WEBVTT
00:00:20.119 --> 00:00:26.679
Hello and welcome to episode four of Towards, our Cathedral Project.
00:00:26.919 --> 00:00:34.119
My name is Sarah Batup, and I'm the Chief Clinical Officer at Towards and one of the co-founders.
00:00:35.079 --> 00:00:42.920
In this episode, I'm going to talk about what I've learned in my career about the importance of being watched.
00:00:43.320 --> 00:00:57.799
In previous episodes, I've talked about how I believe psychological therapists in training are not watched as much as other health and social care trainees.
00:00:58.359 --> 00:01:01.000
So what do I mean by watched?
00:01:01.719 --> 00:01:14.599
Well, I mean observed and supported, being given feedback and feed forward based on what the trainee is doing or not doing.
00:01:14.920 --> 00:01:35.240
That means persistently and consistently observing their practice, following a framework of learning competencies, and really guiding and supporting that trainee to develop competence and clinical quality in the work that they're doing.
00:01:35.480 --> 00:01:38.200
I believe that this is truly important.
00:01:40.439 --> 00:02:00.680
I've argued previously that psychological therapists may not be watched as much as other healthcare professionals because there is some kind of concern about the importance of privacy in the psychological therapy room.
00:02:01.000 --> 00:02:06.040
Now, of course, privacy and confidentiality is crucially important.
00:02:07.320 --> 00:02:20.840
But what is also crucially important is that we know what is going on in that therapy room between that trainee therapist and the very important person that they're working with.
00:02:21.240 --> 00:02:27.800
We need to understand what's going right, what's not going so right, and how that trainee can improve.
00:02:27.879 --> 00:02:31.319
And that trainee needs to know that information too.
00:02:31.640 --> 00:02:50.520
So I've learned through my experience of training therapists in many, many different settings, both here in the UK, in Europe, and in the US, that providing feedback and watching a trainee therapist is absolutely crucial.
00:02:52.360 --> 00:03:00.360
I also believe that the extent that we watch qualified therapists could be improved as well.
00:03:01.000 --> 00:03:10.439
Of course, many competent therapists will take their cases to supervision, and you might argue that this is being watched.
00:03:11.000 --> 00:03:21.159
They may also take recordings of their work to their supervisor, and you may also think that this is then being watched as well.
00:03:21.800 --> 00:03:23.400
And of course it is.
00:04:43.800 --> 00:04:54.839
Yes, they provide supervision, but what they don't really know is what their therapists are doing in the therapy room with the very important people that they're working with.
00:04:55.079 --> 00:05:02.439
So I think that it's important to watch both trainees and qualified therapists.
00:05:03.639 --> 00:05:11.480
Now, beyond that, you know, we know that there's a problem in psychological therapy.
00:05:11.720 --> 00:05:28.040
We know that there is a huge variance between therapists, with some doing absolutely bliming fantastic work, most of us doing kind of okay work, and some people just failing to hit the mark, unfortunately.
00:05:28.439 --> 00:05:45.720
Now I argue that if we had watched those therapists when they were training, they may have become more effective, or we may have noticed that really they were in the wrong career, and we could guide them gently away from being a therapist.
00:05:47.160 --> 00:06:20.120
I would also argue that if we were watching our qualified therapists in services like the NHS, for instance, that the variance between therapists there would be reduced because we would be able to understand what are the therapists doing who are doing really well, and what are the therapists doing when they're not doing so well, and we could actually support them to be a better therapist.
00:06:20.759 --> 00:06:27.160
This is all in the service of being the very best therapist that you can be.
00:06:27.639 --> 00:06:46.759
Now there might be people listening to this, particularly therapists whose blood pressure is going up right now, who might be cross and upset about what I'm saying, saying that you know it's you know what they do with their clients is private and you know they shouldn't be watched.
00:06:46.920 --> 00:06:51.240
And there may be an air of big brother about this.
