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The Future of Therapy Training: Exploring Process Coding with Pioneers Dr. Henny Westra and Alyssa Di Bartolomeo

Dr. Henny Westra and Alyssa Di Bartolomeo on how to become a better counselor.

I've long said there are three keys to becoming a better counselor.

And no, it has nothing to do with getting certified in CF-CBT or whatever is the newest therapy model.


To become a better counselor just takes three things.

  1. Working with a coach/consultant/supervisor.

  2. Track your outcomes.

  3. Watch your tape.


I've talked a lot about the first two.

Working with a coach is important. When you work with someone more skilled than you, they can see things you can't. We call this process deliberate practice. 


Tracking outcomes is also important. Knowing our data helps us see our weak spots. Think of it like baseball stats, but for therapists. For instance, do you know your first session drop out rate? We call this process routine outcome monitoring. I've not talked much about the third, watching tape. Mostly because I didn't have a good framework for reviewing tape. I mean, of course, misremembering is very common. So in the past I've advocated for reviewing tape as a way to get around the problems of therapists misremembering what actually happened in therapy.


And also, I've just found that when I watch a therapy tape I see all sorts of things I missed the first time around.


Still, neither of those are a specific framework for reviewing tape.


All of that changed the other day, when my former coach, Alex Vaz, sent me a paper written by Dr. Henny Westra and Alyssa Di Bartolomeo.

Dr. Henny Westra of York Univesity
Dr. Henny Westra of York Univesity

Their paper, Developing expertise in psychotherapy: The case for process coding as clinical training, makes the case that learning different frameworks for watching tapes of your sessions has the potential to dramatically improve our ability to help clients. They call this process coding.


I was so hooked by their paper that I reached out to them for an interview, and asked Alyssa to be my new coach.

Alyssa Di Bartolomeo of York University
Alyssa Di Bartolomeo of York University

We haven't started yet, but the pre-work she's already given me has been a humbling experience. More on that later.


So for now, here's our interview. As you listen, make sure to listen to the big problem they see with traditional training. Once you understand that, the importance of what they're trying to do will fall right into place.


If you're interested in becoming a better counselor, then this episode is for you.


Best,


Jordan (the counselor)

-Fin-


Links and resources mentioned:


This is the article summarizing the early research Laurence Alison et al conducted on police interrogations. I believe it was in this paper they discuss, “you can’t always make things better, but negative interactions can sure make things worse.”


This is Gary Klein and Daniel Kahneman’s article on the areas where expertise can develop and the areas where it can’t. My big takeaway was areas with clear and quick feedback are the ones who produce expertise.


One of my favorite articles. O'Sullivan and Ekman show that most people, even trained therapists, just aren't that good at reading different facial expressions.


Miller and Mathews discuss her path to becoming an expert therapist. I've not read this in a few years but I remember her learning a lot from her work observing horses.


Contact Dr. Henny Westra at hwestra[ at] yorku.ca

Contact Alyssa Di Bartolomeo alyssaad @] yorku.ca; Twitter/X @aadibartolomeo


 

If you liked this post, consider watching this next. I think you'll like it ;) It's about process coding and becoming a better counselor.

 

Jordan Harris, Ph.D., LMFT-S, LPC-S, received his Doctor of Philosophy in Marriage and Family Therapy from the University of Louisiana Monroe. He is a licensed professional counselor and a licensed marriage and family therapist in the state of Arkansas, USA. In his clinical work, he enjoys working with couples. He also runs a blog on deliberate practice for therapists and counselors at Jordanthecounselor.com.

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