Are Counseling and Psychotherapy a Con? The Gauntlet is Thrown in New Zealand

February 15, 2013 By scottdm 2 Comments

Earlier this summer, I was contacted by Donna Chisholm, editor of and reporter for Metro and North & South Magazines in New Zealand. She was doing a feature article on the effectiveness of psychological services. The State spent scads of money on treatment. Concerns had been raised by some that “people may be wasting their own and the taxpayers money with ineffective services, therapists, and counselling.”

“Could we talk?” she wanted to know. After sorting the time difference between New Zealand and Chicago and working around my crazy travel schedule, we connected via Skype. I learned that her interest in the subject of treatment outcome began when she heard fellow kiwi, and counselor, Steve Taylor , being interviewed on radio about the effectiveness of Social Services.

Over the last few years, Steve had given a number of such interviews, pointedly criticizing the system for failing to measure results. Time and again, he highlighted popular programs for which there was either no empirical support or which the available evidence indicated did not work.

These gibes did not go unnoticed. Once he was anonymously attacked on air while commenting on Family Court outcomes in New Zealand. Throughout, Steve stuck to his stance, using research to make his point, arguing that providers and systems of care needed to produce evidence of real outcomes via the use of routine outcome measurement.

The article Donna wrote appeared in print this week, entitled, “Counselling: Cure or Con?” Provocative and well-written, the piece puts “Feedback-Informed Treatment (FIT) front and center, concluding that “a profession whose practitioners spend their days analysing others, its about time they started examining themselves.” It also provides practical, research-based advice for anyone thinking about seeing a therapist. Anyway, read it for yourself:

North & south counselling outcomes article march 2013

Resources on Feedback-Informed Treatment, Training, & Research

January 24, 2013 By scottdm Leave a Comment

Last week, I spent a day in London working with the clinical staff of the Hertfordshire Partnership NHS Foundation Trust. The subject? Feedback, of course! As soon as I stepped off my transcontinental flight, I knew it was going to be a fun day. Every way I turned at the Heathrow airport I was greeted by a machine asking for feedback about my experience: after exiting customs, at the baggage claim area, at the duty free shops. Amazing!

The process was as engaging as it was efficient. Tell us about your experience…by pressing a button bearing one of four different faces. The similarity to the ICCE Young Child Outcome Rating Scale was striking (to say the least). I felt compelled to register my feedback at every opportunity.

From London, I travelled to Gotheburg, Sweden for the first Scandanavian Advanced Intensive Training in Feedack Informed Treatment. The event, organized by GCK, Gothenburg’s Center for Competence Development, sold out in a week with participants coming from all over Scandanavia. I taught the course together with ICCE Senior Associate Susanne Bargmann using a curriculum based on the FIT Treatment and Training Manuals. The series was developed to support, in part, ICCE’s application to the US Substance Abuse and Mental Health Services Administration (SAMSHA) for designation of FIT as an evidence-based practice. Together with the Training of Trainers (TOT) and Supervision Intensive workshops, the manuals and Advanced Intensive training provides participants with the latest, cutting-edge, evidence-based information and skills in FIT.

Back in October, I blogged about an article that reviewed the evidence regarding psychotherapy training. In it, the author John Malouff concluded, “There appears to be no evidence that coursework and research completion…have any value to future psychotherapy clients…”. He continued, “Training programs…carry the responsibility to show that the training they provide have positive benefits for future clients.”

Well…on that score, learning FIT, available evidence shows, leads to direct benefits to consumers of behavioral health services. Together with New Zealand based psychologist and ICCE Senior Associate Eeuwe Schuckard, I’ve updated the review of the research supporting FIT practice (click here).

Don’t wait to learn about or deepen your understanding of and skills in feedback informed treatment. The Advanced Intensive scheduled for March 18-321st has a few spots left. You can register online by clicking here.

By the way, shortly after the publication of Malouff’s review in Psychotherapy in Australia, I wrote to the editor, Liz Sheehan, and asked for permission to reprint the article. Click here to read it.

Outcomes in New Zealand

March 23, 2010 By scottdm Leave a Comment

Made it back to Chicago after a week in New Zealand providing training and consultation. As I blogged about last Thursday, the last two days of my trip were spent in Christchurch providing a two-day training on “What Works” for Te Pou–New Zealand’s National Centre of Mental Health Research, Information, and Workforce Development. Last year around this same time, I provided a similar training for Te Pou for managers and policy makers in Auckland. News spread and this year my contact at Te Pou, Emma Wood brought the training to the south island. It is such a pleasure to be involved with such a forward thinking organization.

Long before I arrived, leadership at Te Pou were promoting outcome measurement and feedback. Here’s a direct quote from their website:

Outcomes information can assist:

service users to use their own outcomes data to reflect on their wellbeing and circumstances, talk to clinicians about their support needs and inform their recovery plans
clinicians to use outcomes information to support their decision-making in day-to-day practice, monitoring change, better understanding the needs of the service user, and also to begin evaluating the effectiveness of different interventions
planners and funders to assess population needs for mental health services and assist with allocation of resources policy and mental health strategy developments through nationally aggregated data.

Indeed, using outcome to inform mental health service delivery is a key aspect of the Past, Present, and Future: Vision Paper–a review of “what works” in care and a plan for improving treatment in the future. The site even publishes a quarterly newsletter Outcomes Matter. Take a few minutes and explore the Te Pou website. While you are there, be sure and download the pamphlet entitled, “A Guide to Talking Therapies.” As the title implies, this brief, easy-to-read text provides a non-nonsense guide to the various “talk therapies” for consumers (I took several copies home with me from the workshop).

Before ending, let me say a brief hello to the Clinical Practice Leaders from the Problem Gambling Foundation of New Zealand who attended the two-day training in Christchurch. The dedicated staff use an integrated public health and clinical model and are working to implement ongoing measurement of outcome and consumer feedback into service delivery. The website contains a free online library including fact sheets, research, and books on the issue of problem gambling that is an incredible resource to professionals and the public. Following the workshop, the group sent a photo that was taken of us together. From left to right, they are Wenli Zhang, me, Margaret Sloan, and Jude West.