Culture Focused Practice

 Hey, Dr. Tara Vossenkemper here, and you are listening to the Culture Focused Practice podcast. Thank you for being here with me. We are getting into feedback today. Y'all know at this point you should know anyway, that I love feedback.

Feedback should neither feel like a firing squad, nor a hug circle. Although I am pro hug circle for the record.

And what I love about EOS, because you all know I love EOS, and if you're a first time listener, you should know that EOS is the Entrepreneurial Operating System developed by Gino Wickman. You can read the book Traction, get a feel for it.

EOS gives us structure to say hard things IE feedback without spiraling or sugarcoating. That's one of the things, one of the many things I love about it. And so if you ever feel like you dread giving feedback because it turns into a therapy session, or basically total shutdown. You're not alone. A lot of people don't like feedback. It's very uncomfortable. The point of this episode is to really unpack how some of the EOS tools can create psychological safety.

By having structure in place, we can create psychological safety for your team to actually have real conversations and for you to be able to effectively have real conversations. No more passive aggressiveness, no more, you know, global messages that should be specific to a person. No more email threats.

None of that bullshit. We can just wash it away, throw that baby out with the bath water.

Okay, so we have five agenda items on today's episode. Number one, why feedback fails and feel so damn hard. Number two, the EOS lens on feedback. Three real talk, you are probably assuming too much. Number four, anchoring in values without weaponizing them. And number five, what it looks like to lead through feedback. We're gonna bring it all home.

So first and foremost, why feedback fails. You know, there's two broad things that come to mind for me here. So one is just there can be a lot of emotional fallout from unclear expectations.

So if there's not clarity around what's expected, either from a conversation or from a role or from a person or from numbers or metrics or reviewing shit, I mean any of it.

If there's not clarity, what we can end up with is emotional fallout. This can, it's not unique to leadership, and by that I mean to say that the feelings that you have when stuff like that happens, I'm gonna guess something like resentment, frustration, confusion, just really annoyed that you're having that same conversation over and over again. Just like sort of banging your head against a wall.

That is not unique to you. Realistically, the person on the other end (i.e., your employee) is feeling very similar. They also are feeling resentful and frustrated. They don't understand why we keep having the same conversation. They don't get it in the same way that you don't understand.

The feeling is the same. The understanding of what's happening is different. They might think that they're doing whatever they need to be doing. You think that they aren't doing whatever they need to be doing. Both of you are confused af. That is not what we want. That's a lack of expectation. If we're clear on expectations, we don't have that emotional fallout.

Another piece to emotional fallout with regard to unclear expectations. It really can start to erode confidence and motivation. So when people think they're doing something well, or they think they are just going in the right direction, and they're told that they're doing poorly and that they're not going in the right direction, but they aren't really given a direction to go into, like unclear expectations, if you're, you're picking up what I'm laying down.

They're not gonna try harder. They're gonna start to shut down, or they're gonna start to pull back, or they're gonna start to look elsewhere. And it depends on the type of person that your employee is. Some people might fight and get a little more, Hmm, I'm gonna say rebellious, but I don't really like that word.

They're gonna have more of a fight response, you know, whether it's, uh, snarky comments, things like that. Some people are just gonna straight up shut down, like you're gonna see just a total lack of engagement. They don't get it, and they're not sure how to ask about it, and so they're just gonna shut it down.

Both of those things, whether it's the resentment and frustration on both sides, or the shutting down or fight response, that is emotional fallout from not having clear expectations.

It starts to feel personal in those moments too, where you know, it can start to feel personal for leaders and owners like, why aren't they doing this? They must, they must not respect me, or they must think this way about me. No, it literally can be as simple as, you haven't been clear about what you expect, and this is the outcome.

A second piece to why feedback fails and why it feels so damn hard is that you could be engaging in one of two things. So one is just avoidant leadership, like you're not stepping in to give enough feedback on a consistent basis. And the related thing to that is, and now you're having surprise conversations, but not the good surprise where everybody's clapping and cheering and you walk away with prizes, but like the shitty surprise.

Like you stepped in something and you thought it was mud, but it turns out it was dog shit. So it stinks. And now your shoes are covered in poo and. You're, you have to like wipe it off before you go in somewhere, but you can't use your finger because it's dog poo. Nobody wants surprise conversations that feel like that.

What you wanna do is be, again, if I just keep going back to this notion of being very clear about what you expect, not only with regard to the role, but also with regard to the cadence and the rhythm of the conversations that you have and the way that you give feedback. That's settling for people.

People know what to expect. Doesn't feel like they're. You know, at risk of stepping in dog shit, whenever they walk out the door, it feels like they know where the clear path is.

Second agenda item. Agenda item number two, EOS lens on feedback. Look, I'm gonna be level with you. Feedback is embedded in everything.

