Building Therapist Expertise with Dr. Tony Rousmaniere

Dan and Dr. Tony Rousmaniere, President of Sentio University, continue in part 2 of the conversation.

In part 2 with Dr. Rousmaniere, they discusses the intersection of AI and therapy, the challenges of establishing a new therapy school, and the importance of continuous improvement in therapeutic practices. Dr. Rousmaniere emphasizes the need for therapists to engage in deliberate practice, fostering a culture of vulnerability and openness, and the significance of accountability in therapy. 

🎞️ Video version of the show@PsychotherapyAppliedPsychology on YouTube
🛜 Check out the website: Listen to every episode on your podcast player of choice

Connect with Dan
☏ Leave a voice message on Speakpipe
🔗 LinkedIn
📬 TheAppliedPsychologyPodcast@gmail.com

🦋@danielwcox.bsky.social

Chapters

• 0:00 Introduction
• 1:05 The Role of AI in Therapy
• 3:00 AI’s Impact on the Therapy Field
• 6:00 Founding a New Therapy Training School
• 13:00 Sentio School Structure & Practicum Model
• 21:30 Challenges in Therapist Improvement Post-Graduation
• 25:00 The Cultural Shift Toward Deliberate Practice
• 29:00 Implementing Deliberate Practice in Real-World Settings
• 32:00 Identifying & Developing Micro Skills
• 36:00 Addressing Criticism & Barriers to Adoption

Transcript

0:00

[Music] Broadcasting from the most beautiful city in the world, I'm your host, Dr. Dan Cox, a professor of counseling psychology at the University of British Columbia. Welcome to psychotherapy and applied psychology, where we dive deep with the world's leading applied psychology researchers, to uncover practical insights, pull back the curtain, and hopefully have some fun along the way. If you find the show useful, it'd be much appreciated if you shared it with someone else who might enjoy it too. Today I can be more excited to welcome one of the world's authorities on how to become a better therapist. In this conversation, we dig into the role of AI and therapy, my guest's amazing experience establishing a new therapist training school, and what might be the most important thing that we can do, which is to change our culture around therapist training and improvement. I had so much fun having this conversation and I really think that this guy and his colleagues are on to something, and a large part of me thinks that we need to blow up traditional training models and target deliberate practice ideals that these folks are espousing. This episode starts with my guest talking about how people are using artificial intelligence as their therapists. So without further ado, it is my pleasure to welcome back my very special guest, Tony Ruminier.[Music] I am staying optimistic. If you were to Jevin's Paradox. Huh. Jevin's Paradox is a term that refers, I think it goes back to when the steam engine was originally developed. And there were all these concerns like oh my gosh, they're making all these machines that are part of the industrial revolution, and they're going to take all these jobs away from human beings. And there was going to be no jobs left. And while there was a period of disruption that went on for a little while, what they found over time is actually a hundred times more jobs were invented. It's kind of like when the internal combustion engine was invented, it did put a lot of the horse-drawn carriage riders out of business. But then there's all these taxi companies and bus companies and transportation companies. And you know, there's a hundred times more jobs are created. I think that will happen from AI. I think Chatchy BT and the other AI providers will actually provide enough limited emotional support to get people open and interested in the idea therapy. And then I think human therapists, I even have to qualify therapists as human. I think human therapists will be on a treatment team with AI therapists. And AI will provide things that we can't provide, like being available to am, like being available seven days a week for almost free. And then the human therapists will provide the thing that I can't provide which is being human. Bright, alright, yeah. So, since we sort of, there are a couple things I want to get to. Sorry, I took this off on a ticket. No, this is great. I have a ton of questions. I've asked almost none, but I feel like it's a scrap. Yeah, okay, so I want to get back to sentio. But before we do that, what we've, no, let's do that real fast. And then I want to get into, we've talked a lot about training. I want to get into more for the people who are already in practice. But so let's hold off on that if that's okay. And let's get back to sentio real fast. So, okay, I totally get this as like the idea of it. I totally see the importance, the value of it. But actually putting into practice, there's a big, there's a chasm between, this is a great idea. We have some people who could facilitate it to actually making this happen. So I'm just curious. Like how did you get, I mean, frankly, you had to get funding for it, which was huge. And then I'm sure there are a lot of people who put in a lot of effort on the front end with no financial remuneration at all. Correct. So like, okay, so you had to have a group of people who are really motivated. Let's just just, let's just put that to the side because you just had to have that, right? Like how did you get funding for it? Why did you decide