I think it's a question a lot of us ask ourselves but strangely enough I'm not sure it has been a
guiding light in terms of how we organize our trainings. Too often we go to sort of one-off
trainings where we hear a lot of research and it's very intellectual, but it's not actually designed
to help us grow to become better clinicians so that when we go back in our therapy office on
Monday morning, we've really integrated whatever we learned and are ready to give it to our clients.
So this is a really frustrating experience and I know for myself and through talking
to my colleagues and students how common it is to feel a bit stuck and like we're plateauing,
and that is not our fault. The truth is there is a body of research about what it takes to be a great
therapist. What great therapists do differently how they practice, how they use their time. But that has
not translated into how we actually teach students. Instead our training is often very intellectual
and not embodied and not focused enough on the skills we actually need and sometimes
I think the problem is that we allow these sort of assumptions about excellence, what I think of
as like the myths, to get in the way and I want to talk to you a little bit later about those myths,
because in my mind it's really time we pivot as a field into deeper types of learning. We've poured
millions of dollars into manualized treatment but we have spent almost no money figuring out
how to help therapists develop their ability to do those techniques and that's really amazing if
you think about it because any technique is only going to be as effective as the therapist doing it.
What research in our field has done would be more akin to music teachers getting around and
debating which song to play rather than how to play it well, or even how to train their students
to play it well, or really even just teaching the basic skills that might lay the foundation
for being able to even play a song like learning scales or learning chords. This kind of idea of
very carefully and meticulously sort of going through a method of training is not rocket science
and the fact that our field hasn't really tackled this issue does a big disservice to our clients.
But also I think it does a big disservice to therapists because most therapists, if not all, are
really wanting to do their best. They're needing support and looking for chances to grow so that
they can best serve their clients. So our field which is all about studying human development,
there's a way in which we could perhaps stretch to include therapist development in that circle.
My name is Dr Tori Olds and I wanted to tell you just a bit about why over the last six years I've
follow the model or stick to the manual or that kind of thing and even rating on that
by an expert of how well did that person do the theory doesn't predict clinical outcomes!
So really all the efforts and money we've put into manualizing treatment seems to be something
of an epic fail. The truth is our field hasn't improved in its outcomes over the last 50 years.
That might be because we have focused so much on competing between theories
rather than focusing on the person of the therapist and how to help them grow
and looking at something that the research does really seem to point to as as being important to
outcomes which are called common factors. Those factors that are important in treatment but are
really common across theoretical orientations. Now that being said, that leads us to myth number three,
because many people have started to hear about common factors but through their
hearing about it, a sort of different myth, a sort of opposite myth, has emerged. So we have the
people that really buy into myth number two and then those that buy into myth number three.
Myth number three is theory doesn't matter at all. The only thing that makes the difference is
the therapeutic alliance. Now there's a lot to unpack there.
So first, with theory doesn't matter, while the common factors research does suggest that which
theory you use may not make a difference in outcomes, having some theory does really matter,
and secondly ,while common factors are important they go way beyond just the therapeutic alliance
which just happens to be the most famous. But truthfully there's all sorts of common factors:
The installation of hope. The ability to help the client confront what they've been
avoiding and feel a sense of mastery and take ownership of that mastery experience.
So there's all sorts of common factors that go beyond just the therapeutic alliance.
So as we're talking about the therapeutic alliance, that leads us to myth number four:
the therapeutic alliance is all about warmth and empathy.
Well warmth and empathy do contribute to the therapeutic alliance but alliance has been studied
really in a lot of detail, and really, they found three ingredients, three elements that contribute
to the alliance and warmth is only one of them. The other is agreement on the goals of therapy
and the third is agreement on how as a team we're going to reach those goals.
So now into myth number five confidence is really important in being an effective therapist.
Well, this is partly true and the nuance of that is really captured in this famous article around
this topic and the title of the article is: Love Yourself as a Person, Doubt Yourself as a Therapist.
So it seems to be the research seems to show that it's actually the combination of two sort of
counter qualities, one really valuing ourselves as a person, kind of believing and having confidence
in our innate value and goodness and capacity but also sort of doubting ourselves as a therapist.
In other words, just having, at least you could say, some humility, really always questioning
and wondering, "am I doing good enough with this client, is there anything I could be doing better?"
Whereas, when people both kind of love themselves and sort of think "oh yeah, I'm great
as a therapist," actually that combination doesn't predict outcomes as well as this humility piece.
it seems it's really important not to be arrogant and just assume that we're doing a great job.
Now finally to the last myth, myth number six: you can't teach someone how to be a great therapist
because it is based on innate sort of inborn qualities or strengths. The truth is just like any
other area of expertise, therapy is based on micro skills that can be taught and learned through
a lot of practice. Now it is true that there is something called facilitative interpersonal
skills as conceptualized and researched by Tim Anderson and his lab did find that you
could test someone on their facilitative, or rate them on their facilitative interpersonal skills,
before as a student, before they've even seen their first client and then a few years later
test their outcomes and predict how they're doing based on their skills their interpersonal skills.
But like anything else, interpersonal skills can be taught and learned
and I know this from personal experience because I was a very shy and anxious kid and even kind of
going into high school and college I was a little less anxious but I was also
still not really open and that warm and I really took it as a sort of mission to learn how to be
more open-hearted and expressive and warm. I kind of templated off my sister on that one, because
she's the epitome of that just naturally, but for me, it wasn't natural and yet it was something I
could really develop through conscious intention. So the old adage does in this case seem really
true that practice makes perfect. But then of course, that leads to the question, how do therapists
practice? And thinking about this allowed me to do really two things. One is, I mentioned,
I created a road map of the skills and the micro skills that I think are important in therapist
development and that was really through doing a lot of research. Not only
through working with my students and in our clinic but really delving into the research and
then two, thinking about well how do we practice, if these are the skills, how do we practice them?
And that sort of led me to stumble along a field called deliberate practice. So in the next video,
I would like to talk to you about both of those things. Sort of go over the roadmap and really look
at what are the areas where we can most fruitfully put our attention if we want to grow based on what
the research says. And two, talk about deliberate practice which is not specific to psychology. It's
really the study of expertise, how what kind of efforts and what is the format for practicing
any kind of skill you're wanting to develop. It's only just now beginning to be incorporated into
our field in some really exciting ways so you don't want to miss that. Thanks for watching
and I'm really interested in any of your thoughts or reactions around these six myths. Take care
thanks so much for watching. This video is actually part of a promo for an online course my sister
and I are launching and in this course we'll really delve into these skill areas that I was
just mentioning, while also using deliberate practice exercise to help you embody them.
So if you'd like to watch the second video in this series where I talk about deliberate practice
and why it is such a groundbreaking approach to clinical training, feel free to click on the
link in the description box below. That will also be how you will learn more about the
course. So I hope to see you in the next video and of course in the course as well. Thanks!