To the lovely ladies: Alberta, Amelia, Angela, Bertha, Caroline, Catherine, Cindy, Eliza, Elizabeth, Emma, Frances, Georgia, Josephine, Julia,  Linda, Louisa, Margaret, Olivia, Patricia, Paula, Pearl, Petronia, Rose and Virginia – of Key West.*

I just got back from a post-Christmas week vacation in Key West, Florida. If you’re a fan of New Orleans and Las Vegas, there’s a good chance you’ll love Key West. As a “Big Lebowski”-like friend once said of Key West: “It’s the end of the road, man.”

Besides enjoying my family, the delightful weather and end-of-year Key West zaniness, I got to catch up with my best friend, a clinical psychologist – actually, a psychiatric social worker – who runs his own family therapy practice. On a lengthy New Year’s Day conversation, we both realized there’s more commonality than we ever imagined to the way we conduct business.

Of course, we started the conversation commiserating on being small professional services business owners and the attendant problems. We shared techniques for getting deadbeat customers to pay and controlling the amount of free consulting we provide prospects before they sign up. We also lamented an economy much less friendly than in the past. Alas, we concluded there was nothing unique about our current business predicaments.

My eyes were opened, though, when I asked my therapist friend where he stood on the planning-searching continuum to conducting business, fully expecting him to be solid in the planning camp. Not so. Even as he subscribes to the traditional idea of treatment plans to guide the course of therapy, he recognizes that top-down, monolithic planning seldom works for many patients. While planners think they can “strategize” to solutions for knotty problems, searchers know they cannot – and accordingly look for smaller intermediate “victories.” My friend’s approach is similarly agile, with a preliminary course he sees as almost certain to change over time. He often looks for small early-on victories. His mantra is to learn and adapt as he goes. And, tellingly, he notes he’s evolved to the searching camp over the years: at first a hard-core planner, time has made him more the practical searcher.

My friend is also fully committed to measuring his business performance – to determining if his sessions with clients are leading to success. Indeed, he sees his work as scientifically driven: he develops treatment hypotheses for each patient, continually testing their validity. If one fails, he replaces it with another. And he constantly evaluates his personal performance as a therapist, monitoring the progress of patients in their worlds – at home, work, school and the justice system. He often concludes his therapy sessions by directly asking patients if his interventions are effective, experience showing that positive direct feedback might in fact be the most important indicator of treatment success.

As a proponent of a scientific approach to therapy, my friend is especially mindful of threats to the validity of his therapeutic work. He well understands treatment by therapist interactions, noting that individual therapists are adept at some types of treatment but not others. He also knows he’s not best for all types of problems and personalities – and will refer patients to other providers accordingly.  Finally, he gauges the personalities of his patients before prescribing treatment. What might work for a “thinking” patient might not for a “feeler” – and vice-versa. Where there are big unknowns, he might even make a “random” assignment of an initial approach, with the understanding that if it doesn’t work, they’ll quickly try something else.

In addition to his therapy practice, my friend is on the faculty for a Master’s program in family therapy at a top university in the Midwest. I don’t think I’d like to be his student, though. For the classes he teaches, he’s old school with no grade inflation – B curving his graduate classes with a C given for each A. He’s especially tough as a thesis advisor for his students. If he’s on your committee, you’d better be prepared to handle challenges to your hypotheses, study design and statistical analysis. And if your study population consists of college students, you’re encouraged to be very careful on your claims of how the treatment generalizes to the population. In short, students need to be particularly attentive to the internal and external validity of their research.

When all was said and done, I found a lot of good advice for the science of business in my friend’s wisdom of patient therapy. I refuse, however, to accept my wife’s pleas to become his client!

* The ladies of Key West are, in fact, street names. If you visit Key West, have dinner at the unassuming but terrific Cuban restaurant, El Siboney, on the corner of Catherine and Margaret.

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