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CBT Coaching Techniques

 

Rabbi Joshua Ritchie MD   •   November 16, 2014

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CBT Coaching Techniques

 

Before I go further, I have covered a few decades and a few schools of counseling, coaching and therapy in a bit of a hurry, so let me pause for a moment and give people a chance to ask a question, if they’d like. To unmute yourself on the phone, it’s *7, and to unmute yourself on WebEx, you go to the mute button by your name. And to remute yourself after…oh really…apparently we have quite a large number of people on which is great. Thank you for joining us. So if anybody has a brief comment or question…

 

Voice: Actually you can’t actually see the video because there’s over twenty-five people.Ritchie: Yeah, video, we only have a limit of twenty-five, so the rest of you can join the phone. Those of you who can’t join by video can join by calling in the phone number that we’ve sent out.

 

Man 1: Hello, professor?

 

Ritchie: Yes, hello.

 

Man 1: It’s Hashid speaking. I want to join you this morning, and I just wanted to speak up to say I’m here and enjoy hearing the description of coaching all over again.

 

Ritchie: Yes, thank you. Did you have anything you wanted to comment on or add or question?

 

Hashid: I very much like how you put it. I like how you broke up therapy and coaching – the way you’ve combined all of these aspects in coaching, and I think you put it well.

 

Ritchie: Yeah, thank you. Actually, I did discover something recently when reviewing the history of solution-focused, I was wondering it isn’t more well-known in the cognitive behavioral world because it’s very similar and it’s got some improvement on it and some of the things have come back into it. You see solution-focused in the cognitive behavioral world, but you don’t see it quoted by article or by name, and now I’ve finally discovered why. Most of the developers and most of the workers in the solution-focused therapy and counseling and coaching world, were trained, originally, as social workers, and so, most of their stuff was published in the social work literature and so people who work in social work read social work literature and people who work in psychology and psychotherapy, the psychologists read their literature and psychiatrists read theirs and it’s surprising how little people read other specialty’s literature.

 

As a matter of fact, one of the other interesting things, again quoting Shahad (very popular lecturer from Harvard), he says of all the articles that are published in various psychological journals, for instance, only the average number of readers of a published article, is hard to believe. Everyone has to publish articles if they want to maintain their university positions or advance or get tenure and so on, so everybody has to publish a lot of articles, so everyone’s researching and publishing, the articles that they publish in these big journals, famous journals that get them their professorships are read by an average of only 7 people. Actually read the whole article. Other people just read it by the title or the abstract but actually read the article in its entirety is only an average of 7 people so it’s amazing how little people even read their own literature, much less they certainly don’t read the literature of other related specialties, commonly. Where there are some people who do, like myself, but people who are immersed in one specialty, don't’ cross boundaries, don’t do enough interdisciplinary work.

 

Woman 1: Dr. Ritchie?

 

Ritchie: Yes.

 

Woman 1: I’d like to ask a question.

 

Ritchie: Yes, who’s speaking?

 

Woman 1: This is Rachael from Jerusalem. I’m listening carefully and I’d love to know where you got your coaching training.

 

Ritchie: Oh, it’s been a mixture of places. First of all, if you want to know who I am, it goes way back to the fact that I was a physician. I graduated medical school at the University of California – San Francisco way back in 1962.

 

Rachael: In psychiatry?

 

Ritchie: I’ve done psychiatry. Medical school is far as medical school – we didn’t go through my whole field. I’ve worked in psychiatric hospitals and have worked in psychiatry, yes.

 

Rachael: You did a residency in psychiatry then?

 

Ritchie: No, I did not do a residency. I did work in psychiatry as a medical director of a psychiatric hospital. I did various things in the medical world, and I’ve taught in various medical schools and a lot of what I was teaching doctors was doctor-patient communication and how to work and communicate with patients. I did work with psychiatrists in the psychiatric hospitals doing the medical clearances and evaluations with the patients, so I worked very closely with psychiatrists for a number of years. I also learned techno therapy many years ago and became a hypnotherapist – way back in the 80s, I think it was. There’s a lot of steps in it but a lot of the coaching that I learned was not just in the medical field, so I learned techno therapy and neurolinguistic programming which was, as I said part of the foundation of what became solution-focused therapy, but I also think I learned as much, actually more, in a sense by when I was privileged when I came to Israel to become a disciple and a ben bias who would see dozens and maybe hundreds of people a day in Yeshivas and I would spend almost everyday, for the eight years I was with him, I would spend at least an hour a day in Yeshivas, where he would meet with people at Yeshidas,