California? Which has to be the worst state in the nation in terms of bureaucracy and red tape for both becoming licensed for, I'm sure it applies to their education system as well and becoming it. Like, and then why MFT? Like, you know, sorry, so that's my rambling. I'll summarize that. I could talk about this for hours, but it would be important. I'm sure. You know, everyone, but I'll say what we discovered is that it is effectively not allowed to start a new therapy graduate school in any state except for California. Really? Yeah. Now they don't say that. I would never guess that. They don't say that. It's not like there's a law you are not allowed to start a new graduate school. However, every other state except California says, if you want to run a graduate school, it has to be accredited by a national accreditation agency. And you can only get accreditation if you've been running for three plus years. So in effect, you're not allowed to start a new graduate school. And it's just not it's just not allowed. And the only state that lets you do that is California, you can get approval from the California regulator and they will let you operate. And we so we got approval from them that which I'm sure was an insane amount of work. About 500 pages of paperwork and it took about two and a half years of mostly waiting and we got that done. And now we're operating and now we're going through the accreditation process which will let us operate in all the other states. So that's like accrediting it as an educational institution? Yeah, we have approval in California and we are in the process of getting accredited for all the other states which is it's designed to be a long process. The first stage takes it approximately three or so years. The next stage will take approximately five years. So the whole thing will be over 10 years before we're fully fully accredited school. So our current students currently we only accept students who want to work in California. Is it brick and mortar? No, it's a mix. It's hybrid. So we have online courses and then we have in-person residencies which are these intensive week long residencies where students meet. And so it's a mix of the two. Okay, okay. So they're doing that a lot of their practices and stuff online. Yes. And a lot of all the client sessions are online as well through the Centio Counseling Center. Centio Counseling Center is our online clinical practicum site also known as an internship. We're students see psychotherapy clients that are adults. We specialize in serving clients with trauma and we provide very low fee accessible therapy for people who who frankly couldn't afford therapy otherwise. Where do the names? Oh, I'm sorry. Go ahead. Yes, go ahead. I was just going to ask where the name Centio came from. Centio is Latin for to think or perceive or feel. Okay. And we just thought it was a good name. Yeah. So then why MFT instead of... So I mean this gets pretty thick in the weeds but each professional association has their own rules and various requirements and not going to think we felt that the MFT degree would grant us the most flexibility to... can I be blunt? It would grant us... If someone is listening from another professional association please fast forward 10 minutes. Don't listen to what I'm about to say. But the rules for most of these professional associations are heavily focused on paperwork. It's likely accreditation rules. They're focused on proving effectiveness by measured in inches of paperwork. And as you know you're going through their accreditation paper process. Oh man. Oh you're... It's very well-intentioned. You know it's the great people that have very good intentions and it does not do its job. It does not show... You have schools that students will complain or crappy schools and they are fully accredited in every possible way. And because we all know if you just throw enough money at lawyers they will get you accredited. Like it's just a paperwork in. And I hate to say it but it's the case. We don't want to just be accredited. We actually want to provide very very effective training for our students. And we thought the MFT degree had the most flexibility to let... Because we're doing things in an unusual way. We are... If you look at the slides for our classes there's a lot of emphasis on skill reversal. We're typically there to be more didactic lecture and you know academic stuff. Now we do have academic stuff. We have very rigorous you know there's reading, there's writing, there's exams, there's all the traditional academic stuff. But we thought the MFT degree would let us most focus on clinical competence. And then over time we will add a counseling degree, we'll add a psychology degree, we'll add a social work degree, that kind of thing. So as much as you feel comfortable talking about this, how did you get the money to do this? We are fortunate to have found a generous donor who cares a lot about this cause and understands our mission. The donor has kind of started us out with enough seed money to... We have a runway for a number of years. So we could go for 10 years before getting... Which is what we think it will take to get fully accredited. And you know over time school generation revenue, we're already generating revenue. So you're already in the black? I wouldn't go that far. I wouldn't go that far. You know where it's start up we're new. We're