Jessie didn’t choose this life. She was born into harsh circumstances. Growing up in a rural Western desert town, separation and loneliness were what she knew best. The basics—food, water, shelter, safety—were always in question. Family life was also a struggle. Her parents and siblings were constantly moving from one place to the next; that is, until her mother was killed in a brutal and unexpected attack. Then the family was split up by the authorities. One brother was shipped off to California, the other farther north. Jessie was sent to live with other displaced orphans—a spot known to locals as the Lockup. A more apt description would be the Wild West.

Although food and water were plentiful, power struggles, bullying, and physical altercations were constant occurrences. In time, Jessie learned to use her small size and agility to surprise her opponents with powerful kicks, and she moved up the pecking order. The prize was isolation, a quiet spot where, outside of meals and activities, she was left alone, unbothered by the other residents.

At this point, many professionals might label Jesse “institutionalized.” Truth is, as lonely as she seemed, she’d grown fond of the place. Idyllic? No. But it was the first stable home she’d ever known. She’d even earned a degree of respect among the staff. “As long as you give her space,” they’d say, “she won’t give you much trouble.” Eventually, all came to know that even if the gates were unlocked, Jessie wasn’t going to leave.

Everything changed the day the big white ranch truck drove up the long, windy dirt road leading to the Lockup. Without warning, she and two other residents were packed into the vehicle. She didn’t have time to object. A long journey followed, through mountain passes, hail, and rain, to a place unlike any she’d seen before. Gone were the sand and sagebrush. In their place, were brilliant green rolling hills dotted with aspen trees and surrounded by tall, angular mountains.

It was here she met Shayne. Their first encounter was alternately frightening and intriguing. She knew she shouldn’t trust him. He could be a predator—she’d encountered many in her short life. And yet, when the broad-shouldered, plaid-wearing man approached, he seemed different, safe.

“Hey there,” he said in a quiet, confident voice. “My name is Shayne. Take all the time you want. No need for any trouble here.”

His words didn’t matter. Her instincts kicked in. Slowly, she turned her back and moved away. Out of the corner of her eye, she watched as he stood there, kicking at the dirt, playing with a length of rope in his hands. Who was this guy? Decked out in brightly colored, round-toe boots and a cream-colored, flat-brim hat, he was either a cowboy or the best poser she’d ever seen.

That’s when she surprised herself. Without thinking, she turned back around, facing him head on. It wasn’t a threat. She was curious.

Just as quickly, he was moving toward her, repeating his name, extending a hand. His eyes—they looked so kind. And that smile, half-cocked and playful. Despite the tightness in her limbs, Jesse cautiously stepped toward him.

“I knew it wouldn’t take you too long to say hello,” the cowboy said, his tone easy and lighthearted. Taking another step, she returned his attention. Again, her own behavior caught her by surprise. After all the abuse and neglect, the urge to connect was still there. With the touch of his hand, that feeling grew. It was more than reassuring. It actually felt healing.

Jessie and Shayne spent more and more time together. While mostly pleasant, every so often, her traumatic past would creep into their interactions. Typically, she’d freeze up, hold her breath, tense the muscles in her face, and grind her teeth. Shayne seemed to know, even anticipate such moments, saying he could tell something was up simply by looking at her ears. Without hesitation, he’d adjust, the same way a masseuse changes the force and pressure of touch, or a dancer alternates between following and leading. It never took long for the tension to dissipate. Each time, her feelings of comfort and security grew.

Three months after their first meeting, everything about Jessie was different. It would not be an exaggeration to say that her life—and being—had been transformed. The old wounds were gone. In their place was a kind heart and gentle spirit, a deep attachment to others, and a confidence that has made her a leader at her new home. Jessie now spends her days helping those who were once like her. In partnership with Shayne and a herd of others, they’ve become a team of healers, leading by example. Visitors come from around the world to watch and learn.

Few readers are likely to be surprised by a story about the healing capacity of a healthy relationship. Most of us can recount experiences in therapy, similar to Shayne and Jessie’s, in which attunement and connection were central to positive change. Research on the power of the therapeutic alliance is reflected in hundreds of studies dating back more than four decades. It’s something we know in our bones.

Curiously, despite being widely acknowledged as important, even critical, a recent study by psychologist Crystal McMullen at the University of Southern Queensland in Australia found a significant number of graduate schools spend no time on learning or fostering the development of relationship skills. And while continuing education workshops abound on mindfulness, brain-based, and other state-of-the-art interventions, few opportunities exist for professionals hoping to work directly on improving their ability to connect and attune with clients.

