International Therapist Leadership Institute is an organization dedicated to supporting and enriching the lives and careers of therapists everywhere. We do so by providing resources, seminars, events and networking opportunities - including practice building tips, strategies, videos and audios.
Our goal is provide a community that gives you education, helpful links, motivational articles and quality events. Please let us know how we can serve you!
In your service,
Casey Truffo,
Founder, InTLI and author, Be A Wealthy Therapist: FINALLY! You can Make a Living While Making a Difference
When they asked Michelangelo how he made his statue of David he is reported to have said, “It is easy. You just chip away the stone that doesn’t look like David.”
In our therapy or coaching practices, in order to say ‘yes’ to the right things, we have to say ‘no’ to other things. Frankly, I never want to say ‘no’ to people or projects. This leads to overwork, fatigue and burnout.
In order to create the space for new opportunities, new ventures, new relationships and even new clients, there needs to be, well, space.
What do you need to say ‘no’
to so there is space for ‘yes’?
Here is a suggestion. Make a list of the activities that you have committed to – personal or professional. Estimate the time it would take to complete them all. Now, after you get over the shock of what you have committed to, begin to flag the ones that bring you love, money or joy. Then look at the ones that trigger anxiety. Do you have to do them? What would really happen if you said ‘no’?
Our profession can lead us easily to compassion fatigue. Please don’t let that happen to you. Stand up and say ‘no’ to the things that don’t serve you. I can almost guarantee that you will see new opportunities that you never saw before.
For me it will be saying no to tweaking the blog and saying yes to completing the writing of my new book, The Entrepreneurial Therapist.
What about you? What will you say no to? Please share in the comments section below.
Have you ever wondered why we cry at certain movies? Sometimes they are happy tears, often they are sad ones. How is it that we can get so involved with characters we don’t know such that within two hours, we are shedding tears for their fate?
I was asked that question by a reporter once. I came up with fancy-pants theories about family of origin issues and general cultural angst. But now I am rethinking it.
Artists use their skill to create responsiveness in their audience.
Art can amplify emotion and create great impact very quickly. But how do the artists create that intensity of feeling?
(Note: These are my notes from my conversation at TLC2010 with Jeff Zeig about his new interest and project, a documentary.)
Jeffrey Zeig, Ph.D. is the Founder and Director of the Milton Erickson Foundation, having studied intermittently with Dr. Erickson for more than six years.
Jeff spoke to us at the 2010 Therapist Leadership Conference about his current area of interest: How art amplifies emotion and creates impact. Currently, he is working on a documentary called: The Art and Science of Impact with Viktor Frankl’s grandson, Alex Vesely.
To get a sneak peek at this new documentary, please play the 3 minute video trailer below. Then let us know what you think!
Let me share what I learned from his presentation:
The deepest level of rapport we can have, not only with our clients but with our children, loved ones, and friends, is called attunement. It often is created and enriched by emotional experiences.
Jeff says, “There are moments when you want to amplify emotion — in therapy and in life.” He is examining how we can have greater impact in our work and in our lives by exploring how artists use their art to create greater emotional impact for their audiences.
For example, if you listen to the first 90 seconds of Beethoven’s Fifth Symphony, you hear the first four, very strong notes. These notes are followed by lighter notes – going back and forth and rolling into crescendos. These contrasts (again whether in life or in our sessions) evoke emotion and can have great impact.
Often times, we as therapists sit in the same posture – session after session – and speak with pretty much the same tone of voice. But imagine if you saw a classically trained Shakespearian actor, say Richard Burton, sitting on stage like a therapist saying in a soft voice while looking at the audience, “To be or not to be?” Would that have the same impact as he would have on stage moving around and saying those words in a strong voice with pointed gestures? (Not that I am recommending you do that in session, but it is an interesting thought when thinking about evoking emotion.)
Art is about amplifying emotions so Jeff is looking at art (architecture, interior design, choreography, music composition, painting and especially movie making) and deconstructing those arts into elements of impact to learn how artists amplify emotion.
