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Non-judgmental Ethics Sunday: Can Therapists Fake Their Own Online Reviews?

posted by Joshua on February 26, 2017 in Ethicist, Nonjudgment
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Continuing my series of responses to the New York Times’, The Ethicist, without imposing values, here is my take on today’s post, “Can Therapists Fake Their Own Online Reviews?

I am caught between competing ethical requirements. I am a mental-health professional with substantial experience; some people call me an expert. I recently expanded my private-practice hours. To increase patient numbers, I joined an online referral service (at considerable expense). Here’s where the ethical dilemma comes in: Like most “locator” sites, the service includes “customer” ratings. The site reps instructed me to have current patients complete the ratings. My professional training (I’m a psychotherapist) made it very clear that it is a big no-no to solicit testimonials from patients; doing so can badly interfere with the treatment relationship. Patients are in treatment for their own needs and should not be required to consider the therapist’s other actual or prospective patients. (Psychotherapy isn’t a simple commercial transaction.) So my professional-ethics training tells me to leave any ratings up to any patients who find me through the site, which then asks them to rate me. This would mean virtually no traffic through the site.

Discussions with fellow clinicians have revealed that many if not most have “primed the pump” with favorable “reviews,” written by friends or family members or by the therapists themselves. This thought makes me very queasy! But it seems to be a necessary action in the online marketplace. Basic ethics say not to lie, especially self-servingly. Still, I’m wondering about the ethics of depriving potential patients of the ability to find me (by remaining essentially invisible on the site) and to see if I might be able to help them.

So what do you think of this solution? I have submitted a few ratings to the site, directly quoting my actual, satisfied patients but using made-up names. My thinking is that the patients’ spontaneous comments about our work are real, but I haven’t made an improper demand of anyone. Furthermore, because I genuinely believe I may be able to help a potential patient who might read the reviews, fudging their origins doesn’t seem like too bad a con. I think the worst harm my actions might cause is that someone meets with me once and determines that I’m not the right therapist for him or her; that’s actually fine and a pretty common event. And readers know better than to take customer reviews too seriously, right?

My response: Your request, after describing the situation and your thoughts on it, is to be told what you’ve decided as the best course of action isn’t too wrong. You didn’t ask for alternatives. You didn’t ask for help. You asked for judgment and justification.

You’re also asking opinion. If there were an objective measure of right and wrong you wouldn’t ask a newspaper columnist. You’d use the objective measure. How much more right is that person’s opinion than your own? You’ve come up with a plan. Why can’t you rely on your opinion?

On a personal note, I understand kids asking their parents to tell them right, wrong, good, and bad. I can understand adults asking for other ways of looking at something and for help solving problems. I can understand adults asking for legal advice. I don’t understand adults asking to be told right, wrong, good, or bad. At what point do you say, “I’m mature enough to know my values enough to act on them with confidence? I wouldn’t ask this question if the writer had asked for perspective, advice, or help, but he or she didn’t. He or she asked for judgment and permission.

The New York Times response:

You speak of competing ethical requirements. I understand what one of them is: honesty. What I don’t get is what the countervailing ethical requirement is supposed to be. The only candidate you offer is a supposed ethical duty to make your powers as a healer known to people who need them. If there were such a duty, talented psychotherapists would mostly be violating it. So what you have, on the one side, is a wrong; on the other side, a bunch of excuses.

This is a common form of dishonesty, you point out. “But everybody does it” is an excuse we learn in grade school. Parents can reply, with the Bible: “Thou shalt not follow a multitude to do evil.” (That’s Exodus 23:2. Exodus 23:1 begins, “Thou shalt not raise a false report.”) Now, “evil” seems a bit tough here, because what you’re doing is less harmful than it might be. Many people discount these customer ratings, because they are aware that these reports, like yours, are often fakes. They indeed “know better than to take customer reviews too seriously.” But then your reports are either going to have little effect or they’ll selectively persuade the ignorant and the credulous. Taking advantage of people with these epistemic weaknesses is exploiting the vulnerable.

