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Top Performance Blog

Feedback Informed Treatment in Statutory Services (Child Protection, Court Mandated)

"We don't do 'treatment,' can we use FIT?" It's a question that comes up with increasing frequency as use of the Outcome and Session Rating Scales in the helping professions spreads around the globe and across diverse service settings. When I answer an unequivocal, "yes," the asker often responds as ...
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March 17, 2021 / Feedback Informed Treatment - FIT

Do We Learn from Our Clients? Yes, No, Maybe So …

When it comes to professional development, we therapists are remarkably consistent in opinion about what matters.  Regardless of experience level, theoretical preference, professional discipline, or gender identity, large, longitudinal studies show "learning from clients" is considered the most important and influential contributor (, ).  Said another way, we believe clinical ...
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March 2, 2021 / Behavioral Health, deliberate practice, evidence-based practice, Feedback Informed Treatment - FIT, FIT

Developing a Sustainable Deliberate Practice Plan

Amateurs have goals.  Experts have a system. Bold statements to be sure, both supported by research on deliberate practice -- the one activity documented to improve clinicians' therapeutic effectiveness. Much is made in the self-improvement and therapy literature about the importance of setting goals.  Unless you've been hiding under a ...
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January 20, 2021 / Feedback Informed Treatment - FIT

Making Sense of Client Feedback

I have a guilty confession to make.  I really like Kitchen Nightmares.  Even though the show finished its run six L O N G years ago, I still watch it in re-runs.  The concept was simple.  Send one of the world's best known chefs to save a failing restaurant. Each week a ...
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January 4, 2021 / deliberate practice, excellence, Feedback, Feedback Informed Treatment - FIT, FIT, Therapeutic Relationship

Umpires and Psychotherapists

Criticizing umpires is as much a part of watching baseball as eating hotdogs and wearing team jerseys on game day.  The insults are legion, whole websites are dedicated to cataloging them: "Open your eyes!" "Wake up, you are missing a great game!" "Your glasses fogged up?" "Have you tried eating ...
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December 9, 2020 / Feedback Informed Treatment - FIT

Augmenting the Two-Dimensional Sensory Input of Online Psychotherapy

Take a look at the graphic to the left.  It shows the use of the Outcome and Session Rating Scales (ORS & SRS) from the beginning of this year to the present by users of one of the three , authorized FIT software programs. What do you see? A couple of ...
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November 30, 2020 / Feedback Informed Treatment - FIT

Death of a Friend

It's rarely good news when the phone rings in the wee hours of the morning.  This time, it was a colleague calling to let me know that Rich Simon -- the founder and editor of the Psychotherapy Networker and long time friend -- had died. To say the news came as ...
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November 19, 2020 / Feedback Informed Treatment - FIT

The Cost of Caring

Eighty three million, six hundred fifty thousand, thirty seven. Can you guess what this number represents? No, its not the net worth of the latest tech millionaire.  Neither is it the budget of a soon-to-be released Hollywood blockbuster. Guess again. Give up? It's the number of adults in the U.S ...
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October 6, 2020 / Feedback Informed Treatment - FIT

Is competence hurting to your clients?

Here's an interesting dilemma.   In December 1799, three physicians were summoned to the Mount Vernon estate to treat the former first president of the United States for a sore throat.  The accepted therapy of the day was administered skillfully and competently multiple times.  Several hours later, the president was dead.  Historians agree ...
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September 14, 2020 / Feedback Informed Treatment - FIT

Culture and Psychotherapy: What Does the Research Say?

I remember exactly where I was on April 4th, 1968 -- in a pool doing laps.  I was a junior member of my hometown's swim team.   I'd barely started when the coach blew his whistle calling the practice to an abrupt halt.  As we toweled off, he told us something ...
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August 7, 2020 / Feedback Informed Treatment - FIT

BAD THERAPY

Bad therapy. Are you guilty of it?  A quick internet search turned up only 15 books on the subject.  It's strange, especially when you consider that between 5 and 10% of clients are actually worse off following treatment and an additional 35-40% experience no benefit whatsoever!  (Yep, that's nearly 50%) And what ...
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July 28, 2020 / Feedback Informed Treatment - FIT

Does Teletherapy Work?

With the outbreak of the coronavirus, much of mental health service delivery shifted online. Regulations regarding payment and confidentiality were scaled back in an effort to deal with the unprecedented circumstances, allowing clinicians and their clients to meet virtually in order to reduce the spread of the illness.   But ...
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July 22, 2020 / Feedback Informed Treatment - FIT

Getting Beyond the “Good Idea” Phase in Evidence-based Practice

The year is 1846.  Hungarian-born physician Ignaz Semmelweis is in his first month of employment at Vienna General hospital when he notices a troublingly high death rate among women giving birth in the obstetrics ward.  Medical science at the time attributes the problem to “miasma,” an invisible, poison gas believed ...
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July 9, 2020 / evidence-based practice, Feedback Informed Treatment - FIT, FIT, Implementation

Forgiveness

One warm, summer June day, Marietta Jaeger, her husband Bill, and their five children packed into their borrowed R.V. for a cross-country road trip touring the American west.  "This was going to be the adventure of a lifetime, a grand family vacation, the one we were going to talk about for ...
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July 1, 2020 / Feedback Informed Treatment - FIT

The Expert on Expertise: An Interview with K. Anders Ericsson

I can remember exactly where I was when I first "met" Swedish psychologist, K. Anders Ericsson.  Several hours into a long, overseas flight, I discovered someone had left a magazine in the seat pocket.  I never would have even given the periodical a second thought had I not seen all ...
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June 23, 2020 / deliberate practice, excellence, Feedback, Feedback Informed Treatment - FIT

Renewing your FIT & Deliberate Practice Efforts following the COVID-19 Outbreak

First, the coronavirus outbreak.  Then the lockdown, followed by an ever-rising number of deaths and catastrophic economic fallout -- and just when the tide seemed to be turning, George Floyd was murdered in Minneapolis resulting in nationwide protests and unrest. I don't recall a time in recent memory when events ...
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June 4, 2020 / Feedback Informed Treatment - FIT
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Recent Posts

  • Feedback Informed Treatment in Statutory Services (Child Protection, Court Mandated)
  • Do We Learn from Our Clients? Yes, No, Maybe So …
  • Developing a Sustainable Deliberate Practice Plan
  • Making Sense of Client Feedback
  • Umpires and Psychotherapists

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