087: Role-Play Techniques (Part 5) — The Devil’s Advocate Technique

In today’s podcast, we will illustrate the Devil’s Advocate Technique, another one of the role-playing techniques in TEAM-CBT. You can use this technique for any habit or addiction, such as:

  • Drug or alcohol abuse
  • Overeating / binge eating
  • Shopping addiction
  • Internet addiction
  • And procrastination, which is our problem for today.

David and Fabrice are joined by Sara Shane, a member of David’s Tuesday evening psychotherapy Stanford training group for northern California mental health professionals. Sara has volunteered to demonstrate the technique to see if she can get some help with procrastination.

Sara explains that she has a small clinical practice in the central valley of California working with children but would like to expand her practice to include teenagers and adults, so she can use the exciting TEAM-CBT skills she’s been learning in the Tuesday group over the past year. In addition, Sara is bilingual, so this would open up the possibility that many Spanish speaking individuals could have the opportunity for treatment with TEAM-CBT.

But to do that, Sara would have to start marketing her practice, but she’s been procrastinating. She never seems to get around to it, and always places the wants and needs of others in her family above her own.

David asks her what it is she’d have to do. She says she wants to put together a brochure describing her work so she could send it to people on her mailing list who might send her some referrals. David ask her to list the first few steps of her task, limiting what she would have to do to just to get started, something requiring only about 5 minutes.

Here are the first steps, and time required for each:

  1. Sit down at the computer and turn it on. (30 seconds)
  2. Open a blank document in MS Word. (30 seconds)
  3. Jot down a few names for my practice, even if they aren’t especially good (since they can be revised later). (4 to 5 minutes)
  4. Add my contact information. (1 minute).

So, the total time required would be six minutes or so. David asks if she’d be will to do it tomorrow morning from 9 AM to 9:06 AM. She said she’d actually like to start tonight, but it is already 9 PM and she still has a two-hour drive home. So she agrees to do it first thing in the morning instead. She also agrees to send an email to Fabrice and David and the Tuesday group at 9:06 with one of two messages: “Mission Accomplished” or “I stubbornly refused.”

Now we’re ready for the Devil’s Advocate Technique. David and Fabrice will play the role of the Devil who tempts Sara to procrastinate, using the actual thoughts Sara has when she’s procrastinating. They include:

  1. I’ll do it later.
  2. There’s always tomorrow.
  3. I don’t have any appointments tomorrow, so I can start to work on the marketing materials then.
  4. I have to take Mom to her doctor’s appointment now, so I can work on the marketing materials later.
  5. Right now, I just need some rest and relaxation, some time for myself.

David begins and tells Sara, “Oh, you can do it later. There’s no reason for you to have to do it now!”

Sara’s response is decent, but not super-strong. You’ll hear on the audio that it’s a bit half-hearted, and not overwhelmingly convincing. And if she can’t crush the tempting thought during the session, she definitely won’t be able to resist it when she’s home alone.

Instead of giving Sara some tips on how to improve it—which David says the therapist should never do when working with someone with a habit or addiction—David suggests that maybe the problem of procrastination perhaps isn’t something Sara wants to work on right now.

This is called Sitting with Open Hands, and it’s far more powerful than trying to “help.” Trying to help a patient who’s struggling with a habit or addiction will usually just make the problem more intense.

Fabrice points out that people don’t need to be “taught” how to say “no” to some tempting thought. They just have to make a decision!

When David sits with Open Hands, Sara gets agitated and insists she really does want to defeat her procrastination. That’s the most common reaction to “Sitting with Open Hands.”

Then David asks if she’d like to try again. David verbalizes the first tempting thought again, and Sara immediately hits it out of the park in a convincing way.

David and Fabrice take turns as the “Devil,” verbalizing all Sara’s tempting thoughts. One by one, Sara destroys them. She leaves the session on a glow, quite excited about the new direction for her practice.

David and Fabrice emphasize that the Devil’s Advocate Technique is not a method you would just throw at someone with a habit or addiction. Instead, you would work with the person systematically, going through the T E A M model, one step at a time, just as you would with any patient. The Devil’s Advocate Technique is simply one of the M = Methods in TEAM. And it probably won’t be effective if you haven’t done skillful paradoxical agenda setting first, to find out if the patient really is motivated to give up his or her addiction.

Did it work? Was this little mini-session effective? That’s always the question, isn’t it?

Well, here’s the answer! Fabrice and I received this email from Sara this morning:

Hi Dr. Burns and Fabrice,

Thank you so much for the opportunity to volunteer last night for the podcast. What an awesome experience! I am so inspired and motivated that it was hard to stop creating my business postcard to email you that I had accomplished my mission!!!

This is really funny but truly AMAZING!!! I have done beyond what I agreed to do, and this just makes me feel so HAPPY!!!



Sara Shane

Way to go Sara! Fabrice and I are so proud of you, and looking forward to the exciting expansion of your practice!

* Copyright © 2018 by David D. Burns, MD

Some Cool Upcoming Workshops

Coming in May!

May 20th, 2018  Advanced, High-Speed CBT for the Treatment of Depression and Anxiety A one day workshop by Drs. David Burns and Jill Levitt. 6 CE Credits, $135
You can join in person or online from wherever you live!

There are only a few spots left for the live workshop in Palo Alto, but we still have room for you to join us for the online version. We will have helpers to guide the small group exercises for those online, as well as those who attend in person.

Coming in June! One of my best two day workshops ever!

“Scared Stiff: Fast, Effective Treatment for Anxiety Disorders”
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June 4 -5, 2018 Calgary, Canada
June 6 – 7, 2018 Winnipeg, Canada
Mike Christensen and several others will be joining me at both locations to help out with supervision of the small group exercises. You’ll LOVE this workshop and you’ll learn TONS of powerful techniques to treat every type of anxiety. You’ll learn how to heal your clients and your own feelings of insecurity and self-doubt as well!

I greatly appreciate your support, and hope you will continue to spread the word about TEAM-CBT and i am trying hard to reach as many people as possible with my free programming and blogs designed to help individuals struggling with depression, anxiety, relationship conflicts, and habits and addictions, as well as the therapists who treat them!