How Clients (and all of us) Think (or Not)

These findings come from medical treatment and doctor-patient research.  To borrow a phrase from politics, it’s not the evidence, stupid — it’s the narrative.

Clients easily accept results they like and nitpick the evidence that they don’t.

When clients encounter a finding they don’t like, they have a need to explain it away.

How clients process information — clients process it through their existing beliefs, and it’s hard to override those beliefs.

Naive Realism: Clients have the idea that whatever they believe, they believe it simply because it’s true.

Mental Model: A conceptual framework and mental representation about how something works that helps clients make sense of the world.  Once a mental model is in place, clients force new information to fit within it.

Clients presented with corrective information that runs counter to their pre-existing ideology will not update their beliefs accordingly, and the corrections actually strengthen misperceptions among the most strongly committed clients.

Sometimes it’s better to do less, but that doesn’t sit well with clients; it sounds like a loss of resolve or capitulating to uncomfortable feelings or circumstances.

First, recognize that the facts alone are unlikely to change client’s mind.  Also, clients get defensive when you tell them they’re wrong.

Presenting clients with facts in conflict with their belief spurs them to re-examine all the reasons they’ve held this belief in the first place, and this process of remembering serves to reinforce the initial belief, despite contrary evidence.

Belief is a very difficult thing to overturn, especially when the belief is held by clients with a vested interest in the old message.   Sometimes these investments are monetary, but they can also be personal, family or status related or altruistic.

When the evidence presents a messy, unsatisfying picture, clients are likely to take refuge in a more comforting story, even in the face of evidence that it’s wrong. 

New evidence must be framed in an appealing story, one that acknowledges the existing narrative.  

For truth to win, stakeholders must also have a shared vision of what the problem is, so they can mutually recognize the correct solution once it’s found…that means establishing agreement on what “effective” means.

And then there’s the question of what constitutes evidence.  Proponents of comparative effectiveness research look for answers in large-scale trials, but these studies hinge on statistics about large groups of clients.  Such number crunching rarely has the power of personal anecdote. “Studies have shown that powerful anecdotes trump data; clients see that again and again,”

Science works in data and statistics, but life and investing is made up of stories…they’re the way clients make sense of the evidence.

To take hold, evidence-based messages must also meet the human need for comfort and empowerment. “…uncertainty is very hard, so you need to find a way to reframe it so that you can say, ‘The good thing about this is…,’

Explanations that offer hope and empowerment will always hold more appeal than those that offer uncertainty or bad news, and when new evidence offers messy truths, they must be framed in a positive light if they’re to gain traction.   You can ask clients to give up ineffective interventions, but you must never ask them to abandon hope.