Don’t get me wrong. I had a good experience in graduate school. I learned a great deal, met many talented and knowledgeable professors, and even passed several licensing and registration exams. As a professional, I’ve attended scores of workshops and trainings, all of which have expanded my knowledge and understanding of therapy. Yet despite these many experiences, and my continued interest and hopefulness, I was dogged by doubt, deeply discouraged that my investment of time and effort had yielded so little improvement in my effectiveness. Sure, I had more theoretical knowledge, but my clients didn’t seem to feel better. How did I know this? For several years, I’d been tracking the outcome of my work using a couple of standardized measures. More on this to come.

In the meantime, let me come clean about Jessie and Shayne. In case you haven’t figured it out, Shayne is not a therapist and Jessie is not his client. The details of the story are true, save two: Shayne is, in fact, a cowboy and Jessie is a horse. Born in Jerome, Idaho, now living in the big sky country of Montana, Shayne is a successful stonemason by trade, with a background in business. As part of an elite group, he’s also a master of horsemanship and now dedicates his life to teaching others. Jessie is one of many he’s worked with over the years, “saving her from the humans” that have so often been the source of trauma and pain.

Cowgirl Dreams

I’ve always loved horses. As a child, I dreamed of being a cowgirl. My room was filled with toy horses, horse paintings, and books about horses; the curtains were even hung with wrought-iron horseshoes. Most of all, and for reasons I’ve never completely understood, I wanted to be connected with horses, or more accurately, a horse. Maybe it has something to do with my grandfather. Although he died before I met him, he loved horses too, tending a herd of 500 on the open prairies of Saskatchewan.

The relationship my grandfather had with Billie, his own horse, was the stuff of legend in my family. According to all who knew the pair, whether chasing coyotes or protecting each other and the livestock, they worked together as one. “It’s like they could read each other’s minds” my mother would recount. With only an aged black-and-white photo of them together, and my grandfather’s weathered saddle in the corner of my bedroom, my childhood self knew what she wanted, and I’ve spent many years chasing a teacher who could help me learn how to build a similar bond.

Like so many life-changing experiences, none of what happened next was planned. I was in Seattle, Washington, attending what’s referred to as a clinic in the equine world, with the well-known cowboy and horse whisperer Buck Brannaman. I’d wanted to see him in the flesh ever since watching a documentary about his life. The image of him riding his large brown horse, Rebel, across an open meadow was imprinted in my mind. It didn’t hurt that he was the spitting image of my grandfather when he rode. That’s when I met Shayne for the first time. He wasn’t hard to miss. Plus, he was the only one there who seemed to be able to do what Buck was teaching.

At the end of the class, I waited excitedly in a long line of people hoping for an autograph, hug, or selfie with Buck, the “horselebrity.” Unlike most, I wasn’t just there as a fan; I wanted to be a student—his student. When I finally made it to the front of the line, I simply blurted out, “I wanna be a cowgirl.” Buck and Shayne looked at each other, then laughed. Undaunted, I continued, “But I don’t have my own horse.”

That’s when Shayne spoke up, “Well, of all the problems you could have, that’s an easy fix. Meet me in McGinnis Meadows.”

Buck nodded in agreement, “You couldn’t be in better hands, my friend.”

Within weeks, I began flying back and forth from my home in Vancouver, British Columbia, to remote Montana. I spent a fortune on airfare, used all my vacation time and then some. There, with the mountains of Glacier National Park as a backdrop, I spent hours watching Shayne work, studying his every move: how he walked, the movement of his hands, even the angle of his feet in the stirrups. Much of the time, he seemed to be doing nothing. Invariably, that’s when he was prone to say, “Watch closely. If you blink, you’ll miss it.”

I must have been blinking a lot. Many times, I simply couldn’t see what he was talking about or doing. Often, exhausted and unable to sleep, I’d lie in bed wishing there was some kind of a protocol or script I could follow instead, similar to how I’d been trained in graduate school. Then again, on the rare occasion that he gave me explicit directions, I still couldn’t make it work. That’s when my thoughts would turn harsh. I’m never going to get this. Cowgirl-schmowgirl. I’m just not good enough.

Whenever I verbalized those thoughts, Shayne would remind me reassuringly, “This is a lifelong journey.” Then he’d add, “And by the way, you haven’t yet put in the time to earn the right to be frustrated, so enough of that. It’ll come. For now, just enjoy the process.”

Despite my deep skepticism, and occasional fear he was being more businessman than teacher, I persisted.

Identities Collide

A few years later, in my other life as a therapist, I was reviewing data from my clinical practice. I’d been measuring my results ever since attending a workshop with Scott Miller during my first semester of graduate school. I administered two simple scales at each session with all my clients. The first, given at the start, measured progress. The second, given at the end, assessed the quality of the therapeutic relationship.

Somewhere along the way, I started consulting with Scott about my outcomes with clients, much as I’d done with Shayne about my work horses. On one particular occasion, after looking over my data, Scott paused. “Look at this, Brooke,” he said. “Maybe there’s something wrong here.”

