Are we doing it all wrong? How to *actually* improve as a therapist
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- Опубліковано 25 тра 2023
- Are we doing it all wrong? How to actually improve as a therapist
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Ever wonder what it looks like to actually improve our effectiveness as therapists? I think about this one often, so we’re going on the professional development rabbit trail in this one!
Sources & Links mentioned:
Daryl Chow:
darylchow.com/
Daryl Chow’s blogs on professional development:
darylchow.com/frontiers/
APA Article: “Better relationships with patients lead to better outcomes”:
www.apa.org/monitor/2019/11/c...
Article: "Signs That Therapists are Barking Up the Wrong Tree in Our Professional Development”:
darylchow.com/Daryl_Chow/Blog/...
NYT Article: “The Curious Conundrum of Freud’s Persistent Influence”:
www.nytimes.com/2017/08/14/bo...
Article: “#3. Clinical Practice vs. Deliberate Practice: Why Your Years of Experience Doesn’t Get You Better”:
darylchow.com/Daryl_Chow/Blog/...
The Science of Psychotherapy UA-cam Channel:
/ channel
Video: "Daryl Chow on getting better results”:
• Daryl Chow on getting ...
I’ll also be checking out a book co authored by Daryl Chow: "Better Results: Using Deliberate Practice to Improve Therapeutic Effectiveness”:
amzn.to/45uBA7L
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This video is geared toward therapists of all kinds, including psychologists, MFTs, LPCCs, social workers, and others in the clinical counseling field.
Welcome to Private Practice Skills! I’m Dr. Marie Fang, psychologist in private practice. I post videos offering tools I learned the hard way about starting and growing private practice so that you don’t have to.
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This video is not intended as professional or legal advice. Be sure to seek the services of a professional if you are in need of them.
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My moto is C. G. Jung’s quote “Know all the theories, master all the techniques, but as you touch a human soul be just another human soul .”
I'm a busy, successful private practice therapist. Thirty years. Ten of those years I was a clinical supervisor in agency settings.
Here's my opinion, and thanks in advance for listening:
The discipline of psychology has very little to offer psychotherapists. It's good for a foundation of information (sensation, perception, learning).
The fetish with studies, controls, statistical validation is absurd in psychotherapy practice. There are too many variables and life is a constant flux of many influences that cannot be manipulated beyond the mathematician's desk, which is not life.
What makes me better are the following:
My own therapy. It never ends.
Reading and taking inspiration and intellectual discipline from philosophy literature. Not psychology. I've learned more about anxiety from Kierkegaard than I ever will from psychology.
Life experience, a lot of it. Outside the library.
A practice of "not knowing" and constantly being curious about my experience and other people's experiences.
Thank you.
I have been a therapist for over 30 years as well! I agree with all of these. I love the book There has been 100 years of Psychotherapy and the World is Getting Worse. ❤ I rarely see a therapist practicing for over 30 years! I am just getting started! 😂😂😂
I’d appreciate the long version. I agree with this criticism of the therapy world. I was taught that the core of therapy is the relationship so what goes into a relationship and we continually need to improve our skills. No approach or magical tool is gonna work if there isn’t a healthy good relationship. I also do not like when people say therapy is forever because it’s not. There should be an end point in a treatment plan. What makes a therapist effective isn’t “performing” it’s about being with, building resilience, awareness and self advocacy in the face of many challenges and learning to live well with and through.
OMG YES YES YES!!!! Thank you thank you thank you! First of all being a new therapist I am constantly judged by "seasoned", "licensed" therapists about how I just graduated and don't know enough. (keep in mind I am 53 yrs old and have a lot of lived experience) but most of all clients resonate with me because of my presence. Secondly, I see this A LOT with therapists that market themselves as "trauma informed" or "specialize in trauma" but have no interpersonal skills at all and the client ends up wondering why they wouldn't help them with their trauma yet they took a class about it and it is the "thing" to be a trauma therapist. This video was amazing and I am going to check out Daryl Chow.
