Snippets
Over the last several months, I've been writing a series of short, but true stories from my life and work. After some gentle encouragement from Carrie Witta of Very Bad Therapy podcast fame, I created a substack account and have been posting the "Snippets" once a week or so ...
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Results from the first bona fide study of deliberate practice
In 1997, Wampold and colleagues published a study that revolutionized psychotherapy outcome research. It addressed a question that had long divided the field; specifically, were some therapeutic approaches more effective than others? Each side in the debate claimed the data supported their position -- and, like a Rorschach ink ...
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Fasten your seatbelt
“History” has a way of feeling as though it happened long ago. Selfies are such a ubiquitous part of our culture it’s hard to believe the technology that gave rise to them appeared only 15 years ago. One more example. Seatbelts. On entering the car, my kids and grandkids ...
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A not so helpful, helping hand
“Your reach should exceed your grasp,” was one of my dad’s favorite sayings. Smile on his face, he would often add, “be prepared to end up empty handed” – which reminds me of a memory. I was seated on the right side of the room, in the aisle seat, ...
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Alas, it seems everyone comes from Lake Wobegon
You've heard of it, right? Lake Wobegon? The fictional town in Minnesota made famous by master story-teller, Garrison Keller. The place where, "all the people are strong, good-looking, and above average?" Turns out, if the city were "Psychotherapy," it would not be a fictional place. Since 2012 when the ...
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Missing the boat
All of us have them. Key developmental experiences. Ones that stick in our memory, make a permanent “dent” in our thinking or behavior. I was sitting behind a one-way mirror watching a therapy session. The young man being interviewed was dying, his immune system failing due to the AIDS ...
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The Growing Inaccessibility of Science
It’s a complaint I’ve heard from the earliest days of my career. Therapists do not read the research. I often mentioned it when teaching workshops around the globe. “How do we know?” I would jokingly ask, and then quickly answer, “Research, of course!” Like people living before the development ...
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How to (and not to) become a more effective therapist
I'm not sure what was going on in our field last week. From the emails I received, it seemed something big -- no, monumental. Here are just a handful of the highlights: "The single modality that's transforming how clinicians do therapy ... and making them so successful." A new ...
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When is it time to “hang it up?”
She'd started young. At age 3, she was named "Miss Beautiful Baby." Shortly thereafter, she became a regular --"Bubbles Silverman" -- on the Uncle Bob's Randbow House radio show. Voted "most likely to succeed" by her high school classmates, she sang everywhere and anywhere before landing a position as ...
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What therapist experience, a nickel, and cup of coffee have in common
Once upon a time, a nickel (the U.S. 5-cent coin) had value. As a kid, I could get a generous scoop of ice cream at Sav-On, Big Hunk candy bar at Bock's variety store, or a super-sized glazed doughnut at the Donut Man shop on Route 66. At ...
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The Success Probability Index (SPI)
Its the biggest update to Feedback Informed Treatment (FIT) in two decades. In the beginning, all we had were the measures. Clinicians administered the outcome and session rating scales at each session and then compared client scores to the clinical cutoffs (CCO) and reliable change index (RCI) to determine whether ...
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Simple, not Easy: Using the ORS and SRS Effectively
How difficult could it be? One scale to assess progress, a second to solicit the client's perception of the therapeutic relationship. Each containing four questions, administration typically takes between 30 to 60 seconds. Since first being developed 23 years ago, scores of randomized-controlled and naturalistic studies have found the ...
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Do certain people respond better to specific forms of psychotherapy?
Dr. Danilo Moggia is a psychologist and researcher working at the University of Trier in Germany. Over the last several years, he's been devoted to studying how "machine learning" (ML) can be used to improve the fit and effect of mental health services. Wikipedia defines ML as, "an area ...
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Thinking Out Loud
Type the title of this post into Google and you get 275 million results. Scroll through the pages and you'll find most are links to the hit song by Ed Sheeran -- videos, fan pages, or stories about the 100 million dollar copyright lawsuit filed by the estate of the ...
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How “effortlessness” impedes professional development
I remember her. My very first, real client. Cynthia -- not her real name, her real name was Susan, but I'm not supposed to tell you that! (Just kidding, that wasn't her name either) Early thirties. Married. Couple of kids. Depressed. I was still a student, a therapist-in-training -- ...
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Be careful what you wish for, or …
Despite happening decades ago, I remember it as though it were yesterday. My oldest, Kirk, was fiddling with a cassette tape recorder. He was four at the time and wanted to listen to "his music." You know, the kind all parents regret having given to their kids at some ...
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