You maintain that your form of fakery is better than the straight-out inventions of others, because your ratings are based on things that clients have actually said. But because these are not real reports, readers are not getting a reflection of the real views of your clientele: What if a fair sampling would include some critics? You suggest that it’s a “fairly common event” for people to decide that you’re not the right therapist for them. Bothering to rate someone positively is a sign of satisfaction; it’s conceivable that the fact your clients haven’t done so is itself evidence of something. I’m putting aside the issue of whether metrics of consumer enthusiasm are entirely appropriate in the realm of psychotherapy. (Imagine Dora on Sigmund Freud: “Worst. Analysis. Ever.”)

That you are embedded in this ethical morass is not, of course, your fault. It sounds as if the people who created the website you signed up for have invented a permanent temptation to dishonesty and done little to obviate it. (A “closed-loop” system — which aims to restrict comments to registered, verified patients who have seen the practitioners — is harder to game in the way you describe.) The web, like every technology, creates new opportunities both for doing wrong and for doing right. Print made possible the wide circulation of lies as well as of truths; so, too, did the telegraph, the radio and television. Indeed, language itself is like this: no lies, no truths. There are three mechanisms for counteracting falsehoods: exposure, the education of consumers and the conscience of the producers. The last of these, as your letter suggests, isn’t to be relied upon. Your one consolation, and ours, is that your dishonesty is a mere grain of sand on the great mountain of falsehood. Still, you should take these fake ratings down. If you want to replace them, why not write, under your own name, a paragraph summarizing the comments of satisfied patients?

This past week, my primary-care physician called me with some startling news: iron-deficiency anemia. She was so concerned with my results that she ordered a colonoscopy and upper endoscopy to look for internal bleeding and recommended I take ferrous gluconate to increase my iron levels.

I have no history of iron deficiency or anemia. The more I thought about it, the more I thought of a possible cause. I have been donating blood on a regular basis for the last several years at a local bloodmobile. After the first few times, I was turned away because my iron level was found to be too low. Next blood drive, no problem. The latest was another story. The staff nurse pricked my finger and told me my iron was too low but then said something along these lines, “Oh, let me get so and so, she can always get the proper reading.” Just like that, my iron level was high enough to donate, which I did. When I asked how that could be, she said, “She knows how to get the proper reading, she has to poke a little deeper.” Hmm.

My doctor now thinks that donating blood could be the reason for my iron-deficient anemia. She was shocked to learn that the staff in the bloodmobile neglected to suggest I contact my doctor and blatantly manipulated the results to make me eligible to donate blood.

Is it my responsibility to alert the teaching hospital that operates these blood drives? I feel horrible that someone has possibly been given my iron-deficient blood. Maura Toomey, Brookline, Mass.

My response: First, these two statements seem to contradict each other: “I have no history of iron deficiency or anemia” and “I was turned away because my iron level was found to be too low.”

Second, all you asked was if it was your responsibility to alert. Whether others consider something your responsibility seems a question of opinion on an abstract concept.

I’m going to digress from answering the question to wonder why you wouldn’t contact them, independent of others’ opinions. I see no downside to contacting them and the potential for what seems clear to improve others’ lives. Are you concerned you will suffer by contacting them or make the nurses look bad?

This is why I teach skills instead of abstract philosophy. Then you see the issue not as something to debate about without acting but as an opportunity to act and help people. If you don’t have skills, you miss opportunities to connect with people and help solve their problems. Even if you don’t have the skills, you could ask your doctor to contact the hospital, keeping your identity confidential.

How does a newspaper columnist’s opinion on responsibility help the people receiving the iron-poor blood, except through influencing your behavior, which learning skills would have done directly?

The New York Times response:

The helping professions may themselves be in need of help: That seems to be the lesson of the day. It looks as if you have important information about the way some blood donations are conducted in your area. What the staff nurse said suggests that what happened to you may have happened to others. A large-scale 2011 study found iron deficiency in a large portion of regular donors — about two-thirds of the women and half of the men — and those were just people whose donations had been accepted. As your doctor is aware, regular donation can result in (and worsen) iron deficiency and anemia. And of course, there are good recipient-side reasons iron-deficient blood, which doesn’t carry oxygen very well, should be avoided. (Anemia can also be a symptom of transmissible diseases.) So for the sake of both donors and recipients, it’s a bad idea to ignore signs of anemia in those who donate at blood drives. You should indeed notify the hospital that runs the bloodmobile. It may be too late to stop your blood from being used, because it’s not going to be stored for more than six weeks. But sharing your experience with the relevant officials could help prevent this abuse of the proper protocols from continuing.