This video was an eye opener for me as it does call out the field on where it is these days. I’ve been in the field for almost 16 years, so I can at times feel that I’m good at where I’m at with my clinical skills. But that can lead to stagnation. We as therapists can’t be complacent and rigid. We have to continue to evolve, learn, process, and grow. Thank you Marie for all your videos as I’ve been following for a while. I’ve learned so much 😊
As a counselor in training this helps SO much. A lot of what I have been thinking so far - at the practicum phase I have found myself deeply confused on how to be a good therapist. The phrase “Art vs. Science” really gave words to how I have been feeling. School teaches you to stick to the basics but when I’m in session I feel like I have to go beyond just immediacy and reflecting. Tons of thoughts - but thank you
It is soooo validating to hear the comparison made to jazz, because I have used this very comparison with my interns. The idea that we learn the technical skills and the "rules" so that we have the proficiency to know when to go off script and improvise in the moment with a client. I'll also compare it to drawing and cartooning where you learn the technical skills to make something look "right," but then warp those ideas in order to create something very stylized. There's artistry, but it's informed, grounded artistry that is constantly being expanded and refined.
Thanks, Marie I have been following Daryl Chow for years and I love his work. His book, The First Kiss is an excellent read for clinicians to build a meaningful therapist client relationship. And Better Results is also good. He is a big proponent of Feedback Informed Treatment, which I use with every client. Glad you discovered him. His work constantly make me question how effective I am with clients
Yay for FIT - I too implement it routinely and find it so useful. I'll have to look into "The First Kiss" - thanks for the book recommendation.
I appreciate this video! I think for me being in private practice for 13 years now, and a therapist for 22 years, that I’ve also learned the art of letting go when I need to and not having an agenda. My spiritual foundation helps immensely.
As a developing future therapist starting to pursue my masters in Clinical Mental Health Counseling. This was a favorite video. Thank you Marie!!
LOVE this content and I especially resonate with the idea that interpersonal skills and continuing to improve them being more important than being an expert. I once worked for someone that did not work as growing and improving themself but instead was constantly telling everyone what an expert they were in their field. This did not resonate with me and it helped to motivate me to go out on my own. Yay for that! Thanks for all the great info you provide.
Gosh him and Scott Miller are really helping our profession become more authentic. I'm getting tired of all the Insta/FB/website therapists showing some GREAT insight they had about a client (for all we know it might have been the only one they've ever had!) This age of master therapists/therapy scripts and such can leave the rest of us feeling like we never obtain such heights in our sessions. I want authenticity in our profession both in the therapy room and without! I want to be pushed so I grow too.
Im actually a massage therapist but therapy is therapy and this video definitely game me some good points for my own practice!! Thanks!
I absolutely love Dr. Daryl Chow's work and research. I just joined his Deliberate Practice workshop and I can't wait to learn more.
As a social worker - we are taught rapport / trust / education and inspecting what you are expecting - is crucial for positive outcomes. I love that you are highlighting this and I can't wait to check him out!!! Your insight is so real, practical and helpful!! Thank you!!!
Soo good I’ve been looking for the “perfect” trainings, ceus and workshops as a new therapist to really heal my clients. This has me questioning how I spend my time training as opposed to building relationships ❤. Your videos are so helpful thanks 😊
THIS is what I was taught from the beginning. I am in my final two months of my internship and I graduate in August. I was taught that a therapeutic alliance and bond with clients is the number one indicator on how well the client will do no matter what modality is used.
I chose a person centered approach, which has no real techniques, but values the therapeutic alliance and interpersonal skills. Thank you for bringing this to light so that I can read more and learn along the way. This is especially crucial for a new therapist like myself.
Really needed this video today. Thank you.
You havve no idea how helpful this has been to me/us. i cannot be so discriptive now. BUT YESSSSSSSSS!!!!! THSNKS>>>
Thank you for all your videos ❤️
Fun *and* informative! Thank you!