 

I got to sit in as an observer, which was a unique special situation, rarely did people ask but it was a bit strange that someone would be sitting in on their private conversation at the yeshidas. There would be times that someone would ask, who is that? And he would casually say, oh that’s the doctor. Isn’t that splendid? We never actually discussed cases, but I got to observe by shimus as it is called in our tradition – by getting to see how he counseled and coached people. And later as I learned and coaching became a career and became a specialty, I started learning coaching about twenty years ago – as I started learning coaching, I got to see, oh wow, that’s what he was doing, so I’ve studied not only all of the things I have talked about like cognitive behavioral field and the solution-focused field but the coaching, which is sort of developed on its own, but coaching and positive psychology are really two parts of the same coin.

 

They are all in a sense overlap and synergistically integrated – being as my whole approach, as many people is, to be eclectic, I don’t believe in being a doctrinaire purist in any one of these approaches to how to help people so as a eclectic person, I’m looking to take the best out of the various approaches and schools and techniques and methods, so based on what I’ve seen by Torah greats, like the dozens of rabbis I was privileged to meet living here in Jerusalem and being introduced to them, whenever the rabbi used to visit the other thadiki, he would take me along as, supposedly as his driver, which was wonderful. I got to go in and visit with the other rabbis, so again, I was privileged to sit in while he was meeting with – whoever he was meeting with – I got to join in on those sessions.

 

Rachael: It would be amazing if you wrote a book about that – I’m sure many people would love to read about your experiences. Do you ever plan on writing a book?

 

Ritchie: I’ve thought a lot about it. I’m glad you raised the question – what I would need to do it would be I’d need an editor. I could very easily do it, but writing takes me a great deal of time – it’s very laborious. I publish medical papers, and that’s how I got spoiled. You perfect a medical paper by drafting and redrafting maybe fifty times, I’ve published in the New England Journal of Medicine, the American Medical Journal and places like that, the JAMA and so on. There you don’t just casually write for like a book, so my writing is distorted by that. I can speak, as you see, so if I could dictate my memoir, so to speak of these people and if someone could help me re-edit it into book form, I’d love to do that, so if any of you listening can do that or know somebody who can do that, I would very much love to. The rabbi’s daughter has been encouraging me to do it, I would love to do it, I think it would be a great service, and I do think it would be something that would be good for me to do, but I would need help to accomplish it.

 

Rachael: Can I ask you again though? Did you ever get certified any place? Did you go through a coaching school? Or mainly what you’re teaching at your school is basically what you’ve brought together from solution-based therapy and NLP and etc. or did you actually go through a coaching program and you’re putting in some of that in your program as well?

 

Ritchie: Well, I never enrolled in somebody else’s program. I did train with some coaches, one of them is on our faculty, Stewart Hirsch, who’s an executive coach, and he and I have been working together for twenty years. We’ve been coaching each other. I have read, I think every book on coaching, I’ve read most of the books on all of the things I’ve talked about. I have a library of about a thousand books on coaching, cognitive behavioral, solution-focused etc., over a thousand books, that I’ve read, and I’m very good at reading and incorporating it, so I’ve been practicing…

 

Rachael: You worked as a coach?

 

Ritchie: Yeah, I worked as a coach. I don’t spend that many hours a day at it because I’m busy coaching our students. I think my job is to coach our students and our graduates but I do see a few private clients or talk to a few private clients, a lot of them on the phone, but I am more dedicated, and I have been my whole life, as teacher positions and medical personnel and now of coaching and counseling for about the last twenty years. We’ve been teaching counseling, I founded the Refuah Institute twenty years ago, we’ve been teaching counseling for over fifteen years and coaching for about ten years now. My certification is through AAPC – which is some group I have been working for ten years now – it’s the American Association of Professional Coaches. And you? You sound like you might be a coach…

 

Man 1: Hello, professor?

 

Ritchie: Yes, hello.

 

Man 1: Hi this is Yonkles. I just wanted to give you a little advice about editing. I do myself publish books, and the first thing is just to not get lost – you should sit with friends and family and speak into…

 

Ritchie: Let’s not take people’s time…and if you’d like to give me some advice, then…yes, it’s good advice, thank you, I appreciate it.

