Feedback Informed Treatment

Talk therapy works.  Meta-analyses of research studies clearly shows that it leads to desired change in people’s lives.

Nevertheless, what works in talk therapy has remained illusive.  The helping professions, in following the research paths used in medicine, have focused their attention almost solely on therapeutic modalities, defining and labelling problems and vying for superiority on what approaches work best with specific problems.  Unfortunately, these efforts have largely failed (despite declarations of so-called “gold standards”) to provide any convincing evidence of efficacy in the real world.

In recent years, the work of Scott Miller, Barry Duncan, Bruce Wampold, Mark Hubble and others have provided helping professionals with some exciting conclusions that offer great potential for better outcomes in mental health services.  Through extensive review of the literature and research, they have clearly identified the strongest predictors of retention, progress and success in treatment: (1) the consumer's rating of the alliance with the provider of services and (2) the consumer's rating of early progress in response to the provider, level and type of treatment offered. 

The implications of these findings are significant.  A poor therapeutic alliance or the lack of early progress will likely result in consumer dropout and/or a negative outcome.  The use of feedback informed treatment practices (FIT), therefore, allows practitioners to pay close attention to these predictors and, in collaboration with the consumer, make necessary adjustments that will maximize the possibility of treatment success.

The tools used to achieve this are the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS).  These ultra-brief measures enable consumers to give feedback to the clinician regarding progress and the strength of the therapeutic alliance.  These feedback informed treatment practices are very much in keeping with the principles and philosophy of solution focused practice (paying attention to what works and what's important to the client).  As such, HBTC strongly recommends that solution focused practitioners ultize these practices in their work.

For further learning, HBTC recommends The Heart and Soul of Change (click the image above) as a key resource in understanding what works in therapy, regardless of your therapeutic approach.  In addition, we also encourage solution focused practitioners to join the International Center for Clinical Excellence (click image at left).  The ICCE is an excellent community for practitioners all over the world who are committed to achieving postive outcomes in their work with consumers.