someone who is willing to know you work, and go back to the fundamentals.

Best wishes, 

Daryl Chow, MA, Ph.D. (Psych)

Note:

*You can email me at daryl@darylchow.com  if you would like to receive a copy of the taxonomy. 

 

What Have You Changed Your Mind About? 

What Have you changed your mind about?

 When thinking changes your mind, that’s philosophy. When God changes your mind, that’s faith. When facts changes your mind, that’s science. 

~ from Editor John Brockman, the Edge book, What Have You Changed Your Mind About? 

Do you know someone who seems to know everything? When you share a new idea with this friend or colleague, they give you that “I-knew-it-all-along” kind of nod and smirk? This person is more likely to be thinking about what they are going to say next, than listening to what you have to say. I have to admit, I find it hard to talk to Mr. “Knew-It-All-Along.” It’s never their intention, but I feel stupid with them.

Here’s a book about a bunch of really big smarts from a variety of fields, who come to the conclusion that what they knew, was wrong, and were willing to change their minds, something which Mr. “Knew-It-All-Along” will find this very hard to do.

In this book, editor John Brockman asked renowned scientists and thinkers around the world this one simple question:

What Have You Changed Your Mind About?: Today’s Leading Minds Rethink Everything (Edge Question Series)

Take this specific example from developmental psychologist, Paul Bloom. (He wrote a brilliant book on the moral development of kids, called Just Babies.) Who would have thought that you can make a case against empathy? Listen to his compelling argument with neuroscientist, Sam Harris podcast before you make up your mind.

(Since the time of this writing, I just realised he’s book on this topic is finally out. It’s called, Against Empathy)

Here are two  of my favorites:

1. The Collaborative Community, by futurist and founding father of the internet, editor at large for Wired magazine and author of The Inevitable Kevin Kelly:

“Much of what I believed about human nature, and the nature of knowledge, has been upended by Wikipedia.”

Kevin Kelly goes on to elaborate about the power force of communities that shaped Wikipedia as we know it today.

2. What Constitutes Life Satisfaction by cognitive scientist and nobel prize winner in economics, Daniel Kahneman: “Conditions that make people satisfied with their life do not necessarily make them happy.” Kahneman makes a compelling argument on this topic. I had to re-read this a few times, at different times to let this one sink in.

The folks at Edge.org are a generous bunch. I just realised the whole damn book is free in their website! [https://www.edge.org/annual-question/what-have-you-changed-your-mind-about-why](Somehow, I found it more compelling to read it in the paperback form. Maybe’s it’s the tactile thing, but I also reckon the layout and the commitment we give to a given book, makes it more focused.)

If this book were to be released in 2015,  past president of the DSM-IV committee, psychiatrist Allen Frances   would have been an important addition to this series  on his change of mind and his outcry of the DSM-V (Check out Dr. Frances’ talk on the recent issue of diagnosis Inflation, and his thought provoking book, Saving Normal).