 

Man 2: Hi, it’s Maffy. You were talking about how coaching can help depression. What is the reason for why so many more people are depressed nowadays than in the past?

 

Ritchie: I’d really not rather try to do that now. It’s a good question but I don’t think that’s the scope of this evening – or morning for people in the states. We can talk about that at some other point, but it is a common problem and it is something that can be easily dealt with and I’d rather, than theorize about the causes, I’d rather help people learn how to help people out of depression.

 

Maffy: Right, very good. Thanks.

 

Ritchie: And I think a lot of people spend too much time trying to make up reasons for what causes it, and rather than focusing on the problem. I’m very much from the school that I want to focus on the future and not messing around with why and so on, I’d much rather talk about what we can do to get out of the depression and what we can do to not only get out of depression but to also come to a state of successful fulfillment and really reach our full potential and achieve what we want to achieve and have our quality world, our preferred future that we don’t stay stuck either in depression or even in mediocrity and that we help people accomplish all that they are capable of accomplishing and that God created us. God gave us all talents and abilities that we don’t usually fulfill and coaching is to help people fulfill more of their God given potential. If you’re depressed, you don’t fulfill your potential, and we want to bring them back and you can only be really inspired if you’re in a state of joy so we have to bring people out of their depression and bring them to a state of joy.

 

Maffy: And just focus on the moment, you’re saying.

 

Ritchie: Yes and get back in touch with their good moments and their ability to be in good moments and ability to be happy and help them envision a positive future, part of the problem with someone who’s depressed is they don't have the ability to envision a positive future and there are ways to help them do that.

 

Maffy: Because they’re always looking at the past…

 

Ritchie: They’re looking at the past and stuck with their problems and stuck in negativity and one of the things that we know and what we learned from NLP and various other schools is that there’s such a thing called state bound memory. Depending on our emotional state, when somebody is very sad, they only think and can only remember sad parts of their life, and to remember happy times and successful times, you have to work at helping them do that because they’re stuck ruminating from one negative thought to another so if you can start helping them by asking them, can you remember any one little success that you’ve had or can you remember any other time that you’ve had trouble and you overcame it or can you remember any strength or resource that you’ve used to get out of your negative state and/or your unsuccessful state?

 

Once they begin to any one little glimmer, you have them expand or expound upon it. You have them tell you more details in how they succeeded in overcoming a difficulty – how they succeeded in overcoming a sad or depressed state or a trial or tribulation. Almost all of us go through crises – it’s a normal problem to go through crises – it’s one of the things I didn’t mention in my development of Refuah – we developed a crisis training center here in Jerusalem about fifteen years ago. We trained over a thousand people in crisis training, and we ran a crisis hotline for about seven years, so crisis is something that happens to normal people – on the average about once every two years. Crisis means that they are temporarily disturbed and disabled – they go through depression, confusion, they’re overwhelmed, they don’t cope, they can’t prioritize, they’re disturbed both in their emotions, in their cognitive thinking abilities and in their physiology – so that’s a normal phenomenon.

 

If somebody loses a loved one, if someone loses a job, somebody’s injured, they go through what we call a crisis or a key to anxiety reaction, they sometimes call it, in psychiatric terms. In the crisis and counseling world, we call it acute crisis – that lasts for usually – people usually recover in a month to two months. If they don’t recover in the normal one to two months, then it’s called post-traumatic distress disorder, so that is a normal phenomena and a lot of people will start coaching because they start going through a crisis. They’ve been successful but something overwhelming hit them, they lost a job, they’re losing money, they’re going bankrupt, somebody gets sick, somebody gets injured, whatever it is that there’s a dramatic, traumatic shift in their life, and they’re not coping.

 

Then they’ll need coaching or crisis counseling but as a good coach, in our program, you’ll learn to be a crisis counselor as well, and one, you can get them through the crisis, and two, you can not only bring them out of the crisis and back to the normal state, but you can even carry them through to even a better place because once you’ve gone through a crisis and you’re confused and overwhelmed, you can go one of three ways, you can return to normal, you can stay stuck in a post-traumatic stress for years, or you can come out stronger and especially if you have a good coach, you can come out stronger because do you not only recover but you can even learn from it and you can coach them to get even more successful, more strong, more resourceful, more capable than even before the crisis because we’re empowering them to use all their resources and skills and the next time they face a crisis or a challenge, they’ll handle it even better because they’ll have learned more coping skills and more of their own internal resources and more how to use external resources that are available to them – so the overlap is again there. A good coach should be a crisis counselor.