It would be interesting to talk about state provided mental health and the new corporations who provide online-only therapy. I've worked for one and know people who worked at the other. Based on what you're saying here, they force people to do exactly what Daryl Chow warns against. What about insurance companies forcing certain behaviors to pay for services. There's a lot out there that's setting poor examples for what happens in the therapeutic relationship. I didn't hear a lot of what we can do to be better here but what about: always be intentional, present, empathetic, ethical, and compassionate while using the skills you've learned and continue to gain new skills to enable you to do all these things better? I also think you have to be careful how you diverge from what you've learned corporately, you don't want to deviate so much it becomes a whole new untested (and perhaps ineffective with certain populations) modality.
As someone who *tries* to have an open mind and tries to rigorously examine my own biases and assumptions regularly, I greatly appreciate this.
Such a great topic of exploration!!
This was a great video! I can understand some of these points can ruffle feathers and for me as a new clinician it gave me some peace. I am constantly like “oh I need to take this class to feel more competent” so it’s nice to like…take the edge off. Really focus on the interpersonal skills. I am definitely going to be a subscriber to Daryl Chow
Me too!!! Feeling liberating huh?
Love this video/topic! Can we get an extended cut? I'd love to hear more on this
Marie - Thank you so much for addressing this material! I'm overjoyed to see you talking about it, as you have a wide reach and give folks a small bite here to hopefully become curious and pursue more information in the area of practice effectiveness and therapist development. I became aware of Daryl Chow's work several years ago, and for a much longer time have paid attention to the input to the therapy field from Scott D. Miller (for others reading this, Daryl and Scott are co-authors, collaborators, and friends). Powerful stuff to pay attention to. Possibly at some point in a future video you could touch on the availability/use of the Session Rating Scale (Miller, Duncan, & Johnson) - a tool to begin more formally assessing quality of client-therapist relationship?? Being aware of the evidence for what actually makes for effective therapy has 1) gotten me feeling irritated at CE requirements that exist under the presumption that they make for better therapy outcomes, 2) helped me turn loose of the idea that I need to perfect the execution of any particular technique/modality, 3) helped me feel much freer to weave together the therapy I provide session to session, being guided by the principle that I should have a good rationale for doing whatever I do with my clients without feeling bound to whether I'm "staying true to a model" or following some manualized strategy, and 4) promoted my leaning much more heavily on gathering formal data on relationship quality with my clients and making focus on their perception of the quality of our relationship and perceptions of what I'm delivering a recurring part of my conversation with them. You rock!
Oof this hit hard - Thanks as always for the videos
This was such an interesting video!
As mentioned above though it can feel kinda discouraging to hear all the things that don’t make a difference without suggestions or tips for how to actually make a difference and deliberately improve upon our interpersonal skills, would love to see a follow up video if your rabbit trail led to any good tips and suggestions of what we CAN do 🤗
This is right on time for me as a new therapist. I have been trying to research everything so that I can show up for my clients, but the therapeutic relationship is at the core of therapy. AND I did not know those things about Freud 😮
enjoyed the video! so important not to become complacent. If we are asking our clients to change - or they are coming to therapy to make changes - then we should be doing the same. I find that through continued educational learning, it provides a way to learn more about things I don't know about, or want to get better at knowing about. Just always learning. I also think its important to pivot and make changes throughout your lifespan as a therapist. I have made changes over the years (clientele, etc) and am making another one now as I continue to grow and evolve. I also do my fair share of blogging and find that its a area that helps me learn more about things. I find that we often know when its time to use the energy we have in other ways. I will definitely check out Daryl Chow.
That intro just rocked my entire world
oooo tell me about that lil light that you were holding at the end. I looked in your kit, but I don't see it there. I think I could use that lil thing at times.
I agree with his points.
BTW, many don't care how long videos are. (Although, you may care if there's a lot of editing involved lol)
I could not agree more with some of the points, especially the one underlining the need for deepening interpersonal skills. I personally believe this is not possible without having experience of being in therapy, and correct me if I am wrong, but it seems to me that quite a few therapists either completely forgo that or do some during training and then only go for supervisions (btw, there was nobody to analyse Freud ;)).
