Here’s your paradoxical tip of the day!
Therapists’ perceptions of how patients feel–the severity of symptoms–tend to be extremely inaccurate, at best, but most therapists are not aware of this.
What does this mean? Is it true? And if so, what are the consequences?
Is there a solution to this problem? And what, if anything, does the solution have to do with the first of four “Great Deaths” of the therapists ego?
Use the Reply / Comment feature below to let us to know how you understand today’s tip.
* Copyright © 2018 by David D. Burns, MD.
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Testing and letting go of the self image that you are a “good” therapist who doesn’t need to review you work with the patient
Yes, Claus, good point. If you use the Brief Mood Survey before and after every session with every patient, and the patient’s Evaluation of Therapy Session after the session, you will often discover three things: 1. your perceptions of the patient were way off; 2. you were not effective during the session; 3. your patient gave you failing grades on the empathy and helpfulness scales. This can hurt, but can also lead to breakthroughs in the treatment! All the best, david
This means that therapist perceptions of how a patient is feeling are extremely low (0-9% accuracy) even thought the therapist might think the patient is feeling great and he/she is connecting. The consequences of not knowing this (how the patient is feeling) can be devastating – patient gets worse, feels they are not being understood and might consider suicide as an option.
The solution is to measure (using accurate scales – Burns’ Brief Mood Survey is very accurate) before and after every session. Also, ask the patient if they are being heard/connected. You might be surprised they aren’t!
As for the first of the four Great Deaths, it’s quite clear that therapists perceptions are extremely unreliable and inaccurate. I would be nervous going to a doctor who had no idea what was going on with me 90% of the time!
Accurate measurement is key.
Hey, you totally nailed it! Way to go! Thanks, too, for participating! David