The Feeling Good Therapist - Worst Best Average Technique
Worst Best Average Technique with host, Richard Lam, LMFT, featuring Sarah Chickering, PhD
Richard Lam and Sarah Chickering demonstrate the Worst, Best, and Average cognitive behavioural therapy techniques that therapists can use. This can help patients correct their overgeneralizations like "I'm not good at anything" and labelling by using rational thinking. In this cognitive behavioural therapy exercise, the patient challenges the thought, "I am a bad therapist."
IN THIS VIDEO:
Richard Lam (Host): Welcome everyone to the Feeling Good Therapist where we learn skills and tools that will help you in your personal life or in your therapy practice. And today we have the lovely Sarah Trickering who will be teaching us a really amazing technique called Worst Best Average, a technique created by Dr. David Burns. Sarah?
Sarah Chickering (Guest): Great, thanks Richard for having me. So today I want to share with you this technique called the Worst Best Average technique and this is a really good tool to use when we struggle with all or nothing thinking, black and white thinking, or when we label ourselves in only one way. So let me share this tool with you.
Process of Worst Best Average Technique:
The first thing we need to do is to choose a negative thought, it's usually like a harsh label that you're giving yourself. So for example, you might struggle with thoughts like, I'm not a very good dad or I'm not a good therapist. How about choosing a negative thought to start with?
Richard Lam: Sure. We can do it, I'm not a good therapist.
Sarah Chickering: Okay. So instead of using that label for yourself, I want you to think of the opposite of that. So if I'm not a very good therapist, it would be something like, I'm a good enough therapist or I am a good therapist.
Richard Lam: Okay. Yeah, that sounds good. We can write I’m a good therapist.
Sarah Chickering: I'm a good therapist. Okay, so we put that positive label here at the top of the sheet. Now, the next step is to list the qualities of what make a good therapist. For example, when you think that I'm a good therapist, what's a quality of a good therapist?
Richard Lam: For sure, someone who's really caring.
Sarah Chickering: It's a great quality. Okay. A good therapist is really caring. What's another quality you think of there?
Richard Lam: Along the same lines, someone who's really empathetic and understanding.
Sarah Chickering: Someone who's empathetic and understanding, also really important and true of a good therapist. How about a third quality?
Richard Lam: I like the wanting or willingness to continue learning and expanding on their skills.
Sarah Chickering: Excellent quality. Willingness to continue learning and expanding skills. I think that's so true. What's another quality?
Richard Lam: Do you mind if I change that one?
Sarah Chickering: Sure.
Richard Lam: I feel like sometimes there's willingness, but then I don't actually take action. So maybe continuing to learn rather than willingness to learn.
Sarah Chickering: Continuing to learn. I like that distinction because you want that proactive piece.
Richard Lam: Yeah, I definitely want to take action. I feel like I haven't been.
Sarah Chickering: Yeah. Good quality of a good therapist. What's the fourth quality there?
Richard Lam: Someone who is able to kind of get results and help people feel better.
Sarah Chickering: Someone who gets results and helps them feel better. Yes. I can see why you would choose that.
Richard Lam: Results driven.
Sarah Chickering: Yes. I like it. Let's shoot for at least one more quality of what you would think of with being a good therapist.
Richard Lam: I don't know. Do you have any ideas, Sarah?
Sarah Chickering: Yeah, let's see. When I think of a good therapist, I think of someone who is teachable.
Richard Lam: Yeah, that's a good one.
Sarah Chickering: And it may be humble to look.
Richard Lam: They're willing to receive new information. I like that.
Sarah Chickering: We have at least five qualities of what you would term a good therapist. It's great work there. And now what we want to do is go over here to this side of the tool, and I want you to rate yourself on each of these qualities, at your very worst times, at your best times, and then on average, where you think you land. So at your worst time, you're just having a hard day caring. How would you rate yourself 0-100%?
Richard Lam: Yeah, I think probably when I'm super stressed and there's a lot going on in my life, I'm probably not as caring.
Sarah Chickering: So maybe like a 40. Especially when you're stressed, you have a lot going on. That's understandable. How about a day when you are really productive, you're not stressed, you're knocking it out of the park with your caring. Where would you rate yourself at your best time?
Richard Lam: My best, I'm probably like a hundred. Trying to be humble, but I want to put that hundred.
Sarah Chickering: Yeah. I believe it. No, I believe a hundred percent. What about on average, what do you think, how would you rate yourself for being really caring? It's average.
Richard Lam: I think generally I'm pretty caring, even sometimes I'm not having the best day, but maybe like 85.
Sarah Chickering: 85, great. So let's go to this next one and rate yourself again on your really hard days and your best days. And on average, what about your empathy and understanding what a worst state looks like there?
Richard Lam: Yeah, I think generally, it's still pretty good. And sometimes I'm like very in the moment and forget about what's going on. So maybe like 70 percent of my worst.
Sarah Chickering: Yeah. I think you're so empathic. I can see that for sure. What about your best?
Richard Lam: At my best, I still think this one might be a hundred where I'm fully feeling like I get it. I understand. And they're telling me that they understand too.
