What I’ve realised over the last couple of weeks

A few days ago I was listening to the book Tiny Habits by BJ Fogg and was struck by something he said when describing part of his process for helping clients form new habits. BJ said that he often helps his clients identify the smallest change they can make that will have the biggest difference. This really resonated with me; not only in how this relates to how I use this with my own clients, but especially how in how small changes have helped me in Deliberate Practice. I figured that I develop my skills as a Therapist best when I am making a small number of tiny changes, but to make things easier, I try to find the smallest change that I hope will have the biggest effect on improving my skills. The smaller the change, the better. These tiniest of changes work best because I am far more likely to sustain them, I don’t feel overwhelmed by them. While I can get frustrated at times, in feeling that these tiny changes are not enough, that I’m not getting anywhere in improving my work, they do provide a sense of achievement in the long run.

The second reflection I have been focusing on is allowing myself to be flexible in my work with clients – not expecting myself to follow rigid rules that create a sense of safety for myself. I noticed that I would create a new rule, expect myself to follow it diligently and would feel guilty with failure when I couldn’t. For example, I would expect myself to do the Session Rating Scale debrief with a client at 10 minutes left in a session. While this rule has been useful; it gives me permission to explore feedback with a client earlier in a session, helping the conversation not feel rushed. It has also created an unnecessary sense of pressure at 10 minutes to the end. I have then decided to tell myself that it’s ok to not follow these rules exactly, especially while I’m not running my own practice. When I’m one day running a practice with my soon-to-be Wife I will have more control to make changes for these issues. For instance, I would like to talk to a new client about why I may run through the Session Rating Scale at 10 minutes left in session, but I already have admin matters that I have to raise in the first session (informed consent, fees, our booking system, intro of my role, session structure, intro to ORS and intro to SRS). So trying to add in an explanation to why I go through the SRS at 10 minutes left would only take up more valuable time that could be used for connecting with the client and letting them tell their story. Whereas when my partner and I are running our own practice, I could trial having extra time with a client before the first session starts, to explain these things without eating into the session itself.

In short – I am being kind to myself while I do not have full control to make the changes I would like to make – and that’s ok. For now I do what I can. The importance of being kind to myself here is also because I know that my over-explaining tendencies contribute to having less time for other things in a session and that working on my over-explaining will take a long time in of itself, because it’s one of my greatest personal challenges.

So the two lessons are: a) Create small, simple changes, b) Be Flexible in my approach.

What I’ve managed to do since my last post

In an earlier blog entry I spoke about a plan to save approximately 10 minutes on a Friday to either reflect using my Session Reflection Scale or by engaging in some solitary deliberate practice using LOVO. Since that announcement I haven’t done either – not once. Initially I blame being busy, tiredness or forgetfulness. On the flip side to the coin however, I have been focusing on giving myself more slack in doing Deliberate Practice; given that I was getting pretty crazy with DP before. I think what has stopped me from reflecting on my cases using the Session Reflection Scale is that I’m worried I will see more of my skill gaps that I need to work on, feel overwhelmed and then pressure to decide if I need to take any new actions to improve further. On the other hand I could say that it would still be beneficial to at least do some solitary deliberate practice. Despite this though I have decided to allow myself to focus on small changes, that I don’t need to rush to improve.

After all, I already have plenty of changes on my radar:

1. Simplifying my goal-setting process with clients by drawing out the process instead of using the document I had previously created for goal-setting.
2. Asking a client if a reduction in Session Rating Scale score is “accurate” before exploring the reduction in the score further.
3. Saying to a client something along the lines of “is this concept clear enough that we can move on?” or “is this concept clear enough” to help me manage overwhelming the client with information – being an explainaholic.
4. Practice of encouraging clients to note any feedback they have about a session on their phone through the week, if they can’t think of how to word their feedback during a session.
5. Practicing allowing myself to be flexible, instead of creating rigid rules that I expect myself to follow in a session.

Make the smallest change for the biggest difference

It can take some time to figure out which small change will have the biggest positive effect on my work, but I think it’s worth it. Small changes are more sustainable, easier to manage, track and adjust. Small changes also serve me consistently, whether I’m overwhelmed, tired or if I have lots of time and energy; I can sustain tiny changes no matter how I feel; maintaining progress. If it turns out that a small change has made no difference, my sense of failure is reduced and I’m less likely to feel that I’ve wasted energy and time. Whereas with big changes they can be overwhelming, tiring, difficult to track and there can be an immense sense of failure when they do not work out. It’s not just me that this helps, bringing up the idea of tiny changes has helped some of my clients build a sense of control and achievement; especially when they are feeling overwhelmed or chronically procrastinate. I love it when a concept I’m using to help myself can also be implemented by a client to help them.

No matter how you’re trying to improve your skills as a therapist, remember that it’s ok to not rush and to make small changes at a time. Your mind and body will thank you for it later. As BJ FOGG would say change can require having to tackle ‘bad habits’, like a ball of knots, if you try and rush taking the knots apart you are only going to feel angry and tired. The biggest knot may be right in the middle of the ball, it’s ok if you can’t get to that big knot immediately and it’s ok to need to work at the smaller knots to eventually access that big knot. Small changes mean you will get to that big knot in the end and when you do it will only be the more rewarding.

Till next time and as always – thanks for reading.

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