(Here’s an early article in 2010 by Gary Greenberg on the heated battle of the DSM-V. Well worth the read)

~~~

Now, back to us. Let’s take a moment and ask ourselves: When was the last time you changed your mind?

Do we read new things seeking to be confirmed, or do we open ourselves to be disconfirmed?

Do we hold tentative, or do we end up solidified in our ideas, metaphors, and beliefs about what we know and practice as a psychotherapist?

Once again, “When thinking changes your mind, that’s philosophy. When God changes your mind, that’s faith. When facts changes your mind, that’s science.” My add-on: When you change your own mind, that’s atheism. When someone changes your mind, that’s love.

In relations to our field of mental health/psychotherapy, I would love to hear from you in the comments below, the very same question John Brockman asked six years ago:

 

WHAT HAVE YOU CHANGED YOUR MIND ABOUT? WHY?

Daryl Chow, Ph.D.

 

 

How Do You Get Better At Eliciting Feedback?

 

ask-more-questions

…But what questions should we ask?

In the previous post, we addressed the issue of how to receive feedback.

In this post, we take a step back and address how we can elicit feedback.

But before we dive right in, ask yourself:

Do you really want to know? I used to find myself hesitant to ask for feedback when I know someone was amiss in the session. I’ve learned from my colleagues that this is common. What I learned is to point it out anyway, “You know Tim, I noticed that I might have missed something essential to you today. Am I mistaken? Can you help me figure out what that is, or what we could have explored further on?”

How we convey a sense of openness to the other person’s point of view will determine the type of feedback we get.

When we ask, ”Is everything ok today?” will skew towards a vocal-tic response, “Yeah. All good.”

Where we point the lens, it becomes the foreground. Discuss in advance what you are looking out for. While it may sound counterintuitive at first, take some time to process the following:

High session ratings of engagement by your client is not predictive of good outcomes (e.g., Owen, Miller, Seidel, Chow, 2016). In contrast, highly effective therapists seem to be able to elicit low engagement scores in early sessions. High alliance scores in the first session tells us nothing. The client could be truly happy with the session, or she might not feel safe to tell you how badly you missed her point today.

srs-1srs-2srs-4srs-3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you know the average alliance formation trajectory among your clients? Which of the above fits your pattern?

We’ve also found in our initial Supershrinks study (Chow, 2014; Chow et al 2015. Stay tuned. We are on to some replication studies. More on that next time) that as compared to the average cohort, highly effective therapists are more likely to report being surprised by client feedback. That is, the top performers are more likely to report being surprised by client’s feedback that their counterparts. It does seem to suggest that the highly effective therapists are more willing to be corrected. They have a sense of openness to receive and consider client’s viewpoints, even if it may be contradictory to the therapist existing expectations.

Janet Metcalfe and colleagues suggest that individuals are more likely to correct errors made with initial high confidence than those made with low-confidence, so long as the corrective feedback is given (Barbie & Metcalfe, 2012; Butterfield & Metcalfe, 2001; Butterfield & Metcalfe, 2006; Metcalfe & Finn, 2011). Although it may seem intuitive that deeply held beliefs are more entrenched and are the hardest to change, experimental studies have indicated that individuals are more likely to overwrite their responses and correct their beliefs (Butterfield & Metcalfe, 2001; Butterfield & Metcalfe, 2006), and are more likely to retain the correct answer compared to knowing the correct answer at the outset (Barbie & Metcalfe, 2012).

What? That’s a mouthful. Put it this way. Stand tall, and stand corrected.

Here’s some key points to remember when trying to elicit feedback from your clients at the end of a session:

1. Prime the Recall:

Give a good rationale WHY your client’s feedback about the session is crucial to you;

2. State What This is Not:

For example, “This is not an evaluation tool…You know how we are asked to do feedback surveys at restaurants? This is exactly what it’s not! Simply because those types of feedback, do not effect a change that will impact you. Your meal isn’t going to change because of your feedback. Here in the session, your feedback is important to me as it can help me tailor to fit you specifically…”

3. Juxtapose Open and Close Ended Questions:

Conventional wisdom argue to use open ended question. “What was the session for you?” Most of the time, this is too vague for clients. Instead, ask the specifics. “As you recall out what we talked about, and the exercise we did before we wrapped up, What was helpful to you?” After they share with you a response, follow it up with, “What was not helpful to you?” “…I know it’s tough to give feedback… we don’t normally tell others what we think, but your point of view is very important to me. I won’t take it personally, but I will take it very seriously…. cos’ sometimes, I just can’t see what I can’t see.”

4. Be Specific:

If you want specific feedback, be specific with your questions. “You know Kelvin, I got a feeling that I’ve pushed you too far today, especially when we were attending the issue about your fears. Am i mistaken?”

“What should I do more of?”

And

“What should I do less of?”

5.  The Small of Things:

Say this, “You know as it’s hard to give someone feedback, I just want you to know that even if you think it’s a small or minor issue, please, I would love to hear about it.”

Cite examples: “You know, I once had a client who told me that I was too careful with her, and she wanted me to just be blatant with her. Do you feel that way too?”

As a form of closure, you can ask, “If there’s just one thing, what stands out for you today that you’d like to remember from our session?” Write that down, and begin to form ideas to bridge this into the next session.

Don’t forget to take a gamble on your own to make a prediction of how your client rates the session, before you see their ratings on the alliance measure. (see an older post that I talked about this practice, called Rate & Predict exercise)

All systems balances itself with a feedback loop. It’s up to us to elicit the specifics, and then follow through be an open and warm receiver. It’s abit like receiving presents during this Christmas. Be thankful.

At the time of this writing, I wish each of you a happy new year.

Best,

Daryl Chow, PhD

30th of Dec 2016

 

How Do You Get Better at Receiving Feedback?

 

waitress-funny-service-with-a-smile

“How was your meal sir?”

“Fine, thanks.” I lied.

Five minutes into the meal, the waitress comes back to me. She’s wondering why I haven’t touched my pasta one bit since she last enquired.

“Erm, your meal going ok?”

“Yes, it’s fine.” I feel for the leading question. I smiled, and returned to my conversation with my two friends.

The truth is, the pasta was so salty that I couldn’t continue without numbing my mouth. But I couldn’t be bothered. I was planning to wash it down with a cup of coffee later, and continue my conversation.

This time, she’s bold. She stepped into the fire and asked me again, “Sir, is everything ok?”

I thought to myself, man, she’s persistent. I gotta hand it to her. Maybe I should just tell her.

“Actually, since you asked me for the third time. I have to say,  Frankly, I don’t think I’m a fussy eater, but the pasta is so salty I can’t eat anymore of it.”

In a million years, I couldn’t have guessed her reply. She came up with a one-liner. In fact, it was just two letters.

“Oh,” she said.

Bypassing the awkward silence, she stepped one foot back, and inched away. We couldn’t believe what just happened. I’m a hopeful guy. I waited to see if she might return with  a replacement, indulge me in a tiramisu  cake to sweeten my tooth from the numbing sensation in my mouth, or maybe even waive the cost of that half eaten dish.

None of that happened.

If you ask for feedback, you got to learn to receive it. Period.

Another time, at a phone centre in Singapore, this customer service personnel blatantly said to me, “Bro, everything’s good (with the service) right?”

“Erm,” I said.

“Hey, don’t mind, please give me a good feedback rating here (pointing to the form) please.”

For once I manned up, and said no. It just doesn’t make sense. He was asking for my help, not my feedback. He wasn’t very please with me thereafter.

