In 1974, David Rick decided to examine what influences the results of psychotherapy. The group of patients selected was “tough”: adolescents suffering from severe mental illness, those whose management of care is, of course, complex. The researchers tried to answer a simple question: “In whom did the treatment succeed, and in whom did it fail.” They examined various variables (gender, age, intelligence, socioeconomic status, parental mental state, duration of treatment, etc.), but none of them were able to distinguish between successful and unsuccessful treatments. Then, in studying the data, a surprising conclusion emerged: the most powerful predictor of treatment outcomes was “Who treated the patient?”. It turned out that there were some therapists who consistently had better treatment outcomes, and others who consistently had worse treatment outcomes. There are therapists who are “master therapists”, and there are those who are “just therapists”, “therapists”. With the “master therapists” the treatments are successful, and the “just therapists” – much less. And naturally the following question immediately arose, so obvious: Who are these “master therapists”? What characterizes them? What distinguishes them from ordinary therapists?
It turned out that 3 basic qualities were central in turning a therapist into a “master therapist”:
1. a master therapist signals to himself something he needs to compromise on, and he draws attention to it,
2. a master therapist establishes a way Where he can go back and evaluate what he seeks to improve on; He examines himself, and tries, around the same goal, to get better and better,
3. He expands his effort not only in the clinical session; He studies, gets paid, receives training; He makes an ongoing, daily effort, even outside the treatment room, to get better.
The combination of the three factors (marking what needs to be improved, re-evaluating it more and more while striving to improve it, and settling for broad excellence with an outstanding environment), is, in fact, the same activity called “intentional practice”. Unlike regular practice based on repetition of activity, in “directed practice” the practice is focused (I practice something) and systematic (to get better at a certain thing, I practice it more and more “). In simple words, while” simple practice “is intended To teach us something, “intentional practice” is meant to improve something in
us.The findings that examined how much “intentional practice” turns therapists into “master therapists, are pretty clear. Many researchers have shown that excellence in psychotherapy requires “deliberate practice”: setting a goal, making an effort to improve in that specific goal, and engaging in psychotherapy outside the treatment room in a systematic attempt to improve clinical practice. Thus, for example, when deploying therapists from “master therapists” to “just therapists”, it turns out that “master therapists” invest 2.8 times more time in treatments than “just therapists.” They also define for themselves what they need to improve and practice. Etc. They, simply, strive. And it turned out that this process has no real end: even after seven years, characteristics of “intentional practice” (determine what needs to be improved, strive to improve, and engage more and more in treatment), led to improvement. “Just does not fade.
One of the fascinating breakthroughs in our understanding” Who are the “master therapists”? “Was when it became clear that the goal of improvement, which the master therapist chooses for intentional practice, is not sophisticated. It is not a complex theory, but a client of the common factors. The same general factors that are not related to a particular theory and their impact on the success of the treatment is enormous. Examples of these general factors are the therapeutic alliance, the ability to inspire hope, understanding how the therapeutic process works, emphasizing the patient’s strengths Others, are active “general factors” in treatment.Refer to them, as a goal for improvement, repeated practice around them, And thinking about them even outside the therapeutic set, this reference is is the “intentional practice” in psychotherapy; She is the one who turns therapists into master masters.
In recent years, an effort has been made to pinpoint the possible goals for “intentional practice” in psychotherapy. This effort seeks to give therapists a tool through which they can identify one goal, from a variety of common factors, the general factors, to “practice” on it.
Consider, for example, the dyad component. This element, the dyad, refers to a phenomenon that occurs in any treatment: out of intimacy, a “connection” is created between the patient and the therapist, and this “connection” allows the patient to grow. When a therapist tells the patient, “There’s a lot of frustration here … not yours, not mine, but both of us, together,” she refers to the same dyadic element, to the same connection between her and the patient, to that momentary “fusion” that can allow him, the patient, to feel Things alone he is not too brave to feel. The dyad, the reference to the same “connection” between patient and patient, is considered in all contemporary theories as a significant lever in psychotherapy. The “intentional practice” of the dyad requires attention: it requires you, the therapist, to pay attention to when this component was injured in the treatment, and whether when it happened – the treatment
really “gained”, that is – something good came out of it. If, for example, following the therapist’s statement “there is a lot of frustration here in the room … not yours, not mine, but both of us, together” the patient withdraws (for example, convenes himself and says: “I do not know, sad for me”), the reference to dyad Did not bring good. She achieved, in fact, the opposite result. Instead of the patient entering the dyad, and staying in it, he “runs away” back to himself. But, if the patient’s response is “true, but maybe because it’s both of us’s we can hold on to this frustration, not collapse, ‘then the intervention was excellent. It allowed the patient to experience “together”, discover its benefits and move forward. “Deliberate practice” means that the therapist can isolate the dyad component and practice it until she reaches the point where she knows how to bring it in with the right timing and intensity so that the patient will benefit from it. Thus “deliberate practice”: setting a goal (“I want to improve in the way I raise the dyad”), practicing it (“I will diagnose all my use of this ingredient until I can bring it to perfection”), and delving into it outside the treatment room (“I will read about Winnicott’s transition space, on Kohut’s fusion and Ogden’s analytical third until I know the theory behind “the dyad”). More and more, so – until the therapist turns from “a therapist who knows there is a dyad” to a “master therapist who juggles a dyad”.
The MATRIX is a tool that allows the therapist to dive into the clinical material and offer insights, centers for intentional practice, and levers, which will make the therapist more creative, accurate, and effective, that is … will allow him to move for a pleasant master therapist.