00:06:52.360 --> 00:06:54.920
Now I stick to my guns.
00:06:55.079 --> 00:07:07.959
I stick to my guns because this is all about the client, this is all about the patient, this is all about a therapist being the very best therapist they can be.
00:07:09.240 --> 00:07:33.240
In my experience of talking to therapists when I'm recruiting them, not only at towards but in other organizations where I've been a senior leader, when I've talked about the importance of being watched in the service of being the very best therapist that you can be, therapists tend to fall into two categories.
00:07:33.480 --> 00:07:42.120
There are the ones where you can see that they're disgusted, angry, and upset at what I'm suggesting.
00:07:42.280 --> 00:07:45.639
And sometimes they tell me that and they walk away.
00:07:45.959 --> 00:07:49.959
And there are those whose eyes light up.
00:07:50.519 --> 00:08:10.280
You can see that they are excited at the prospect of getting really worthwhile feedback, learning consistently forever as part of their career, and really, really wanting to be the very best therapist they can be.
00:08:10.600 --> 00:08:21.879
Now I'm not saying that the people in the first group don't want to be the very best therapist that they can be, but actually, I don't want people in the first group.
00:08:22.519 --> 00:08:48.919
I want people whose eyes light up when they think about the idea of getting feedback from somebody who's maybe more experienced than them, learning from them, thinking about how they might improve their practice, getting insights into their practice, and really, really striving to make a difference to the clients and patients that they're working with.
00:08:49.240 --> 00:09:00.839
It is for this reason, enabling therapists to be the very best they can be, that I believe in the importance of being watched.
00:09:02.039 --> 00:09:11.079
I would never ask a therapist to do something that I wasn't prepared to do as well, and therefore I too am watched.
00:09:11.399 --> 00:09:20.519
I ask those who supervise and train me, and even after 40 years, supervision and training is a crucial part of my practice.
00:09:20.759 --> 00:09:27.559
I want to be watched, I want to know what I'm doing not, you know, not so well, what I'm not good at doing.
00:09:27.639 --> 00:09:32.359
I want to know how I can improve, I want to know where my blind spots are.
00:09:32.599 --> 00:09:37.879
I want to do this because I want to make a difference to the important people that I work with.
00:09:38.039 --> 00:09:44.759
So I would never ever ask any therapist to do anything that I wasn't prepared to do myself.
00:09:44.919 --> 00:09:47.639
And yeah, it makes me anxious too.
00:09:47.799 --> 00:09:59.239
And when that anxiety goes away and I don't care about it anymore, maybe I should stop being a therapist because I'm anxious because I care, because I really want to make a difference.
00:10:00.119 --> 00:10:02.519
So, how can we watch?
00:10:03.000 --> 00:10:08.439
Well, we can watch by seeking client consent to record sessions.
00:10:08.599 --> 00:10:14.199
It might be a video recording, an audio recording, or a transcript of a session.
00:10:14.519 --> 00:10:30.199
These are all live verbatim methods of recording, whereas therapists we can watch our own work, our supervisors can watch our work, and our teachers can watch our work, and our peers can watch our work.
00:10:31.000 --> 00:10:40.039
And in my experience, most clients, when you explain why you want to record, are only too pleased to give consent.
00:10:40.839 --> 00:10:44.759
And for those that don't, that's okay too.
00:10:45.559 --> 00:10:59.079
But as long as we are trying our best to have some live examples of our work consistently and persistently, I think that's that's that's absolutely great.
00:11:00.519 --> 00:11:06.279
Other ways of being watched are doing lots and lots of role play, and that's a normal way of learning.
00:11:06.519 --> 00:11:11.959
But role play with loads and loads of feedback from all of the people in the room.
00:11:12.199 --> 00:11:14.759
Giving feedback is a gift of kindness.
00:11:15.000 --> 00:11:18.919
We shouldn't just be saying, Oh, that was wonderful, you're a great therapist.