doing better financially than we expected at this. Yeah I wouldn't expect you to be clear. I would think that would take quite a while to get there. Yeah it's... We have 10 years to get there. I think within five years we're going to be more than in the black. So we might even be there next year. In part because we're part of the reason we're online is we're keeping costs low. We don't have a big facility that we have to pay janitors to take care of it and all that kind of stuff. But we are a nonprofit where 501C3 nonprofit, which in America means the tax deductible nonprofit. And so we do receive donations from people who want to support our calls and then get a tax deduction. Okay. Okay. Wow. And the same with our clinic. Our practicum site is a tax deductible nonprofit, a community mental health center as well. Okay. So we've talked a lot about training. Yeah. In the people are in graduate school internship. That sort of framework. What about... When you're training, there is a program. There is some infrastructure designed to... That has resources to set you up and do all these things. But then when you're out in the real world, most people either in private practice or working for an organization, they don't... Any infrastructure they would have to create themselves. Or it's just... How do you conceptualize this... Or I mean, conceptualize isn't the right word because the conceptualization of what the liver practice is is the same. But actualize it or help people actualize it in the real world. Can I be blunt? Yeah. It's very hard. Yeah. It's very hard on multiple levels. On one level, therapists are at the most basic level. Therapists are paid for time in the chair. We're not paid for results. If you're in private practice, there's a little bit of paid for results. But you have clients stick around for 20 years who aren't even getting better. And so even in private practice, the results is loosely connected with the pay. If you work for a large agency, you're definitely not paid for results. You're just paid for time in the chair. You're paid for the service delivered. And so there is a fundamental alignment problem in terms of incentives right there. Second of all, if you work hard to get better, the license board doesn't care. When I got licensed, 100% of my clients that I'd seen in my practice could have deteriorated. As long as my supervisors sign my paperwork, I would get licensed. I could have sent them my outcome data. They would have been like, why are you sending us? We have no idea what to do with this. Imagine in baseball, hiring players without seeing their scores. This is fantastic. Imagine hiring an artist without seeing their work. Imagine hiring a pilot without like, I mean, it's unthinkable, right? Like theoretically, even CIA operatives working under deep cover, someone somewhere has notes on their performance in a honey, not therapists. There's no record of performance in any way. Right. I think anybody who's taken the E-Triple P knows that like, you know, if E-Triple P is anything, it's a measure of IQ conscientiousness. But you know, I'd love to test preparation. Yeah, I'd love to see the correlation between that and therapist effectiveness. I mean, yeah, it's completely uncorrelated. It might be negative. It might be negative. If anything, if I was to predict, it would be, you know, nothing or negative. And so, I mean, there's also issues of accessibility, you know, how accessible is the field? Because the more money you have, the more you can, you know, use it for test prep and this, and then the other thing. While if your, you know, low income is harder to jump through all these hoops, we've erected to become a therapist that unfortunately have very little to do with actually being an effective therapist. So, yeah, this is what we are trying to, I don't want to say we're trying to fix this because I mean, that's a big, there's also this culture issue, which is most therapists have never seen themselves on video or maybe once or twice in training. And so, they will go 10, 20, 30 years without seeing their own work. And what does that do? They create a very fragile ego because you're supposed to be good at what you're doing, but you've never actually seen your own work, you've never gone feedback on your work. And so, typically people just get more and more insecure and you'll see this when I go do presentations at conferences, I'll ask for live volunteers for a demonstration of deliberate practice. And I prefer to have trainees. And the reason is, trainees do not have ego around their work. They're trainees, they can show a mistake and they're like, I'm a trainee, I have no idea what I'm doing. But if you have a volunteer who's been a therapist for 20 years, they don't want to show their mistakes in front of a bunch of colleagues, particularly medical residents. If I'm at a grand round, I won't even ask for volunteers. Because there's a culture of you do not show your mistakes in front of other people. Yeah, to develop this whole routine where I show my mistakes so they can give me feedback because it's safer for them. So they get to be the expert. And so, there's a major culture change has to happen in our field. And I think Scott Miller has written a lot about his Rod Goudier, has written a lot about this Bruce Wampold. John Frederickson, there's a lot of people have written about it, but