Presents

Clinical Thinking
A notebook page turned back to reveal another layer beneath

A reflection for developing clinicians

Clinical Thinking #3: I Think I Missed Something

What if the thing you missed wasn't something the client said, but another layer of the conversation?

Have you ever left a session convinced you missed something but couldn't explain what?

Maybe you replayed the session on the drive home.

Maybe you thought... “I should have asked a different question.” “I should have challenged that.” “I don't know... something just felt off.”

Most new clinicians assume they missed something the client said.

But what if that's not what you missed?

When you replayed that session in your mind, did you notice the other conversation happening in the room?

Not the conversation your client was having with you, but the conversation you were having with yourself.

While your client was speaking, your mind was quietly asking questions too. “Why did that catch my attention?” “What am I feeling right now?” “Should I stay with this...or move somewhere else?”

Most of us don't even realize this conversation is happening until we replay the session afterward. Yet it quietly influences every question we ask, every silence we hold, and every intervention we choose.

And while you were having that conversation with yourself...

Your client was having one too. One you could never fully hear. “Can I trust you?” “What happens if I tell you the whole story?” “Will you understand?”

None of these conversations unfold in isolation. Each one quietly shapes the others, moment by moment.

Replay the session one more time.

Did you notice how: every reflection... every silence... every intervention... ...was shaped by the interaction between the three conversations?

This is perhaps one of the greatest shifts in a clinician's growth. Most new clinicians leave that session believing they missed the right words. But words are only one part of the conversation.

Experienced clinicians aren't paying attention to more words. They're paying attention to more layers.

That's why supervision isn't a place to just ask, “What should I have said?”

It's a place to ask, “What was happening that I didn't yet know how to see?”

Supervision with room to think.

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Supervision that honors where you are
and supports where you're going.

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