00:11:19.000 --> 00:11:21.559
That's not really a gift, it's lovely, isn't it?
00:11:21.719 --> 00:11:26.039
But actually dig deep and have a think about what could the person do better.
00:11:27.159 --> 00:11:32.439
We can watch in supervision, so we can watch those recordings together.
00:11:33.000 --> 00:11:47.079
Using deliberate practice with the information that we've gleaned from watching, we can actually commit to deliberately practicing a particular skill or process.
00:11:47.719 --> 00:12:01.239
We can have clear goals that we want to achieve, and also I think the importance of being watched applies in supervision where we can actually bridge back and bridge forward.
00:12:01.639 --> 00:12:03.319
So, what do I mean by this?
00:12:03.479 --> 00:12:08.759
I mean in a general supervision practice, it would always be useful to bridge back.
00:12:08.839 --> 00:12:12.519
What did we cover in last week's supervision?
00:12:12.679 --> 00:12:14.839
What were the skills that you were working on?
00:12:15.000 --> 00:12:20.519
And shall we have a look at some examples of where you've been continuing to work on those?
00:12:20.759 --> 00:12:27.559
So it's consolidating that learning and then bridging forward to the next session.
00:12:27.719 --> 00:12:35.079
What are you going to do in between sessions and what might and then what might we cover in next week's supervision?
00:12:35.319 --> 00:12:51.079
This is watching in a different way so the therapist knows that you're interested in the skills that they're working on that you've remembered, and that it's so important that you want to make sure that it goes on the agenda for the next session.
00:12:51.319 --> 00:13:11.559
So I think bridging back and bridging forward enhances supervision and enhances deliberate practice and actually improves the likelihood that that supervisee is going to go away and practice those skills in the service of making a difference to the people that they're working with.
00:13:12.119 --> 00:13:14.839
Together, we can make a difference.
00:13:15.079 --> 00:13:16.359
Thanks for listening.
00:00:20.119 --> 00:00:26.679
Hello and welcome to episode four of Towards, our Cathedral Project.
00:00:26.919 --> 00:00:34.119
My name is Sarah Batup, and I'm the Chief Clinical Officer at Towards and one of the co-founders.
00:00:35.079 --> 00:00:42.920
In this episode, I'm going to talk about what I've learned in my career about the importance of being watched.
00:00:43.320 --> 00:00:57.799
In previous episodes, I've talked about how I believe psychological therapists in training are not watched as much as other health and social care trainees.
00:00:58.359 --> 00:01:01.000
So what do I mean by watched?
00:01:01.719 --> 00:01:14.599
Well, I mean observed and supported, being given feedback and feed forward based on what the trainee is doing or not doing.
00:01:14.920 --> 00:01:35.240
That means persistently and consistently observing their practice, following a framework of learning competencies, and really guiding and supporting that trainee to develop competence and clinical quality in the work that they're doing.
00:01:35.480 --> 00:01:38.200
I believe that this is truly important.
00:01:40.439 --> 00:02:00.680
I've argued previously that psychological therapists may not be watched as much as other healthcare professionals because there is some kind of concern about the importance of privacy in the psychological therapy room.
00:02:01.000 --> 00:02:06.040
Now, of course, privacy and confidentiality is crucially important.
00:02:07.320 --> 00:02:20.840
But what is also crucially important is that we know what is going on in that therapy room between that trainee therapist and the very important person that they're working with.
00:02:21.240 --> 00:02:27.800
We need to understand what's going right, what's not going so right, and how that trainee can improve.
00:02:27.879 --> 00:02:31.319
And that trainee needs to know that information too.
00:02:31.640 --> 00:02:50.520
So I've learned through my experience of training therapists in many, many different settings, both here in the UK, in Europe, and in the US, that providing feedback and watching a trainee therapist is absolutely crucial.