It's so simple. Once you get it set up, it just continues to feed itself. You have to tend to it. But I mean. With any good garden where you plant shit, you still might need to water it. You still might need to plant seeds on an annual basis. You still have to take the veggies when they're ripe. But the point is, if you have this great garden set up, the tending is minimal and it nourishes you and then you're also nourishing the soil and it's this whole ecosystem that is self perpetuating.

Maybe not self-contained necessarily, but it continues to flow and work in really smooth and seamless way.

So there's three points for this agenda item, EO, s, lens on feedback. Number one, I said this already and I'll say it again. Having structure creates safety. People like knowing what to expect.

They like to know what they're stepping into. They like to know when feedback takes place, when they can speak up. When they can get their questions answered, when you're gonna give them direct feedback, that is all a relieving experience. This is, I, again, I'm, I'm very ex, I think, you know, I'm existential at this point.

So for me it's about the anxiety of the unknown. And so when we have structure in place, what it does is it allows people to relax and breathe because they know what to expect. So there's a sense of safety, of psychological safety in that. And I would say emotional safety, depending on how the feedback goes.

Second piece to this lens on feedback. Another way that EOS just bakes in feedback to everything is through meetings and metrics. So if you have something like an L10 style meeting with your leadership team, or even if your departments have Elton style meetings, you are constantly engaging in feedback oriented processes through issues, list items, through your scorecards, through your to-do issues, through your rocks.

Everything is looking at what are we doing? Is it working? What's the issue? Boom. Are we going where we wanna go? So there's sort of constant feedback that's happening sometimes directly and sometimes more indirectly.

So l 10s are one way of doing this. Another way is to have quarterly conversations. These are more direct calls for feedback. Gino Wickman says that they're mandatory, they're optional for us. I, I worked in a different industry. I could see them being mandatory, but with the setup of our business, it doesn't make sense.

So the optional quarterly conversations are between an employee and their direct supervisor, and the conversation is two questions. What's working, what's not working? Each party answers the question and it's in relationship to them and of the employee and the role. Can be incredibly productive.

Third thing, I already said this 'cause it's baked into L 10, but you can also treat it separate, is to have scorecards. Scorecards are, it's our, it's quantitative data, it's numbers, it's metrics, it's KPIs, things that you can measure and write down. 50, 10, 100%, whatever the number is. A scorecard is an incredible way to get feedback on the health of the practice and employees.

I've done data for years, therapists hate it, but you know, that's a lie. They start out hating it and some, you know, it's like, it's not really second nature to them, but once it's started and it's going, and I repeat the message, this is not meant to be punitive. This is a type of feedback.

Of course, you have feedback from your clients where you're asking them, how is this going? Is this working? I may or may not be the right fit. Do you wanna talk about a different clinician? Are we working on goals that you wanna work on? All of those questions are related to the quality of the clinical work.

And we also have the data. So if we're talking about clinical work in particular, we might be looking at session counts, retention, churn rate, weekly hours averages. We're looking at things that would indicate to us that the therapy is going well, and we cross-reference that with what clients are saying.

Both are important. One is not more important than the other. Both are important. So scorecards are very, very integral in assessing the quality of clinical work and the overall health of a practice period.

Third piece, so again, we're talking about the EOS lens on feedback. This third thing is using a tool like GWC to create clarity without blame, really into blame. Blame is a pretty defensive tactic and posture, and I just, I don't know. I'm not really into defensiveness.

GWC is, gets it wants in capacity to do it, and it's a yes or no question for each of them. It's yes or no. You get no other options. It's not sometimes, sometimes is no, it's either yes or it's no. So gets it is does the person get their job? Do they understand their role?

Do they get how it fits into the larger structure and system? Do they get what's expected of them, yes or no? Once it is. Do they want the job based on compensation expectations, the role itself and how it fits. Specifically, this is as it is not the role in six months or six years, but the role right now, do they want this?

And a good way of thinking about this is are they working hard? Like if they say they want it, it does their behavior match up? That's really the question. 'cause somebody might say, well, yeah, I want it. But if you're not seeing any behavior that would indicate they want the role, then it's a no.

And in, in this case in particular, when you're doing GWC, the direct supervisor, the leadership, the ownership input really fucking matters because your view on what's happening, that's gonna be very different from the person who's in the seat. So just to clarify that piece.

C is gonna be capacity to do it. So financial, emotional, logistical, cognitive. Physical. There's a bunch of different ways where capacity can show up a bunch of different styles in which capacity can show up, and somebody might have capacity initially, and then maybe their schedule changes or maybe they have a baby, or maybe they just, you know, they're going back to school for something slightly different and it's okay.

Capacity can change. So having GWC as a, almost like a launching off point for a conversation. It can be really helpful where if I'm talking with somebody, and I think I've used this example before, but if I'm talking with somebody and I say, this is a 40 hour a week job, like, we need you for 40 hours, and they say to me, I want this so much, and I, I totally get it, but I, I only have 30 hours available in a week.

