Integrity In Our Work

By: Ann Marie Vorbach, Ph.D., LP

One of the most helpful and powerful ways that I think about what I do – in life and in our work – is to practice the Four Agreements.  If these are unfamiliar to you, you might take some time to read the book of the same name, “The Four Agreements,” by Don Miguel Ruiz. While the book was written as a ‘spiritual treatise’ the principles are useful in every situation that we deal with as Deer Oaks clinicians.

  1. Be impeccable with your word.  As psychotherapists and consulting experts, our words can have tremendous power.  Use that power for good!  One good way to practice this is to only promise what you can deliver.  And then, be sure to deliver what you promise, even if it isn’t perfectly clear to you that it is valued.  When we follow through with what we say we will do, then it builds our credibility and others know that they can trust us.
  1. Don’t take anything personally.  This reminder is so important when working with difficult people.  Whatever anyone else does or says is more a reflection of them – their values, ideas, priorities, and feelings – than it is about you.  Even when they work very hard to convince you, that YOU are the problem.  When a patient becomes angry with you, when they don’t seem to get better, despite your best efforts, when staff don’t listen to you or aren’t supportive – remember that there are many, many external forces at work in any given situation.   That can take the pressure off to feel responsible or guilty, and we can be freed to do our best work.
  1. Don’t make assumptions.  When we diagnose and create treatment plans, we are required to make judgments about others – there is no way around this.  However, approaching our work with a sense of curiosity and questioning is far more effective then assuming that we know exactly what is going on.  People are changing all the time and can surprise us.  When we operate out of our assumptions about how or who others are, then we can impose limits on our own creativity and fail to see change as it occurs.
  1. Always do your best.  This one is pretty straightforward, but bears repeating.  There are times when we feel at our best, and times when we don’t.  However, no matter how we may be feeling on a given day, we can bring the best that we have within us at that moment and in that place.  We don’t have to be superheroes, but we do need to trust that we have something valuable to offer in the situation that we are in.  We also then need to be willing to offer what we have in many ways.  We interact respectfully, not only with our patients, but with the staff in our facilities.  We can always find some contribution to make in a nursing home and with our patients, but we cannot make everything better, all the time.

So, anytime you are feeling at a loss, frustrated, burned out, uncertain… think about these 4 rules as a way to evaluate yourself and your experience. You may be guided to greater wisdom as a clinician as well as to a greater appreciation of your part in the larger picture of the work that we do.


Anne Marie Vorbach, PhD, LP joined the Deer Oaks Team in 2012 and is a Regional Clinical Manager.  She oversees clinical services delivery for the Idaho, Minnesota, Nebraska, North Dakota, South Dakota, and Wyoming service locations.