~~~

Feedback is tough. In the process of writing their book Difficult Conversations: How to Discuss What Matters Most, authors Doug Stone and Bruce Patton realised that most people found it the most difficult giving and receiving critical feedback.

We expect our clients to give us just their honest feedback about the session, and we expect ourselves to enter into potential landmines with open arms. What we really need to learn is the fundamentals of being a good feedback elicitor and receiver, with all the good, the bad and the ugly that comes with it.

Look at your personal library.  Do you own a book that teaches you to be a good receiver of feedback?  I recommend you check out Stone and Patton’s 2014 book “Thanks for the Feedback: The Science and Art of Receiving Feedback Well” It’s not a psychotherapy book. In fact, I think therapists should do their best to read outside of the jargon-laden therapy world to widen your lens and speak a common language.

I once heard a therapist say to a client who was mad at her for making her feeling interrogated with a barrage of questions, “Thank you so much for your feedback. It must take so much courage to say what you said.” On the surface, it sounds ok to say that. It’s polite. It’s what we are taught to say.

Lets face it. Is it easy to take negative feedback from you client? No. Is is pleasant? Hell no. Then I think we should be honest and simple say that. “You know, I must admit, this is hard to take in. I’m trying to digest what you are saying… because this is important… What you are saying is that I’ve interrogated you, bombing you with questions after questions. It’s hard for me to admit… but you are right. Instead of helping you,  I’ve made you feel like a criminal, when you have don’t nothing wrong…. I’m sorry. I’ve let you down today. Again, it’s tough to hear this, but thanks for telling me.”

Supervisors can also highly benefit from digging deep into learning about how to elicit and receive feedback. It’s easy to take for granted the collegial bond, and expect supervisees to vocalise their concerns when the need arises. I argue, that because of the relationship, it can be even harder in a supervisory context than in a therapy.

The authors of Thanks for the Feedback points out three key triggers that can set us off when we receive critical feedback:

  1. Truth Triggers: When something we deny or disagree with. It makes us feel indignant;
  2. Relationship Triggers: Think about how your dad can say something that makes you explode, but when your trusted coach say the exact same thing you take it as good advice. Who matters more than the What, and
  3. Identity Triggers: This gets personal. It shakes the core of you. “We feel overwhelmed, threatened, ashamed, or off balance” by the feedback. (Has that happened to you before? I’m no stranger to this. It hurts.)

