You Need Clinical Confidence if You Want to Be a Good Therapist

One of the most important components of an evidence based practice is something that we refer to as clinical confidence. But I don’t know that everybody knows what that is, especially in relationship to Solution Focused Brief Therapy. So today I want to break that down.

So in Solution Focused Brief Therapy, the number one thing that people come into this approach wondering is, does this approach work. And particularly, does it work with _____. And people think of their most difficult clients. Does it work with depression? Does it work with anxiety? Does it work with couples? Does it work with kids? Does it work in groups? Does it work with addiction? People come to me with all kinds of questions, and it tells me that there’s not a lot of clinical confidence out there in our field.

Because here’s what clinical confidence actually means. The answer to the question of “Does Solution Focused Brief Therapy work?” is actually, “Yes, if the clinician believes that it works.”

This is true for all forms of psychotherapy, which is why this is such an important thing in the work that you’re doing with your clients. You have to believe in what you’re doing, in order for it to make a difference.

I’m going to tell you a story from my childhood to give you an example of this. When I was young, I was a very, very good baseball player. And I had a baseball coach named Coach P, and put me on the varsity baseball team when I was really, really young. I think I was 15 years old when I made the varsity baseball team. And Coach P could see I was a young kid, I had some talent, and I was really young.

And we were playing this game. I wasn’t starting, I didn’t play all the time, but we were playing in this one particular game where I was going to have to go to bat, and I was going to have to go to bat at a very important time in the game. And I go up to the plate and I’m holding my bat and I’m nervous. I’m really, really nervous.

Coach P can see that I’m really nervous. And he calls timeout. And he calls me over to him and he says, “Connie, you look really nervous now.” Not wanting to show him that I was scared, I said, “No, coach, I’m not nervous.” And he said, “Yeah, I can see you’re really nervous.” He said, “Elliot, you want to know why I have you on varsity?” And I said, “Yeah, I’d love to know.”

And he said, “Because we have been analyzing your baseball swing. We’ve been analyzing your baseball swing for a couple of years. And you have the perfect swing for a really good fastball. And this pitcher has a really good fastball. So I want you to just wait on a fastball, and then do what you normally do. Just put your perfect swing on it, and we’ll live with the results.” And I was like, man, “Okay, coach.”

And I remember feeling this massive boost of confidence, like, “All right, he’s ready for me to do it.” I go up to the plate, and the first pitch he threw me was not a fastball. The second pitch threw me was not a fastball. The next pitch he threw me was a fastball. I hit a double, a run scored, and we won the game.

And after the game, I ran up to the coach and I said, “Coach, how did you know that I had a perfect swing for this particular person, and a really good fastball like he threw?” And my coach said, “I didn’t know that. I just needed you to believe in yourself.” Just that one thing. Coach P tricking me, in essence, into believing myself, increased my capability in that moment, and I was able to have a successful moment.

And I’m saying the same thing to you. I need you to believe in yourself, in what you’re doing. Because it’s not the approach. A lot of people will say, “I used Solution Focused Brief Therapy with a particular client, it didn’t work, and you guys got to show me how to fix it.” And sometimes that’s true. You can misapply the strategies, techniques, questions, whatever.

But more often, it’s that you applied it without true, unshakable belief in what you’re doing. Because when you have belief, your capability and your proficiency goes up. When you don’t have belief in yourself, your proficiency and capability goes down. This is very, very important.

So does Solution Focused Brief Therapy work? Yes, it does. When does it work? When you believe in what you’re doing. There is already empirical evidence demonstrating the efficacy of this approach, as with other approaches. But the same as with everything else in our field, if you don’t believe in what you’re doing, you are not going to be effective.

So I’m making this video to let you know clinical confidence matters. You have to believe in what you’re doing. Draw from the empirical evidence to cause you to believe in what you’re doing, but also know that you are trained. You know what you’re doing. You have the right kind of education, the right kind of practice. And if you believe that if a client answers these questions, their lives will get better, they will.