Decision fatigue can damage your clients and you as therapist, (July 2021)
In the course of a therapeutic hour an EMDR therapist may make dozens of decisions. They include what to target, the appropriateness of the cognitions, the kind of BLS to use, the possibility of needing to take action to avoid client overwhelm and dissociation, and many others. The quality of the therapist’s decision-making is crucial in two respects: first and foremost, the well-being of the client depends on it; then for the therapist poor decision-making may cause serious reputational and financial damage. This brings me to the real issue that I’ve never seen mentioned in EMDR circles – the reality of decision fatigue as recently highlighted by some unusual research published in the Royal Society Open Finance[1].
The researchers involved wrote that decision fatigue “typically involves a tendency to revert to the ‘default’ option, namely whatever choice involves relatively little mental effort’. In other words, as you become tired, you may get mentally lazy. The study involved examining the credit decisions of loan officers at a leading bank over the course of a working day. Officers tended to start work between 8am and 10am, took lunch between 1pm and 3pm, and leave at 6pm. The ‘default’ decision was to reject the loan application 60% of the time. What happened was that the default position, i.e. rejection, increased between 11 am and 2pm as lunch approached and again during the last two hours of the day. They concluded that decision fatigue, by causing more rejections than justified, cost the bank hundreds of thousands of pounds in a single month. The Economist article that discussed this research pointed out similar patterns have been found in other situations[2]. Doctors, for example, are more likely to prescribe antibiotics over the course of their shift even when that may not be necessary.
Mental activity can result in physical exhaustion as any therapist can attest after a day-long shift seeing patients every hour with only short intervals in between. The risk of poor decision-making is likely to show the same pattern as described in the research above. Working hard for long periods can result in tunnel vision. One answer is to take breaks to counter this as well as boosting creativity. Taking a break by leaving the workplace, if only for a cup of tea, maybe the only practical way many workers have to recharge their mental batteries. One of the advantages of working from home due to the pandemic is the ability to take breaks at the time of one’s choosing. Breaks are not a waste of time but are an essential requirement for maintaining decision quality over the course of a day of therapy.
[1] http://royalsocietypublishing.org
[2] The Economist, May 29th 2021
Born in Wales, educated in the UK and in the USA. Worked in the corporate and charity/non-profit sectors for 35 years. Was CEO and Director of national and international for-profit and not-for-profit companies before moving into the therapy world.