What’s Missing from this Picture?
By Scott Miller and Mark Hubble
Therapists usually enter the field because they’re drawn to it and have innate capacities to do the work. But whether they excel depends largely on their professional community. Unfortunately, current psychotherapy practice doesn’t foster excellence as much as mediocrity, inertia, and an intense fear of change.
Classical pianist Rachel Hsu enters the auditorium. Among the many pieces she’ll perform on this occasion is the Concert Étude no. 3 by Franz Liszt. “Un Sospiro” (Italian for sigh), as the composition is known, is a famously challenging work to play, and a pleasure to watch. The hands mirror the sound of the music, moving rapidly up and down the keyboard in an intricate, crisscrossing fashion, which when done correctly, evokes images of water tumbling over rocks in a small mountain brook. Most experts consider Liszt’s Étude no. 3, with its third staff, abundance of notes, and complex fingerwork, exceptionally difficult—a 12 on a scale from 1 to 10.
Clad in a simple, black-satin dress and red sash, Rachel silently makes her way to the piano. A hush falls over the crowd as she sits and, with a practiced poise, effortlessly adjusts the bench, which offsets her diminutive size. She straightens her back, takes a deep breath, and raises her hands, holding them momentarily above the keys. Then, magic!
To say the audience is stunned would be a gross understatement. Simply put, those in attendance are entirely unprepared for what they’re witnessing. It’s six minutes of perfection; a combination of music and performance that brings many to tears—an experience made all the more compelling by the fact that the pianist is only 8 years old.
Exceptionally talented children are nothing new, of course. In a host of fields, individuals who seem touched by greatness, like carriers of a “divine spark,” appear from time to time. Mozart immediately comes to mind, who, like Rachel, was giving public performances as a pianist at the age of 8. Rachel, who also plays the violin, follows her piano performance with a flawless rendition of the Violin Concerto no. 2 in D Minor by Henryk Wieniawski.
Contrary to what might be expected, this performance didn’t take place at Carnegie Hall or a similarly prestigious venue. It wasn’t a musical recital for a gathering of proud parents. Instead, Rachel was a presenter, along with a host of other internationally regarded researchers, clinicians, performers, and celebrities, at the first Achieving Clinical Excellence conference. Held in Kansas City, Missouri, last fall, it was organized for behavioral health professionals.
The purpose of the meeting was to lay out a series of steps for achieving excellence in psychotherapy that research has shown result in superior treatment outcomes. In fact, they lead to greatness in all fields, pursuits, or professions. Rachel and others—including David Helfgott, the classical pianist whose triumph against all odds was celebrated in the award-winning film Shine—were invited to demonstrate how much can be accomplished by applying the steps, thereby, hopefully, inspiring the mental health professionals in attendance to commit to the hard work necessary for excellence.
The conference couldn’t have been timelier. One only has to pick up a newspaper, turn on the TV, or search the Internet to hear news of America’s declining global performance. Two recent issues of Time magazine have chronicled an across-the-board pattern of decline in America’s standing worldwide that encompasses student test scores (once number 1, now 17th in science and 25th in math), infrastructure and public works (23rd), overall life satisfaction (28th), and quality of and access to healthcare (37th).
Not only are our children faced with the prospect of a lower standard of living compared to prior generations, but the country as a whole is falling behind other nations. China now possesses the world’s fastest computer and is leading in green technology. While our economy has been in a virtual freefall, China’s has sprinted ahead by leaps and bounds. IHS Global Insight—the largest economic organization in the world—recently announced that U.S. manufacturing fell, for the first time in a century, to second place, behind you-know-who.
Psychotherapy’s Track Record
Turning to the field of mental health, what accomplishments can it boast of in recent years? What was the last truly revolutionary discovery in the field of psychotherapy? What “treatment” (analogous to penicillin in medicine) has ever successfully eradicated a mental or emotional disorder? In fact, while we’ve been at our posts, provisioning and parading an army of techniques and methods, rates of depression and anxiety have soared.