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I Was Wrong: The Healing Power of Admitting Mistakes in Psychotherapy

January 14, 2016 By scottdm 1 Comment

i was wrong

 

 

 

 

Across modalities, the therapeutic relationship has consistently been found to be a robust predictor of treatment outcome.  Most practicing clinicians understand this finding and work hard at establishing and maintaining a collaborative working alliance.

mistakes
Here’s a less well known, but sobering statistic: clients report tensions or actual breakdowns in the therapeutic relationship in 19% to 42% of sessions.  These figures rise to 41% to 100% of sessions when trained observers are used to identify “ruptures” between clients and therapists.

Given the frequency of such occurrences, therapy really is about constantly re-pair-ing—a continuous process of getting back “in touch” with and connected to the person seated opposite us in the consulting room.  Findings from a number of studies (1, 2, 3, 4) emphasize the value of therapists openly acknowledging and exploring ruptures, all the while maintaining an open and non-defensive stance.  Failing to do so, the data make clear, leads to higher dropout rates and poorer outcomes.

rebuild

Given the frequency of such occurrences, therapy really is about constantly re-pair-ing—a continuous process of
getting back “in touch” with and connected to the person seated opposite us in the consulting room.  Findings from a number of studies (1, 2, 3, 4) emphasize the value of therapists openly acknowledging and exploring ruptures, all the while maintaining an open and non-defensive stance.  Failing to do so, the data make clear, leads to higher dropout rates and poorer outcomes.

Of course, admittimistakes were madeng a mistake presumes knowing one has been made.  It’s easier said than done.  Clinicians’
experience of the quality of the therapeutic relationship frequently differs from those they treat.  And while a significant body of evidence documents the benefits of systematically monitoring the status of the alliance via simple measures like the Session Rating Scale, little is known about what therapists actually do with such information to inform and improve outcome. That is, until psychologist Chris Laraway entered the picture.

Dr. Laraway’s thorough and engaging study not only provides a systematic review of the alchris larawayliance and feedback
literature, but also the first empirical model for how feedback can be used to resolve ruptures in the therapeutic relationship.  What’s the secret?  The entire study is just a click away—or for those interested in the “Cliff note” version here.  Thanks to Chris for allowing me to make it available.

These, and other, new findings are being integrated into the curriculum for this summer’s Professional Development Intensive.   This two-day event focuses on raising your effectiveness to the next level by improving your ability to engage, retain, and help a more diverse clientele.  Given the intensive nature of the training, registration is limited.  All of our March intensives sold out months in advance.  Register now at: http://www.eventbrite.ie/e/fit-professional-development-intensive-2016-tickets-17740785166.

Until next time,

Scott

Scott D. Miller, Ph.D.
Director, International Center for Clinical Excellence
FitProfessionalDevelopmentIntensiveAug8th2016

 

Filed Under: Feedback Informed Treatment - FIT

Comments

  1. Mike Gathers says

    January 14, 2016 at 8:15 pm

    Attachment jedi master Allan Schore has been preaching the value of rupture and repair for a long time now. The quicker you can notice the rupture and skillfully repair it, the better. RE: The good enough mother.

    We are forming “good-enough” attachment relationships with our clients and “re-parenting” them. At least that’s one way to look at it.

    Reply

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