Be non outcome focused: hold yourself to a standard of practice and do the job right, whatever the result. Change is slow, often gets worse before it gets better, and the point that lands may be the tenth time you make it.
The principle
Be non outcome focused. Hold yourself to a standard of practice and do it, because you never know when something you do will bear fruit later.
“it's very important to be non outcome focused. Just hold yourself to a standard of practice and do it. And you don't know when something you do is really going to bear fruit later”
37:57Psychiatric Technique for Diagnostic Interviewing and Therapy: 6 Mantras Every Clinician Should KnowApr 2026 If you do the job right, regardless of the outcome, you have done the right thing. That should be the ultimate guideline.
“If you do the job right, regardless of the outcome, you've done the right thing. That should be the ultimate guideline”
44:51Psychiatric Technique for Diagnostic Interviewing and Therapy: 6 Mantras Every Clinician Should KnowApr 2026
Why change takes time
It is not the first or the fifth time you point something out that it lands. It is the tenth time, a year and a half into treatment.
“it's not the first time you point it out. It's not the fifth time you point it out. It's the 10th time, a year and a half into treatment”
38:39Psychiatric Technique for Diagnostic Interviewing and Therapy: 6 Mantras Every Clinician Should KnowApr 2026 In therapy and in change generally, things often get worse before they get better. The old coping skill is gone and the person has to face what it covered, and it takes a period of destabilization to rebuild something new.
“oftentimes in therapy or change, there's things get worse before they get better. Because there's a period where now you don't have your coping skill and you You have to face all those things. And it takes a period of destabilization to rebuild something new”
42:13Psychiatric Technique for Diagnostic Interviewing and Therapy: 6 Mantras Every Clinician Should KnowApr 2026
Talking to patients
When a patient is better, tell them not to be surprised if things get worse again, because that is life. But they have picked themselves up out of this and now know what to do next time.
“if they're better, I say, hey, by the way, don't be surprised if things get worse again in the future. That's life. But at this point, you've picked yourself up out of this and you know what to do next time”
42:51Psychiatric Technique for Diagnostic Interviewing and Therapy: 6 Mantras Every Clinician Should KnowApr 2026
From these episodes
Every point above is something said on the Psychofarm podcast, with the words as spoken and a link to the moment in the episode. It is education, not medical advice, and an episode reflects what we thought when we recorded it.