00:02:52.360 --> 00:03:00.360
I also believe that the extent that we watch qualified therapists could be improved as well.
00:03:01.000 --> 00:03:10.439
Of course, many competent therapists will take their cases to supervision, and you might argue that this is being watched.
00:03:11.000 --> 00:03:21.159
They may also take recordings of their work to their supervisor, and you may also think that this is then being watched as well.
00:03:21.800 --> 00:03:23.400
And of course it is.
00:04:43.800 --> 00:04:54.839
Yes, they provide supervision, but what they don't really know is what their therapists are doing in the therapy room with the very important people that they're working with.
00:04:55.079 --> 00:05:02.439
So I think that it's important to watch both trainees and qualified therapists.
00:05:03.639 --> 00:05:11.480
Now, beyond that, you know, we know that there's a problem in psychological therapy.
00:05:11.720 --> 00:05:28.040
We know that there is a huge variance between therapists, with some doing absolutely bliming fantastic work, most of us doing kind of okay work, and some people just failing to hit the mark, unfortunately.
00:05:28.439 --> 00:05:45.720
Now I argue that if we had watched those therapists when they were training, they may have become more effective, or we may have noticed that really they were in the wrong career, and we could guide them gently away from being a therapist.
00:05:47.160 --> 00:06:20.120
I would also argue that if we were watching our qualified therapists in services like the NHS, for instance, that the variance between therapists there would be reduced because we would be able to understand what are the therapists doing who are doing really well, and what are the therapists doing when they're not doing so well, and we could actually support them to be a better therapist.
00:06:20.759 --> 00:06:27.160
This is all in the service of being the very best therapist that you can be.
00:06:27.639 --> 00:06:46.759
Now there might be people listening to this, particularly therapists whose blood pressure is going up right now, who might be cross and upset about what I'm saying, saying that you know it's you know what they do with their clients is private and you know they shouldn't be watched.
00:06:46.920 --> 00:06:51.240
And there may be an air of big brother about this.
00:06:52.360 --> 00:06:54.920
Now I stick to my guns.
00:06:55.079 --> 00:07:07.959
I stick to my guns because this is all about the client, this is all about the patient, this is all about a therapist being the very best therapist they can be.
00:07:09.240 --> 00:07:33.240
In my experience of talking to therapists when I'm recruiting them, not only at towards but in other organizations where I've been a senior leader, when I've talked about the importance of being watched in the service of being the very best therapist that you can be, therapists tend to fall into two categories.
00:07:33.480 --> 00:07:42.120
There are the ones where you can see that they're disgusted, angry, and upset at what I'm suggesting.
00:07:42.280 --> 00:07:45.639
And sometimes they tell me that and they walk away.
00:07:45.959 --> 00:07:49.959
And there are those whose eyes light up.
00:07:50.519 --> 00:08:10.280
You can see that they are excited at the prospect of getting really worthwhile feedback, learning consistently forever as part of their career, and really, really wanting to be the very best therapist they can be.
00:08:10.600 --> 00:08:21.879
Now I'm not saying that the people in the first group don't want to be the very best therapist that they can be, but actually, I don't want people in the first group.
00:08:22.519 --> 00:08:48.919
I want people whose eyes light up when they think about the idea of getting feedback from somebody who's maybe more experienced than them, learning from them, thinking about how they might improve their practice, getting insights into their practice, and really, really striving to make a difference to the clients and patients that they're working with.
00:08:49.240 --> 00:09:00.839
It is for this reason, enabling therapists to be the very best they can be, that I believe in the importance of being watched.
00:09:02.039 --> 00:09:11.079
I would never ask a therapist to do something that I wasn't prepared to do as well, and therefore I too am watched.
00:09:11.399 --> 00:09:20.519
I ask those who supervise and train me, and even after 40 years, supervision and training is a crucial part of my practice.
00:09:20.759 --> 00:09:27.559
I want to be watched, I want to know what I'm doing not, you know, not so well, what I'm not good at doing.
