deliberate practice – Frontiers of Psychotherapist Development

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Develop Your Own Wealth of Learnings

In a previous post, I talked about the iterative cycle that we can take in our professional development (click HERE to revisit it, and download the free infographic).

Here’s something that I’ve recently revisited that struck a chord:

“The theorists can only build his theories about what the practitioner was doing yesterday.

Tomorrow the practitioner will be doing something different because of these theories.”

~Gregory Bateson, 1951/68.

Most good theories that we develop in our practice derives after the fact, not before.

Do Not Seek Out A Supervisor

August 22, 2017 / darylchow / 9 Comments

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.

Stop Talking, and Start Performing.

June 16, 2017 / darylchow / 0 Comments

What if one of the ways of transforming our practice in psychotherapy is to stop calling it talk therapy, but to see it as a performance ritual?

What if we stop talking, and start performing?¹

I suspect that if we step beyond therapy models, and see our work as a therapeutic and healing endeavor, we can begin to embrace it is a performance ritual.

In gist, here’s how most therapy goes: Once we create a space and a climate of safety, we dive into the sea of one’s human suffering, and hopefully, in the act of the two or more humans coming together weaving a “believable myth”² (be it addressing cognitive distortions, self-critical markers, past traumas, etc.), growth and change can happen.

The act of two persons working as “of one mind”³ , should not be relegated to a manual’s precription or one (or even two) dogmas. Neither should it be left to “make things up” as we go. Here’s why:

The moment we start to see therapy as a performance, we can break it down into component parts.

Here are some examples:

1. How do you prepare for a session?⁴

2. How do you begin a session/subsequent session?

3. How do you establish an effective focus with your client?

4. How do you deepen the emotional experiencing?

5. How do you close a session with an impact?

…Etc. (See a related post on Figure Out the “What” Before the “How”)

To those who see therapy as an art form, we can begin to learn to set the stage to enliven the possiblity of deep human interaction, and weave a structure to what seems un-structured to the naive eye. (Even music and theatre improvisers follow a set of rules in their seemingly free-form jams⁵).

To those who see therapy as more of a science-based pursuit, we can afford to develop some hypothesis for fruitful and – God forbid – playful creation. We can learn to be more responsive⁶ and utilise⁷ what each person bring of themselves into the therapy room.

Afterall, there is a creative art form in science, and there is a methodical science in art.

Once we see things in component parts, things get more complicated than they seem. Ask a person to rate how well they know about how a toilet flush works, and enquire again after you ask the same person to list out, in detailed step-by-step fashion of how the whole ceramic bowl and flushing systems work, their self-assessment ratings are more than likely to dip.

That said, by breaking things down into its component parts, it allows a devoted practitioner to develop a focused deliberate practice plan to improve at that particular area⁸.

Question:

What have your identified to work on, that has a leverage on improving your outcomes?

The moment we “stop talking, and start performing,” we invite a different way of seeing our work. We can then invite a host of repetitore that can lit up a fire of engagement in this thing we can psychotherapy.

As musician Frank Zappa says, “The mind is a like a parachute. It doesn’t work if it is not open.”

Enjoy,

Daryl Chow, PhD

Notes:

1. I came around to this term by interviews with Michael Port and Amy Port on the Art of Charm podcasts. Michael Port elaborates further in his book, Steal the Show.

2. Jerome Frank’s (1993) book, Persuasion and Healing is a seminal read.

3. Doug Flemons book is titled “Of One Mind.” Though it is primarily about hypnosis, I think it’s a highly relevant read for engaging with someone in therapy.

4. See a brilliant recent 2017 book by Daniel McGinn, Psyched Up

5. I highly recommend Patricia Madison’s Improv Wisdom. For those who are interested in the world of music improvisation, Derek Bailey’s Improvisation is a must-read)

6. see Ben Stilles’s work on Responsivity. E.g., Stiles, W. B., Honos-Webb, L., & Surko, M. (1998). Responsiveness in psychotherapy. Clinical Psychology: Science and Practice, 5(4), 439-458.

7. Utilisation is at the heart of Milton Erickson’s work.

8. Here’s a recent chapter I wrote for a recently released edited book. 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. There a chalk full of diverse chapters in this book.

