Пълният препис на Deliberate practice and distributional thinking

WEBVTT 00:00:00.000 --> 00:00:05.599 So you're a therapist who's interested in getting better outcomes, but you're overwhelmed and not really sure where to start. 00:00:05.759 --> 00:00:12.080 You look at all of those training workshops and they cost a fortune and it's unclear whether they're actually going to lead to better outcomes. 00:00:12.320 --> 00:00:19.839 In this video, I'm going to teach you a completely different way to think about improving your outcomes, and I'm going to do it in less than three minutes. 00:00:20.160 --> 00:00:23.679 The key is to think distributionally. 00:00:23.839 --> 00:00:32.560 And what I meant by that is it's the absolute opposite to everything we have been taught in our psychology training up to date. 00:00:32.719 --> 00:00:35.600 We think about the individual client in front of us. 00:00:35.759 --> 00:00:41.119 I want you to change your thinking entirely and think about the entire distribution. 00:00:41.439 --> 00:00:44.719 There are 162 games in a major league baseball season and the players have a saying. 00:00:44.880 --> 00:00:47.520 Every team's going to win 54 games, every team's going to lose 54. 00:00:47.600 --> 00:00:49.520 It's what you do with the other 54 games, it counts. 00:00:49.840 --> 00:00:55.119 Our equivalent of that baseball analogy is the hundred clients that you're going to see each and every year. 00:00:55.280 --> 00:01:03.920 Now, of those hundred clients, it is predictable that for the average therapist, 30 of them are going to drop out, which means there's only 70 left to go. 00:01:04.239 --> 00:01:08.239 Of those 70, 5 to 10 of them are going to get worse. 00:01:08.480 --> 00:01:10.079 That brings us down to 60. 00:01:10.319 --> 00:01:18.719 The difference between the top therapists and the mediocre therapists, all therapists are going to produce good outcomes with 20 to 30 of them. 00:01:18.959 --> 00:01:24.239 Great therapists are going to produce great outcomes with 50% of them. 00:01:24.480 --> 00:01:30.079 The difference between the good therapists and the poor therapists is that middle 30%. 00:01:30.640 --> 00:01:35.040 Now let's look at a really good therapist data to get a sense of what I'm talking about. 00:01:35.280 --> 00:01:41.120 Right here, we've got the outcome distribution for one of the best therapists that I've worked with. 00:01:41.280 --> 00:01:44.799 Now, to try and make sense of it, I've ordered it by outcomes. 00:01:44.879 --> 00:01:51.200 So if you have a look here, you can see from the people who got the worst outcome to the people who got the best outcome. 00:01:51.439 --> 00:01:53.040 Let me try and make sense of it. 00:01:53.280 --> 00:01:57.359 Right here, we've got the quadrant of people who deteriorated. 00:01:57.760 --> 00:02:02.159 Here, we've got the people who made no gains or who dropped out early. 00:02:02.480 --> 00:02:08.240 Here, we've got the people where she's made positive gains, but they're small. 00:02:08.479 --> 00:02:12.560 And here is the group who have made large improvements. 00:02:12.879 --> 00:02:16.800 Every therapist has the same distribution of four. 00:02:17.039 --> 00:02:24.800 The group of people who deteriorate, the group of people who drop out, the group of people who make small gains, and the group of people who make large gains. 00:02:25.039 --> 00:02:36.080 What makes this therapist one of the best is the low number of people dropping out, the low number of people deteriorating, and the large number of people who are making large gains. 00:02:36.319 --> 00:02:46.240 Your challenge, and the way I want you to think about it, is not whether you need to learn schematherapy or EMDR or metacognitive therapy or go off on a silent mindfulness retreat. 00:02:46.479 --> 00:02:57.520 Your challenge is to look at your distribution and figure out what can you do that will lead to the biggest gains that are going to skew things in the right direction. 00:02:57.840 --> 00:03:00.319 For most people, it's going to be dropout. 00:03:00.719 --> 00:03:04.240 Great therapists have dropout rates that sit more like 10%. 00:03:04.879 --> 00:03:07.759 Average therapists have dropout rates of 30%. 00:03:08.319 --> 00:03:16.719 If you can improve that one number, your dropout rate, overall your effectiveness is going to improve out of the ballpark. 00:03:16.960 --> 00:03:23.680 The next thing you can do is to look at the group of clients that you are unsuccessful with. 00:03:23.919 --> 00:03:26.400 Who do you fail to make rapport? 00:03:26.719 --> 00:03:29.599 Who do you fail to understand what their needs are? 00:03:29.759 --> 00:03:38.960 And who do you fail to come up with a meaningful therapeutic connection that moves them from where they want to be towards their goals? 00:03:39.199 --> 00:03:42.000 I'm going to throw it back to you, but that's your challenge. 00:03:42.240 --> 00:03:53.520 Think distributionally, find out where on the distribution you can have the most impact, and set all of your goals for this year about shifting that part of the distribution. 00:03:53.680 --> 00:03:54.080 Good luck.