I looked. Then looked some more. Perhaps my blinking had gotten the best of me once again. I had no idea what he was seeing. Jumping from stat to stat, clicking on and comparing reports from different years, he said, “Well, the fact is, your scores are improving—a lot.” More clicking. “And it looks like it all started about, yes, two years ago.”

Thinking my practice hadn’t changed that much over the years, my only response was an uninspired, “Huh.”

He continued, “The obvious question is, ‘What are you doing different?’ These numbers are unusual.”

Instantly, I felt doubt wash over me. Maybe I screwed something up when using the tools or entering the data.

Scott stayed on point. “So, what is it? What’s changed?”

Now it was my turn to pause. “Good questions,” I slowly replied, and then began racking my brain. More blinking. Truth is, I didn’t have any ideas—at least initially. Together, we began reviewing the prior two years of my life, looking for clues. We easily ruled out training and supervision, as I’d been consistently involved with both throughout my career. After doing some fancy statistical analysis, he was able to rule out any change in effectiveness owing to my growing clinical experience.

“Well, there’s only two possibilities,” Scott laughed. “Either you’re lying, or you’ve become really good at this stuff.” I froze. Thankfully, he continued, “And I don’t think you’re lying, so what is it?”

Several months passed before it all came together. I was attending a supervision group I’d been a part of for some time. While reviewing a clip of one of my sessions, several of my colleagues commented on its smoothness, how everything just seemed to flow. My first thought was, I have nice peers—which I do—but they persisted. As the discussion continued, the hair on my neck slowly began to stand up. The words they were using to describe the interactions between my client and I had an eerie familiarity. They were the same ones I used when describing Shayne’s work with horses: focus, feedback, balance, adjustment, connection, responsiveness, attunement.

Following the meeting, I went back to my data. Sure enough, the shift in my results had started shortly after my visits to McGinnis Meadows began. Was it possible, I wondered, these two important yet unrelated areas of my life and identity had unknowingly come together?

I decided to test that hypothesis the next time I spoke with Scott. Rather quickly, he zoomed in on my alliance ratings: the measure I ask clients to complete at the end of each visit. When I first started using the scales, my clients mostly gave me high marks. Over time, and without my noticing, they’d gradually started to decline—a trend that accelerated when I started working with Shayne. That’s right, declining. In other words, my clients were telling me I was doing worse in managing the therapeutic relationship.

Scott stopped me in my tracks. “Contrary to what one might expect,” he said, “the research actually shows that getting negative feedback early on in therapy is associated with better results at the end. It speaks to the capacity of the therapist to create an atmosphere in which clients feel safe to say what might not be working for them. In turn, the clinician can both validate the client’s concerns and make whatever adjustments are necessary to better meet their needs.”

It all made perfect sense to me and connected directly to what I’d been learning from Shayne. “Focus on the spots where you and your horse are struggling,” he often says, “not on what you want to do because it feels good.”

I closed my eyes, remembering one day when Shayne was standing in the arena, next to his horse, Irish. All of his attention was focused on the horse’s ears. “I don’t like his expression,” he said, explaining that the rotation and angle of the ears signaled frustration or crankiness. “He’s not at ease. Let’s see if I can find a way to communicate that suits him better.” Sure enough, with a few minor adjustments, Irish’s ears relaxed, and his expression softened.

If you focused on the particular action Shayne took at any given time—the technique, so to speak—you risked missing what’s most important in the process: Shayne carefully attended to his partner, using moment-to-moment feedback to recognize and respond to any dis-ease. The resulting attunement enabled the horse to stay peaceful and engaged long enough to learn new skills or, if necessary, heal from prior traumatic experiences.

Attunement and Responsiveness

Attunement and responsiveness are hot topics, and the subject of a fair bit of research, in psychotherapy. The former refers to a therapist’s ability to pick up on the nuances of interactions with clients. When done well, the people we work with feel seen, heard, and helped. In other words, we “get” them, know how they feel and what they need. This experience is, as a recent study by John Snyder and George Silberschatz documented, a central component of the therapeutic alliance, the quality of which is one of the strongest, most reliable predictors of treatment outcome. Not surprisingly, the evidence shows clients of practitioners who are better at attuning form stronger, more effective therapeutic bonds.

The latter concept, responsiveness, refers to doing the right thing at the right time, adjusting interventions on the fly to fit the unique and evolving circumstances of the client and therapeutic interactions. According to researchers Bill Stiles and Adam Horvath, it’s one of the key factors accounting for why certain therapists are more effective than others. How much more effective can one practitioner be than another? Consider this: a 2012 study by Stiles and another colleague found recovery rates of individual therapists ranged from 23.5 to 95.6 percent!

But how best to learn these two vital skills?

Looking back now, it all seems so clear. I was only able to uncover the connection between my improved clinical outcomes and Shayne’s horsemanship because I had a large body of outcome data, which enabled me to see the change in my effectiveness over time. It provided a baseline for comparison. Had I not measured the results of my work, I would’ve missed it.

