Frontiers of Psychotherapist Development

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

Tag: clinical supervision

Specific Ways to Build a Portfolio of Mentors

Specific Ways to Build a Portfolio of Mentors

In a previous post, I advocated the need to go beyond seeking the help from one individual.

It is up to you to Build a Portfolio of Mentors. It doesn’t happen to you; it’s what you do to make these mentorship work.

There are at least four types of mentors you can seek out.

1. Formal Mentors:

Seek out people that inspire you.

When I first reached out to Scott Miller, I didn’t think he would respond, let alone agreed to guide me in my development. Fast forward a decade later, he still is my someone that I turn to for guidance, even as we collaborate in our writings and teachings.

Another person I sought after at the tail end of my masters in 2005, was a highly perceptive and personable therapist, Juliana Toh who was teaching us systemic therapy. This was the ONE module that made all the difference to me. Near the end of the course, I asked Juliana if a few of us can connect with her for ongoing supervision. She agreed. And this set up another decade’s worth of consultation with her. Priceless. (One of the common practices she had that I adopted was for us to bring in taped-sessions).

 

2. Informal Mentors:

Seek out colleagues, friends, in and outside of your organisation to connect on a routine basis. 

Tell them that you’d like some guidance in some particular area of your work. Buy them lunch during your once a month meeting. 

Use these meetings as a check-in, a pit-stop, or even a form of accountability for the stuff that you are working on.

 

3. Seek Consultation as a Team:

While formal and informal mentors may not typically be a paid service (besides, I don’t think your friend should accept your money), another form of highly valuable professional guidance you can obtain is to seek consultation as a organisation.

This is typically more economical in cost. It is also beneficial if the agency wants to implement new changes in their organisation, and the leaders aim for everyone to be on board.

Consultations are much more powerful and effective, as compared with sending the team to a 1-2 day workshop. The reason is that ongoing routine consultations are aimed at a more SPECIFIC and SUSTAINING manner. Workshops typically ignite interest but fail to fan the flame.

So if you are a leading a team and them to a workshop, make sure you have a clear committed plan ahead on how to sustain the interest of implementing these new ideas.

I spend much of my time mentoring practitioners and consulting with agencies. Even though I offer a special extra value of connection in between, only a minority of people ask me questions between our consultations.

If you seek out a consultant, you shouldn’t feel afraid to bother them in between the formal consultations. That’s because most of the important challenges surface in-between!

In one agency, after an initial training they had with me, they had planned for the ongoing consultations to be once every three months. While they were trying to integrate the use of outcome measures into their daily clinical practice, several of the clinicians were struggling on how to introduce the measures. Thankfully, one of them emailed me on how to address this issue, as the next consult was 8 weeks away. And I provided them some tips and resources as they rolled out the implementation.

 

4. Instrumental Mentors:

Books and reading materials can be your “Instrumental Mentors,” if you approach this with a mindset of “Just-in-time” learning mentality.

Therapists complain that they do not have enough time to read, given their unending workload. “Just-in-time” learning can help to speed up the learning process but being highly focused and targeted with what you read. 

I’m currently enrolled in an online learning course with Scott H Young, called Rapid Learning. One of the things he advocated is to treat each thing that you are learning as a PROJECT. I think it’s a brilliant idea. It gives a handle, and projects can be broken down into parts with an overarching specific goal, along with a deadline, milestones and a week-by-week breakdown of how you plan to accomplish it. 

Here’s some examples: if you find yourself struggling with dealing with your client who has high self-criticism, you might persue reading materials from Leslie Greenberg’s work in emotion focused therapy. 

If you are working with a couple who are struggling with rekindling their sex life, you might turn to Ester Perel’s work.

If you are working with a family who is facing power struggles with their teenage daughter, you might turn to Salvador Minuchin’s work in structural family therapy.

The key to using Instrumental Mentors via a just-in-time learning approach is to develop your FOCUS.

Here’s how:

1. Block out 30mins to an hour per week within your work hours (yes, you heard me right. Keep it at work, because this form of deep work DIRECTLY addresses your clinical work);

2. Identity the ONE THING that you need to work on at this stage.

3. Read with a just-in-time learning mentality, which means you have to read with the SPECIFIC OBJECTIVE in mind (and avoid Facebook during this blocked out time, AT ALL COST).

4. Keep a learning log. I’m sure I’m not alone; all of us have experienced this thing called Professional Amnesia. That is, we learn something so important at one point in time, but we forget these perennial learning, and instead, get enamored by what’s new and shiny.

By keeping a learning log, you can (and should) revisit them. I’ve been using a free Simplenote to archive my weekly learnings over the past five years. Every so often, I’d open the app, look at a past learning title and test myself, if I can recall what I learned in the past. I’m often shocked at the experience of Professional Amnesia. “Did I write that?”

(I love simplenote. It’s by the creators of wordpress-the platform I use for my website. I’ve used several note taking apps. Evernote has a ton more features, and I use evernote more for web clippers. On the other hand, What I love most about Simplenote is the constrain. You can’t change the font or font size, you can muck around with the formatting, etc [unless you use markdown symbols]. And that’s really helpful to capture your learning ideas down quickly. PLUS, it’s super quick to retrieve your notes, especially if you tag them. I tag my weekly learning log as “TherapyLearnings”. It all syncs across platforms and devices seamlessly. All that… for free! 

This is also a good way to stave off our allure towards the timely things, and return to the time-less matters that count.