 

A crisis counselor should be able to use coaching skills and some cognitive behavioral skills and help get them some NLP skills to get the person into a different state of mind and get them out of their negative, depressed, confused state of mind and help restore them by remembering how they transitioned previously from that overwhelmed to successful coping. Once they begin to remember that, you can see right in front of your eyes, that transition. I’ve had a number of patients and some of them very vividly remember how they came to be really overwhelmed in real crisis – they couldn’t function, they couldn’t work, and within an hour, by getting them, sometimes in seconds, by asking them, have you ever gotten through a crisis before? Have you ever had a difficulty you came through?

 

And then, they start remembering a few years ago, this and that happened to me…and yeah, what I did was…and as they remember what strengths, what they did, what resources they had, as they start to recall it, then you can keep asking to elaborate and describe it and they tell you, yes, then I did this and I talked to that person and then I tried that and then I got a little better then I got stronger then this happened, that happened, and before they’re finished, their whole being is changed from someone who came in very confused and depressed and anxious to somebody who’s excited and looking forward because they’ve restored their confidence and they’re now ready to use all of their resources and skills that they’re now back in touch with. They had just temporarily lost it. They were overwhelmed and in this negative state, but by reminding them and getting them back in touch with their own previous skills, they then can reclaim them and use them.

 

It’s very dramatic – it’s very beautiful – it’s something you can watch right in front of your eyes. I’ve helped people overcome traumas – there was once an eye surgeon who was sent to me, where he hadn’t been able to go into the operating room for two years, and he was scheduled to assist at a surgery the next morning. So what I did with him was I didn’t ask why and when he stopped going into surgery, I just helped him remember how he used to successfully go to surgery. In a semi-hypnotic state, in a mild NLP trance, I walked him through it and did a rehearsal in the theater of his mind, had him imagine his going to the hospital, putting on his scrubs and his gloves, and going into the operating room and then sent him home telling him he’s going to wake up in the morning and he’s going to go do this and indeed he did and continued the rest of his career. So in one lesson, in an hour session, overcame his inability to go do work in the operating theater.

 

There are ways to help people get back in touch with their coping skills and their competencies that are really almost miraculous, and that is something that’s not that hard to learn. It does take time and takes practice and takes a certain type of want to help people. You have to be an empathetic, compassionate, respecting person, you have to be what it says in our Torah sources that seek qualities of a good Jew. They can be very respectful, they’re not commanding authority and commanding people what to do. They’re respectfully guiding people, and that’s one of the big strengths and secrets of coaching – that you’re empowering people – letting them learn to use their skills rather than our telling them what to do. We help them discover their own strengths – now that takes quite a skill, but it’s better than telling them what to do. Much better. Much more permanent, much more effective, much more powerful.

 

It actually works – they can use it, they own it, they can use it for the rest of their lives. So as the story goes, rather than feeding somebody everyday a fish, they’re hungry, they don’t have to keep coming back to you if you teach them how to fish. So we want to teach people how to cope and how to use their resources and their skills and how to make them realize there are more choices, more broader choices, and make better choices. Once we’ve coached them how to use their resourcefulness and their skills in making better choices, t hen they’ll be less dependent on us. That doesn’t mean we can’t still coach them when they want and need it, and some people very much appreciate and use coaching on an ongoing basis but we’re not looking to make them dependent. We’re looking to empower them.

 

Woman 2: Professor Ritchie? This is Connie Burger.

Ritchie: Oh hi, Connie!

Burger: If I may, I’d like to say a word to the group that’s listening.

Ritchie: Oh yes, please, thank you.

Burger: My name is Connie Burger, and I’m a Refuah graduate, I do coaching and counseling, and I just want to tell the group that’s on that coaching really does work. Refuah Institute gives a phenomenal coaching course, and people that come out of the course are really well trained, well educated and really do a good quality job helping people. If anybody has any questions about the course, I want to make myself available. My interest is because I want to have more people get proper training because I want the clients to get proper help, so anybody has any questions, you can contact me, and I highly recommend this course.

 

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