it is not an easy lift. And this culture has to change, site by site by site. Like you said, what if someone's working at a certain site and they want to start doing deliberate practice, they have to kind of art. My advice is to go in, identify other people who will have the same drive and feel comfortable being vulnerable and model it yourselves. Don't ask anyone else to do it first. Model it, show that it's safe, show that it's helpful, and then gradually people will join. So let's say, can I give one more example? So, when I have a new supervision group of trainees, I always start the food superstition group by showing a video of me making a mistake. There I have a video of me, and this is not from when I was a trainee. This is from when I was a licensed therapist. And I just did really bad therapy. I mean, it's hard to watch how bad it is. I was learning a new therapy model. I was screwing it all up. I was focusing on the model instead of the client. And it was just really bad. And the client dropped out. It's not like, oh, it all ended up for the best. The client left. And I showed that video to the trainees. And I say, I want to show you this in part because I don't want to ask you to do anything I won't do. We all show mistakes. It's safe to show mistakes. But also to show like I wasn't a trainee, I was, this will be an issue throughout your whole career. We will make mistakes throughout our whole career. And this is ideally a lifelong learning process we engage in. And so I want to show you this video and I want you to tell me what am I doing wrong in this video. And we spend time with them giving me supervision. Just to kind of create a culture of safety. We call this a failure facing culture. So let's say that I work at a clinic and there's six of us. And the six of us are close and we decide, hey, we really want to do, we read some of your work and we get inspired. And like it's consistent with our ethos and our comfort with each other. And they're, these are people who are truly bought in. And they come to you and they say, hey, Tony, so can you, we really want to do this, but we don't know like we kind of don't know where to start. Yeah. What would you say to them? I would honestly say start in our YouTube site. And it's all free. We're not making any money off this. It's completely free. So this is not, you know, some kind of scam or anything. But here I'll send you the, the link. And the reason I would start here is to see what it's like. And you'll see many people doing many different demonstrations that deliver practice. And so you can kind of look through them and get a feel of what do you want to try? Because there's, there's all these different varieties we've talked about today. Now once in, in look for where are people's motivation, deliver practice relies on inherent motivation. You're not getting paid more to do this. You're not going to get any awards for doing it. You're not going to get a, you know, your clients won't know, no, no, no. So it's got to be inherent motivation. And then pick the method of deliver practice that you want to do and start doing it with people that want to do it. Now we've got a ton of free resources on our website where people can use our resources. We've got the book series, Scott Miller has, stuff John Trezwick sent us. Bruce Wampold has a, a web service called a skill setter, which is great. There's like you can use chat, you can chat, you can chat, you can ask it to, you know, practice off it. But try to do it and then try to show yourself doing it to the other people at the site. So you're not trying to convince them, you're kind of showing them. And model vulnerability, let them see the benefits and give them time. And for some of them, it might be a few months, for some of them, it might be a few years to come around and say, you know, I want to try this. So that, so if you're, if you're the individual practitioner and you're, you sort of want to do this, want to devote some of your time to this, it does seem like one of the plays, although they're not necessary, one of the plays would be to try to find a colleague, either your site or another site, to, to, that you can show, but then perhaps bring them into the fold so that the two of you can work on it together. Yes, highly motivated colleague who ideally is comfortable feeling vulnerable. The thing is, we're all in this together. When I started writing about my mistakes at first, I was nervous. And then I very quickly, and like, look, I'm writing about everyone. We're all making these mistakes. You know what I mean? Like your mistakes might be slightly different than mine, but we're all making mistakes. And we're all nervous about it. And so just to kind of be okay with that. And what we find is that when we start showing our mistakes, everyone's anxiety goes down, because we don't have to pretend to be perfect anymore. I'm thinking too about, you know, the, the average therapist that they have, you know, this would be sort of a conservative way that they would say, you know, every once in a while, they're going to say, oh, I had a session today and it just went terribly, you know? And I think for a lot of therapists, they don't know where to go with that. It just, it just sucked. And like they, they're very self-critical and they're sort of self-critical in the broad, you know, it's a bit ephemeral in terms