Stone and Patton offers some suggestions of dealing with such triggers. For truth triggers, they suggest learning to separate appreciation, coaching, and learning to see your blindspots. For Relationship triggers, they suggest separating the We from What. Finally, for identity trigger, they suggest learning to challenge our pre-existing assumptions and cultivating a growth (vs. fixed) mindset (ala Carol Dweck’s philosophy). (See their book for further elaboration)

That’s all well and good. I think what matters most is not just having these content knowledge, but we need to learn how to explicitly receive and respond to critical feedback.

To whet your appetite, check out Doug Stone’s interview about the book on The Art of Manliness podcast (Ladies, I assure you that you’d find is not an exclusive gender bias podcast). Around the last 10mins of the interview with Brett Mckay, listen to an example Doug gives about men’s lack of attention to women.)

Doug rightly points out,

“One of the most difficult conversations people have is to give and receive negative feedback “

Maybe someone should have taught the waitress on how to follow-through after asking for feedback. She missed a huge opportunity. I don’t blame her. She had the courage but not the skills yet.

Ask, and be ready to receive.

Stay tuned for the next post on the why the difference between performance feedback and learning feedback matters to your development.

Best,

Daryl Chow, Ph.D.

Guess who’s the king of feedback?

jimi-hendrix-1967

 

Scenius vs. Genius

 

brian-eno-with-u2-chefs-hat

Who Are These Chefs hanging out with Brian Eno?

Not only does his brilliance shine in his collaborations,  he’s also good at coming up with words.

Heard of the term “ambient music“? He came up with it.

Heard of the word “Scenius”? Probably not. He came up with it.

Genius is individual, scenius is communal

Brian Eno, highly acclaimed ambient musician and producer of such major artists as Talking Heads, David Bowie, and U2, coined this term to debunk the notion of genius.. He explains,

 “I was (previously) encouraged to believe that there were a few great figures like Picasso and Kandinsky, Rembrandt and Giotto and so on who sort-of appeared out of nowhere and produced artistic revolution. As I looked at art more and more, I discovered that that wasn’t really a true picture. What really happened was that there was sometimes very fertile scenes involving lots and lots of people – some of them artists, some of them collectors, some of them curators, thinkers, theorists, people who were fashionable and knew what the hip things were – all sorts of people who created a kind of ecology of talent (emphasis mine). And out of that ecology arose some wonderful work…I thought that originally those few individuals who’d survived in history – in the sort-of ’Great Man’ theory of history – they were called ’geniuses’. But what I thought was interesting was the fact that they all came out of a scene that was very fertile and very intelligent.” (Eno, 2009)

Eno’s point is to help us look beyond ourselves as standalones, but rather as individuals within context that can facilitate creativity and growth.

brian-eno-u2

U2, with the man behind some of their best albums.

Transporting from music to therapy, while solitary deliberate practice  is necessary, it isn’t sufficient. If the voluminous amount of self-help books published each year is a reflection of our appetite, we are certainly persuaded that we got to “make it on our own.”  The pursuit of excellence is not a solo endeavor. As such, the development of a psychotherapist is not an individual enterprise.

Here’s How:

1. Surround yourself with people who inspires and brings life to you. Seek them out;

2. Open yourself to the scrutiny of watching your therapy session recordings. Do likewise with your colleagues;

3. Seek out therapists (maybe even non-therapists) whom you admire. Talk to them. Find out what inspires them, and what sort of sweat, blood and tears they go through to get good at their craft. Don’t just scrutinise their outputs (i.e., performance). Zoom in on their inputs (i.e., practice routines, systems, what they read, what they work on, how they work on it).

I am a better version of me when I’m surrounded by a community of folks who add life to life. These people don’t have to think like you, share the same ideas, or may not even be likable by others. If we all think alike, no one thinks at all.

We can’t change those who are around us, but we can change who are around us.

Seek out to be part of an ecology of talent – a scenius community that fosters excellence. No therapist is an island.

So I would like to know how do you become part of  such a forward moving community? How do you get to surround yourself with people who draw out the best in you?