It might not be about wanting it or getting it. It literally could just be capacity, and the answer is no. And so therefore, that's not that right person for that seat, which that's, that sucks, but you know, it happens. So GWC is another way, yet another way that EOS fakes some feedback into everything about the business.

So lemme just recap those because I covered a lot. So the EOS lens on feedback, again, we've got structure which can create emotional, psychological safety. We've got L tens, quarterly conversations and scorecards, and now we have gwc. So, there's a bunch of different places in which it's baked in.

Agenda item number three, real talk, you're probably assuming too much. So what can happen sometimes is that leaders confuse longevity and familiarity with clarity. So your oldest clinician doesn't mean, I don't mean old age. I mean like longevity with the practice doesn't equal your most informed or your most understanding of policy clinician. They're not the same thing.

What can happen sometimes is that we as leadership assume, well, this person, they've been around for years. They know what's expected. You don't know that. You don't know that, and I'm gonna answer, most likely, no the fuck they don't. They don't, 'cause they're just sort of doing things almost like mechanically, you know, they know what to do and so they just do it and slash or they know what to do, they don't like it that way. So they've made a little modification and now they do that thing.

So it might be that we assume they really get it. They really understand their role. They're totally, they got it. They totally get it. No, we don't know that for sure.

So I would say it is often the case that leadership will confuse the two. They'll confuse longevity or familiarity with clarity. Clarity of role, clarity of expectations, clarity of processes and policies. They're not one and the same.

Additionally, what leadership will tend to do is overemphasize culture and underemphasize structure. Look, I fucking love culture. Don't come at me with this. I also know culture and structure, they have to go hand in hand. You cannot have one without the other period.

So feelings do not trump clarity of expectations ever . Just point blank period. Feelings and emotionality are not more important than being clear on what's expected.

And the vibe, which I love A good vibe is not more important than the process. It's not, they have to be treated equally. Some people might say that structure is more important than culture. I'm not one of those people, and I will also not say that culture is more important than structure. I think both are non-negotiables. They both need to be present and no, I don't think that's asking too much. Don't come at me for a second time.

Two more agenda items. Number four, anchoring in values without weaponizing them. I fucking love this so GD much.

Again, we're talking about feedback that works here. So whenever we are using values to fuel and drive and sort of inform how we engage with each other. They are a part of what we're doing.

They're not buzzwords. We are not paying lip service. We are living out our core values. And when we do that, what we're also doing is creating shorthand. We're creating a language of communicating with one another. So when I send an email and I say, fuck yeah, Megan really owned her shit. That was incredible. Every single person knows what I'm talking about.

If I do a one-on-one and I say, Hey, um, I'm not seeing authenticity, like, tell me what's up. That's not a buzzword. And it's not me saying you're not authentic. Get it together.

It's me saying like, Hey, you know what? You know what this is, like, what's going on, like, level with me. What's happening? So having core values as a shared language gives us a shorthand way of engaging with each other. And also whenever we do shout outs, whenever we talk about values fits whenever we, all the things that we do with regard to values connects us and then again, no lip service, no buzzwords, not weaponizing, further instills the significance of these things in living them out together without seeming like we are just painting by numbers, so to speak.

Another thing that this actually, this next point comes up for me a lot. So another thing that's really important in anchoring, in values, I have said to my leadership team, I, I mean, on more than one occasion where I do not want to become cult-Like I don't want to be this place that we are so self-contained and so.

You know, um, these values are important. This is how we live them out. This is what we do, that we don't see anything outside of this, and we're unwilling to take into consideration other input. I can't have that. And so I, I think there's a balance here. I think there is staying in tune with your values and staying in alignment with them, not weaponizing them, not using them against people and trying to like.

Um, make people feel small or anything like that if they, they messed up or made a mistake. But I also think there's something around continuing to assess if they fit. And so for me, the goal with having core values, I sort of think about what's the intention then if I don't wanna become cult-like, and I don't want this to just be, you're here, you with us and never look elsewhere.

Instead, I wanna really actively think about do these fit for us? Are they accurate? Are we in alignment with them? Do we live them out? Do they fit all of the needs that we have as a growing practice, as a continuing to evolve and grow place of being? The intention is accuracy and growth. And so I think that's the thing is that you have to continue to question if they fit for you.

That's the only way that I can make sense of how we do this without it shifting into some sort of weird therapy cult. I don't, I don't wanna do anything like that.

So it's not a set it and forget it, it's a set it, assess it. So again, I think about feedback. It's also this almost like self-directed feedback. Does this really fit? Because you don't wanna turn into a cult. Well, you might actually want to, I don't know you directly, but I would hope you don't wanna turn into some, you know, therapist cult.