Don’t forget that the people who write those inspiring materials are also actual human beings. Reach out to them if they spark something in you. Email them, chat with them. Seek them out to be your formal mentors, or seek consultation with them as a team. The world is no longer divided into authors and readers. Every true author is an avid reader, and every reader is capable of becoming an author. So let’s connect.

 

FINAL TIPS:

1. “Show Your Work”: If you seek out a paid mentor/supervisor/consultant, make sure you do not just “talk about your work.” Instead, “show your work” with the use of audio/visual recordings, so that your mentor knows your work (eg segments of your therapy recordings + outcomes). What good is gossiping even with a good theory in mind?

2. Before and After: What’s crucial is what you do before and after a mentoring session.

Do the Prep work…

and then…

Do the reflection. 

Maximise the sessions and time you devote to the mentorship connection. It’s not just the hour or two that you spend that counts. It’s what you do for the prep, and what you do at the end to pull it all together, so that it sticks.

Afterall…

LEARNING =TRANSFER

 

Anything worth building requires more than an individual.

Your development requires this team approach.

Best,

Daryl

What are the Perennial Pillars for Psychotherapists?

For songwriters, the perennial pillar is song craft. It is not technical mastery.

A songwriter knows that technical agility at an instrument is not going help him create a better song. It’s easier to identify and work at improving techniques. It’s much harder to improve on their ability to engage with listeners through their songs.

At the time of this writing, in 2017, we commemorate three critically acclaimed albums.  

 

Perrenial Albums

If there are any three records you’d need to hear in your lifetime, it’s these.

 

Half a century ago, The Beatles released Sgt Pepper’s Lonely Heart’s Club Band. 30 years ago, U2 brought us the follow-up album from The Unforgettable Fire, Joshua Tree. And 20 year ago, Radiohead released Ok Computer. Modern music has never been the same since.

Sgt Pepper would never have had the chance to grow if the Beatles did not take the time away from touring.

The Irish boys from U2 narrowed the focus based on the American landscape in the making of Joshua Tree. Because they made that decision, the album reflected their evolving social consciousness of their time. The album become a timeless piece of art.

Radiohead’s Ok Computer, was spawned from the band’s disillusionment with a relentless touring schedule, resulting in their lives becoming a tour-bus race at the speed of light from one concert venue to the next. They had enough. A break was needed. 

(As an aside: It is significant to note that none of these records were the artists’ first albums.)

Consider three lessons we can draw from these landmark albums:

 

1. Take the Risk and Push Your Limits,

2. Get a Guide, and

3. Study the Process, Not the Outcome.

 

Continue reading

Do Not Seek Out A Supervisor

Do Not Seek Out A Supervisor

 

Seek out a portfolio of supervisors, mentors and coaches.

The apprenticeship model of clinical supervision certainly has its merits. It takes us beyond what we read and what we derive from experience in clinical practice. After all, clincial supervision has been defined as the “signature pedagogy” of our field.[1]

However, clinical supervision as we know it, has little to no impact on our actual improvement. If we are to truly develop, and have a deep impact on our clients’ lives, we need to take a more expansive view about this master-apprentice model of professional development.

Instead of enlisting a supervisor for guidance,

we should instead build a portfolio of supervisors, mentors, and coaches.

 

No one person has all the keys to guide you. It would be unwise to expect to learn everything from one teacher. Instead, we need to first identify areas that we have gaps in our knowledge, and then seek out coaches in that particular domain of expertise.[2]

Do your prep before you approach your guides. Figure out what you need to be working on. Make it concrete and write them down. (It’s not enough to just think about them in your head). Date it. When you look back, you get a sense of your evolution.

Remember: Keep one eye on your performance (i.e., client outcomes), and the other on your development (i.e., how you are learning).[3] Enlist the community of guides to make sure you have both eyes focused on where it should be.

 

Surround yourself with people that can help you become a better version of yourself, not become a mimicry of them.

 

Your Partner in Crime, 
Daryl 

~

Notes:

[1] Watkins, C. E. (2010). Psychotherapy supervision since 1909: Some friendly observations about its first century. Journal of Contemporary Psychotherapy, 1-11.doi:10.1007/s10879-010-9152-2

[2] Some of these terminologies were borrowed from Dorie Clark’s book, Reinventing You.

[3] Chow, D. (2017). The practice and the practical: Pushing your clinical effectiveness to the next level. In D. Prescott, C. Maeschalck, & S. D. Miller (Eds.), Reaching for Excellence: Feedback-Informed Treatment in Practice: APA.

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

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

 

#4. Why Our Self-Assessment Might be a Delusion of Reality

 

Homer

It seems that we share more in common with Homer Simpson than we like to admit. Did you know that social psychologists found that in general, people rate themselves as more attractive that they really are?(1)

In my doctoral study of highly effective psychotherapists(2), the results of an area investigated about therapists self-ratings of their Healing Involvement (HI) in therapy left us initially scratching our heads. Orlinsky and Ronnstead(3) describes someone with high HI as someone who views themselves as personally invested, efficacious in relating with the client, affirming, and highly skilling, experiencing flow states in therapy, and employ constructive coping strategies. What we found was a negative relationship between their outcomes performance and HI rating. In other words, therapists who rated high on their HI scores were more likely to be less effective than their peers! How is this possible? Going further, the same group of therapists we studied, half of them rated their current effectiveness as above average. None rated below average. What’s more, these self-assessment of effectiveness ratings did not predictor their actual client outcomes. Continue reading