Reflections on Psychotherapy Networker Conference, DC 2019

Therapeutic alliance, clinical confidence, & deliberate practice

One of the most beneficial sessions, entitled “A Day for New Therapists: Learning the Principles of Successful Practice” was presented by Lynn Grodzski, LCSW, MCC, LLC . This session outlined all of the important steps required for practitioners setting up a full-fee private practice. The session used a case-based learning approach to teach about difficult problems and methods of self-supervision. Grodzski’s presentation technique mirrored her talk promoting a “getting to yes session structure”, ongoing measuring of client success, client retention, and building clinical confidence. It was an excellent workshop that encouraged participants to build “a deliberate practice” instead of learning a new treatment approach per se. Using this frame, clinicians are taught to begin by mapping your own clinical performance and work on becoming a better version of yourself.

Best clinical results were shown to be associated with therapeutic alliance, level of clinical confidence in methods used, and deliberate practice. This notion of deliberate practice resonates with humanistic person-centered approaches. It calls upon the clinician to locate those aspects of practice with which they are most confident. This clinical confidence emerges over years of supervised and reflective practices that result in evidentiary supports of positive health impacts on clients served. In my view, client retention, positive client feedback & self-reports, clear markers of improved health, such as non-verbal body language, clear & confident speaking, and relaxed sense of self & esteem in the presence of others, including strangers constitute evidences of wellness. Sometimes, the initial problem identified by the client as the reasons for clinical support remains unchanged, yet health improves. This speaks to the powerful impacts of self-care in situations or problems that are beyond the client’s control to change. This is an especially important consideration for clinician self-care as well.

Where clients are unable to tell you verbally that they are not ready for the work you have identified as central to their treatment or that they disagree with collaborative goals co-created together, future sessions will not take place at that time. It is possible that people return to therapy at a future time or with a different psychotherapist. In fact, confident therapists will have this conversation about goodness of fit with clients during the initial informed consent & assessment phases of work together, and every now and again where work ensues over a good period of time. Drawing upon Solution-Focused techniques, it is therapeutic to ask clients early on – how they will know when they no longer need treatment or when they feel well? Clients must always feel that their best interests are central to health care provided and that they have a moral, legal, and ethical right to care-providers that best meet their needs.

Lynn’s all-day session also underscored the importance of substantial clinical experience in the field before embarking on a model of work that requires honest and competent self-supervision with a clearly identifiable set of professional skills, in-depth knowledge of at least one or more related areas of expertise, and perhaps, a proven track record. Do you feel confident about the psychotherapeutic areas of intervention that you advertise to clients? Have you secured a method of supervision? What evidences do you use to continuously measure your clinical confidence, professional competence, and client therapeutic alliance? Are your clients getting what they have agreed to pay you for? How do you know ?

#wellness #heal #smallbusinessowner #privatepractice#selfcare

Published by Lisa Romano-Dwyer PhD, RSW

I am a registered social worker in the province of Ontario. I am currently creating professional resources for clinical practitioners.

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