Newsletter 611 – Are we Getting Better at What we do?

getting better 1Professional counseling does not occupy any of my time thee days but that’s where I have most training, where I am licensed by the state, and the subject of much of my writing and teaching. Not surprising, then, Psychotherapy Networker (PT) magazine goes to the top of my reading pile whenever it arrives. The articles on therapy have surprising relevance both for mental health professionals and for non-counselors like many who read this newsletter. The March/April issue addresses an issue that we all could consider profitably: We are older as a discipline, profession or individual. But is there any evidence that we are better? Stated differently, “Do our old ways fit the new times?” The PT answer seems to be “not much.”

 

  • First we need to remember that established methods that have worked for years are not necessarily bad just because they are old.
  • At times we all succumb to fads that claim to be revolutionary breakthroughs. (Mindfulness and evidence-based practices are among the most recent.) Therapists aren’t the only ones “succumbing to the allure of novel procedures and fancy theories, particularly those that promise quick and dramatic cures” and changes. In time most fads fade and we rush to something new.
  • Despite all our approaches, methods, theories, and training seminars, this conclusion emerges as “one of the most robust research findings in the psychological literature: all therapies…produce the same level of results, regardless of the particular insights they promulgate.”
  • “We need to embrace what our research tells us: a professional relationship organized around empathy, genuineness, respect, openness, congruence, collaboration, and goal consensus helps people change.”
  • Cultural awareness counts a lot. Mary Piper writes that the main area where “we’re failing right is taking into account the impact of the larger culture on all of us…. The kind of verbal, cognitive, come-and-sit-down-in-an-office [or talk on the telephone or Internet] approach is deeply unsuited to the poor and underserved populations that we’re ignoring.” Overall our work “remains largely a white, upper-middle-class phenomenon.” Often we fail to recognize and understand the growing elderly population or the young emerging generations where we’re not connecting.
  • No one of us can connect with everybody but we must not forget that we work and lead in community.

 

This picture is not limited to mental health professionals. For all of us the question remains. We are getting older but are we getting better? Please comment.

  1. “This picture is not limited to mental health professionals…. We are getting older but are we getting better?”
    A possible parallel to the therapy profession remains that or the Christian church industry. Immigrant communities and youth in North America shun Euro-centric, ecclesial institutions that require theologically-educated professionals that cost too much and ignore older followers.
    I praise God that many immigrants are bringing with them from overseas their less-formal patterns of church reproduction, and that youth are discovering faith-inspired community outside of traditional elephant barns.
    Though not yet enough.

    • Rodger Bufford
    • May 15th, 2015

    There is a bit of recognition that mindfulness approaches involve explicit inclusion of Buddhist principles. Toward that end, Shonin (2013) advocated training in Buddhist meditation for clinicians who practice mindfulness interventions. Shonin, Van Gordon, and Griffiths (2014) stated: “instructors of (Buddhist-derived interventions) may wish to consider the merits of receiving prolonged training in meditation so as to be able to impart and embodied authentic transmission of the subtler aspects of meditation practice” (p. 133).

  2. Hi Roger! I think there is more than a bit of recognition that mindfulness has a Buddhist foundation. I think this is a fad way beyond therapy; it penetrates a lot of our culture. In itself meditation is not bad, of course. The scriptures talk about this in many places. Much depends on what we meditate on. In some ways this mindfulness focus sounds like more of the eastern attempts to westernize and popularize Buddhism.

  3. I received my copy of PN yesterday, (the issue on burn out) but haven’t had a chance to read it yet. I think about what Mary Pipher (quoted above) said quite often. I t does bother me that so much of what we do never reaches those who greatly need it, but can’t afford it.

    • Randy Rhoades
    • May 18th, 2015

    In my fields of discipline, discipleship, missions, and education almost all your bullet points could be equally affirmed. Reflecting well on these points leads me to more questions that require more analysis.

    Our efforts to improve have created a boldness to try a lot of trends and fads which each showed a measure of promise. But, “Which of these trends has added significantly to our disciplines?” and “were some of the trends more of a distraction from our major goals, perhaps majoring on minors?”