For example, when you go to the movies, attunement is really important. The director needs to get you attuned with the film to get you interested in the story. How does he or she do that? What are the auditory or visual cues or sequential techniques that help get you into the characters and feel your way into the story? If we look at how that is done, can we apply some of those techniques to our own work to create more attunement and create deeper emotional impact?
For the documentary, Jeff interviewed James Foley – an A-list Hollywood movie maker – who created 11 feature films including Glengarry Glen Ross. Jeff says, “I spent two hours with him going over the first five minutes of his movie, Perfect Stranger, with Halle Barry and Bruce Willis. The first five minutes are the title sequence. He showed me how he built attunement and created responsiveness with the audience – all in the first five minutes of the film.”
Imagine if we learned how to connect with our clients that quickly!
This documentary won’t be out this year but I have a surprise for you. I have the video trailer for this documentary which I will show you in a moment. I found it really interesting.
This documentary, again, is called: Art and Science of Impact. Jeff told me, “This project is about synergy. If we are to advance in our field, we need to do more than just immerse ourselves further within the field. Let’s look at other fields to see how they create attunement and impact. Then we can deconstruct it and apply it to our own work and relationships.”
Now – your turn …
What do you think?
Do you find that art evokes emotion?
Can you see how we easily attune with characters in a play or movie?
Might it be a good idea to see if we can deepen our level of rapport with our clients by studying how artists create emotional impact?
I look forward to hearing your comments. Please share them below in the comment section below.
In a graduate school business class, years ago, I studied “entrepreneurship.” This was about creating a business and selling products. At the time, I was a computer business consultant in Hartford, Connecticut, USA. I was considering starting my own computer consulting business and took this class to see entrepreneurship in the consulting business might be a good avenue for me.
Our first assignment was to break into groups and (on paper) create a new company and that company’s first product line. We had to come up with a “brand” and figure out how to manufacture, market, sell and distribute our company’s product line.
This was in the 1980s – nearly 30 years ago and a visible part of our culture were young people called “yuppies.” Yuppie was short for “young urban professional” or “young upwardly mobile professional.” Some people called them DINKs for “double income, no kids.” These singles and married couples in their twenties and thirties were bright, on the go people with much disposable income. The “yuppie” lifestyle was about having money, nice things and a lot of time to enjoy their life or career.
What my study group and I knew was that yuppies were a great target market. They had a lot of disposable income and were happy to spend that money on items of convenience.
My group designed a line of disposable, designer-looking, paper products. We called them “Yup-cups, yup-plates and yup-towels.” I lead the product design, branding, and marketing part of the project and loved it. Luckily others loved creating the manufacturing and distribution plans because when it came to those topics, I lost interest.
To this day, I can’t remember what grade I got in the class. Because the next 10 years of my career were shaped and changed by a different class assignment.
We were asked to take an “Are You an Entrepreneur?” assessment quiz. A high score on this test suggested that you will be successful and an entrepreneur. My score was very low and the comment was” Stay working for someone else. You do not have what it takes to be an entrepreneur.”
Whoa, I felt sad. I wanted to work for myself – choose my own hours and have that computer consulting business with clients I wanted to work with.
On the other hand, it somehow felt right. The idea of manufacturing and distribution and managing a hundred or a thousand people didn’t seem like my cup of tea. I took it as a sign that I would not be successful as an entrepreneur. I stopped dreaming of my own consulting business.
It took me about ten years of working for others (and deep soul searching) to understand. Then I got it! I was never going to enjoy owning a business that included a lot of manufacturing with dozens of people working for me. But creating a small business (a micro-business) with 10 or less employees (or even just me!) appealed to me. I wasn’t interested in creating a product driven business. I wanted to provide service to people – to have a service business.
Since then I have started three successful micro-businesses – including the computer consulting business, my therapy practice and my online coaching and training organization.
The moral of the story? Therapists in or who want to be in private practice are entrepreneurial by nature.