of what it is that it is that they actually struggled with. So I think perhaps this could, this sort of way of thinking could allow people away to take the session, do their best to decompose what they felt like they're really inept at or really struggle that, identify that and work on that specific skill. We call it growth edge. What's their growth edge? Now, sometimes they'll be able to identify it themselves, but often they will need to hire an expert supervisor to explain what their growth edge is. And that, you know, that cost money, it's not easy to do, but I mean, that's typically how we improve is we hire an expert to look at our video. Importantly, it really should be a video. You know, just, because we're not aware of what we're doing wrong, we can't write down in the notes. But we're, and often when we watch videos with trainees, they're like, oh, I screwed this up. They actually did that for well. They did something else they messed up, you know, and they can't be aware of it. It's not, I mean, if you think about it, if you were a painter, imagine getting better at painting by writing notes about your painting and showing the notes to the professor. And your notes are like, oh, my painting this week, I had a lot of red. And then the green was really thick. Do you think that was a mistake? Like the professor, maybe I got no idea. I have to see the painting. You know. And that's what therapy is like. It's very subtle. It's very nuanced. It's very emotional. And notes just can't capture it. There's no chance. And so, put show your videos to experts and get the feedback from the experts and try to get them to identify a micro skill. Now this can be challenging because many experts are not taught to think in terms of micro skills. They're taught to think in terms of these big concepts. Like have a better alliance or, you know, more congruence and, you know, all that is great. But it's vague. It's not very actionable. And ideally, what we want is actionable micro skills that you can rehearse many times. And so, how do you help people actually figure out when they're watching a session, how to identify the micro skill? We put them through a one-year residency on how to learn how to do it. And what's like this, like, give us just real quick, like, what's the, you know, like the secret? I can't get in control with the words. There's a lot. I mean, the issue is this there's a lot of things that go into it. And that's why it takes a year to, in our experience, it takes a year to really learn how to do it. And because you're not just identifying the micro skill, but you're, you're first of all, resisting the constant pull to just talk instead of rehearse. The training is typically asking you questions about a hundred other skills, which are all very important. And so, you're constantly facing this temptation to be distracted to talk about something else. There's all kinds of other internal processes, which we have to help supervisors deal with. And then you have to figure out how to operationalize a skill, which is often not easy. You then have to work within the student zone of proximal development. If it's too hard for them, it's not going to help, even if it's the right skill. If it's too easy, it's not going to help as well. You then want to give them the right amount of feedback, the right corrective feedback. We found supervisors air towards more positive feedback, like saying, like, oh, this very help, but that's great, they're doing great. That's actually not helpful. We found that training's anxiety goes up with the positive feedback. They're anxiety goes down when the supervisor says, no, you said that wrong. You're sorry to say it right. Because the trainees know they're doing something wrong. They just want to know what it is. And so there's a whole art to feedback that we provide. There's a whole art to how much rehearsal went to move on to another skill. I mean, it just goes on and on. So we found it takes about a year to learn how to do it. And that is interesting. You say that the students will really focus on a lot of other stuff. And that's something that I've definitely found in teaching. Basic skills, of course, I teach. We use the Clara Hill book. And so she has very explicit skills. And we follow the book very much. So they're working very specific things. She's great. Yeah. And one of the things that I do, it doesn't matter how many times I say it in class, they're always saying, yeah, but what about this and what about it's like and I and I tell them and you know, we don't. The grade is not based on how good of a therapist they are. It's like, are they using the skill? That's really it. Are they using the skill? And they it's it's I'm throughout the whole semester. I can't say don't worry about that. Don't worry about that. Don't worry about that. Don't worry about that. Yeah. Yeah. I'm a big fan of Clara Hill is another mentor of mine. We've done research together. And her book is excellent. I'm glad you mentioned that. And look, it's natural that the trainees want to know all these things. Like, of course, I want to know they want to help people, right? They became therapists because I want to help people. And when you're practicing baseball, you know, you want to win the game. You don't want to just practice the one move. But the way you win the game is practicing the hard moves. And so it's