Had Shayne had some type of quantitative scales available, I’m sure he would’ve used them. Instead, he had to rely on his judgement, honed over two and a half decades and confirmed by the superior progress his horses made. On this score, regarding the impact of experience on our experience as therapists, the evidence clearly shows that most of us can’t count on our own judgment. The data indicate, for example, our assessments of the quality of the therapeutic relationship often diverge significantly from our clients’. What’s more, we tend to overestimate our own effectiveness—by as much as 65 percent!

For all that, measurement alone is not enough. We also must work with our data: identifying and responding to problems, soliciting feedback from clients, and making and testing small adjustments in our style in an attempt to improve. Again, that’s what Shayne did, a process that, in time, enhanced my ability to identify, often in the moment, therapeutic ruptures, stalling progress, and deterioration—the very definition of responsiveness.

He watched and responded to the horse’s ears, eyes, head, neck, tail, even the angle of hoof placement. Good therapists try to do the same, noticing the words clients use, their tone of voice, facial expression, and body posture: skills that can be significantly enhanced by monitoring one’s performance with measurement tools. Indeed, a brand-new study released by psychologist Jeb Brown confirms that clinicians who use metrics to inform their practice and learning, in time, become more effective than 60 percent of their less engaged peers.

Improving attunement requires one additional step—deliberate practice. Scott talked about this early on in our consultations. “You’ve got to find your performance edge,” he’d say, “and then develop, execute, and evaluate a plan for improvement.” That meant focusing on my errors, when what I usually did, didn’t work. It was exactly what I’d been doing with Shayne, although he used different words to describe the process. His “way of life with horses,” as he called it, was aimed at making small improvements in one’s ability to connect with them by observing, remembering, correcting, and adjusting over a long period of time.

Scott and Shayne each said on different occasions, “There are no shortcuts.” And, as I’ve learned from experience with both people and horses, improving one’s ability to attune doesn’t come from reading a book, attending a weekend workshop, or memorizing the latest treatment technique or protocol. You have to feel your way forward, often stumbling in the dark, informed by corrective feedback and ongoing coaching by someone who’s more accomplished.

I can tell you from personal experience that developing “feel” is an intensely frustrating process. It’s so hard, in fact, many aspiring riders give up, concluding after much effort that success is more innate talent than learned skill. If not that, then they forgo their own development, giving into the temptation to copy the behavior of those who appear to have the “gift”—whatever that might be, in whatever field that is.

All this means being yourself is the starting point of attunement. It’s only from this place that refinement of one’s ability to respond more effectively becomes possible. Traditionally, our field seeks standardization. Learn by watching and then repeating what the masters do. Step one. Step two. Step three. Voila! Attunement.

The only problem is, it doesn’t work. In this, Shayne and Scott were unified, choosing instead to engage learners in a process, a series of intentional, highly tailored experiences, ultimately leading to the development of “feel” unique to each individual—their history, body composition, temperament, and so on. Such teachers are rare because working in this way requires so much effort and expertise. To succeed, they really have to know, and be attuned, to you.

Meanwhile, Back at the Ranch

Flames flicker in the vintage wood-burning stove, their reflection bouncing off the stamped tin ceiling of the main lodge. Seated nearby, in a hodgepodge of farmhouse wood chairs, are 13 visitors to McGinnis Ranch. Some are wrapped in brightly colored Pendleton blankets kept scattered about the room. Others are staring blankly out of one of the many windows looking onto the meadow, tall mountains in the distance.

Despite the silence, the energy in the group is palpable. Most are city dwellers and have never been on a ranch before. All are psychotherapists. In the morning, each will be paired with a 1,500-pound horse. Their job? To build a safe and secure bond with this once-wild animal, one that will allow the duo to work together in unison. Along the way, many will discover the wisdom of Buck Brannaman, whose quote hangs on a nearby wall, “A horse is the mirror to your soul. Sometimes you won’t like what you see, and sometimes you will.”

Nestled into a pair of oversized leather chairs, Scott and I are chatting about the tone of the evening, as well as reviewing the next morning’s activities. Earlier, we’d led the group in introductions over drinks and dinner. We’d also spent time briefing everyone on how the three-day course would unfold so there’d be no surprises.

Suddenly, the lodge’s massive wood door swings open, hinges complaining under the weight. In walks Shayne with Trouble, one of the barn cats, trailing closely behind. “Ya’ll better get yourselves into bed,” he says, continuing toward the kitchen. “Morning comes early here.”

By six a.m., Janice, a psychologist from New York, has already led interested group members in 30 minutes of yoga. She’d graciously volunteered the night before in an effort to calm jittery nerves. Everyone has eaten, the breakfast spread abundant and healthful. People are milling about, some sipping coffee, others checking their gear: hat, gloves, boots, an extra layer of clothing in case of temperature changes.

