May 2011 – Tips & Topics

TIPS & TOPICS from David Mee-Lee, M.D.
Volume 9, No.2
May 2011

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In this issue

— SAVVY – Teaching tips that work
— SKILLS –Practice these teaching techniques
— SOUL – Tornadoes and dodging bullets
— SHAMELESS SELLING – Tips from the TNT book
— Until Next Time

Welcome to all the new subscribers to Tips and Topics. Thanks for joining us for the May edition of Tips and Topics (TNT).
SAVVY
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I have been training, conducting workshops and creating learning opportunities for over thirty years.  Even more intensively over the past fifteen years, this has been my “bread and butter” that pays the bills.  So when I was at the Annual Meeting of the American Psychiatric Association Meeting this month, a particular seminar caught my eye: “How to Give a More Effective Lecture: Punch, Passion and Polish

Phillip J. Resnick, MD has been teaching for even longer than me and is known for his informative, entertaining and effective workshops on psychiatry and the law.  He is Professor of Psychiatry and Director of the Division of Forensic Psychiatry at Case Western Reserve University, School of Medicine in Cleveland, Ohio.  It was fun to compare and contrast what I do in my lectures and workshops and learn from others more experienced.

In SAVVY this month, I am sharing a variety of Dr. Resnick’s teaching nuggets and tips which captured my attention. I will also add in a few comments and tips of my own. Whether you are a trainer, teacher or participant in lectures and workshops, you’ll find these interesting and informative.  If you are a trainer, learn from his years of experience.  I resonated and agreed with most of what he taught us.  I don’t have all the references and literature citations for the statistics I pass on from Dr. Resnick’s seminar.  However you can find his contact information easily if you Google his name.

If you are typically more a participant/audience member in workshops, here is a chance to be informed about what makes for an effective learning experience.  You can help the trainer of your next workshop by informing him/her know about what worked for you- or not.  This month’s tips will make you a more informed consumer of training.  When you complete your next workshop evaluation form, you can now provide some specific, instructive and useful feedback to the speaker.

TIP 1 

Review these teaching tips to evaluate what will make learning experiences more effective

1.
Be enthusiastic and believe in what you are teaching.
* “If you aren’t fired with enthusiasm, you’ll be fired with enthusiasm.”

Vince Lombardi

US football coach (1913-1970)
2. Get to know your audience a bit before your start.  Find out who will be in the audience and what their learning needs are.
* “People don’t care how much you know until they know how much you care.”

John C. Maxwell

An evangelical Christian pastor
3. Help participants identify from all your content “what is in it for me?”
* 70% of evaluators’ satisfaction comes from presentation style not content.

*  Participants remember 70% of material covered in the first 10 minutes of a 50 minute lecture and only 20% of material covered in the last ten minutes (Hartley and Davies, 1978)

4. People love stories. “Let me tell you a story” gets participants’ attention.
*  Many physicians and other clinicians are not taught much about addiction treatment. I sometimes tell the story about an internist.  He was making me feel welcome on the medical staff and we were having lunch together.

He said: “You just got out of training in psychiatry at Harvard, what are they teaching you these days about this thing that alcoholism is a disease?” I didn’t know what to say because I was so naïve about addiction that I didn’t even know it was a debate back then in the late 1970’s.

So I was struggling to know how to respond.  But I had received good mental health training on how to turn people’s questions around, I said: “Well what do YOU think?” He pontificated and it bought me enough time to fake my way through lunch.

Now, if you were to ask me: “Is alcoholism a disease?” I would have a much more coherent answer without having to play games with the question.

5. Use examples freely and often to make content very understandable.

 
*  When explaining about “signs” and “symptoms” as diagnostic “tools” that help the assessor determine the condition of the patient, the Online Medical Dictionary defines them as:  “Objective evidence of disease perceptible to the examining physician (sign) and subjective evidence of disease perceived by the patient (symptom).”

*  You probably would have to read that sentence a few times before it makes sense – if even then -about what is the difference between a “sign” and a “symptom”.

*  However if you use examples, the definitions quickly come alive.  “Signs” are those “things” that we can see like a stop sign, and “symptoms” are those “things” that the patient tells us.  For example: Pain would be a symptom (you can’t see it, but the patient can tell you that he/she has pain). Flinching or “guarding” when touching a painful area would be a sign that the patient is experiencing pain.