    Beside asking , “Are we getting better?” Perhaps we should also ask, “Which elements or principles of the old not necessarily bad ways were essential?” Then, “In our efforts to improve have we weakened or forgotten some of the foundations of our disciplines?” and, ”Have the more popular expressions of the fads and trends moved forward before establishing a firm grip on essential principles?”

    As I read various journals I am seeing huge impacts of the cultural slants or assumptions from which even the hopefully objective researchers are writing. As I look to behaviors that should result from quality discipleship I find myself saying, “I have seen that globally our cultures have affected the church more than the church has affected culture.” Perhaps that comment could be reframed for all disciplines leading us to ask, “How are our disciplines affected by our cultures?” “Which basics assumptions within our cultures are to some degree opposing the foundations of our disciplines?” and, “What will be our work-around to bring improvement in spite of those differences.”

    More to the point of “Are we getting better?” may be to frame that question within our own context, the community in which we work, “Is what I am doing seeing improved transformation in my own community?” We seldom live in the same exact mix of environment, conditions, and peoples in which the researchers observe. For no matter which research we read or trend we embrace the application for each of us will come down to the circles of people within our own reach.

    Thanks for your points. They help me reflect.

    Randy Rhoades

    • Randy, Your comments have led me to more reflection as well. Thanks for your insightful post.

      First, I think you are right: the fads often go away leaving little impact. Even so, like you I want to be aware of them and ask what they may bring that can be of value. I agree that sometimes the fads move on and we miss the elements of truth and value that they might uncover or stimulate. And certainly we do need to use caution before we jump to something new and risk leaving some essentials behind. Obvious example is the rush to use medications so that talk-therapy is cast aside. Now we see that the old one-on-one interaction is essential, often as effective or more effective than drugs.

      The core message that came to me from your post were your thoughts on culture. Significant observation: the culture often impacts us more than we impact the culture. We can start with the church and education. Certainly in counseling.

      When I was involved learning to coach my instructors were adamant: the principles of coaching apply to any culture universally. To my mind that indicated narrow thinking, unintended ignorance, and more arrogance than my teachers ever realized (or would want.)

      Some of my counseling students want formulae or “views of integration” that will make it easier to bring there counseling and their Christianity together. These students (and some of their professors) seem oblivious to the role of culture in everything we do.

      Even in writing blog posts like this!

    • Gillian Vriend
    • May 18th, 2015

    As a a cross cultural worker in Thailand this newsletter hits the spot. I have been involved in training counseling, prayer ministry,(and now coaching) and practising all of those in SE Asia for 8 years. Right now, debriefing those coming out of Nepal is a high need. So is preparing materials to take into Nepal to train trainers to bring some modicum of mental relief to those who cannot leave.

    I wholeheartedly echo the emphasis on relationship. It is the bridge over which everything else travels, and, even if nothing else seems to travel over it, other than love, care and kindness, that is still very good. However, we need skills too. In the Nepali situation, this is a simple, portable, low tech, developing world ‘tool kit’, which brings some education, techniques which bring relief, and, with that enabling, some hope.

    Above all we need God. As I get older I am aware more than ever of my own smallness. This is no bad thing. The more I raise up Jesus as the Great Counselor and the Healer, and the Holy Spirit as the person who guides us into truth, the more amazed I am by the results. With simple people who may not know Him. Or others, more complex, who may know much in their heads but too little in their hearts. He never fails. And in His shadow, with His directing, I go with confidence and joy. That timeless truth will never grow old.

    • Gillian, I love your post. Thanks for your clarity and insights.

      Whenever I have gone to other countries (Thailand included; maybe Thailand especially) I am reminded of the difficulty of bringing American ideas elsewhere. I grew up in Canada and lived for a while in London where I was almost overwhelmingly impacted by the cultural differences even though the countries had so many similarities. What works where we live must be adapted when we work elsewhere. And interacting with the local people is a key to adapting (See Paul’s interactions with the Athenians in Acts 17 before he gave his famous speech.)

      One of my professional colleagues suggested one day that Evidence-based approaches are universal. He is an incredibly intelligent therapist but he did not seem to grasp that culture has an impact even where we do the research and who we choose for subjects. Very often evidence-based approaches (another current fad) only apply in the communities or countries where the research is done.

      Your approach works because you have cultural sensitivity and Holy-Spirit sensitivity.

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