Tom, the participant with the most riding experience, is busy offering reassurance. “Don’t worry,” he says, his spurs jingling rhythmically as he paces across the wood floors, “we probably won’t even get on the horses today.”

“Where’s Andrea?” I ask.

“Here,” comes a reply from the back of the group. Behind the sea of cowboy hats, she’d been rendered invisible.

“Where?”

“Here!” now hopping up and down, waving her arms.

“Great.” The room now quiet, I continue, “Before heading up to barn, let me just remind you what today is about. We’ll be working on the fundamentals of horsemanship. That means self-awareness and self-regulation. We’re not going to be learning a technique and applying it to the horse. It’s more about looking inward, at yourself, observing your internal process and what you experience as you interact with your horse. Once you’re aware of and in charge of that, you’ll be able to start to communicate effectively.”

“Attunement starts within,” Janice quips.

“Cliché,” Scott responds, “but oh so true.”

“So we won’t be riding today?” Tom interrupts, “I didn’t think so.”

“I think you’ll be shocked at the level of focus and concentration required just to catch your horse and get the halter on correctly,” I reply.

“Yikes,” Janice sputters, any benefits from the morning yoga disappearing.

“Don’t worry,” I jump in. “Even if you forget everything we’ve talked about, you’re not alone. We’re here to help.”

Later that Evening

“I’m not sure I can eat any more,” one of the participants remarks. We’re seated around a huge firepit, making s’mores. Our bellies are full of local farm-to-table fare. Millions of stars now dot the night sky.

A few feet away stands a large, canvas tent. Not the average camping variety, mind you. With three crystal chandeliers, indoor heating, and artwork hanging on the walls, it’s the epitome of “glamping.”

“The trick to the perfect marshmallow,” Tom explains, “is positioning. You want it close enough to the flames so that the outside browns but doesn’t burn or catch fire.”

“I’m not sure why every part of me hurts,” Janice shares, “I don’t feel like I did anything particularly physical today.”

I don’t say it out loud, but I’m just as sore everyone else. No matter how many times I’ve been to the ranch, the experience always leaves me feeling my age. It’s like conditioning camp for athletes, challenging mind and body to work together in a very focused and intense way.

“Speak for yourself,” Andrea responds immediately. “I was chasing Chief around the arena all day. Have you ever seen a horse so big?” Standing slightly more than 16 hands—or nearly five and a half feet in height at the shoulder—her horse is one of the biggest at the ranch, and the de facto head of the herd.

“Chasing?” Tom questions. “Looked more like dancing to me.” Right then, his marshmallow burst into flames. “Damn, what’s wrong with these?” he exclaims. Then, mindful of his experience throughout the day, he adds, “Kind of a metaphor, eh? Nothing’s gone right. I should’ve known I was doomed as soon as I met Ray.” He’s referring to the horse he’d been assigned, a medium-size, chestnut-colored gelding, named after legendary horseman Ray Hunt. Group members chuckle recalling the interaction between Tom and his equine partner. Their first task had seemed so simple: enter the enclosure, approach your horse, and get the rope halter on its head. That’s when all hell broke loose, particularly for Tom.

“Unlike you, I think your horse was having fun,” one participant remarked, “waiting patiently until you got close, and then bolting.”

Everyone had been warned about running after the horses. It can spook them and lead to serious injury. Advice notwithstanding, the temptation to do exactly that is hard to resist. Horses are both perceptive and agile. They quickly size you up, instantly reading your ability to communicate effectively and moving away at the slightest provocation.

Tom had done his best to comply. As a result, his gait had morphed into a kind of determined, high-speed waddle, as he stretched his arms out, halter in hand, trying to sweettalk Ray. “Come here, boy, hold up. I’m not gonna hurt ya. . . .” Ray would have none of it.

“And those spurs,” Andrea chimes in. “I couldn’t see you, but I sure could hear you going round and round the pen, cha-ching, cha-ching.”

“Yeah, until Shayne yelled at me to take ’em off,” Tom interjects, moving to retrieve a new marshmallow. “I think we all know my horse was just sour and grumpy this morning.”

“I don’t think Shayne yelled,” Janice challenges, sandwiching her perfectly melted marshmallow between layers of graham cracker and chocolate.

“Felt like it,” Tom mutters in response, placing his roasting stick back in the fire. Turning to Andrea, he says, “You must be on cloud nine. Everything, all day, worked out between you and Chief. Remember him lowering his head so you could put the rope halter on?”

“Right from the start,” says Janice, “you and Chief connected, like you had some invisible bond or something.”

“Really? Huh.” Andrea replies. “It was cool, but, you know, honestly, I have no idea how it happened. Beginner’s luck, maybe?”

“An easy horse?” Tom suggests.