 

(http://www.emergencymedicaled.com/Definitions/Signs%20and%20Symptoms.htm)

 

 

6. Don’t use jargon words or acronyms without explaining them.  If the audience is unfamiliar with jargon words and acronyms, use them sparingly even if you have already explained them.
*  Of course if you want to show off, go right ahead and use words people don’t understand, like “eschew obfuscation”.  Or you could just say: Don’t make something difficult to understand as it confuses people.

*  Here are a couple of sentences that should make sense to a member in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), but would mean little to someone unfamiliar with AA/NA:

 

“Pay attention to HALT and BUDDING in AA and NA.  You could regress into unmanageability and “self-will run riot” alienated from your Higher Power.  Working the Steps will help with surrender; and going on commitments, getting names and numbers and working the program will help achieve serenity.”

 

This means: Be careful to not get Hungry, Angry, Lonely and Tired (HALT) and be aware of other relapse triggers that can Build Up to a Drink or Drug (BUDD-ing). You could lose control of your substance use with many negative consequences including a loss of spirituality. Understanding and discussing the 12 Steps of AA/NA will help resume a path of recovery.  Visiting other meetings and sharing your recovery, reaching out to others; and attending and actively involving yourself in AA/NA will lead to serenity.

 

Dr. Resnick had many other valuable tips, some of which I share in SKILLS; and others I will share in the future.

 

If you want more tips on training and learning methods, see the January 2005 edition of Tips and Topics

www.changecompanies.net/tipsntopics/?m=200501

 

References:

Hartley, J., & Davies, I. K. (1978). Notetaking: A critical review. Programmed Learning and Educational Technology, 15, 207-224.

SKILLS 

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Next time you present or participate in a workshop, notice if the following tips on teaching SKILLS are used. 

TIP 1
Try these teaching techniques to increase participants’ learning experience.

1. Have participants discuss and work in pairs on a case or task.
*  When the more skilled of the pair has to formulate his/her thoughts and explain to the other, this helps them. When the less experienced person has something explained to them with the opportunity for discussion back and forth, this helps them.

*  Any time the audience is involved interactively (e.g. Q&A, working in pairs or groups) people are better able to apply knowledge into action.

*  People retain much more from peer learning than lectures.

2. Practice eye contact with an audience member lasting 3 to 5 seconds before shifting to another person.  This increases connection with the audience.
*  If the room is large enough, by making eye contact with one person, you will in essence be making eye contact with 3 to 5 others in the same location.

*  Eye contact longer than 3 to 5 seconds begins to look like staring, which breaks a connection with the audience.

3. When using Power Point slides or any visual aid slides, have no more than four points to make in no more than 8 lines on the slide.
*  Complicated graphs with too much data on them cannot be digested and are a waste of time.

*  If there is much content which cannot be summarized easily, then give this information as a separate handout.  Don’t just cram it onto a slide where the font is so small it is unreadable, even in the front of the room.

4. There are a few tips to do with the style, volume and tone of your voice.
*  Use a conversational tone, rather then a preachy or dry academic or hurried pace and tone.

*  When you want to convey authority, lower your voice.

*  Getting closer to the microphone gives a warmer, fuller tone.

*  Avoid caffeinated coffee as it dries your mouth.
5. The conclusion of your presentation should be the one thing you want your audience to remember.

 
*  10% of what you tell them is all the listener is going to remember.

*  The ideal conclusion is a powerful synthesis of what you presented with some new bit of perspective.

*  Call attention to the most important points: “The most important thing to remember is….” Or “the take home message is……..” Or “If you learn only one thing today…..”

 

When next you fill out that Workshop Evaluation Form, think of all the areas the speaker did well, or not so well.  The feedback you give could vastly improve the speaker’s teaching and your learning experience.

SOUL

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In the USA this year, it has been the deadliest tornado season in over fifty years. Over 500 people have tragically lost their lives and the tornado season isn’t even over yet.  It’s a good thing I live in California where we only have earthquakes where I live.  These don’t threaten every year like hurricanes and tornadoes. My heart goes out to the victims and families of the tornado disasters.  I’m grateful that it can’t happen to me. 

But not so fast!  Because I travel almost every week across the nation, I check the 10-day weather forecasts for my destination city and for the cities where my plane will connect. Last week, in Oklahoma City, “it can’t happen to me” turned into “it happened to me“.  I had the opportunity to see what it feels like to be threatened by a tornado.