Best, 

Daryl Chow, Ph.D.

~~~

Further Readings:

1. Check out one of my favorite thinkers of our times, Kevin Kelly’s take on Brian Eno’s notion of on Scenius. If you want to step out of the world of therapy and take a glimpse of what the future hold, listen to this guy. He’s one of the pioneers of the internet. I highly recommend his latest book, The Inevitable: Understanding the 12 Technological Forces That Will Shape Our Future

2. If you are trying to break out of your comfort zone and put your work out these in the work, check out Austin Kleon’s book, Show Your Work!: 10 Ways to Share Your Creativity and Get Discovered . He also wrote about the idea of Scenius in this book, &

3. The Cambridge Handbook of Expertise and Expert PerformanceDeeply embedded in  this seminal edited handbook , there a good chapter on this topic of the role of social encouragement in the development of expertise. Much of the ideas on deliberate practice in various fields are illuminated in this handbook as well.

 

Why We Need This One Person For Us To Get Better

miles-davis

I play what we can play, not me. I never play what I can play. I’m always playing way over and above what I can play.”

~ Miles Davis

When this guy was in the room, I played better.

We first met Randolf Arriola when I was  about 17 years old. My bandmates and I saved up enough money to go into a recording studio (recall that this was in the late 1990’s when home recording equipment was not yet readily available) to attempt to demo some of our songs. Back then, Randolf was working as an assistant sound engineer with Freddy, who owns this suave  studio*. Frankly, we weren’t so sure we could afford recording there.

Fast forward a few weeks, we abandoned recording at Freddy’s studio. In gist, he made us sound horrible. He said with some confidence, “I can make you sound like Collective Soul.”  We said, “What?”  We collectively didn’t want to sound like them. It was not what we had in mind. We were smothered by bands like the Verve, Radiohead, Led Zeppelin, Jimi Hendrix, etc. Not Collective Soul.

Instead, we bailed out of the formal recording studio and we ended up at Randolf’s tiny room where he lived with his parents in a two-bed room apartment. His bedroom could fit a single bed, a 16 channel mixing, some rack mount stuff, a handful of guitars, and a PC with a monitor. That’s it.

As for the humans, we could fit about 3 to 4 other people in there. Randolf would be sitting on a stool designated for him to face the screen, while the rest of us took turns to sit beside him to review the tracks that we were recording. Forgot about “rockin’ in a free world” and head banging recklessly. There was literally no room for that. With all the equipment around us, we were sardines in a tin can.

We stuck with Randolf for years to come thereafter. He ended up not only becoming our sound engineer and co-producer, he also became our mentor, collaborator, and session guitarist. He was our Brian Eno and Daniel Lanois is to U2, all packed into one person. I mean, this was guy knew every detail about music, from the gears, song craft, repairing instruments, modifying stomp boxes, producing, sound engineer… He was his own company.

The truth is, when he was around us, he raised the bar of our performance. I mean, we were by no means U2 (or collective soul for that matter). The point is that we ended up playing better than we can. (Check out Randolf performing with us at the Esplanade in Singapore 6 years ago).

I believe this came from Randolf’s deep devotion to the craft. And he has this uncanny ability to be so specific about what we can do to push our songs, ourselves, individually and collectively to the next level.

We spent so many nights talking about music, listening to music and riffing about it. I was introduced to a plethora of wide range of music from my bandmates and Randolf.  He personified music. I learned so much about the psychology behind music from him, and how to simplify from the BS and get to the heart of things.

He was critical, but not criticising. He pushed us, but never made us feel small.

Instead, he made us feel like the hero on our hero’s journey.

Combined with some home-brewed 4 and 8 track records we made on our own and Randolf’s tiny home studio recordings, we released an album together. (We were not in the top of the charts,  nor were we expecting to. We just loved music making. In fact, after some time the album got so painful a process that we just wanted to get it out of the way!). In no small ways, it was a  life lesson still embedded in me more than a decade later.

I picked up two key takeaways from my musical journey: 

1. Seek out a few people who can guide me in specific areas,

2.  Stay close to someone who is better than you.

Randolf is a freakin’ brilliant musician in his own right. Watch him do his magic with real-time live looping.

Here’s Randolf featured in TedX:

This speaks to  our work as therapists.

We need a good coach. We need someone who we can help us raise the bar of our performance, and help us become better versions of ourselves (not a copy of the supervisor/coach).

