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Psychotherapy (and psychotherapist) outcomes are good but largely stagnant

I have been asked to write a chapter on the importance of obtaining regular feedback on client progress in a book on psychotherapist self-practice & self-reflection.  This initial section (see below) of a draft of the chapter comments on the current state of psychotherapy itself:

(Note the ideas in this blog are explored in more detail in the chapter "Client feedback: an essential input to therapist reflection" in the forthcoming Haarhoff, B. and Thwaites, R. (2016) "Reflection in CBT: Increasing your effectiveness as a therapist, supervisor and trainer." London: SAGE Publications Ltd.)

Attachment style in both health professionals & their clients, therapeutic alliance & mindfulness

I had lunch with a health professional friend the other day.  Later he emailed me saying "The last few times we have met you have mentioned the importance of attachment style in determining aspects of the interaction between patients and health care professionals."  He went on to raise a series of questions about health professional-patient relationships, about the way that the attachment style of both health professional and patient can affect outcomes, about how adult attachment is measured and the possibility of improving attachment patterns, and about links between attachment & mindfulness.  Gosh a lot of interesting questions being raised here.

Do psychotherapists, doctors and leaders develop "emotional chainmail"? Some ways of building both stability and empathy.

In the last couple of days I've written two posts on the possibility of developing "emotional chainmail" when faced with repeated experiences of suffering ... "Do psychotherapists, doctors and leaders develop "emotional chainmail"?  Description of a possible problem" and "Do psychotherapists, doctors and leaders develop "emotional chainmail"?

Do psychotherapists, doctors and leaders develop "emotional chainmail"? Two kinds of empathy.

I wrote yesterday about how, at the weekend, I was involved in an hour and a half's deep emotional conflict resolution with an old friend that was witnessed in a group by another eight people.  As pretty much always, in the feedback that emerged over the next twenty four hours, different people reported very different reactions to what they had seen.  I still (after forty years involvement in a wide cross section of psychotherapy groups) find it jaw-dropping the sheer variety of what different people feel & think when observing absolutely the same event.  However, it seemed that most of those who spoke were deeply moved and respectful of what we'd done and how well it had worked out ...

Do psychotherapists, doctors and leaders develop "emotional chainmail"? Description of a possible problem.

I've been in a peer "psychotherapy group" residential retreat again recently and I was involved in an interaction that has crystalised a series of thoughts about potential "emotional armouring" in therapists that I've been aware of more vaguely for some time. And in fact these "suspicions" involve not just psychotherapists, but also doctors and leaders more generally as well. Happily there are great advantages of this emotional stability & resilience, but I believe there can also be very genuine personal & interpersonal costs. So what am I talking about here?

Some suggestions for giving and receiving helpful feedback

                      (this blog post is freely downloadable as a Word doc and as a PDF file)

"Man cannot remake himself without suffering, for he is both the marble and the sculptor."      Dr. Alexis Carrel

"It is a puzzling thing. The truth knocks on the door and you say, "Go away, I'm looking for the truth," and so it goes away."     Robert Pirsig

"There are people who live their whole lives on the default settings, never realizing you can customize."        Robert Brault

Lessons from a personal multi-source feedback project

"A friend is someone who sees the potential in you and helps you to live it."     W. B. Yeats (adapted)

"Honest criticism is hard to take, particularly from a relative, a friend, an acquaintance or a stranger."    Franklin Jones

A few months ago now, I initiated a personal feedback project.  It was triggered by a number of factors.  I was soon to start the third part of an Emotion-Focused Therapy training and was interested in possibly using myself as "a case study" for the course; I had received some quite surprising & confronting feedback from a friend and I wondered how idiosyncratic or widespread his viewpoint might be; I had been encouraging feedback in groups that I run and I wanted to explore this more deeply; and finally I'm in a very good position to ask for & receive honest, thoughtful feedback from a broad social circle.

How good is your GP or hospital? Listening to patient experience.

"Better together: Scotland's patient experience programme" works to use the public's experience of NHS Scotland to improve health services.  At the end of April they published provisional results for GP Practices throughout Scotland, and pilot results for a few initial hospitals are beginning to come through as well.  I find this fascinating, sobering, helpful stuff. 

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