In this post, I will tell you one thing you can do to be a SuperShrink!
But first, what is a SuperShrink? SuperShrinks are unusually talented and effective psychotherapists. Don’t we all want to be one?
Most of us believe that if we master the counseling theories, diagnose the client properly, and use the appropriate interventions that we will succeed in treating the client. We know it’s important to build an alliance with the client, but that’s the easy part, right? The real challenge, and therefore where most of our effort should be, is in both mastery and selection of appropriate interventions.
Wrong.
According to a 2006 study by Wampold and Brown of over 6,000 clients and almost 600 mental health providers, variability in outcomes were primarily due to the quality of the alliance. NOT the education level, age or qualifications of the therapist. NOT the treatment method used or the client’s diagnosis, age or gender.
And how do we increase the quality of the alliance? By doing what most of us don’t do: soliciting feedback. Particularly negative feedback.
According to Scott Miller’s examination of various outcome studies, it is through the processing of negative feedback that you will become a SuperShrink! Now, he doesn’t mean that you should direct your clients to say negative things about you. What he is referring to is regular, systematic feedback gathering with openness to negative feedback. Rather than automatically blaming the client for being “resistant” when therapy isn’t working, looking objectively at your own performance and being willing to make adjustments.
Or, as he puts it “would you rather be approved, or improved?”
Miller’s examination of several outcome studies leads him to the following conclusion:
“The quality of the patient’s participation in therapy stands out as the most important determinant of outcome…[this] can be considered fact established by 40-plus years of research on psychotherapy.”
So, the question becomes: How do we get clients more engaged in therapy?
It’s all about the quality of the relationship. In order to develop and grow excellent therapeutic relationships with our clients, we MUST be sensitive to when things are going wrong. If we ignore signs of client dissatisfaction, we will miss the opportunity to make adjustments to improve the relationship. The worst thing we can do is to think that we are so experienced that we have nothing left to learn.
But…we may not know when clients are dissatisfied. This is why it’s important to collect feedback on a regular and systematic basis. To accomplish this, Miller has developed two rating scales: the ORS (Outcome Rating Scale) to be given at the beginning of each session, and the SRS (Session Rating Scale) to be given at the end. He also has special scales created for children. Both of these scales can be downloaded at no cost here.
Soliciting feedback can also prevent early drop-outs. According to Miller, approximately half of our clients will drop out of therapy. According to a 2007 study of over 6,000 diverse clients by Miller, Duncan, Brown, et al., therapists who failed to solicit feedback about the therapeutic alliance were two times likely to have their clients drop out of therapy prematurely!
So, be a SuperShrink and start using Miller’s feedback forms today.
Yours in the Joy of Knowledge,
Dr. Barb LoFrisco
Source: SuperShrinks presentation.