This made me seek out clinicians who are better than me. People who can teach me and guide me. Early on,  I decided that I’m going to be a perpetual student. No shame.

Who do you seek out to raise the bar in your development as a therapist? Do you get specific directives on what you can work on that can leverage on your effectiveness, and not just some theory talk or  vague “case consultation”?

Stay tuned for more on this topic of clinical supervision and coaching. (Or simply signup on the right sidebar for to receive hassle-free updates in your inbox from Frontiers)

You might also be interested in these past posts:

The Scandal of Clinical Supervision: Here’s the Shocker (Part 1 of 2)

The Scandal of Clinical Supervision: How to Resolve It (Part 2 of 2)

Clinical Practice vs. Deliberate Practice: Why Your Years of Experience Doesn’t Get You Better

p/s: My mentor Scott Miller wrote recently on this common topic as well.

*Note: In order to protect his privacy, Freddy is not his real name. Freddy was after all kind enough to entertain a bunch of kids like us in his recording studio.

Love to hear your more from you about who this person who guided you in your personal &/or  professional life.

Til then,

 Daryl Chow, Ph.D.

 

Three Surprising Facts About Psychotherapy You and Your Doctors Need to Know

boy hearing for the first time (w hearing aid)

With the help of a hearing aid, boy hears for the first time.

This is for those who are thinking about seeking help. Maybe you are wondering, unsure of who to go to and what to look out for. Or maybe you just need a reason to give a shot at therapy/counselling before you take a psychotropic drug for your emotional problems.

Click here to find out more: Three Surprising Facts About Psychotherapy You and Your Doctors Need to Know

boy with new pair of shoes_overjoyed

Boy overjoyed with a new pair of shoes

Like the images of the two boys, I hope you get the help you deserve, and experience a renewed sense of joy in your life.

Best,
Daryl Chow, PhD

You might also be keen to read from related posts:

Why Our Self-Assessment Might be a Delusion of Reality

Clinical Practice vs. Deliberate Practice: Why Your Years of Experience Doesn’t Get You Better

The Tension of Opposites: Clinical Intuition vs. Clinical Data (Part 2 of 2, The Rate & Predict Exercise)

 

In the previous post, I advocated the marriage of our clinical intuition and the use of outcome informed data.

Do not let me convince you. Let your experience convince. Put it to the test. Try them on for size.

fashion-men-vintage-colorful

Here’s how:

I call this the Rate & Predict exercise. There are two parts:

A. Using an Outcome Measure (Outcome Rating Scale, ORS; Clinical Outcome Routine Evaluation, CORE),

1. Rate: After the first session, ask your client to RATE the outcome measure in subsequent sessions;

2. Predict: Before you see your client’s score, PREDICT what they would score. It is important that you write down scores for each of the sub-scales, if any. (for ORS, Individual wellbeing, close relationships, Social, General). This prevents us from falling into the “I knew it all along” hindsight bias effect.

3. Evaluate: Compare and contrast the scores. See what stands out. Talk about the with your client.

B. Using an alliance measure (e.g., Session Rating Scale, SRS),

1. Rate: At the end of the first session, ask your client to RATE how they feel about the level of engagement in the session;

2. Predict: Before you see your client’s score, PREDICT what they would score. It is important that you write down scores for each of the sub-scales (for SRS, level of emotional connection, goals, approach/method, overall).

3. Evaluate: Compare and contrast the scores. See what surprised you. Form your feedback questions from there.

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The Tension of Opposites: Clinical Intuition vs. Clinical Data (part 1 of 2)

Data & intuition = better decisions

 

There are those who embrace routine outcome monitoring (ROM), and those who shy away from it like the plague.

On one side of the fence, skeptical practitioners point their crucifix against the use of any client-focused outcome measures, while others who embrace ROM think that outcome measures are like the second coming, thinking that it can supersede decision making about the treatment process.

The adamant Non-ROMer would say, “How can a simple outcome measure tell me about whether my client is benefiting from treatment and how effective I am? Besides, change takes a long time to happen, and it’s gonna get worst before it gets better.”

While the rookie ROMer would say, “The outcome measure is sufficient to inform me about whether my client is benefiting from therapy and how effective I am. Change happens early all the time, and it won’t get worse before it gets better.”

Like all fundamentalism, such rigidity snaps easily under pressure. The words of Gregory Bateson reminds as that the test our stability is how flexible we are.

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