The bigger your achievement, the more it’s a beginning

posted by Joshua on February 25, 2017 in Art, Awareness, Stories
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Back when I made my art, I would sometimes find a new venue or commission that would give me the chance to work bigger than before. I’d sign a new gallery, meaning more pieces, or a museum. Or a venue with a budget would commission me.

My art was technical, with laser cut steel, 8 foot photographic quality images, power cables, and so on. I could only scale up when I had a budget and a space big enough to mount the displays and for people to step far enough away to view it.

How did I decide how big to make a new display?

From my experience building subway advertising displays a quarter-mile long, meeting safety and fire codes for ten years in brutal industrial environments, I knew I could solve any technical challenges if I had the resources, usually meaning time and money. So those were my constraints: time and money.

When I made bigger works, I would make them as big as time and money allowed.

That meant that every time I made a new, big display, I would be frantically putting the finishing touches on it just before unveiling it to all the people I invited for its debut, with no spare time or money to fall back on.

I’d be full of anxiety, even fear, that my solution wouldn’t work. When you scale something as technical as my work, even with my experience, I often couldn’t tell how the new size would look until I saw it.

Before turning it on to see how it would look in place, usually an hour or less before guests, including potential buyers, would come, full of anxiety and fear, I would find myself doubting myself, asking

Is this too big? Did I push too far? Why did I push my boundaries so much??

Then I turned on the lights and they always looked good. Seconds after doubting myself and asking, “Is this too big,” I would say to myself

This is too small! I should have made it bigger. Why did I doubt myself??

If I’d had more confidence, I could have made it bigger.

Plus, since I was always doing new things, beyond anyone’s expectations with a medium only I understood like I did, nobody saw the flaws in my work that I did. They were amazed by the main developments.

Every big accomplishment is a new beginning, a platform to build on

However big and beautiful each piece was and how hard it was to reach that level, once I did it, I knew my ability. I could take for granted that level of accomplishment.

It forced me to ask

If I can do this, what more can I do?

which led me to do more.

I see this pattern with my book. I worked hard to reach this point. As I’m writing, Leadership Step by Step has 41 reviews—40 5-star reviews and 1 4-star.

Leadership Step by Step, 41 reviews

A screenshot of reviews from Amazon for Leadership Step by Step. Click the image to see more.

Some of the reviews are touching and meaningful. The number has long past friends and colleagues, into people in the wild who don’t know me and have no motivation to write to be nice to me.

For example:

As a former non-commissioned officer with the US Marines in Iraq, I have read a lot of books on leadership to enhance my own abilities. This is by far the best book I have read on the topic.

and

This is a very beautiful book. The author has drawn from a wide variety of fields and is able to distil a great deal of wisdom and knowledge into simple and powerful exercises.

and

I was actually moved by Joshua Spodek’s book.

among many others.

As hard as I worked to reach here, now that I see the effect the book has had on the people it has, I see it as a platform.

Writing the book was never just about selling lots of books, though I hope to. It’s always been a means to an end, another channel to give people my new way of learning to lead by creating meaning, value, importance, and purpose, to increase their self-awareness, and all that. I believe that there will be a before and after my book, meaning that, if I market it effectively, that after enough people get it, and the active, experiential technique of learning, that no one will go back to the old ways of learning leadership, entrepreneurship, and my other courses in school of lecture, case study, reading psychology papers, and other intellectually active but socially and emotionally passive ways of teaching.

For the past few months, maybe a full year, of executing the plan to write and market, my life has been all trees, no forest. Now that I’m seeing things work out, I can start stepping back and looking at a strategic level, seeing the book as a platform.

Whatever your achievement, the bigger the achievement, the more it’s just a platform for the next stage. Accomplishments open doors, only letting you see there’s something on the other side. You have to step across the threshold, explore the new space, and make something of it.

You

What accomplishments have opened doors for you?

What ends can you make into new beginnings?

The heart of my leadership technique in a 46 second video!

posted by Joshua on February 24, 2017 in Inc.com, Leadership, Tips
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On top of my column with Inc., I did a series of videos in their Inc. Video: The Playbook series. Other speakers in the series include Tim Ferriss and Tony Robbins.