“Who knows?” Janice answers, munching her s’more. “It was amazing to watch though. It was like your feet moved his hooves. When you took a step, he took one, the two of you moving together. My horse? Jeez. All I can say is, it’s a bit ironic his name is Chaos. Statue would be more accurate.” With that, the group roars with laughter. Janice’s horse had looked so willing and friendly to start. He’s one of the ranch staff favorites, a little nugget of a guy with one striking blue eye.

I smile but say nothing, choosing instead to listen as the group dissects the day. Ray, Chief, and Chaos are horses I know well. Each has taught me important lessons. Ray, for example, helped me understand, appreciate, and notice readiness. If you just put yourself in his line of sight and wait, he’ll walk right to you. The temptation to chase, exert control, or impose an agenda is, for most, including me, simply too much. And if you did that with Ray, bang, it was off to the races and he won every time. His impact on my work as a therapist, though not immediate, was obvious. I slowed down, worked at containing my desire to lead or force the process. I improved at paying attention to their needs in the moment, staying present while waiting for them to move in my direction.

“What do you suppose your horses were each trying to teach you?” Scott asks, entering the conversation for the first time.

With that, everyone turns toward Janice. “Uh, I followed Shayne’s instructions exactly, his hand movements, feet, posture. But no matter what I did, Chaos moved less and less, until he was finally just standing there, like his hooves were locked in concrete, the immovable beast.”

Again laughter, increasing when Tom’s third marshmallow goes up in flames. “I give up,” he says in frustration, casually tossing his roasting stick aside.

“Now, that’s an interesting question,” Andrea remarks, then goes silent.

“I was at a workshop once with Don Meichenbaum,” Scott continues, a twinkle in his eye. I’ve seen it before and know a story is coming, some Yoda-like communication. “Here’s a guy who’s been deemed one of the 10 most influential therapists of the 20th century, and he’s talking about how to become a more effective therapist. The first tip he offers is, ‘Choose your clients carefully.’”

Following a brief silence, someone asks, “Was he kidding?”

“Sort of. But more, I think, he was making a point. When things don’t work, it’s easy to look to our clients or, in this case, the horse. . . .”

“You mean, or rather Don means, instead of ourselves?” Janice completes Scott’s thought.

“That’s right. The research paints a clear picture: more effective therapists are better at connecting with and engaging whoever walks through the door. However tempting it might be to shift the focus to our client, the burden is on us to manage their engagement. That’s why, when someone I’m supervising suggests their client is unmotivated, the first thing I think is, So they don’t find you all that interesting, eh? The bottom line is, it’s not the client’s job to be motivated, attached, compliant, whatever.”

“Pretty hard on the ego though,” Tom mumbles as he moves to retrieve his roasting stick.

“But it has to be right,” Janice interrupts. Looking across the firepit to Shayne’s teaching partner, Des, she adds, “Chaos wasn’t a statue with you. As soon as you came over to help, like magic, he was suddenly Mr. Motion.”

“I promise you, it wasn’t always that way,” Des quickly replies. “I’m not trying to go all woo-woo on you, but if you can turn a horse into a statue, then you can sure as hell do the opposite and get it to move.

“Interesting way to put it, Des,” Scott responds. “And here again, the evidence shows the same pattern occurs in psychotherapy. A client sees one therapist, and nothing happens; they see another, and it works. The point is, we matter. The individual therapist matters. In many ways, you are the most important ingredient in treatment.”

“I’m not saying some Zen-thing here,” Des clarifies, “like ‘the answer is within,’ or something. Learning to communicate effectively with a horse is a lot of work, but it all starts with first becoming conscious of you. What you do. Your thoughts, behaviors, and actions. Then, with feedback, constant small adjustments, trying out new things, fine tuning, and letting the horse guide you about what does and doesn’t work along the way, you gradually improve.”

“D-e-l-i-b-e-r-a-t-e p-r-a-c-t-i-c-e,” one of the other participants slowly spells out.

“Yeah,” Scott says, “And no denying that process, like you say Tom, can be hard on the ego, especially if you have a lot of experience. As frustrating as that can be, however, it’s natural. Whether learning to drive a car, ride a bike, or do therapy, over time, much of our performance becomes routine. We achieve what researchers call automaticity, doing without having to think about everything we’re doing. Whatever we’re engaged in becomes smoother and with that, our comfort, confidence, and efficiency grows.” Following a brief pause, he continues, “Paradoxically, that’s also when we cease to improve.”

Scott then reminds the group about one of the studies included in the prereading material for this retreat. Psychologist Simon Goldberg and colleagues tracked the outcomes of 170 therapists for up to 17 years. The results showed practitioner effectiveness neither improved nor stayed the same, but actually worsened as experience in the field lengthened. It’s the largest and most sophisticated such study on the subject to date. Before its publication, the field could hold out hope that hours spent in the trenches facilitated professional development. This study left no doubt: time is not an effective teacher.

