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Climate Change in Denmark

December 5, 2009 By scottdm Leave a Comment

hans_christian_andersen_gbHans Christian Andersen, the author of such classic stories as The Ugly Duckling and the Emperor’s New Clothes, once wrote, “Life itself is the most wonderful fairy tale of all.”  That sentiment is certainly true of my own life.  For the last 16 years, I’ve been privileged to travel around the world conducting training and providing consultation.  Each year, I meet literally thousands of therapists and I’m consistently impressed and inspired by their dedication and persistence.  Truth be told, that “spirit”–for lack of a better word–is actually what keeps me in the field.

This last year, I’ve spent a considerable amount of time working with practitioners in Denmark.  Interest in Feedback-Informed Treatment has taken off–and I have the frequent flyer miles to prove it! While I’ve been traveling to the homeland of Hans Christian Andersen for many years (actually my maternal grandfather and his family immigrated to the United States from a small town just outside Copenhagen), momentum really began building following several years of workshops arranged by Henrik and Mette Petersen who run Solution–a top notch organization providing both workshops and year-long certification courses in short-term, solution-focused, and systemic therapies.

In October, I worked with 100+ staff who work at Psykoterapeutisk Center Stolpegård–a large outpatient center just outside of Copenhagen.  For two days, we talked about research and practice in psychotheapy, focusing specifically on using outcome to inform and improve clinical services.  Peter Koefoed, chief psychologist and head of Training organized the event.   I was back in Denmark not quite one month later for two days with Henrik and Mette Petersen and a then third day for a small, intensive training with Toftemosegaard–a center for growth and change–smack dab in the middle of Copenhagen.

At each event, I was honored to be accompanied by Danish psychologist Susanne Bargmann, who is an Associate and Certified Trainer for the Center for Clinical Excellence (ICCE).  I first met Susanne at a two-day workshop sponsored by Solutions a number of years ago.  Her attitude and drive is infectious.  She attended the Training of Trainer’s event in Chicago and now runs a listserve for Danish practitioners interested in feedback-informed treatment (FIT) (by the way, if you are interested in joining the group simply click on her name above to send an email).

Recently, she published an important article in Psycholog Nyt–the official magazine for the Danish Psychological Association. The article is really the first written in Danish by a Danish practitioner to suggest “practice-based evidence” as a scientifically credible alternative to the narrow “specific treatments for specific problems” paradigm that has come to dominate professional discourse and practice the world over.

Anyway, I’ll be back in Denmark several times in 2010.  In May, I’ll be teaching “Supershrinks: Learning from the Field’s Most Effective Practitioners.”  The course, as I understand it, is already sold out.  No worries though as the workshop is being offered again in November–so sign up early (click here to access my workshop calendar).  Also, in September, Susanne and I will jointly teach a course for psychologists on research entitled, “Forskning og Formidling”–a required training for those seeking specialist approval by the Danish Psychological Association. Finally, as I’ve done for the last several years, I’m scheduled to do two days for Solution as well.  If you live and work in Denmark, I truly hope to see you at one of these events.

Bargman Nye Veje For Evidensbegrebet from Scott Miller

 

Filed Under: Behavioral Health, excellence, Feedback Informed Treatment - FIT Tagged With: cdoi, Danish Psychological Association, denmark, icce, international center for cliniclal excellence, ors, outcome rating scale, practice-based evidence, session rating scale, srs, supershrinks

Where is Scott Miller going? The Continuing Evolution

November 16, 2009 By scottdm 2 Comments

I’ve just returned from a week in Denmark providing training for two important groups.  On Wednesday and Thursday, I worked with close to 100 mental health professionals presenting the latest information on “What Works” in Therapy at the Kulturkuset in downtown Copenhagen.  On Friday, I worked with a small group of select clinicians working on implementing feedback-informed treatment (FIT) in agencies around Denmark.  The day was organized by Toftemosegaard and held at the beautiful and comfortable Imperial Hotel.

In any event, while I was away, I received a letter from my colleague and friend, M. Duncan Stanton.  For many years, “Duke,” as he’s known, has been sending me press clippings and articles both helping me stay “up to date” and, on occasion, giving me a good laugh.  Enclosed in the envelope was the picture posted above, along with a post-it note asking me, “Are you going into a new business?!”

As readers of my blog know, while I’m not going into the hair-styling and spa business, there’s a grain of truth in Duke’s question.  My work is indeed evolving.  For most of the last decade, my writing, research, and training focused on factors common to all therapeutic approaches. The logic guiding these efforts was simple and straightforward. The proven effectiveness of psychotherapy, combined with the failure to find differences between competing approaches, meant that elements shared by all approaches accounted for the success of therapy (e.g., the therapeutic alliance, placebo/hope/expectancy, structure and techniques, extratherapeutic factors).  As first spelled out in Escape from Babel: Toward a Unifying Language for Psychotherapy Practice, the idea was that effectiveness could be enhanced by practitioners purposefully working to enhance the contribution of these pantheoretical ingredients.  Ultimately though, I realized the ideas my colleagues and I were proposing came dangerously close to a new model of therapy.  More importantly, there was (and is) no evidence that teaching clinicians a “common factors” perspective led to improved outcomes–which, by the way, had been my goal from the outset.