Yesterday we posted a video of me:

How to Get Your Employees to Work With Passion

subtitled

Joshua Spodek, author of Leadership Step By Step, explains the importance of making members of your team comfortable sharing their motivations with you.

Click here or the image below to see the video.

Inc Playbook Work With Passion Joshua Spodek

Inc.’s Playbook: “How to Get Your Employees to Work With Passion,” by Joshua Spodek

Watch Callie Schweitzer, of Arianna Huffington’s Thrive Global, interview of me

posted by Joshua on February 23, 2017 in Education, Leadership
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Yesterday Callie Schweitzer—Global Managing Editor for Arianna Huffington’s Thrive Global, where I write a column—interviewed me about Leadership Step by Step and leadership in general. Click here or on the image below for the interview.

She described it after as the best interview she’d done.

Schweitzer Inteviewing Joshua Spodek

Callie Schweitzer, Global Managing Editor for Arianna Huffington’s Thrive Global, interviewed me about Leadership Step by Step

Over 4,000 people have watched it already, so it’s one of my biggest exposures so far.

I recommend watching it!

Leadership Step by Step spotted in the wild!

posted by Joshua on February 22, 2017 in Exercises, Leadership
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Seen at the Barnes and Noble in Union Square!

Some are in the business section, aside Richard Branson, some are downstairs, on the first floor, center.

If you’re looking for a copy of Leadership Step by Step, and you should get one if you don’t, I recommend buying these copies. I signed them.





I have to say, most of the stages I’ve passed—signing an agent, signing a publisher, finishing drafts, getting blurbs from prominent people, going on sale online—were meaningful, but seeing it on the shelf at a bookstore, and on a table, surprised me most with the intensity of feeling at seeing them.

In other news, the Amazon reviews are up to 35, all 5-star but one 4-star. Still averages 5.0.

Leadership Step by Step 35 reviews. 5.0 stars

Amazon reviews: 35 so far, average: 5.0 stars

The Benefits of Experiential Learning for Leaders with Rocket Scientist Joshua Spodek

Mark Bidwell, founder and podcast host of Innovation Ecosystem, posted today a wonderful interview about Leadership Step by Step, experiential learning, exercises, and more. I can only describe Mark as someone who gets it. He ascended the corporate ladder, where he drove innovation, built teams, and so on, then found there was more to life and is creating resources to enable others to.

If you are looking to improve your leadership, social, and emotional skills, Mark gets to the heart of how to, covering techniques that work, as well as the problems of traditional education that suppress learning these things.

Listen to the interview!

A few words about Mark and the Innovation Ecosystem podcast:

We interview remarkable and thought-provoking guests about innovation, leadership and change in the world of business.

Mark Bidwell

I have spent much of my 20+ year career seeking out people and resources to help me innovate and grow businesses. I have worked at BP (NYSE:BP), The Hay Group (part of Korn Ferry NYSE:KFY), and most recently Syngenta (NYSE:SYT), where I led the creation and development of a $2bn Specialty Crops business unit.

Wherever possible, I try to learn from other people’s experience, especially if they bring a fresh perspective to a situation. Through the Innovation Ecosystem show, we will bring you key insights, fresh perspectives, and proven tools you can use straight away to make you more successful professionally and personally.

Innovation Ecosystem Joshua Spodek

How To Lead Better Through Practice: Watch a video with me and David Burkus

posted by Joshua on February 20, 2017 in Education, Exercises, Leadership
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David Burkus is a writer, speaker, and coach on leadership and creativity. A mutual friend put us in touch and he’s helped me with my book, coaching, and writing since.

He’s also hosting the Work Smarter Summit, an online summit of speakers, interviews, teachers, and thought leaders. I’m one of the speakers! … That means it’s quality. Here’s a screen shot:

Work Smarter Summit

A screen shot of the Work Smarter Summit, which includes me, so it’s quality, and I recommend it.

My conversation with him is full of useful information, background, and tips. Here’s a screenshot of my talking to him:

Work Smarter Summit - Joshua SpodekClick here to view the video, which covers leadership techniques, perspectives, and a lot of what is in my book but live and interactive. I describe a few exercises from Leadership Step by Step and demonstrate a few with him.

Then click here to register to see all the other speakers and register for full access to all their videos.

Enjoy!

Learn!

Then practice, practice, practice!

Click here to register