As Scott delivers the bad news, I’m reminded of another study I’ve heard him mention before. When therapists are engaged in deliberate practice, their confidence declines while their actual, measured ability in whatever skill they’re working on improves.

“That’s the Difficult Conversions in Therapy project, or DCT,” Scott confirms. “It’s a series of very clever, randomized controlled trials done by researchers Daryl Chow, Sharon Lu, and colleagues. And there’s other evidence. Norwegian researcher Helene Nissen-Lie, for example, has found professional self-doubt is a strong predictor of outcome and alliance. I’m not talking about adopting the trendy, ‘not-knowing’ stance so popular in certain therapeutic circles. Nothing is gained by either feigned or willful ignorance. Rather, the type of humble, ‘not-knowing-ness’ these researchers have identified is about relishing the moments when what we know for sure is called into question. It’s then that our minds are open, the possibility of learning exists, and consequently, when we’re most likely to recognize opportunities for attunement.”

“Okay,” Andrea breaks her silence, “so being able to attune is not some static state, or fixed skill we’ll eventually master. Like Des said, it’s an ongoing thing.”

“Yes,” I respond, “and it can be a dilemma when things all seem to fall into place, like they did for you today, Andrea. But l can tell you, your experience is not unusual. In fact, we see it a lot here, beginners doing better than experienced riders.”

“Because they’re at their learning edge?” she asks.

“Yeah, that and because they have less to unlearn.”

Andrea nods in recognition.

I jump in again. “The key is staying in that open place as you become more experienced, to challenge the automaticity Scott’s talking about by constantly exposing yourself to experiences that keep you at that sweet spot of discomfort.”

“Oy veh,” Tom sighs, pulling his fourth, deeply charred marshmallow from the fire. “I just wish I could find the sweet spot of s’mores.” Although his tone is lighthearted, no one laughs.

“You’re so right, Tom,” Scott quickly affirms. “Getting a taste of success along the way is critical to being able to stay at your learning edge. It’s the fuel that keeps you hungering for more, building our tolerance for the failures that are an inherent part of deliberate practice, and the feelings those failures evoke.”

Smiling, Tom quips, “All work and no play makes Tom a dull boy?”

“More like it makes Tom likelier to give up, and that’s no good.”

“That thought has crossed my mind more than once today,” he replies.

“And that’s super-important feedback for us, Tom,” I respond, “because it means that we’re failing, that we need to change how we’re working. Set up the tasks differently. Break them down even further and provide more concrete guidance and support.”

In that moment, I remember how Scott interacted with my old clinical team back in Vancouver. He was always the first to take responsibility whenever any one of us started feeling overwhelmed by the learning process. He’d acknowledge, apologize, and then work to keep people engaged at a level that they could tolerate. At the same time, he fostered a culture of openness and joy when we struggled. “That’s where growth starts,” he’d say. “It’s the meat and potatoes in the stew of deliberate practice.”

Suddenly, Tom gets to his feet. Scanning the group, he asks in his best southern drawl, “So which one of you cowpokes is gonna learn me to roast this marshmella’ ry-aht?”

Beyond the Bubble

McGinnis Meadows is a little slice of heaven. Time there goes by so quickly. It always seems as though I’m packing my bag to leave only moments after arriving. Part of it, I’m sure, is the fresh air and wide-open spaces. The near total disconnection from the rest of the world also contributes. Cell phones don’t work. The internet can be spotty. And there’s no TV. Then, of course, there’s the horses. What can I say? Like us, they’re wired for connection. The purity of that bond is what brings me back again and again, and it’s what visitors say is most memorable about the experience.

That said, the ranch is a bubble. The magic that occurs there takes place in isolation. What happens to most after they leave is about what you might expect. On surveys participants complete at the end of the training, nearly all describe the experience as transformative. And yet, some follow through, others struggle, and a handful fall off the radar completely. Given our small, self-selected sample, we can only speculate as to the reasons. What can we say for sure is that desire explains nothing. Everyone wants to improve their attunement, responsiveness, and outcomes.

We’ve identified three qualities that appear to characterize those who stick with the process. First, they’re more intentional in their efforts to put what they’ve learned into practice. If they haven’t done so before the training, they access the measures Scott developed, and begin them to monitor the quality and outcome of their clinical work. If they were already using the tools, their interest in mining the resulting data for professional development opportunities increases.

Second, they embody a “growth” versus “fixed” mindset. These two concepts, introduced by psychologist and researcher Carol Dweck, are simple. The degree to which people believe effort is associated with improved performance predicts how long they persevere, how much they learn, and what they achieve. Conversely, those who attribute success to fixed qualities (e.g., luck, genetics, talent, level of achievement, or physical, emotional, or intellectual capacities) are likelier to give up when pushed to their learning edge.

