{"id":6124,"date":"2024-05-31T00:40:00","date_gmt":"2024-05-30T16:40:00","guid":{"rendered":"https:\/\/darylchow.com\/frontiers\/?p=6124"},"modified":"2024-12-27T00:51:39","modified_gmt":"2024-12-26T16:51:39","slug":"you-need-structure","status":"publish","type":"post","link":"https:\/\/darylchow.com\/frontiers\/you-need-structure\/","title":{"rendered":"You Need Structure"},"content":{"rendered":"\n

Note: This article was originally published in Substack on 31 May 202<\/em>4<\/p>\n\n\n\n

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Working Backwards<\/h2>\n\n\n
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Walk backwards with me for a little while.<\/p>\n\n\n\n

Much of my earlier work has focused on helping practitioners monitor and improve their outcome<\/strong>. It is important that we are keep our eyes on ultimately helping our clients, and when we are off-track, we must take the feedback and feed-forward to a more helpful direction.<\/p>\n\n\n\n

However, focusing solely on the outcome will not get you to the outcome.<\/p>\n\n\n\n

Take, for instance, in a recent ABC Australia article, A Dangerous Numbers Game<\/a>, <\/em>the push for policing quotes sent New South Wales police searches soaring<\/a>. This is largely due to pressures of chasing the numbers, which led to disproportionate targeting of marginalised communities, including racial minorities and economically disadvantaged groups. When officers focused on meeting quotas, the quality of searches can decline, while eroding trust between these communities and law enforcement<\/p>\n\n\n\n

Think about this in more general terms. The pursuit of happiness causes more suffering (more about this here<\/a> in Full Circles<\/em>). Happiness comes as a consequence, and not as a thing to pursue.<\/p>\n\n\n\n

In the words of anthropologist Marilyn Strathern, Goodhart\u2019s Law<\/strong> tells us that \u201cwhen a measure becomes a target, it ceases to be a good measure<\/strong>.\u201d<\/p>\n\n\n\n

Keeping an eye on our client outcome is still vital, but it is what authors Chris McChesney, Sean Covey and Jim Holing1<\/a> called a Lag Measure.<\/em><\/p>\n\n\n\n

Lag Measures<\/h4>\n\n\n\n

Lag measures are the indicators of success that show whether you’ve achieved the desired outcomes. These are typically the end results of your goals and are often the metrics you want to improve. They “lag” because they come after the fact, reflecting the results of past actions.<\/p>\n\n\n\n

Lead Measures<\/h4>\n\n\n\n

Lead measures, on the other hand, are actionable steps that influence the lag measures. They are the activities and behaviors that drive the achievement of lag measures. Lead measures are “lead” because they lead to the desired outcomes and are within the control of the team.<\/p>\n\n\n\n

Lead measures have a direct impact on achieving the lag measure. They are both predictive and influenceable.<\/p>\n\n\n

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Lag Measure (i.e., Outcome) on the Left, Lead Measure on the Right<\/strong><\/figcaption><\/figure><\/div>\n\n\n

So we have to ask the question: What<\/em> leads to good outcome?<\/em><\/p>\n\n\n\n

Engagement<\/strong>.<\/p>\n\n\n\n

In fact, it is not just \u201cgood alliance\u201d that predict outcome, existing evidence2<\/a> suggests that improvement<\/em> of engagement over time is more predictive outcome.<\/p>\n\n\n\n

OK. Engagement leads to Outcome\u2026 So what leads to good engagement?<\/p>\n\n\n\n

Creating an impactful<\/strong> experience in session.<\/p>\n\n\n\n

But as Joan Chittister said,<\/p>\n\n\n\n

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Every impactful person brings to you themselves and not needing to prove \u2018how impactful I am\u2019, \u2018how smart I am\u2019, and \u2018how needed I am.\u2019”<\/p>\n<\/blockquote>\n\n\n\n

We must not get caught up with trying to sound smart and impactful, but we need to think about how each client experiences the session on an inner level.<\/p>\n\n\n\n

Finally, if engagement leads to outcome, and impact leads to engagement, what leads to an impactful experience?<\/p>\n\n\n\n

Structure is the scaffold that allows us to create something impactful.<\/strong><\/p>\n\n\n\n

Why Structure<\/h3>\n\n\n\n

Structuring your sessions is something you have control of\u2014and you can facilitate that\u2014regardless of the therapeutic modality that you using.<\/p>\n\n\n\n

Previously I mentioned<\/a>,<\/p>\n\n\n\n

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Whenever we think of how to structure a session, we turn to therapy approaches. This is why models like cognitive behavioural therapy (CBT) and mindfulness-based approaches are alluring to trainees. EMDR, or eye movement desensitisation reprocessing is also very appealing to clinicians of various experience levels. This approach provides a step-wise sequence protocol. These approaches provide a recipe on \u201cwhat to do\u201d.<\/p>\n\n\n\n

