What Does General Athleticism Got to Do With Psychotherapeutic Skills?

In our careers as psychotherapists, there seems to be a particular trajectory that we strive to achieve. That is, to become specialised in a particular model of therapy. I mean, who’s to blame anyway? That’s what we’ve taught us in school, isn’t it? Learn a bunch of schools of therapy, pick one or two that gels with your belief system and theories of change, and then become really proficient in that area of choice.

Therapists in various stages of their careers are bombarded with the next new shiny method for curing big T’s and small t’s (i.e., traumas of varying magnitudes). It’s worse for some. At the outset of their post-graduate education, many are schooled that CBT is the “treatment of choice” for specific disorders, like depression, anxiety, OCD, trauma (wait, that’s like almost every client I meet).

The Inner and Outer Game of Tennis:

Consider the following story: In 1978, German psychologist Wolfgang Schnieder (I just love the sound of the name, Wolfgang) was handed a study sample of 106 adroit 8-12 yr old tennis players in his country. Little did Schieder and his team at the University of Heidelberg realised that they were handed a project of a lifetime. The German Tennis Federation was fervent to know if the scientists could predict who might go on to be an elite adult player.

“Of 106 kids, 98 ultimately made it to the professional level, 10 rose to the top 100 players in the world, and a few climbed all the way to the top 10. Each year for five years, the scientists gauged the children first on tennis-specific skills and then on measures of general athleticism. Schneider’s expectation was that tennis-specific skills acquired through practice—like the accuracy with which a player could return a ball back to a specific target—would have predictive value for how highly ranked the children would be as adults.

“And he was correct. When the researchers eventually fit their data to the actual rankings of the players later on, the children’s tennis-specific skill scores predicted 60 to 70 percent of the variance in their eventual adult tennis ranking. But another finding surprised Schneider. The tests of general athleticism—for example, a thirty-meter sprint and start-and-stop agility drills—influenced which children would acquire the tennis-specific skills most rapidly. “When we omitted these motor abilities, our model no longer fit the ranking data,” Schneider says. “So we said, okay, we have to keep that in our model.”

“In other words, over the five years of the study, the kids who were better all-around athletes were better at acquiring tennis-specific skills.”

As with the study that examined depth perception and the ability to learn a catching skill, superior hardware was speeding the download of tennis-skill software. Schneider’s study received significant attention in Germany, but because it was published in German, it garnered scant notice in the rest of the world.”

Ten years later, a replication study was conducted. The finding that general athleticism impacting tennis skill acquisition held strong.

The Story of Steffi Graf

Ranked world No. 1 and winning 22 Grand Slam singles titles, Schneider called Steffi Grag ” the perfect tennis player… She outperformed the others in tennis-specific skills and basic motor skills, and we also predicted from her lung capacity that she could have ended up as the European champion in the 1500-meters.” Graf was at the top of every single test, from measures of her competitive desire to her ability to sustain concentration to her running speed. Years later, when Graf was the best tennis player in the world, she would train for endurance alongside Germany’s Olympic track runners.”[1]

3 Types of Knowledge… and How We Have Only Been Pursuing One

In a previous blog, I talked about 3 types of knowledge that we acquire in our training as therapists. Turns out that most of our emphasis in formal education and professional development activities fills up the bucket in only one area: Content knowledge. I suspect this has got to do with our pursuit to getting “tennis-specific,” or what we call “disorder-specific” skills. We fail to attend and elevate the relational elements of “process knowledge” and “conditional knowledge (go to this article for more about the differences in these 3 domains).

When I look at most of my challenging or “stuck” cases, I recognise a pattern. The issues were less about my lack of skill-specific content knowledge, and were more about my failure to connect and communicate that relational understanding to my clients. Authors Ichiro Kishimi and Fumitake Koga would insofar as much go to say that “all problems are interpersonal relationship problems.”

Who is Responsible for the Alliance?

Conventional wisdom says, “it’s the fit between the client and therapist.”

Scott Baldwin and colleagues (2007) set out to test this idea.[2] They went further by testing if the alliance-outcome relationship was due to one of the following:

1. Client (i.e., some clients are better at forming a collaborative relationship);
2. Therapist (i.e., some therapists are better at forming a collaborative relationship);
3. The interaction between client & therapist (i.e., it is the fit between two parties).
4. Alliance happens as a consequence of good outcomes (i.e., this is a reverse of the alliance-outcome relationship, that is the change experienced in therapy led to better alliance formation).

Turns out that not only was the ability of alliance formation not due to clients (hypothesis #1), nor is it due to the “fit” between client and therapist (hypothesis #2) or early improvement impacting outcome (hypothesis #4), it all boiled down to differences between therapists, which accounted for the alliance-outcome correlation (hypothesis #2). What’s more, the differences between therapists accounted for 97% of the variance in client-rated alliance (You’d rarely hear this in the social sciences, where one factor accounts for such a big piece of the variance)! Said simply, some therapists are just better at working with a wide range of folks.

The Takeaway:

Maybe we should consider, one of the perennial skills is to get flexibly good in interpersonal skills. This may not sound like an earth-shattering news. But consider the time, effort and money that we pour into the types of specialised workshops that we attend.

What if we turn things around, return to the fundamentals of our enterprise, and reinvent ways to help our community of therapists improve in areas that have leverage to getting better results for those we devote our professional lives to?

Aim to become a better “all-around athletic” than striving to aim at acquiring specific content skills. Legendary Coach Wooden would say the same thing, that he would aim to make his players better in their physical condition, so that they can outrun and outlast their opponents, than trying to get them good at a particular basketball skill.

UPDATE: Go to our private facebook group for a lively discussion on this topic.

Notes:
[1] The tennis story is adapted from the book, The Sports Gene by David Epstein.
[2] Baldwin, S. A., Wampold, B. E., & Imel, Z. E. (2007). Untangling the Alliance-Outcome Correlation: Exploring the Relative Importance of Therapist and Patient Variability in the Alliance. Journal of Consulting & Clinical Psychology, 75(6), 842-852. doi:10.1037/0022-006X.75.6.842