ACT for Critical Feedback – Reflections

Dear APP Leadership Group,

Thank you again for inviting me to present this morning! I very much appreciate all of the interaction/feedback, especially by zoom at 7am! If you’d like to sign up for a Course, check out our 2023-24 dates here!

A few things stuck out to me…

1. Giving feedback to supervisees (especially less-that-glowing feedback) is HARD! I realized this before…and…it just really struck me as we translated the particular process into the language of MVP and the 3 E skills. That being said, it really is “just” talking to another human, with all the attendant worries, challenges, and joys.
2. I think the MVP model works well. I’ve been claiming for years that MVP it really about talking to people, not “just” patients, and so really works in essentially any situation…and…it’s gratifying to see it in action!
3. We all struggle with this and we do so for very similar reasons, regardless of the setting. Indeed, we had about 30 people gathered this morning who all struggle with this task to one extent or another. It’s worth naming this as a common struggle lest anyone out there think they struggle alone!

Some particular challenges that were suggested by the group include when supervisees are…

1. …unrelentingly resistant. We played this one with Jill (played by our always-wonderful ACTor MJ!) and ultimately I was (be) Explicit and named the behavior along with how it was making me feel. It went something like, “I can see this is hard to accept, maybe even impossible. This is making difficulty for me to feel like we’re on the same page.” Moral of the story: If it’s “in the room,” name it! This gives the other person a chance to either respond positvely or show his/her unwilling/inability to do so. If the latter is true, and persistent over time, then we may be led to the conclusion that the job simply isn’t going to be a good fit for the supervisee.
2. …a friend. Yikes! This is one we didn’t have time to roleplay…and it’s one that really deserves attention. Indeed, even more attention that we have time/space for here. My brief recommendation comes in a series of steps: 1) Ask yourself, “Is this something I can do?” If “no,” then explore alternative arrangements. If yes: 2) Talk to your friend! No doubt your friend is feeling a little strange about this too (if not, s/he should be!). Can the two of you do this? If no, see above. If yes: 3) Be (very!) Explicit about expectations, boundaries, etc. Even more so for typical supervisees, it is imperative that you are able to fulfill your role as supervisor, both for your own sake and that of your friend. It is also of at least equal (arguably more) importance that you can also fulfill your role as friend. I know it possible to balance these roles, having been in the friend-supervisee role myself. And…adding the supervisor-supervisee aspect to our preexisting friendship did, in fact, change the nature and “feel” of our friendship. Honestly, it was hard…and…in that particular case our friendship grew stronger. This was not, however, a preordained outcome. It can, and sadly often does, go terribly wrong, fracturing friendships impacting employment. This a risk. It may, or may not, be one worth taking. Last bit of advice…don’t do it alone! As the supervisor, make sure you have your own mentor/supervisor with whom you can check in, obtain guidance, etc.

There was much more, all of it excellent! Thank you again for the opportunity!

-Tom Carroll

PS – A question proposed after our session yesterday: How do you handle staff with professionalism questions, this stems around staff not answering emails in a timely manner or doing their mandatories when due etc. Again this is tough esp when a person is a good clinician but then does not complete the niceties or the basic requirements of the job.  

Ah, a good question! The short answer is, “use MVP and the 3 E skills” =). One might reasonably ask…”Great…how?” Maybe something like, “You’re doing a great job with patients, nicely done…and…I know this keeps you very busy. One thing that can fall off the list is email, ___ and ____. As much as emails and the like are annoying, they really do need to get done. What sort of things are getting in the way for you?” Hopefully starting off with something like that will open the door for an honest, empathetic, and collaborative discussion focused less on “bad behavior” and more on problem-solving.