Of course, each of us exists on a continuum, depending on the context and nature of the learning task. Most intriguing in this regard is the impact that others can have on our mindset. In a series of experiments with kids, she and her colleagues showed how a single word can trigger a shift, literally disabling the children in their problem-solving efforts. Awareness of this phenomenon has made us exceedingly mindful of how we develop and execute exercises at the ranch. After all, it’s so easy to trip people into focusing on how they’re doing and what others think of them—two qualities of a fixed mindset—rather than on what they’re learning. Key is distinguishing between when people feel overwhelmed versus uncomfortable, the latter being a sign that they’re at their learning edge.

Third, they have a system of practice. In their new book, Better Results, Scott Miller, Mark Hubble, and Daryl Chow note, “Deliberate practice is not an activity that can be left to chance or choice. Rather, to be effective, it must be the default option.” As a way of integrating deliberate practice into one’s daily routine, they propose a framework known by the acronym ARPS.

“A” stands for automated. Like making coffee in the morning, practice needs to be done without having to think or plan.

“R” is for reference point. One of the most common challenges people encounter when deliberately practicing is diffusion of effort. Simply put, it’s easy to get distracted and lost, making it hard to see whether progress is being made or not. Returning to your results on an ongoing basis is a powerful antidote. In a brand-new study of real-world clinicians, Jeb Brown and Christoph Cazauvielh found average therapists who are engaged—as measured by the frequency with which they log into a computerized outcome management system to view their outcomes—end up over time being significantly more effective than their peers.

The “P” is for playful experimentations. In the words of Miller, Hubble, and Chow, “Think like a child. . . . Instead of trying to ‘get it right,’ experiment; instead of focusing on performing, play.” It’s what coming to the ranch is all about: having the chance to engage in experiences offering lateral opportunities to learn.

On a personal level, I’ve recently taken up boxing. I’m sure it’ll come as no surprise that avoiding being punched in the face is a great motivator for becoming sensitive to what others are doing, or are about to do! Also, my newly rescued pitbull, Loki, and I are taking obedience classes together, using our regularly scheduled walk times to practice and make small adjustments based on his responses. In all, my experience has been that as soon as I start looking, the number of opportunities to play with learning soon exceeds the amount of time I have available. With the right intention and focus almost any activity will do: music, theater, art, cooking, and dance can all work.

Note, learning a new treatment model is not on the list above. The temptation to follow this course of action is understandably hard to resist. As humans, we’re always looking for a better way. On this score, the similarities between the fields of psychotherapy and horsemanship are striking. Emphasis seems almost always to be placed on having the right tools (assessments, treatment techniques, etc.) or tack (riding boots, saddle, bridles, bits, etc.), rather than on possessing the “right stuff.” Claims and promises notwithstanding, the evidence is clear: tools and tack do not a therapist or rider make. They do, however, offer a novel and attractive alternative—or perhaps distraction—to the drudgery of deliberateness.

The fourth and final component of a system of practice has already been mentioned, support. Put simply, those who succeed surround themselves with people and resources that help sustain their efforts to improve. By contrast, going it alone almost always leads to giving up. I’m surprised how few practitioners reach for the top when identifying and choosing a mentor. Convenience, rather than expertise, seems to be the primary driver. That’s a mistake. Be courageous and take a risk. So little is lost by asking.

A Final Word

At this point, I’m certain I could recite this entire article, word for word, by memory from start to finish. We’ve written and rewritten in an attempt to convey “the feel” necessary to better attune with our clients. Still, I continue to worry whether the directions provided are sufficient for others to follow in their efforts to improve. It’s abundantly clear the field of psychotherapy lacks the type of training experiences necessary to likely foster the development of relationship skills. The data leave no doubt. We must change. The secret is in me and you, us—the way we each work with particular clients at particular times. I’ll leave it at that, hoping I’ve been clear enough to help deepen the connections we each make with those we serve. In the meantime, you know where I’ll be. Maybe you can even join me at McGinnis Meadows.

 

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Scott Miller

Scott D. Miller, PhD, is the founder of the International Center for Clinical Excellence an international consortium of clinicians, researchers, and educators dedicated to promoting excellence in behavioral health services. Dr. Miller conducts workshops and training in the United States and abroad, helping hundreds of agencies and organizations, both public and private, to achieve superior results. He is one of a handful of “invited faculty” whose work, thinking, and research is featured at the prestigious “Evolution of Psychotherapy Conference.” His humorous and engaging presentation style and command of the research literature consistently inspires practitioners, administrators, and policy makers to make effective changes in service delivery. Learn more at scottdmiller.com.

Brooke Mathewes

Brooke Mathewes,  MEd, is a Canadian-born, Chicago-based therapist.  She specializes in working with people struggling with eating, substance use, cancer, and chronic pain problems.  Each year, together with Scott Miller, she leads a three-day intensive training for therapists at McGinnis Meadows.