Erickson reminded us that since every client is an individual, we need to tailor our approach to fit the client rather than tailoring the client to fit some theory. But, how do we tailor our approach to fit the client? He reminded us again that the three most important skills to learn are to observe, to observe, and to observe.
If we observe a client, there can be obvious responses - a subtle smile or frown, their head nodding or shaking - any number of responses that we can notice and adjust our direction in an obvious and natural way. When we observe, our judgements are put aside. If we are judging or assessing, which is the core of the medical approach so we can diagnose then treat, it is necessary to put our observing aside. This is not a trivial matter because the experience of judging or diagnosing places the client as a mechanical entity, which is essential for some physical problem such as a broken leg, a sore throat, an abdominal pain, but not helpful when we are dealing with a human dilemma such as coping with a loss, or an obsessive behaviour which may help someone to feel safe.
Observing results in responding. Judging results in reacting. When we are observing, we can respond in a natural way, creating some novel possibilities. Judging results in reactions which are rigid and “right” based on past experiences and leads to more of the same.
When we are working with a client, we can ask for feedback before we begin, during a session, or after the session has finished.
Before we start our therapeutic interaction, we can ask what this client hopes to achieve, what they want, what would be helpful or what’s missing for them, that if they could have it, they would be OK. Bill O’Hanlon said that when he was seeing clients, he would ask what will be different when you tell mne you don’t need to see me any more. These explorations can guide us in how to proceed.
During a session, we can ask for feedback - “What’s happening for you?” - which can confirm that what we are doing is helping, or allow us to change what we are doing to align with what would be useful for this client.
At the completion of a session, we can ask “What’s different for you now compared with before we started” which can allow a client to realise that a useful change has happened, or inform us of how we can proceed next time, or even have another session informed by this feedback.
For those who like written evidence, there are scales which a client can fill out that provide feedback about how the session went from their perspective, and how useful the last session translated into lived change. Scott Miller and Barry Duncan have created these easy to use scales
Feedback allows us to connect with the uniqueness of each individual client and to take care of our human clumsiness .
Great post Rob. On the money!