SCOTT D Miller - For the latest and greatest information on Feedback Informed Treatment

  • About
    • About Scott
    • Publications
  • Training and Consultation
  • Workshop Calendar
  • FIT Measures Licensing
  • FIT Software Tools
  • Online Store
  • Top Performance Blog
  • Contact Scott
info@scottdmiller.com 773.404.5130

Is your therapy making your clients worse? The Guardian Strikes Again

June 12, 2014 By scottdm 1 Comment

demand-evidence-and-think

Last week, an article appeared in The Guardian, one of the U.K.’s largest daily newspapers.  “Counselling and Therapy can be Harmful,” the headline boldly asserted, citing results of a study yet to be published.  It certainly got my attention.

Do some people in therapy get worse?  The answer is, most assuredly, “Yes.”  Research dating back several decades puts the figure at about 10% (Lambert, 2010).  Said another way, at termination, roughly one out of ten people are functioning more poorly than they were at the beginning of treatment.

The cause?  Here’s what we know.  Despite claims to the contrary (e.g., Lilenfeld, 2007), no psychotherapy approach tested in a clinical trial has ever been shown to reliably lead to or increase the chances of deterioration.  NONE.  Scary stories about dangerous psychological treatments are limited to a handful of fringe therapies–approaches that have been never vetted scientifically and which all practitioners, but a few, avoid.

So, if it’s not about the method, then how to account for deterioration?  As the article points out, “some therapists had a lot more clients [who] deteriorated than others.”  And yet, while that statement is true–lots of prior research shows that some do more harm than others–there are too few such clinicians to account for the total number of clients who worsen.  Moreover, beyond that 10%, between 30 and 50% of people in treatment experience no benefit whatsoever!

Here is where the old adage, “an ounce of prevention is worth a pound of cure,” applies.  Whatever the cause, lack of progress and risk of deterioration are issues for all clinicians.  A growing body of research makes clear, the key to addressing the problem is tracking the progress of clients from visit to visit so that those not improving, or getting worse, can be identified and offered alternatives.

It’s not hard to get started.  You can learn a simple, evidence-based method for tracking progress and the quality of the relationship at: www.whatispcoms.com.  Best of all, practitioners can access the tools for free!

After that, join fellow practitioners from the US, Canada, Europe, and Australia  for one of our intensive trainings  coming up this August in Chicago.  I promise you’ll leave prepared to address the issue of deterioration directly and successfully.

Filed Under: Feedback Informed Treatment - FIT Tagged With: clinical trial, counselling, lilenfeld, michael lambery, psychotherapy, the guardian, therapy, Training, whatispcoms

SEARCH

Subscribe for updates from my blog.

  

Upcoming Training

 ICCE FIT Intensive Training with Dr. Scott Miller
ICCE FIT Supervision Intensive Online Scott D Miller

FIT Software tools

FIT Software tools

NREPP Certified

HTML tutorial

LinkedIn

Topics of Interest:

  • Behavioral Health (110)
  • behavioral health (4)
  • Brain-based Research (2)
  • CDOI (14)
  • Conferences and Training (67)
  • deliberate practice (27)
  • Dodo Verdict (9)
  • Drug and Alcohol (3)
  • evidence-based practice (65)
  • excellence (61)
  • Feedback (38)
  • Feedback Informed Treatment – FIT (203)
  • FIT (25)
  • FIT Software Tools (12)
  • ICCE (26)
  • Implementation (7)
  • medication adherence (3)
  • obesity (1)
  • PCOMS (11)
  • Practice Based Evidence (38)
  • PTSD (4)
  • Suicide (1)
  • supervision (1)
  • Termination (1)
  • Therapeutic Relationship (8)
  • Top Performance (39)

Recent Posts

  • Making Sense of Client Feedback
  • Umpires and Psychotherapists
  • Augmenting the Two-Dimensional Sensory Input of Online Psychotherapy
  • Death of a Friend
  • The Cost of Caring

Recent Comments

  • Asta on The Expert on Expertise: An Interview with K. Anders Ericsson
  • Michael McCarthy on Culture and Psychotherapy: What Does the Research Say?
  • Jim Reynolds on Culture and Psychotherapy: What Does the Research Say?
  • gloria sayler on Culture and Psychotherapy: What Does the Research Say?
  • Joseph Maizlish on Culture and Psychotherapy: What Does the Research Say?

Tags

addiction Alliance behavioral health brief therapy Carl Rogers CBT cdoi common factors conferences continuing education denmark evidence based medicine evidence based practice Evolution of Psychotherapy excellence feedback feedback informed treatment healthcare holland icce international center for cliniclal excellence medicine mental health meta-analysis Norway NREPP ors outcome measurement outcome rating scale post traumatic stress practice-based evidence psychology psychometrics psychotherapy psychotherapy networker public behavioral health randomized clinical trial SAMHSA session rating scale srs supershrinks sweden Therapist Effects therapy Training