“ The most important thing is caring, so do it first, for the caring physician best inspires hope and trust. ” - Sir William Osler

                                                               Therapists, mentors & coaches: an introduction

key points: 

1.)  what makes some psychotherapists, counsellors, mentors & coaches more helpful than others? 

2.)  links are provided to five ways of increasing therapist helpfulness - feedback, therapeutic alliance, expectancy & hope, deliberate practice & therapist resilience.

"The secret of patient care is caring for the patient."  William Osler

Yesterday I wrote the blog post "Paired meditation deepens interpersonal connection: Tania Singer's wonderful ReSource project" which introduced & overviewed the recent, very impressive ReSource Project.  I also discussed the associated JAMA Psychiatry research paper "Effects of contemplative dyads on engagement and perceived social connectedness over nine months of mental training: a randomized controlled trial" with its abstract including the comments "Secularized classical meditation training programs address social cognition, but practice typically occurs alone.

Yesterday I was skimming through the JAMA Psychiatry journal and I got hijacked by Kok & Singer's recent article "Effects of contemplative dyads on engagement and perceived social connectedness over nine months of mental training: a randomized controlled trial".  The abstract reads - "Importance  Loneliness is a risk factor for depression and other illnesses and may be caused and reinforced by maladaptive social cognition. Secularized classical meditation training programs address social cognition, but practice typically occurs alone.

I have already written a blog post ... "Warwick BABCP conference: 3rd day - even more evidence that therapists themselves are central to improving outcome (5th post)" ... about the great last morning symposium "The singer and not the song? Evidencing therapist effects across the IAPT stepped care model".  I have described in some detail the first two symposium presentations ... Nick Firth's "Therapist effects and moderators of effectiveness and efficiency in psychological wellbeing practitioners: a multilevel modelling analysis" and Dave Saxon's "Variability in practice: therapist effects in an IAPT service delivering CBT and counselling".

Needs-Beliefs-Behaviours

See too Nissen-Lie et al's "Patient and therapist perspectives on alliance development: Therapists' practice experiences as predictors" with its finding about the toxic effects on client rated therapeutic alliance produced by the "leaking" of unspoken critical therapist. 

"Humble warmth" "Therapist predictors of early patient-rated working alliance: A multilevel approach"

Pre-session 'meditation' on client strengths & resources.  Compassion work.

Work on compassion both for self and for others and its effects on self-esteem ... and note too the benefits of "saying turquoise" and other emotional intelligence aspects.

“ A leader is a dealer in hope. ” - Napoleon

Here are a series of forms that I use almost every session with clients, or for screening and orientation at the start of therapy:

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"?

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 ...

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?