(Please note that the links in the note section are amazon affliate links. That means I get a tiny percentage of the books’ sales.)

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

March 6, 2017 / darylchow / 8 Comments

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:

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

February 15, 2017 / darylchow / 0 Comments

“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.

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.

Scenius vs. Genius

October 22, 2016 / darylchow / 0 Comments

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.

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 Performance: Deeply 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

October 20, 2016 / darylchow / 0 Comments

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.

The Pursuit of Excellence is Not the Pursuit of Perfection

January 3, 2016 / darylchow / 4 Comments

“An expert is a person who has made all the mistakes that can be made in a very narrow field.”

-Niels Bohr, Danish physicist and Nobel Prize winner.

The pursuit of getting better at our craft in therapy requires us to make fine distinctions. One of them is to make the distinction between the pursuit of excellence vs. the pursuit of perfection.

The pursuit of perfection has no room for mistakes. Failing = Failure. The pursuit of excellence treats errors and blunders as grist for the mill. It is where the ordinary magic of growth happens. Failing ≠ Failure.

The pursuit of perfection is rigid, exacting, clinical and cold. The pursuit of excellence is flexible, warm and humanistic in the emotionally charged interpersonal encounter of two persons coming together to co-create a better life for one party. In turn, the giver is moved to be a better person in return as well.

The pursuit of perfection is self-centered. The pursuit of excellance is others-centered. It uses the self in service of the other. It doesn’t use the other to enlarge the self.

The pursuit of perfection sees therapy as a performance. As if held within the judging gaze of another, it’s ego is at stake, thus it confines to it’s comfort zone. The pursuit of excellance seeks to re-form the status quo, seeking to reach beyond our comfort zone.

The pursuit of perfection suffers chronic anxiety. The pursuit of excellence embraces uncertainty, and accepts the uncontrollable force of life circumstances. It treats the turn of each event as teachable moments for the inner life. Its antidote to worry is to believe that the most perfect thing to do is to embrace imperfection.

The pursuit of perfection wears a fixed mindset hat. The pursuit of excellence wears a growth mindset hat, which promotes receptivity in learning, and learning to take feedback seriously and not personally.

Finally, and perhaps most importantly, the pursuit of perfection thinks it is pursuing excellence.

May we make room for the pursuit of excellence in the new year ahead!

– Daryl Chow, Ph.D.

*imperfect image above hand drawn with Paper & Pencil on iOS device

8. Productivity for Therapists: The Top 5 What-Not-To-Dos (Part 2 of 2)

July 18, 2015 / darylchow / 1 Comment

In the previous post, I talked about the pit-falls of engaging in the “Blame-Game” and getting mixed up with being busy and being productive.

We continue the final count-down of “What-Not-To-Do” if we want to increase our productivity in a busy schedule.

7. Productivity for Therapists: The Top 5 What-Not-To-Dos (Part 1 of 2)

July 18, 2015 / darylchow / 2 Comments

“Thus we are busy people just like all other busy people,

rewarded for the rewards which are rewarded to busy people.”

– Henri Nouwen, from The Way Of The Heart, p.22.

Just do a google search, and you’d soon be inundated with many blogs and self-help books that specifically addresses the issue of raising productivity. Many of them provide useful to-do suggestions.

While trying to straddle conducting research, providing training and supervision, writing commitments, myriad of meetings, making time to create music, and maintaining a clinical practice, I found out that I had to take a deep look into the issue of productivity, especially since the birth of our beautiful one and a half year old daughter. I love being with her. It was also a crucial time that I work out my schedule, so that I can afford the capacity do the stuff that matters to me. This also means that I would have have to cull activities that are unnecessary time killers. Like useless and mindless meetings.

Necessity is the mother of important learnings.

I realised this issue of time scarcity isn’t unique to me. Many of my colleagues are overwhelmingly busy, sometimes to the point of skipping lunches just to squeeze in a therapy hour for an ad-hoc client, or going home late so as to finish up a report.

I’ve decided to write this post for the busy therapist, but from a less common angle. I reckon that this is more crucial than telling you “what-to-do”, which you would probably already know.

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