07/04/2025
Research indicates that professional humility is associated with higher levels of clinical effectiveness.
In this 10th, and final video, Dr. Nathan Castle and couples therapist, Vivian Baruch, talk about how FIT engenders professional humility, in the process enhancing engagement and outcome.
NC - I'm hearing you talk about these cases with real people, where you get their voice (about their life & their therapy). You mostly do relationship counselling, but it could be with individuals as well. You get their voice, and it conflicts with what you might have assumed was the case. Either they don't think the therapy is as helpful, or they're not feeling as well as you think.
And it makes me think of a lot of therapists out there, and I was one of these prior to using FIT (Feedback Informed Treatment). I thought I could pick up someone who's deteriorating in my care. (The ICCE Performance Benchmarks show thar 5-10% of clients are reliably worse in treatment). I probably never thought about what percentage of the time I would pick up deterioration. But what was so humbling for me when I did the FIT training with the International Center for Clinical Excellence, we only pick up that the client is deteriorating, I hope I'm not butchering the numbers, less than 5% of the time. It's so small!
And (the online tracking systems) MyOutcomes or NovoPsych or FIT-Outcomes or any of those platforms, they can pick this up 80% of the time. So I think in some ways it's a bit of a superpower, if you’re okay with being surprised. I guess that's the key, if you're okay with being “Oh that's not what I thought!” I'd love to hear from you about how you keep that curiosity open. How do you maybe even put your ego to the side at times to be open, surprised and feeling good about being wrong, at your own assumptions?
VB - Well I just remind myself we're all wrong at times. So often what we pick up or think that we pick up is wrong. Really, I can't remember who told me this, but our clients have been doing what they're doing for many years before we meet them. So, we don't have the abilities, I think, to really understand a client just from how they're presenting.
I think what you said is great. The superpower of the FIT measurement gives us the ability for them (clients) to score themselves and how they're feeling in these four areas in their life. And (for us clinicians) to actually use that as a springboard for talking about (their scores). We can say “Tell me more about that”. “Why isn't this getting better since last time? What's your understanding about that?”
So, it's really about their voice. It's not me. I don't have the superpower to understand what's going on in their life. And it’s the same with the alliance (their view of the relationship with me). I might think “Well this felt easy for me. They laughed and they smiled, and I was able to help them emotionally regulate when they were dysregulated. OK, that's gone well”. And then they mark me low on the SRS (Session Rating Scale) and I go “Oh, tell me about that. What was a point (in our session) that could have been done differently?” Or “What happened there?”
Or if it was (a score of) five (out of ten) on (their sense of) being heard (by me or their partner), “Was there a point where it was actually worse? Was there a point where it was a four?” I think the numbers are really teaching us humility. They just keep us on track to remember that we're not “It” for the clients we see. They're the experts in their life. https://www.youtube.com/watch?v=X7sqKghIx5s
For information on the three day FIT online training in Australian time zones, go to https://www.eventbrite.ie/e/feedback-informed-treatment-fit-intensive-online-tickets-910779204117?aff=oddtdtcreator
Research indicates that professional humility is associated with higher levels of clinical effectiveness. In this 10th, and final video, Dr. Nathan Castle a...
