Did your supervisor tell you that? On re-learning psychotherapy

While delivering workshops I’m often asked to teach exercises and demonstrate protocols. Even participants who have no previous knowledge of the presented approach want to learn some techniques. This interest seems to be quite natural when the audience consists of practitioners. After all, our overarching goal is to serve our clients effectively, and not all learning is relevant for that purpose. When I look back at my own professional training I can clearly see a large amount of time (and money) wasted on courses and workshops of questionable clinical value.

Yet, whenever I hear the idea that “just by having a bigger toolbox, you can do more”, I realize how strongly I disagree. Techniques are not everything, and certainly they are not the beginning of learning.

Let me use an example. Did you ever try to shift a broken tile in your bathroom? I did, once. Believe me or not, but having all necessary tools does not automatically mean that the work will be done.  I ended up with calling a tiler. So, if having tools is not a solution while working with inanimate objects, how can they substitute expertise when it comes to working with human beings?

In my personal opinion, an exaggerated focus on technical aspects of psychotherapy may paradoxically weaken our effectiveness because of detaching interventions from their origin and from a broader context. Some authors say that this is exactly what happened to the modern mindfulness practice, which drifted far away from its philosophical and ethical roots and has transformed into “MacMindfulness” (you can read more about the criticism here: McMindfulness: Buddhism as sold to you by neoliberals). I couldn’t agree more with that assessment and I think that the problem is much wider and more common than just the case of mindfulness. Why is it so?

Each therapeutic process starts long before a client knocks on our door. It doesn’t mean that we can bill all that time :), but it means that the duration of the therapeutic process extends beyond the direct contact with the client. Thus, the scope of psychotherapy training and supervision should also extend beyond the direct delivery of treatment.

This idea lies behind my own way of structuring courses and workshops. Attendees move through the same phases which I list below as core components of the psychotherapy process. Thus, I call this way of teaching psychotherapy a process-oriented approach to training. The phases of psychotherapy are as follows:

1. Consciously adopting a certain therapeutic stance;
2. Establishing and strengthening the therapeutic relationship;
3. Conceptualizing presented problems and setting up treatment goals;
4. Choosing techniques/strategies and delivering the treatment;
5. Follow up: gathering feedback and therapist’s self-improvement

As you can see, learning of specific techniques is useful for phase 4. Other parts of your professional development require different types of knowledge and different learning methods.

The listed phases overlap, at least partially, e.g. the work on the quality of the therapeutic relationship lasts as long as your contact with the client. However, they should commence in the sequence listed above.

The role of the supervisor/trainer consists in helping the trainee make the process circular, which means that phase no 5 leads to revisiting all previous phases with a new client. It is also the supervisor’s task to ensure that the trainee retains coherence within and between the phases.

In my next post I’ll go through the learning phases and will discuss their content.

Stay attuned!

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