How not to be among the 70-95% of practitioners and agencies that fail

April 20, 2014 By scottdm Leave a Comment

Our field is full of good ideas, strategies that work. Each year, practitioners and agencies devote considerable time and resources to staying current with new developments. What does the research say about such efforts? When it comes to the implementation of new, evidence-based practices, traditional training strategies routinely produce only 5% to 30% success rates. Said another way, 70-95% of training fails (Fixsen, Blase, Van Dyke, & Metz, 2013).

In 2013, Feedback Informed Treatment (FIT)–that is, formally using measures of progress and the therapeutic alliance to guide care–was deemed an evidence-based practice by SAMHSA, and listed on the official NREPP website. It’s one of those good ideas. Research to date shows that FIT as much as doubles the effectiveness of behavioral health services, while decreasing costs, deterioration and dropout rates.

As effective as FIT has proven to be in scientific studies, the bigger challenge is helping clinicians and agencies implement the approach in real world clinical settings. Simply put, it’s not enough to know “what works.” You have to be able to put “what works” to work. On this subject, researchers have identified five, evidence-based steps associated with the successful implementation of any evidence-based practice. The evidence is summarized in a free, manual available online. You can avoid the 70-95% failure rate by reading it before attending another training, buying that new software, or hiring the latest consultant.

At the International Center for Clinical Excellence, we’ve integrated the research on implementation into all training events, including a special, two-day intensive workshop on implementing Feedback-Informed Treatment (FIT). Based on the five, scientifically-established steps, clinicians, supervisors, and agency directors will learn how to both plan and execute a successful implementation of this potent evidence-based practice.

You can register today by clicking on the link above or the “FIT for Management” icon below. Feel free to e-mail me with any questions. In the meantime, hope to see you this summer in Chicago!

Did you know your clients can tell if you are happy?

January 19, 2014 By scottdm 2 Comments

It’s true. Adding to a growing literature showing that the person of the therapist is more important than theoretical orientation, years of experience, or discipline, a new study documents that clients are sensitive to the quality of their therapist’s life outside of treament. In short, they can tell when you are happy or not. Despite our best efforts to conceal it, they see it in how we interact with them in therapy. By contrast, therapists’ judgements regarding the quality of the therapy are biased by their own sense of personal well-being. The solution? Short of being happy, it means we need to check in with our clients on a regular basis regarding the quality of the therapeutic relationship. Multiple randomized clinical trials show that formally soliciting feedback regarding progress and the alliance improves outcome and continued engagement in treatment. One approach, “Feedback-Informed Treatment” is now listed on SAMHSA’s National Registry of Evidence-Based Programs and Practices. Step-by-step instructions and videos for getting started are available on a new website: www.pcomsinternational.com. Seeking feedback from clients not only helps to identify and correct potential problems in therapy, but is also the first step in pushing one’s effectiveness to the next level. In case you didn’t see it, I review the research and steps for improving performance as a therapist in an article/interview on the Psychotherapy.net website. It’s sure to make you happy!

Excellence in Amsterdam: The 2013 ACE Conference

June 6, 2013 By scottdm Leave a Comment

My how time flies! Nearly three weeks have passed since hundreds of clinicians, researchers, and educators met in Amsterdam, Holland for the 2013 “Achieving Clinical Excellence.” Participants came from around the globe–Holland, the US, Germany, Denmark, Italy, Russia, Norway, Sweden, Denmark, New Zealand, Romania, Australia, France–for three days of presentations on improving the quality and outcome of behavioral healthcare. Suffice it to say, we had a blast!

The conference organizers, Dr. Liz Pluut and Danish psychologist Susanne Bargmann did a fantastic job planning the event, organizing a beautiful venue (the same building where the plans for New York City were drafted back in the 17th century), coordinating speakers (36 from around the globe), arranging meals, hotel rooms, and handouts.

Dr. Pluut opened the conference and introduced the opening plenary speaker, Dr. K. Anders Ericsson, the world’s leading researcher and “expert on expertise.” Virtually all of the work being done by me and my colleagues at the ICCE on the study of excellence and expertise among therapists is based on the three decades of pioneering work done by Dr. Ericsson. You can read about our work, of course, in several recent articles: Supershrinks, The Road to Mastery, or the latest The Outcome of Psychotherapy: Past, Present and Future (which appeared in the 50th anniversary edition of the journal, Psychotherapy).

Over the next several weeks, I’ll be posting summaries and videos of many of the presentations, including Dr. Ericsson. One key aspect of his work is the idea of “Deliberate Practice.” Each of the afternoon sessions on the first day focused on this important topic, describing how clinicians, agency managers, and systems of care can apply it to improve their skills and outcome.

The first of these presentations was by psychologist Birgit Valla–the leader of Family Help, a mental health agency in Stange, Norway–entitled, “Unreflectingly Bad or Deliberately Good: Deciding the Future of Mental Health Services.” Grab a cup of coffee and listen in…

Oh, yeah…while on the subject of excellence, here’s an interview that just appeared in the latest issue of the UK’s Therapy Today magazine:

Excellence in therapy: An Interview with Scott D. Miller, Ph.D. by Colin Feltham.

It starts on page 32.