Training for Excellence: Successfully Training and Launching New Therapists at Open Sky

Wednesday, February 22nd, 2017

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Dr. Tony - Blog Pic

Excellence is a core value at Open Sky. Daily, I strive for excellence and I hope to inspire those around me to pursue excellence in their lives. Aristotle once said, “Excellence is never an accident. It is always the result of high intention, sincere effort, and intelligent execution; it represents the wise choice of many alternatives – choice, not chance, determines your destiny.” I could not agree more. As Clinical Director at Open Sky, I am tasked with overseeing the clinical components of the program. Among other things, this includes hiring, training and developing new therapists.

It is my belief that being a successful wilderness therapist requires much more than being a skilled clinician. To excel as a wilderness therapist, one must also manage the team of students, train guides to understand underlying issues as motivations for the observable behaviors, work with students to identify and replace problematic emotional, cognitive and behavioral patterns and communicate all of this effectively to parents and professionals so there is a more complete understanding of the student’s challenges, strengths and ongoing needs.

Since very few therapists are exposed to wilderness therapy during their academic training, it is imperative to have an extensive and immersive training process. At Open Sky this intensive process can last anywhere from 3 -12 months depending on the therapist’s familiarity with wilderness therapy. The new therapist will not assume responsibility for a caseload until the extensive training is complete. During this time the therapist-in-training is partnered with an established wilderness therapist to learn the role with excellence.

“Excellence is an art won by training and habituation. We do not act rightly because we have virtue or excellence, but we rather have those because we have acted rightly. We are what we repeatedly do. Excellence, then, is not an act but a habit.” Aristotle

Launching sophisticated wilderness therapists requires that they understand much more than what to do and when to do it. A developmental model that focuses simply on teaching a new therapist the “what” without teaching the “why” is shortsighted and will not benefit students, parents, professionals, the new therapist or the organization. What involves the day-to-day duties and responsibilities necessary to be successful. Why involves the underlying therapeutic reasons and values-based rationale for doing the what.

Consider the process of guiding parents through the writing and revising of impact letters. If when training, I only focus on teaching what types of content changes need to be made, the result may be a more effective impact letter, however the family may or may not understand the patterns which contributed to generating the content in the first place. This is first-order change. We are addressing the content, but not addressing the underlying patterns. However, if we address the necessary content changes and speak directly to the underlying rationale and values-based reasons for the suggested changes we have the opportunity to change established (and potentially problematic) patterns. This is second-order change. My goal is to teach every clinician how to work at the second-order change level. Teaching second-order change, like excellence, requires intention and involvement.

There is a saying, “Tell me and I forget; show and I remember; involve me and I understand.” Effectively training and therapist launching requires a hands-on, relational approach. Aspiring wilderness therapists know what they hope to achieve, but may lack the training and habituation to the duties required for excellence. Training for excellence requires intention and involvement from those who have a habit of excellently executing the tasks being taught. This is done by embracing the wisdom of “Tell me and I forget; show and I remember; involve me and I understand.”

While I do not typically carry a caseload, when training a new therapist I often open a partial group and assume the role of team therapist. I partner with the therapist-in-training for several months to tell, show and involve. In practice this involves the following five steps:

Tell me:

Step 1. Explain what tasks and why the tasks are required to fulfill the wilderness therapist role with excellence.
Step 2. Asses the therapist-in-training’s understanding of the role by asking him/her to explain his/her understanding of the wilderness therapist role – both the what and the why.

Show me:

Step 3. Partner with the developing therapist to show role in action. Demonstrate every aspect of the what and explain the why of wilderness therapy.

For the first two months the purpose is to tell and show the new therapist every aspect of the position. We drive to the field together discussing intentions for each student, the team as a whole and the guide team. We set new intentions after talking with the guides who have been in the field all week. We facilitate all individual and group therapy sessions together. We debrief the what and the why following each session. We examine how the patterns that are observable in the field relate to the patterns that were present at home. We discuss how replacing patterns in the wilderness with healthy skills translates to more effective patterns in other environments. We identify ways to effectively communicate what we are learning to parents and professionals. Then, we call parents and referral sources together. We repeat this training for every student, week after week until it is time to shift more fully into the involve me stage.

Involve me:

Step 4. Transfer of responsibility. While partnered with the therapist, provide increasing opportunities for him/her to demonstrate the ability to deliver the what of the role and explain his/her understanding of the why. Allow the therapist to take more responsibility as he/she demonstrates competence.

Step 5. Launch. Transfer complete responsibility to the new therapist.

As the therapist-in-training watches, asks questions and demonstrates a cognitive understanding of the what we do and why we do it, I begin transferring responsibility to the new therapist. The schedule and process remains the same, but the new therapist begins to take the lead and I become the shadow. Over time, the therapist builds confidence as he/she takes the lead on increasingly challenging situations. This is all done with support that decreases as competence increases – scaffolding. We continue this until the “art of excellence is won by training.”

The result is a competent wilderness therapist, an Open Sky team that believes strongly in the new team member’s abilities, and students, families and professionals who can have confidence knowing they are working with a well-equipped wilderness therapist.

Excellence is never an accident. Excellence is an art won by training and habituation. Open Sky’s clinical training model is no accident – it has been developed with intention to habituate clinical excellence.