Julian McNally Developing Mastery in ACT
4 Steps To Mastery
Unconscious Incompetence Conscious Incompetence Conscious Competence Unconscious Competence Where is The Gap?
What Mastery Looks Like…
Why develop mastery?
How effective is ANY psychotherapy compared to medical treatments
Q: Professionals vs. non-professionals – who wins? “…clients who seek help from paraprofessionals are more likely to achieve resolution of their problem than those who consult professionals.” Hattie, Sharpley & Rogers (1984). Comparative effectiveness of professional and paraprofessional helpers. Psychological Bulletin, 95, A: The client!
Professionals vs. non-professionals – what’s the difference (with severely depressed clients)? Bright JI, Baker KD, Niemeyer RA: Professional and paraprofessional group treatments for depression: A comparison of Cognitive-behavioral and mutual support interventions. J Consult Clin Psychol 1999, 67: Type of therapy? Status: professional or not? Adherence to protocol (regardless of which protocol)? No difference! More adherent = better outcome
This woman is a psychiatrist, so we can’t show you her face…
Disappearing jobs
Q: What kind of services go offshore? A: What else can you think of? If nursing and radiology, why not psychotherapy?
Suppose you could offer all this… Convenience Anonymity Widely accessible Client -initiated Flexibility in time, duration and place
Could a robot do your job?
A computer can already do therapy as well as you!
How mastery is developed
Another kind of mastery…
How good (or bad) can a therapist be? Okiishi J, Lambert MJ, Nielsen SL, Ogles BM. (2003) Waiting for supershrink: an empirical analysis of therapist effects. Clinical Psychology & Psychotherapy. 10, 56 counsellors: 60% male, 68% counseling psych vs. 29% clinical; 36% pre-intern, 18% intern, 46% post- intern; 25% psychodynamic/IPT, 34% humanistic/existential, 41% CBT or BT 1779 clients. DXs: 34.5% mood, 21% anxiety, 17% adjustment Minimum 15 clients/therapist Treatment length: min=1, max=69, mean=5.2, sd=7.2 Outcome/progress measurement: OQ-45 every session
Average HLM growth curve Okiishi J, Lambert MJ, Nielsen SL, Ogles BM. (2003) Waiting for supershrink: an empirical analysis of therapist effects. Clinical Psychology & Psychotherapy. 10,
“Supershrink” vs. “pseudoshrink” Okiishi J, Lambert MJ, Nielsen SL, Ogles BM. (2003) Waiting for supershrink: an empirical analysis of therapist effects. Clinical Psychology & Psychotherapy. 10,
Formula for expertise development Designed to improve performance. It can be repeated. A lot. Feedback is immediate. It is mentally demanding. It is not fun. From: (Hard) Ericsson, KA, Charness, N, Feltovich, PJ, & Hoffman, RR, Eds. (2006). The Cambridge Handbook of Expertise and Expert Performance. Or (Easy), Colvin, G. (2008). Talent Is Overrated: What Really Separates World-Class Performers from Everybody Else.
Your mastery development program Schedule practice Practise often – even if a little Eliminate automaticity What feedback and when? Form or join a group (this is bigger than you!)
Types of Deliberate Practice activities 1.Interpersonal Process Recall 2.Observations by your supervisor 3.Video segments
Julian McNally Developing Mastery in ACT