They love providing a service to others. They love to work for themselves, set their own schedule and choose their clients. I see this type of therapist as a specific kind of entrepreneur – you a “thera-preneur.” They do work they love with clients they adore and get paid for their service.
The Classic Private Practitioner is one example of thera-preneur.” It is a lovely model and one I have owned for 15 years and taught about for the last seven years. Most therapists start with the Classic Private Practitioner model. Most enjoy serving their clients this way for their entire career. It is wonderful to see how many of you have embraced this model so successfully!
As I have watched this warm, community of therapy-business owners, I notice that some therapists have decided to use their therapy skills and time in other ways to suit their passions and lifestyle. This is what is so nice about the service-driven business model. It is flexible in that you can design your business exactly as you want it. You can work in a way that serves you as well as your clients.
Many therapists added teaching, training, or coaching to their menu of services. Others added more clinicians to their practice and earned more income. Others decided to write books and gain instant credibility. Some decided to take up an important cause or issue and became the go-to person in their area. There are so many ways you can design your therapy-business in ways that support you, your family, your lifestyle, and your clients.
As I look back, I think that entrepreneurial assessment test wasn’t scored right for service-oriented entrepreneurs like therapists. Because therapy-business owners are entrepreneurs and a wonderful type of entrepreneur: “thera-preneurs.” They are very creative professionals. They are able to design how they deliver services and run their businesses to suit their passions, energy, business and lifestyle goals.
Not much has been said or written about all the options for running a therapy-business. I think you should have this information. That is why I am talking and writing about it now.
What do you think? Have you felt like an entrepreneur?
Are you interested in adding other services or products to your menu of services? If so, what would that look like?
Are you curious or have you thoughts about other ways you could use your therapy skills that would leverage your time – meaning make money beyond the “seat in the chair” therapy hours?
I would love to hear your comments, please leave them below. As you know I read and treasure every comment.
Finally, I am happy to be a part of this fabulous community of “thera-preneurs.” Thanks for the joy you bring into my life and into the world.
May you have the life and business you really want!
On the minds of many therapists are these two questions:
How can I increase client commitment to therapy? How can I make sure they don’t drop out of treatment?
At this year’s Therapist Leadership Conference, Bob Bertolino shared some interesting research related to how and why our clients get better. But first, here are some findings that can cause us to pause.
The average therapy client is 80% better off than the untreated (non-client). That is great news! But, look at this:
Since 1977, Bob reports that our therapeutic outcomes have not improved. In fact, the average client dropout rate – those who terminate prematurely – is 45-50%. This could be for a number of reasons, for example, there seems to be a lack of consumer confidence in therapy; they wonder if it really works. Furthermore, we as a profession haven’t taken strong stance in measuring/tracking outcomes.
Where should we be spending our times to improve client retention and outcomes?
Bertolino reports the common facts that influence positive treatment outcomes are as follows:
87% of client treatment success is due to the client. The means individual factors such as: his or her strengths, and the resources that the client has to tap into. Also, factors such as persistence and faith, and a sense of membership in a community are important predictors. How the client uses these resources is a factor as well – as is the client’s personal level of motivation, and resiliency.
6-9% of positive outcomes come from the “therapist effect.” This is the ability for a clinician to go in and connect with a particular client with methods that generate hope. The clinician sees herself (or himself) as an active ingredient to create change with this particular client.
5-7% is due to relationship alliance between therapist and client. This surprised me – I was taught this was the single biggest factor and today it is reported to account for only 5 – 7% of successful outcomes. Yes, positive outcomes start with the therapist’s ability to create the alliance. Clinicians who are good at creating and maintaining therapeutic alliance are flexible and good at making adjustments as needed. Beyond that, most of the potential for outcome relates to the client and the above-mentioned client factors.
1-2% of outcome success is related to a specific therapy model and techniques. Bertolino suggests that before we take more classes in theoretical models, we find out how positive our clients see our/their outcomes.