Sarah Chickering: And then what would you say for your average there with empathy and understanding?
Richard Lam: Maybe like 80.
Sarah Chickering: Yeah. Let's put it down. What about this quality of continuing to learn? Where do you land there, on a tough moment or tough day?
Richard Lam: Yeah. Continuing to learn. Maybe I haven't been doing such a good job, like, 25%.
Sarah Chickering: Okay. That one might be tougher. What about on a really good day, of continuing to learn your best there?
Richard Lam: I would say maybe like 80%.
Sarah Chickering: Sad. And then where would you rate yourself on average with continuing to learn?
Richard Lam: Probably like 40%.
Sarah Chickering: 40%, doing great. What about someone who gets results and helps their clients feel better? Someone who's results driven. Where are you at your worst with that as a therapist?
Richard Lam: I feel like sometimes I get someone where I'm like, Oh, this is so hard and I'm not able to be successful. I'm not sure how often that happens, but maybe, like, 80s? No, actually, I feel like I do get results, so maybe in the 80s.
Sarah Chickering: Yeah. Maybe that one is not as difficult. Then at your best, I imagine it's gonna be higher than that.
Richard Lam: Yeah. When I'm at my best, I'm really feeling it. They feel good. I feel good.Everything is good. So maybe like a hundred.
Sarah Chickering: Fantastic. Put that down. So then on average, where do you, where do you think you land with that quality? If I get there?
Richard Lam: No, I feel like I can always improve and do better and maybe help people recover more quickly. So maybe like 80.
Sarah Chickering: Okay. Fantastic. Let's go through this last one. Quality of a good therapist is someone who's teachable, humble to learn, and able to receive new information. Where would you rate yourself on that one, Richard?
Richard Lam: Maybe on my worst, 50 percent where I'm just like not having it, like I'm not taking any information.
Sarah Chickering: For sure. What about your best?
Richard Lam: My best? Probably like 100 percent where I'm just like, give me everything I'm learning. Be as critical as possible.
Sarah Chickering: Yes, you're saying bring on that criticism. So then on average, where do you think you are with?
Richard Lam: Maybe like a 75. I can always do better with that.
Sarah Chickering: We've gone through these qualities of what a good therapist would look like and you've rated yourself at your worst, best and average times. And what I want to do now is show you the skill down below. Maybe we could focus on one specific quality or characteristic that you'd like to improve. Maybe the continuing to learn and I noticed that one's a little bit lower than the others. And maybe some steps that you could take to improve that.
Richard Lam: Yeah, I think that is a perfect one to do. I definitely need to increase my average there.
Sarah Chickering: Yeah. So let's talk about some steps you might take to make that a little bit stronger. What could you do to continue to learn? What's a step there?
Richard Lam: I think I heard of this Tuesday group with David Burns. The Wednesday group with Rhonda. Those two sound pretty good. So maybe if I just kind of attend the Tuesday group.
Sarah Chickering: So maybe it's attending one of these groups. Great idea. It's a good step to learn more for sure. What's another step to improve that, like continuing to learn area?
Richard Lam: I've been meaning to take this one where this teacher and psychologist Jill Levitt has created this like core skills for effective therapy where it's like, go at your own pace type of training.
Sarah Chickering: Okay. So maybe signing up for that training. Yeah, sounds like that might be right up your alley. You can kind of go at your own pace and really learn something. So maybe signing up for that. Fantastic. What's another step for continuing to learn that would help?
Richard Lam: Maybe just like to take more training.
Sarah Chickering: I agree. I think taking more trainings is so helpful. I wonder if you could be a little bit more specific about. That goal. What do you mean?
Richard Lam: I know there's a David Burns intensive training coming up where I hear they kind of give you a lot of good information unless you practice with groups and have a lot of different therapists that will help you. So maybe that will kind of help me and improve my continuing to learn.
Sarah Chickering: That sounds like a wonderful goal to continue to learn. So it sounds like you've got three specific areas to take some steps that you continue to learn and make that goal more feasible. And I'm wondering how this went for you, Richard. I wonder what you think about this technique and what have you learned?
Richard Lam: I kind of noticed I'm pretty harsh on myself a lot of times where I do put a lot of emphasis on needing to be better, but really vaguely. And I always think of myself at my worst a lot of times, but actually on average, I'm doing pretty good. And the area that I could use improvement on is in order to like, learn more, do more trainings. Now that we have an action plan and I love that you asked me to be more specific because it helps me kind of have steps to kind of get my average up a little bit more to continue learning and growing in that area.
Sarah Chickering: Right. I'm so glad that helped.
Richard Lam: Well, let's pause right there. Thank you for teaching this awesome technique, Sarah. You did a lovely job. And if anyone wants to learn more about Sarah, feel free to look at the descriptions below. And in the spotlight, we talked about all these trainings and a big part of these are actual trainings that you can do. So feel free to look at the description below for the link. If you want to connect more and try any one of these trainings on your own, I very much recommend it. And if you just want to subscribe to this channel and just learn more of these techniques here and there, happy to have you join us as well. And I'm looking forward to next time. Bye everyone.