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“Mind the Gap”: A Strategy for Insuring you get the Feedback you need to Improve your Game (whatever that is)
Join me in a brief “thought experiment.” Suppose you were a gifted painter or photographer and had the chance to provide an image of yourself that would endure–and perhaps be the only one people would know you by–for hundreds of years after your death. How would you proceed? What criteria would guide your work, be — read more
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Does practice make perfect?
“Practice does not make perfect,” my friend, and award-winning magician, Michael Ammar, is fond of saying. “Rather,” he observes, “practice makes permanent.” Thus, if we are not getting better as we work, our work will simply insure our current performance stays the same. Now, before reading any further, watch a bit of the video below. — read more
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Making the Impossible, Possible: The Fragile Balance
Trip-Advisor scores it # 11 out of 45 things to do Sausalito, California. No, it not’s the iconic Golden Gate Bridge or Point Bonita Lighthouse. Neither is it one of the fantastic local restaurants or bars. What’s more, in what can be a fairly pricey area, this attraction won’t cost you a penny. It’s the — read more
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Do you know Norman Malone? FIT, Grit, and Grace Personified
At the tender age of 10, Norman Malone’s father attacked him and his two younger brothers with a hammer while they slept. Their mother, drugged into unconsciousness by her husband the prior evening, found the children the next morning. Each had suffered grave head wounds, but were alive. Later, all would learn the senior Malone — read more
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What is the essential quality of effective Feedback? New research points the way
“We should not try to design a better world,” says Owen Barder, senior fellow at the Center for Global Development, “We should make better feedback loops.” Feedback has become a bit of a buzzword in mental health. Therapists are being asked to use formal measures of progress and the quality of the relationship and use — read more
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Are you Better? Improving Effectiveness One Therapist at a Time
Greetings from snowy Sweden. I’m in the beautiful city of Gothenburg this week, working with therapists and administrators on implementing Feedback-Informed Treatment (FIT). I’m always impressed by the dedication of those who attend the intensive workshops. More, I feel responsible for providing a training that not only results in mastery of the material, but also — read more
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The Benefits of Doubt: New Research Sheds Light on Becoming a More Effective Therapist
These are exciting times for clinicians. The pieces of the puzzle are falling into place. Researchers are finally beginning to understand what it takes to improve the effectiveness of psychotherapy. Shifting away from the failed, decades-long focus on methods and diagnosis, attention has now turned to the individual practitioner. Such efforts have already shown a — read more
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Love, Mercy, & Adverse Events in Psychotherapy
Just over a year ago, I blogged about an article that appeared in one of the U.K.’s largest daily newspapers, The Guardian. Below a picture of an attractive, yet dejected looking woman (reclined on a couch), the caption read, “Major new study reveals incorrect … care can do more harm than good.” I was interested. As — read more
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Becoming a more effective therapist: Three evidence-based clues from research on the field’s most effective practitioners
It’s one of those secrets everyone knows, but few talk openly about: some therapists are more effective than others. Available evidence indicates that clients seen by these practitioners experience 50% more improvement, 50% less drop out, have shorter lengths of stay, and are significantly less likely to deteriorate while in care. So, how do these — read more
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Therapist Wanted: Dead or Alive
Do you get those letters about the top healthcare providers in your area? At the beginning of the new year, our city’s local magazine publishes a list of the top healthcare providers. It’s a big deal. Organized by location and specialty, the issue contains full-page photos, glossy spreads, and breezy write-ups. Impressive stuff with a — read more
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Dinner with Paul McCartney (and others)
Growing up, my family had a game we frequently played around the dining room table. “If you could invite anyone to dinner,” it always started,”who would it be?” Invariably, my father chose historical figures: Abraham Lincoln, Mark Twain, Leonardo Da Vinci. My mom was more inclined toward the living: Jackie O., J.D. Salinger, Lucille Ball. — read more
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Is Documentation Helping or Hindering Mental Health Care? Please Let me know.
So, how much time do you spend doing paperwork? Assessments, progress notes, treatment plans, billing, updates, etc.–the lot? When I asked the director of the agency I was working at last week, it took him no time to respond. “Fifty percent,” he said, then added without the slightest bit of irony, “It’s a clinic-wide goal, — read more
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The Sounds of Silence: More on Research, Researchers, and the Media
A while ago, I wrote about an article that appeared in The Guardian, one of the U.K.’s largest daily newspapers. Citing a single study published in Denmark, the authors boldly asserted, “The claim that all forms of psychotherapy are winners has been dealt a blow.” Sure enough, that one study comparing CBT to psychoanalysis, found — read more
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Good News and Bad News about Psychotherapy
Have you seen this month’s issue of, “The National Psychologist?” If you do counseling or psychotherapy, you should read it. The headline screams, “Therapy: No Improvement for 40 Years.” And while I did not know the article would be published, I was not surprised by the title nor it’s contents. The author and associate editor, — read more
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Evidence-based Practice is a Verb not a Noun
Evidence-based practice (EBP). What is it? Take a look at the graphic above. According to American Psychological Association and the Institute of Medicine, there are three components: (1) the best evidence; in combination with (2) individual clinical expertise; and consistent with (3) patient values and expectations. Said another way, EBP is a verb. Why then — read more
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An Easy Way to Improve Our Schools (and Psychotherapy)
There is this article that appeared a while ago in the Atlantic Monthly that stuck with me. In it, Amanda Ripley detailed a simple and straightforward method for improving the performance of the public schools: have kids grade teachers. What kind of grades you ask? Not those on standardized achievement tests, and certainly not measures of — read more
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Thomas Szasz, M.D.: Memories of a Friend and Mentor
Very early in the morning of December 9th, 2009, I received a call in my hotel room. My long time colleague and mentor, Jeffrey Zeig was on the other end. "May I ask you a favor?" he said. "Of course," I instantly replied, completely unaware of what was coming. "Tom Szasz is caught in a… — read more
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Barriers to seeking mental health care
With all the challenges facing the profession, it is important to highlight people and organizations that are working hard to make a difference. On that note, tomorrow, Tuesday the 25th of September 2012 is the very first National Psychotherapy Day. Having a day of unified, active promotion of psychotherapy is the brain child… — read more
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REACHing the Next Level of Clinical Performance: What it Really Takes
Do any of these people look familiar? Well, of course, I’m the guy in the middle pointing. To my left is the rock and roll guitarist Joe Walsh. On my right is world-renowned, card mechanic Richard Turner. Why have I pictured myself sandwiched between these two? Because they are both inspiring examples of what can… — read more
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A Lotta Help from One’s Friends: The Role of Community in the Pursuit of Excellence
Dateline: Chicago, IL USA Hard not to be impressed with the USA Women’s Gymnastic team. What skill, percision, expertise, and excellence. By now, I’m sure you’ve seen the interviews. In all instances, each and every one has focused on the team. Despite some in the media attempting to make stars out of the individual members,… — read more
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Is the "Summer of Love" Over? Positive Publication Bias Plagues Pharmaceutical Research
Evidence-based practice is only as good as the available "evidence"–and on this subject, research points to a continuing problem with both the methodology and type of studies that make it into the professional literature. Last week, PloS Medicine, a peer-reviewed, open access journal of the Public Library of Science, published a study showing a positive… — read more