I have also observed some therapist become so confident in what they do that they think they know what a client needs almost immediately. Here I am reminded of what Irvin Yalom wrote in his book "The Gift of Therapy": “The therapist must strive to create a new therapy for each client.” It suggests we have to stay curious even if we think we figured out our client in the very first meeting.
This looks to me like a valuable article that could turn a lot of therapists off before they give it a chance, so I think it's of great value that you have highlighted it in an approachable, softer, more digestible style.
I would like to have heard more about the kinds of 'practice' Chow recommends, away from workshops, etc.
Thinking about his 'jazz' remarks, I know I do spend a lot of private time thinking about my reading and experiences--interrogating and digesting... Is this what he means?
Thank you so much for all the free information you share! I find your videos choppy to watch., fast clips and cuts. As if the editing will make the message better. For me it has the opposite effect. Love from Sweden
What are your thoughts on someone with BPD going into the therapy field? I have recently been diagnosed in my late 20's and I am starting to see improvements in myself and I am starting to thrive and I feel inspired to help others. I am currently blessed with a stable office job that I enjoy, despite it not being my passion. My concern with going into this field is the stress of grad school and being triggered. Do you think this would be a good career choice for me or would it be better to find a way to help on the side? I also love yoga and it has been helping me with my mindfulness and to manage me symptoms. Thank you in advance
Hi, I’m nearing completion of my MA in Counseling and wanted to give you a student perspective. Lots and I mean LOTS of the students in my classes have diagnoses like BPD, depression, anxiety, etc. Grad school is challenging and I’ve found the faculty & staff are super understanding and supportive. Being triggered is unavoidable yet it is also manageable. I recommend you research some programs and chat with admissions to see what’s the best fit 💛
Is it just me or is she looking more and more beautiful every new video?
I don't think you need a new camera. It looks like your camera focused in on your plant. Try moving things around a bit and see if it fixes the problem.
Unrelated to video content, but if you happen to see this comment: where is your top from? I have the hardest time finding lightweight "flow-y" tops and this one is so pretty!
I bought it at a thrift store, so I'm not sure, sorry!
I was frustrated by the bullet point that personal development trainings do not help? Maybe I’m getting personal development mixed with reflective practice ?
I encourage you to take a deeper dive here - The work of Daryl Chow and his collaborator Scott D. Miller is very informative and will help elucidate the fact that we in the field place FAR to much emphasis on learning new techniques and perfecting modalities when that's not what makes us better or effective therapists. The work of Bruce Wampold has also offered much in the way of understanding what makes for better therapy outcomes and what we might want to downplay or discard that are currently sacred cows, so to speak. It's not that personal development trainings do not help - if as a therapist I expand my bag of tricks or extend my capacity for taking different perspectives with client work that can be a good thing; I have more options to draw on and sometimes feel refreshed as a therapist by learning new material. However, there is significant accumulation of good evidence showing that getting CE credits, attending workshops, etc. does not improve therapy outcomes for our clients. While we may feel like we're becoming better therapists, this is being shown to not be the case - other measures of therapy outcomes are critical besides "I feel like I'm doing a better job" and the best growth is in attending to how we establish, build, and maintain the crucial therapy relationship. One final note - it's been shown that therapists' perception of the quality of the therapeutic relationship often does not align with client perception - we can think things are going along swimmingly and we're doing a bang-up job and our client may not agree, and also often don't tell us and don't get everything they could out of therapy (or will just leave).
6:12 What are your thoughts on the impact that Dr. Jordan B Peterson has on other psychotherapists and young men?
I completely agree with the jazz comparison. And I definitely wouldn't have wanted to hang out with Sigmund. All humans are flawed but it seems he was flawed in ways that I would need huge boundaries to stay away from.
I honestly didn’t get why get so emotional about his statements, quite strange video overall.
This video was interesting food for thought but I found the man's bullet points way too vague to be of any practical application to me.
Well I guess so Your the Therapist