frustrated. It's it's challenging. It's much easier to sit there and talk about a hundred other things rather than rehearse. It takes discipline. A discipline that has frankly been lacking in our field. So one thing I wanted to ask you before we end is so we sort of started talking about outcome research. But we've really moved into micro skill. Yeah. Practice. So, you know, some of the literature on like micro skills correlation with outcome is a little bit tenuous or even lacking in terms of the research that's out there or how it's done. I think that some of the responsiveness work that's happening now, I had built styles on and I think he's, you know, one of the leaders in that area and really I think that's a really great framework. But I'm curious about how you approach or think about the the micro skills and their link with outcome because I think we would more or less all agree that at the end of the day what matters is am I helping my client. Yeah, absolutely. So I'm putting another link in the chat. This is every time we see a new study on deliver practice, we put it on this page. And there's been dozens at this time and the research is still preliminary. There have been a number of studies that are showing improved skills with rehearsal with deliver practice. And then there's some studies that are mixed and then there's meta analyses that say, okay, what we really need is more studies. And I just want to just real fast for the listener and I will link all of these many links. But this page is just it's basically a really long with page with just citations, some of which I've had brief. Yeah, it's basically like APA style-ish citations to research on deliver practice. Yes. So there's probably there's got to be somewhere between 50 and 100. I don't know, a big number of it. Yeah, if anyone is doing research or paper or thesis on deliver practice, start here. Yeah, no, this is great. This is fantastic. Fantastic. We did it for you. And it's not hallucinated. If you ask chat, TBT did it too. I think I might have hallucinated. So start here. So yeah, this is a new field. Our field has only really started exploring deliver practice in the past decade or so. And you know, other fields, it took musicians hundreds of years to figure out how to practice. It's taken athletes a long time to figure out how to practice. We're at the very beginning of this. In no way do I want to suggest the way we do it is the right way to do it. Not at all. We are experimenting. Scott Miller's experimenting. Bruce Womble of Clare Hill, everyone's experimenting. And over time, we will discover what is the best way to reverse psychotherapy. And I might not be alive when that final discovery is made. That's okay. I'm at peace with that. So there's a lot more research needs to be done. But I 100% agree with you. The bottom line is are the clients getting better? Is the outcome data improving? And that is hard to do because the majority of the variance in client outcome is at the client level. Right. And so what the therapist is doing matters, but it doesn't, it's not the whole story. And so you need these large and studies and you need ideally longitudinal data. There's a whole bunch of things. We are starting to do that data. We've just started publishing our outcome data. And I, but it's still, it's very preliminary. And I would encourage everyone to be skeptical. You know, we should all be skeptical of new research and new, we should push at it. We should, you know, we should not take anything for granted. And we should be constantly examined. The bottom line is are the clients improving. And that's why we are using outcome data with all of our clients. Because no matter what create ideas, we get excited about the bottom line is are the clients improving. Right. So we've talked about some pushback that you've gotten. And I always like to ask people at the end if there's any, like other than what we've talked about, is there any other pushback that you've gotten for your work? Yeah. I mean, I've had, I mean, the most common pushback is, oh, it's reductionist. You're taking something that is, I've had narrative therapists at a conference once, say it's very top down. It's very expert based. Right. So there's a number of postmodern models of therapy, like narrative therapy, where they're trying to deconstruct this whole concept of the therapist being an expert. And really, the client should be the expert in their own story. I love narrative therapy. I did or at least I tried doing narrative therapy in, in grad school. And I mean, the way I answer that is sure, I found that getting out of the expert's seat as the therapist was not easy to do, because many clients were trying to pull me into that seat. And how do you get better at getting out of the expert's seat? You practice it. So no matter what you're doing sooner or later, you're doing something. And the idea that you should just be born good at it is, is crazy. Like, find a way to rehearse it. Now, it doesn't, you don't have to rehearse it our way. You find your own way of rehearsing it, you know, that fine. And if it's better, let us know and we'll start using your way of rehearsing. But so that is the most common piece. The second is one that you've raised, which is, this is a great idea of it's not practical. I don't have time, I don't have money, I don't have energy. And that's legitimate, you