The questions remain: What do we do to help people not leave treatment prematurely and how do we help them reach positive outcomes? In other words, how do we know that are clients are benefiting from our work? Many therapists will say, “I just know I am effective.” In studies, almost all therapists identified themselves as above average or exceptional. Statistically, we can’t all be above or way-above average as compared to our peers. So let’s figure out how to measure our success.
Research is pointing to the idea of clinicians using a “feedback measure” (which can be as simple as a checklist or a rating scale) given to routinely to the client. These type of feedback measures, can help reduce client dropout rate and improved outcomes by as much as 50-65%.
On the feedback measure, the client reports to the therapist how they are doing and how the therapeutic relationship is perceived by the client. You can see if the client’s functioning is going down or up. You can keep track week to week and look for changes that can pave the way for important clinical discussions.
Two such measures are offered by Scott D. Miller. He offers the “Session Rating Scale 3.0 (SRS)” designed to assess key dimensions of effective therapeutic relationships. He also offers the “The Outcome Rating Scale (ORS)” designed to assess areas of life functioning known to change as a result of therapeutic intervention. These feedback measures aren’t complicated – just four questions each.
These are generously offered at no-charge by Dr. Miller and can be downloaded here.
When we put the client at forefront (since 87% if the success is related to the client) and use feedback measures, it provides a plethora of information. We can notice a client’s score is less than last time and ask, “What does the drop mean? What can you do to help yourself this week?” These measures allow us to connect deeper and be very helpful to the client.
In addition, a feedback measure done regularly can help identify a client with one foot out the door. During or at the end of a session, you can pause and ask, “I’d like to pause here and ask how it is going – are we talking about what you want to talk about?”
If there has been a therapeutic break, we can really hear the client and respectfully tell them we are sorry we missed it and address it with the client. Maybe with simply being asked and heard, enough repair has been done for the client not to leave treatment.
If you are wanting to improve your outcomes and effectiveness, you might want to consider a feedback measurement. There are many measurement scales out there. As I said, two of them are at http://www.scottdmiller.com/?q=node/6 These are very important too as many of you are building private-paying practices. Those clients reaching deep into their own pockets to pay for therapy sometimes tend to spread out their sessions or not come regularly. By using “feedback measures” this might change. (Let me know your results if you start doing this. I’d love to hear how they work for you.)
I can’t wait to hear your thoughts, comments and experiences in the comments box below.
As I close this article, I really want to thank Bob Bertolino for making all this easy to understand. If you’d like to connect with him, please do so at this website.
The bad guys are at it again with an email invading inboxes worldwide claiming that the user must reactivate their AOL online account within the next 24 hours. I want to encourage you not to click on ANY links in these emails. These users who click on these links are asked to provide their email address and in return, are being sent viruses.
A good rule of thumb to help spot these emails is to check the email message for any mispellings, smaller text size and the email address the email was sent from.
Here is an example of this: in an email I received, the very bottom reads 2010 American Online. The actual name is America Online. Looking for small things like this will help you from these email bad guys.
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Are you saying ‘yes’ too often?
In our therapy or coaching practices, in order to say ‘yes’ to the right things, we have to say ‘no’ to other things. Frankly, I never want to say ‘no’ to people or projects. This leads to overwork, fatigue and burnout.
In order to create the space for new opportunities, new ventures, new relationships and even new clients, there needs to be, well, space.
What do you need to say ‘no’
to so there is space for ‘yes’?
Here is a suggestion. Make a list of the activities that you have committed to – personal or professional. Estimate the time it would take to complete them all. Now, after you get over the shock of what you have committed to, begin to flag the ones that bring you love, money or joy. Then look at the ones that trigger anxiety. Do you have to do them? What would really happen if you said ‘no’?
Our profession can lead us easily to compassion fatigue. Please don’t let that happen to you. Stand up and say ‘no’ to the things that don’t serve you. I can almost guarantee that you will see new opportunities that you never saw before.
For me it will be saying no to tweaking the blog and saying yes to completing the writing of my new book, The Entrepreneurial Therapist.
What about you? What will you say no to? Please share in the comments section below.
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