Just when my plane was scheduled to takeoff to Chicago (another frequent hot spot for weather delays) the promised string of storms began approaching the Oklahoma City area and its neighboring towns and counties. Anxious passengers (including myself) watched on TV the yellow, orange and red weather charts snake their way over neighboring towns. Meteorologists kept tracking and predicting what path the wall of storms would take so they could warn people to take shelter.  About 30 miles away from the airport a tornado touched down and I was to learn the next day that ten people lost their lives in Oklahoma that evening.

Were the storms going to track towards the airport? Was I going to experience my first tornado? Now I wasn’t just thinking about missing my flight connections, I was thinking about missing my family.

“Attention all passengers and staff.  Please make your way out of the departure gate area and proceed to Baggage Claim and then down to the tunnel below that.  We are expecting high winds and possible large hail.  With all the glass in the terminal, it is necessary to clear the area.”

Can you imagine hundreds of people headed towards a tunnel -usually just a walkway between the rental car/parking building and Baggage Claim- and all cramming into it?  Can you imagine the same crowd of passengers passing back through the Transportation Security Administration (TSA) checkpoints – all at the same time? Earlier before the warning, we had already cleared security in dribs and drabs, not in a huge mass like this.

Well, cry me a river.  My inconvenience and delay was nothing compared to the devastation and loss of home and loved ones that people in Missouri, North Carolina, Alabama, Arkansas, Kansas, Ohio and Oklahoma have experienced.

 

You will likely receive this edition of Tips and Topics on Memorial Day.  While this day commemorates US Service Members who died while in military service, we might also take the opportunity to remember those who have died this tornado season.

 

Far less attention will go to the 150 to 200 people who will die this holiday weekend from drunk driving. As of the writing of this TNT, so far this year 4,456 people have died on the roads from drunk driving. But the number will already be higher by the time you read this.
http://www.alcoholalert.com/deathclock.html

 

Life is fragile.  Enjoy your day and your loved ones.

SHAMELESS SELLING
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Recently I was telling an audience about the Tips and Topics book we released last summer.  I hadn’t looked through it for a while and was reminded there are some very useful tools and guides.  Here are a few I think you would find useful:

 
*  Pages 131-134: Use it NOW tools: A Client Benzodiazepine Agreement and a Client Addictive Illness Medication Agreement – Helps use Medication Assisted Treatment appropriately

*  Pages 114-118: A comprehensive chart: “Matching Stages of Change and Treatment to Treatment Goal, Intervention and Technique” – Helps individualize treatment to stage of change

*  Page 72: A list of Interactive Journals you can assign to clients matched to which ASAM Criteria Dimension they address e.g., Anger journal, Self-worth journal for Dimension 3; Into Action journal for Dimensions 4, 5 and 6

*  Pages 93-96: Sample interaction and dialogue between therapist and client to illustrate how to engage a mandated client into collaborative treatment:

Therapist: “Thank-you for choosing to work with me. What is the most important thing you want that made you decide to meet with me?”

Client: “I didn’t choose you, they made me come.”

 

Tips and Topics: Opening the Toolbox for Transforming Services and Systemsby David Mee-Lee, MD with Jennifer E. Harrison, MSW.  (158 pages; Sells for $19.95)

I invite you to read it.  Use the material to translate theory into practice; concepts into clinical services; and be a change agent for people, programs, payers and policy makers.

FYI- Here is a preview of the chapter headings:

Chapter 1: Changing a System of Care is not for the Weak

Chapter 2: Attracting People into Recovery, Even When You Don’t Feel Like It

Chapter 3: Screening and Assessment: Finding Your Audience

Chapter 4: Level of Care…or now you’ve got them…what’s next?

Chapter 5: Turning Paperwork into Peoplework

Chapter 6: Let’s Make Sure That’s What We’re Actually Doing

Chapter 7: Consolidating Systems’ Change: Celebrating Successes, Grieving Loss and Resolving Conflicts
Special Offer! I will include a second book, Dynamic Health, for free, while supplies last.

Dynamic Health is a 142 page book of interviews with expert health practitioners, featuring prominent ones such as Bernie Siegel, MD (Patient Empowerment), Dr. Earl Mindell (Nutritionist & author of the Vitamin Bible), Dr. Norman Rosenthal (best known for describing Seasonal Affective Disorder.)  I was invited to contribute to Dynamic Health, and was interviewed about Co-Occurring Mental and Substance-Related Disorders.

 

How to buy

Call The Change Companies at (888) 889-8866. Ask for the Tips and Topics book and the free Dynamic Health book offer.  You can also go online and get started on ordering at www.changecompanies.net/tips-and-topics.php.  It sells for $19.95.

Until Next Time 

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Thanks for joining us.  See you in late June.

David