00:09:27.639 --> 00:09:32.359
I want to know how I can improve, I want to know where my blind spots are.
00:09:32.599 --> 00:09:37.879
I want to do this because I want to make a difference to the important people that I work with.
00:09:38.039 --> 00:09:44.759
So I would never ever ask any therapist to do anything that I wasn't prepared to do myself.
00:09:44.919 --> 00:09:47.639
And yeah, it makes me anxious too.
00:09:47.799 --> 00:09:59.239
And when that anxiety goes away and I don't care about it anymore, maybe I should stop being a therapist because I'm anxious because I care, because I really want to make a difference.
00:10:00.119 --> 00:10:02.519
So, how can we watch?
00:10:03.000 --> 00:10:08.439
Well, we can watch by seeking client consent to record sessions.
00:10:08.599 --> 00:10:14.199
It might be a video recording, an audio recording, or a transcript of a session.
00:10:14.519 --> 00:10:30.199
These are all live verbatim methods of recording, whereas therapists we can watch our own work, our supervisors can watch our work, and our teachers can watch our work, and our peers can watch our work.
00:10:31.000 --> 00:10:40.039
And in my experience, most clients, when you explain why you want to record, are only too pleased to give consent.
00:10:40.839 --> 00:10:44.759
And for those that don't, that's okay too.
00:10:45.559 --> 00:10:59.079
But as long as we are trying our best to have some live examples of our work consistently and persistently, I think that's that's that's absolutely great.
00:11:00.519 --> 00:11:06.279
Other ways of being watched are doing lots and lots of role play, and that's a normal way of learning.
00:11:06.519 --> 00:11:11.959
But role play with loads and loads of feedback from all of the people in the room.
00:11:12.199 --> 00:11:14.759
Giving feedback is a gift of kindness.
00:11:15.000 --> 00:11:18.919
We shouldn't just be saying, Oh, that was wonderful, you're a great therapist.
00:11:19.000 --> 00:11:21.559
That's not really a gift, it's lovely, isn't it?
00:11:21.719 --> 00:11:26.039
But actually dig deep and have a think about what could the person do better.
00:11:27.159 --> 00:11:32.439
We can watch in supervision, so we can watch those recordings together.
00:11:33.000 --> 00:11:47.079
Using deliberate practice with the information that we've gleaned from watching, we can actually commit to deliberately practicing a particular skill or process.
00:11:47.719 --> 00:12:01.239
We can have clear goals that we want to achieve, and also I think the importance of being watched applies in supervision where we can actually bridge back and bridge forward.
00:12:01.639 --> 00:12:03.319
So, what do I mean by this?
00:12:03.479 --> 00:12:08.759
I mean in a general supervision practice, it would always be useful to bridge back.
00:12:08.839 --> 00:12:12.519
What did we cover in last week's supervision?
00:12:12.679 --> 00:12:14.839
What were the skills that you were working on?
00:12:15.000 --> 00:12:20.519
And shall we have a look at some examples of where you've been continuing to work on those?
00:12:20.759 --> 00:12:27.559
So it's consolidating that learning and then bridging forward to the next session.
00:12:27.719 --> 00:12:35.079
What are you going to do in between sessions and what might and then what might we cover in next week's supervision?
00:12:35.319 --> 00:12:51.079
This is watching in a different way so the therapist knows that you're interested in the skills that they're working on that you've remembered, and that it's so important that you want to make sure that it goes on the agenda for the next session.
00:12:51.319 --> 00:13:11.559
So I think bridging back and bridging forward enhances supervision and enhances deliberate practice and actually improves the likelihood that that supervisee is going to go away and practice those skills in the service of making a difference to the people that they're working with.
00:13:12.119 --> 00:13:14.839
Together, we can make a difference.
00:13:15.079 --> 00:13:16.359
Thanks for listening.