Okay, let's do this. Let's bring this home, shall we?

Here's what it looks like to lead through feedback, and some of this is gonna feel like I'm repeating myself because I already talked about these basically. So if you've been listening the whole time, you might say, yeah, Tara, we got it. We fucking know. I'm still gonna say it 'cause we're nearing the end. So talking about that recency effect, you know, primacy and recency effect.

Okay. Again, we've got these Elton style meetings every week. We're looking at our scorecards. What we're doing is we're able to figure out what's off. So I'm looking at gross revenue. I'm looking at weekly session count. I'm looking at utilization. I'm looking at marketing base numbers. I'm looking at conversion rate and inquiries. All of these things indicate to me we are seeing enough clients or we're not running into any billing issues. We are at capacity with our therapist. We are converting a certain number of clients. We have this many who are reaching out, we're hitting these marketing goals.

It's a pulse of the practice I see at in one view what the next week or two will look like. You can see, you can just look and tell from your view of the scorecard. So what's great is that it can indicate when under performance is going to happen before it happens.

That's incredible. If I know we had a low week of sessions, then I know our revenue's gonna drop in the next week to two because we do, uh, probably half insurance based pay, if not a little bit more than, and so there's a little bit of a lag time between session count and revenue.

If I see that our marketing numbers are super high, then I'm probably gonna anticipate an increase in our inquiries. You'll see our inquiries are high, but our utilization is also really high. I'm gonna see a drop in conversion 'cause we're not gonna have space for those clients, and that means we also need to hire.

So what you can do is see the story behind the numbers. It's not just you guessing, it's you having a view of what's happening and being able to assess like, then change something. Look, be proactive. You can do in that moment, you can do what you need to do to either rectify a future issue or plan for something down the pike.

I mean, another example is gonna be that quarterly conversation. So if I'm meeting with somebody and I say, you know what's working? They're gonna tell me what's working. We have a safe space where feedback is the norm. And so my expectation is that they're going to be honest. I might actually lead with what's not working, tell me what's not going well, because I want it to be okay that something isn't going well.

So what I will say about quarterly conversations, I said they were optional. They, they basically are almost, uh, all the time and we reserve the right to make them mandatory for any one person that we might need to. So if I know something's up with somebody and I wanna engage, I'm gonna mandate that quarterly conversation for that quarter.

The off quarters, we actually do biannual review. So let's just say quarters one and four. Three are biannual reviews. Two and four are the quarterly conversations. So every quarter there's engagement or the possibility of engagement with each person on the team. I. So let's say it's quarterly conversation quarter, and I mandate something with Taylor and I say, tell me what's working.

Tell me what's not working. That might morph into a conversation about, you know, gets, it, wants it, capacity to do it. It could be something where she says, I don't really feel like you are entrusting me to do my job enough. I might do something I might share about some of my own confusion about. The expectations and I, I might need to collaborate with her.

I don't, I don't have any idea. I mean, it's sort of like TBD, what comes up, but the beauty is that the space is designed for that sort of free flowing conversation around how things are going, where you're not necessarily looking at metrics together, but you are spending time just talking about yet again what is working and what is not working.

The last thing I'll say about leading through feedback is that what it really does is. It allows for any conversation to take place with the least amount of fear as possible. So what I won't say is that by baking feedback into your system, you will never have fear from your employees around being honest with you. That's not. Of course you will. You're gonna have people who are still wary of speaking up.

It's hard to speak up, but what I will say is that they're going to be way more inclined to speak up and be honest with you. And so they know that it's safe to do this. Even if physiologically there's still a little bit. Like, ugh, A little bit physiologically aroused, a little bit scared, a little bit overwhelmed about doing it.

They're going to, that's what you want. And each time they do, you should give them a metaphorical hug and tell them, thank you so much for sharing that with me. It's important to me that you be honest with me about your experience, about what you're seeing happening, about any feedback that you have.

Whether or not you can do anything with that feedback is a different conversation and another story. But the fact that they gave it to you is an incredible testament to the relationship that you have with that person, as well as the culture that you've built at your practice. That's why feedback is important.

On that note, we're done. This has been great, y'all. What I will say is that if you wanna figure out how to bake this in, if you keep hearing about EOS and you're like, fuck yeah, I need to look into that, bro, just join the EOS wait Mastermind wait list.

I have the Mastermind starting very, very soon. And technically it starts twice a year, but right now in this moment, it's also going to be starting very soon. So the wait list gets first dibs. They get first access when the Mastermind actually opens up. So join, you can go to www.taravossenkemper.com/eos-mastermind.

There's a link for the wait list there, and you can also just read about it to see what's going on with it. Okay. Like I said, this has been great. Thank you so much for being here with me. I didn't say that part, but I'm saying it right now. I will see you next time. Thanks. See ya.