know? I don't really have an answer to that. Until our work is incentivized by performance, it's hard to ask people to work harder to get better. Yeah, that's so good. Go ahead. You go, Johnny. I mean, the one answer to that I found is most people join the field because they want to help people. They actually want to be good at helping people. You know, people don't become therapists to become rich or famous. They want to help people. And so most of us have this burning drive when we are not helpful, we go home and we're like, oh, how could I help that person? And so to try to tap into that and find a way to do it. Yeah, I think, you know, I think that once a person were to acquire the skill where they were able to identify the micro skills that they want to focus on, that if a person put an hour a week into it, oh, that's that's a lot. We don't need an hour, a week, 20 minutes. Right. So I think the perhaps the hardest part is either you or getting with someone who can help that you can work together to identify micro skills. That's the second hardest part. I was the first hardest part. The vulnerability. The vulnerability. Okay. And to an extent, there are some people who are just more comfortable with that. Right. And so there are some people who would just be more willing to be vulnerable and that those are probably going to be the people who are going to be most, you're going to be self-starters, right, with this stuff. And this is why we think it's important to start trainees with this, right? Right. Because you just, you just, you just internalize it. Our trainees are used to, they see five hours of their own videos a week. I mean, they're just, you know, it's what they do. It's just what we do. It's just what we do. Right. Because we do all sorts of really hard stuff. Yeah. But it's just a part of the job. So you just do it. But this, this isn't, we aren't a cultured, into this is part of the job. Yeah. So that's what you're trying to do, which makes a lot of sense to me. Yeah. It's a culture change. Yeah. And that takes time. So yeah. So are there any, we've hit a lot is, is there anything else that we've missed that you want to make sure that we touch on? I mean, this is, you know, this, you're, you're good at your job. You run a good, this isn't my job. This is my hobby. This isn't my job. Well, you're good at your hobby. So no, I think we've covered the only thing I would touch on is to check out some of the links so you can really, so viewers can see it for themselves. And, you know, that's generally when questions start showing up. We've got a lot of recorded webinars that people can go through. And, and so it can kind of come to life and then explore from there. Yeah. And I think, so I'm going to all of the links that Tony's given to me over this conversation. I'm going to include in the show notes. Are there any other, and I do want to highlight again, Tony's touch on it briefly, but he was part, I don't know if there's still ongoing, but a series of books through APA. Yeah. That it's like deliberate practice for boom. And then there's, I mean, it's a bunch of books you guys have put out. Yeah. How many? I think we're coming up on 20. Whoa. Holy hell. That's a lot. So they're still coming out. They're still coming out. So if I think that for, if somebody wants a book when they're, they have a particular approach that they're primarily using or using a lot of, I think that would probably be a good, you know, a good resource for folks. Yeah. To get started. Are there any other links or resources to your work or what you guys are up to that you want me to do that we haven't already? This is, this is the last link I would leave you with. This is, we call it our innovation lab. And this is actually a list of links to everything else we've talked about plus a lot more that, you know, I just, I didn't want to, you know, overwhelm the audience. So there's a lot more in here. And this is particularly useful for supervisors, faculty, for trainers to use. It's all free to use. Everything linked in here is free to use in your own courses or on supervision. You could, you know, your own workshops. What have you? So our goal is to have many different independent sites around the world experimenting with deliberate practice. You know, our field has something of a guru problem where we can end up with these pyramids where there's one person at the top kind of control. Absolutely. And we don't think that's healthy for the field. And so we want to, so far deliberate practice has been different. There's a lot of different groups and individuals experimenting in different ways around the world. And hopefully that will continue because that will lead us over time to the fastest kind of the best, most efficient way to figure out what is actually working. Great. Well, Tony, I can't tell you how much I appreciate this. This has been wonderful. And for those watching on YouTube, you can see Tony has a beautiful collection behind him. That is definitely, but thank you, Tony. I can't tell you how much I appreciate this. Well, thank you, Dan. Yeah. Thanks for the invitation. Ladies and gentlemen, Dr. Tony Rumeneer. That's a wrap on our conversation about deliberate practice. As I noted at the top of the show, it would be much appreciated if you spread the word to anyone else who you think might enjoy it. Until next time.[Music]