learning – Frontiers of Psychotherapist Development

Tag: learning (page 1 of 2)

Develop First Principles Before The Methods

The man who grasps principles can successfully select his own methods. The man who tries methods, ignoring principles, is sure to have trouble.

~ Josh Kaufman, Personal MBA

As a field, we were obsessed with methods, approaches, tools, theoretical orientations, and schools of thought. Money poured into establishing treatment efficacy differences have not yield much fruit; therapists investment in time, effort and money to train in specific models have not demonstrated improvement in our results.

I suspect that one of our key mistakes is a failure to learn first principles, instead of methods.

Develop Your Own Wealth of Learnings

October 6, 2017 / darylchow / 0 Comments

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.

Specific Ways to Build a Portfolio of Mentors

September 28, 2017 / darylchow / 2 Comments

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

Terrible Gifts in Therapy

September 6, 2017 / darylchow / 0 Comments

“Pray for one humiliation a day,” says Franciscan Friar Richard Rohr. “And watch your inner reaction to it.” [1]

This is not some Catholic self-flagellating, guilt inducing exercise. Rather, if we see with fresh eyes, every moment of difficulty that we face in a session with you client, presents a gift to you.

These moments are terrible gifts, if we open yourself to deep learning—this sense of moving aside the Ego, and leaning forward towards healing for your client, and for you.

It is terrible because we will feel uncomfortable. The Ego will be bruised, our sense of self will be shaken.

But it is a gift because it has the powerful potential to help us move out of our comfort zone and into our learning zone.[2]

Every difficult moment in therapy is a gift, only if you open yourself to this moment.

But these difficult moments depend entirely on our response. If we reacted from the Ego, a difficult moment is a curse. If we responded humanely to our client and to ourselves, a difficult moment will bless you.

After all, some burdens are a blessing, and some blessings are a burden.

The next time you are faced with a difficult moment in therapy, do not ask, “Why is this horrible situation happening to me?” Instead, go deeper and ask yourself, “What is this difficult moment teaching me?”

Then do the following:

1. Slow: Make haste slowly; slow down your speech (your heart will follow);

2. Ego: Move the ego aside;

3. Lean in: Move towards your client. And stay right there with the other.

That’s how we grow.

p/s: I love to hear in the comments below what sorts of challenges you face in your clinical practice.

Best regards,

Daryl

~~~

Footnotes:
[1] Listen to the podcast On Being: Krista Tippett interviews Fr Richard Rohr . Here’s the segment about “one good humiliation a day.”

MS. TIPPETT: [laughs] “I have prayed for years for one good humiliation a day, and then I must watch my reaction to it,” which sounds so uncomfortable. There’s nothing in me that wants to pray for one good humiliation a day.

FR. ROHR: No, and there isn’t in me either. I just said that to that group of millennials two weeks ago. Some years ago, I started recognizing that I was getting an awful lot of adulation and praise and some people treating me far more importantly than I deserved. And I realized I was growing used to it, that the ego just loves all of this admiration and projection. And a lot of it was projection. And I didn’t want fame and well-knownness and guru status to totally destroy me, and so for me, this became a necessity, that I had to watch how do I react to not getting my way, to people not agreeing with me, to people not admiring me — and there’s plenty of them — and that I actually needed that. And so I do, I still, I ask God for one good humiliation a day, and I usually get it, one hate letter or whatever it might be. [laughs] And then what I have to do, Krista, is I have to watch my reaction to it. And I’ve got to be honest with you, my inner reaction — I’m not proud to tell you — is defensive, is, “That’s not true. You don’t understand me.” I can just see how well-defended my ego is. And of course, even your critics — and I have plenty of them — at least 10 to 20 percent of what they’re saying is usually true.
[2] Chow, D. (2017). The practice and the practical: Pushing your clinical performance to the next level. Prescott, David S [Ed]; Maeschalck, Cynthia L [Ed]; Miller, Scott D [Ed] (2017) Feedback-informed treatment in clinical practice: Reaching for excellence (pp 323-355) x, 368 pp Washington, DC, US: American Psychological Association; US, 323-355.

Photo by Ben White

I Get the Goose Bumps…

August 30, 2017 / darylchow / 0 Comments

I get the goose bumps when I hear the type of questions discerning therapists raise at my workshops.

Participants reflecting on their questions regarding their professional development

It strikes me every time not only because these are the questions I’ve been pondering about for awhile now, but also because of how universal these questions are.

Here’s what I’m discovering:
When we provide a space for a focused inquiry [1], we create an opportunity to ponder, search, reflect. We step into a deeper sense of focus on the right questions, as we resist the urge for a quick answer.

“You know, if you know the answer, but you don’t know the question you are in a bad way. But if you have questions, you will find answers.”
~ Salvador Minuchin, 2000

Here are some of the examples of actual questions psychotherapists, counsellors, and other mental health professionals like you ask:

What are the Perennial Pillars for Psychotherapists?

August 24, 2017 / darylchow / 0 Comments

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.

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.

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.

Our Real Work

August 15, 2017 / darylchow / 2 Comments

“…In my early professional years I was asking the question: How can I treat, or cure, or change this person? Now I would phrase the question in this way: How can I provide a relationship which this person may use for his own personal growth?” ~Carl Rogers, On Becoming a Person, p.32

What is our real work?

It’s easy to think that the role of a psychotherapist is to treat a person or help our clients change. Indeed, that may be the outcome we hope for. But it’s not the work that we need to put in.

Our real work is not to treat a person. We conflate the outcome we desire with the work that we need to put in, in order to get that outcome.

Our real work is more like a gardener than a builder.

A builder builds, and when that’s done, the work is done. A gardener lays the ground work, and waits for the seeds to grow. A builder’s work is finite. A gardener’s work is never done. She continues to tend to the plants, nurtures and prunes its branches.

Like a gardener, a therapist real work is in the pre-work.

It’s what we do outside of the therapy hour,

in order to get better at what we do in the ritual of therapy.

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.

Frontiers of Psychotherapist Development

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