(However) \u2026this is a conflation between structure and models. Models can provide a sense of structure, but structure need not be confined to restricting ourselves to particular approaches.<\/strong><\/p>\n<\/blockquote>\n\n\n\n

In other words, structuring your sessions does not mean following a therapy model.<\/p>\n\n\n\n

Structure does not mean to you need to be rigid, not abide by a formula. Structure provides you a scaffold to form and shape the work together with your client.<\/p>\n\n\n\n

Without structure, it is much harder to build anything on firm foundations.<\/p>\n\n\n\n

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Structure and Impact Teachings<\/h2>\n\n\n\n

Not everyone might be interested in taking part in this course. It\u2019s a commitment on time, money and effort.<\/p>\n\n\n\n

And that\u2019s ok.<\/p>\n\n\n\n

But I think this topic on Structure and Impact is important; it can not only help you side-step the \u201cdo this specific model\u201d (e.g., CBT vs. IFS, etc, etc) vs. \u201cdo common factors\u201d (there\u2019s no such thing) debate, but also help you make each session come alive for your clients.<\/p>\n\n\n\n

Common Challenges<\/h4>\n\n\n\n

Here are some common challenges faced by therapists:<\/p>\n\n\n\n

\u201cMy client just goes on and on, and we seem to be going nowhere\u2026\u201d<\/strong><\/em><\/p>\n\n\n\n

\u201cI\u2019m often going overtime\u2026\u201d<\/strong><\/em><\/p>\n\n\n\n

\u201cThere seems to be no clear focus or direction.\u201d<\/strong><\/em><\/p>\n\n\n\n

\u201cI feel like I\u2019m working harder than my client.\u201d<\/strong><\/em><\/p>\n\n\n\n

This is what I will address\u2026 and more.<\/p>\n\n\n\n

Just to be clear. Structure is not the be-all-and-end-all. Builders use scaffolds to help them build, and afterwards, it is stripped away.<\/p>\n\n\n

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I\u2019ve compiled everything I\u2019ve written on the topic of Structure and Impact below. We go into much greater detail and application in the course.<\/p>\n\n\n\n

I hope you find these useful. Join us to learn more.<\/p>\n\n\n\n

P\/S: If you are joining us in the S&I course, don\u2019t forget to use the coupon code at checkout: GIFT50.<\/em><\/p>\n\n\n\n

Join Structure and Impact<\/a><\/p>\n\n\n\n

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<\/a><\/p>\n\n\n\n

Why Structure Your Sessions<\/a><\/h2>\n\n\n\n

Daryl Chow<\/a><\/p>\n\n\n\n

April 7, 2023<\/p>\n\n\n

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Deconstructing Impact<\/a><\/h2>\n\n\n\n

April 12, 2023<\/p>\n\n\n

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Thinking in Thirds (Part I of III)<\/a><\/h2>\n\n\n\n

Daryl Chow<\/a><\/p>\n\n\n\n

October 5, 2022<\/p>\n\n\n

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Thinking in Thirds: Going Deeper (Part II of III)<\/a><\/h2>\n\n\n\n

Daryl Chow<\/a><\/p>\n\n\n\n

October 6, 2022<\/p>\n\n\n\n

\"Thinking<\/figure>\n\n\n\n

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Thinking in Thirds Closing The Session (Part III of III)<\/a><\/h2>\n\n\n\n

Daryl Chow<\/a><\/p>\n\n\n\n

October 7, 2022<\/p>\n\n\n

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Your Questions on Structure and Impact #163 \u2b55\ufe0f<\/a><\/h2>\n\n\n\n

December 1, 2023<\/p>\n\n\n

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For more resources on the topic of Structure, see our past missives:<\/h3>\n\n\n\n

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Frontiers Friday #130. Structure (Part I) \u2b55\ufe0f<\/a><\/h2>\n\n\n\n

Daryl Chow<\/a><\/p>\n\n\n\n

\u00b7<\/p>\n\n\n\n

April 14, 2023<\/p>\n\n\n

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Frontiers Friday #131. Structure (Part II) \u2b55\ufe0f<\/a><\/h2>\n\n\n\n

April 21, 2023<\/p>\n\n\n

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Frontiers Friday #132. Structure (Part III) \u2b55\ufe0f<\/a><\/h2>\n\n\n\n

April 28, 2023<\/p>\n\n\n

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If you would like to learn more topics that can help your professional development, subscribe to the Frontiers of Psychotherapist Development (FPD). On Frontiers Friday (FPD), we serve you directly to your Inbox highly curated recommendations each week.<\/em><\/strong><\/p>\n\n\n\n