The measurable improvements in outcome and retention–following my introduction of the Outcome and Session Rating Scales to the work being done by me and my colleagues at the Institute for the Study of Therapeutic Change–provided the first clues to the coming evolution.  Something happened when formal feedback from consumers was provided to clinicians on an ongoing basis–something beyond either the common or specific factors–a process I believed held the potential for clarifying how therapists could improve their clinical knowledge and skills.  As I began exploring, I discovered an entire literature of which I’d previously been unaware; that is, the extensive research on experts and expert performance.  I wrote about our preliminary thoughts and findings together with my colleagues Mark Hubble and Barry Duncan in an article entitled, “Supershrinks” that appeared in the Psychotherapy Networker.

Since then, I’ve been fortunate to be joined by an internationally renowned group of researchers, educators, and clinicians, in the formation of the International Center for Clinical Excellence (ICCE).  Briefly, the ICCE is a web-based community where participants can connect, learn from, and share with each other.  It has been specifically designed using the latest web 2.0 technology to help behavioral health practitioners reach their personal best.  If you haven’t already done so, please visit the website at www.iccexcellence.com to register to become a member (its free and you’ll be notified the minute the entire site is live)!

As I’ve said before, I am very excited by this opportunity to interact with behavioral health professionals all over the world in this way.  Stay tuned, after months of hard work and testing by the dedicated trainers, associates, and “top performers” of ICCE, the site is nearly ready to launch.

Filed Under: excellence, Feedback Informed Treatment - FIT, Top Performance Tagged With: denmark, icce, Institute for the Study of Therapeutic Change, international center for cliniclal excellence, istc, mental health, ors, outcome rating scale, psychotherapy, psychotherapy networker, session rating scale, srs, supershrinks, therapy

Leading Outcomes in Vermont: The Brattleboro Retreat and Primarilink Project

November 8, 2009 By scottdm 4 Comments

For the last 7 years, I’ve been traveling to the small, picturesque village of Brattleboro, Vermont to work with clinicians, agency managers, and various state officials on integrating outcomes into behavioral health services.  Peter Albert, the director of Governmental Affairs and PrimariLink at the Brattleboro Retreat, has tirelessly crisscrossed the state, promoting outcome-informed clinical work and organizing the trainings and ongoing consultations.   Over time, I’ve done workshops on the common factors, “what works” in therapy, using outcome to inform treatment, working with challenging clinical problems and situations and, most recently, the qualities and practices of super effective therapists.  In truth, outcome-informed clinical work both grew up and “came of age” in Vermont.  Indeed, Peter Albert was the first to bulk-purchase the ASIST program and distribute it for free to any provider interested in tracking and improving the effectiveness of their clinical work.

If you’ve never been to the Brattleboro area, I can state without reservation that it is one of the most beautiful areas I’ve visited in the U.S.–particularly during the Fall, when the leaves are changing color.  If you are looking for a place to stay for a few days, the Crosy House is my first and only choice.  The campus of the Retreat is also worth visiting.  It’s no accident that the trainings are held there as it has been a place for cutting edge services since being founded in 1874.  The radical idea at that time?  Treat people with respect and dignity.  The short film below gives a brief history of the Retreat and a glimpse of the serene setting.

Anyway, this last week, I spent an entire day together with a select group of therapists dedicated to improving outcomes and delivering superior service to their clients.  Briefly, these clinicians have been volunteering their time to participate in a project to implement outcome-informed work in their clinical settings.  We met in the boardroom at the Retreat, discussing the principles and practices of outcome-informed work as well as reviewing graphs of their individual and aggregate ORS and SRS data.

It has been and continues to be an honor to work with each and every one in the PrimariLink project.  Together, they are making a real difference in the lives of those they work with and to the field of behavioral health in Vermont.  If you are a clinician located in Vermont or provide services to people covered by MVP or PrimariLink and would like to participate in the project, please email Peter Albert.  At the same time, if you are a person in need of behavioral health services and looking for a referral, you could do no better than contacting one of the providers in the project!

Filed Under: Behavioral Health, Feedback Informed Treatment - FIT, FIT Software Tools, Practice Based Evidence Tagged With: behavioral health, common factors, consultation, ors, outcome rating scale, session rating scale, srs, supershrinks, therapy, Training

Achieving Clinical Excellence: The Conference

October 26, 2009 By scottdm Leave a Comment

A few weeks ago, I announced the first International “Achieving Clinical Excellence” (ACE) conference to be held at the Westin Hotel in Kansas City, Missouri on October 20-22nd, 2010.  You can now register for this and all other ICCE events, by clicking here.  Through a variety of keynote addresses and workshops, participants will learn the “science and steps” to excellence in clinical practice.  Attendees will also meet and learn directly from internationally ranked performers from a variety of professions, including medicine, science, music, entertainment, and sports.  I do hope you’ll join us in Kansas City for three days of science, skill building, and inspiration.

In the meantime, I wanted to tell you a bit about one of the conference’s keynote speakers, K. Anders Ericsson, Ph.D. As anyone who has been following my blog knows, Dr. Ericsson is the editor of the massive and influential “Cambridge Handbook of Expertise and Expert Performance.”  He is an internationally known writer, researcher, and speaker who is commonly referred to as “the expert on experts.”

 At the ACE conference, Dr. Ericsson will bring his knowledge and experience to bear on the subject of expertise in behavioral health.  I promise you won’t want to miss it. For a flavor, give his recent article from the Harvard Business Review a read.

Filed Under: Behavioral Health, excellence Tagged With: addiction, cdoi, conferences and training, icce, ors, outcome rating scale, session rating scale, srs, Therapist Effects, training and consultation

The Crown Jewel of Research on CDOI: Professor Jan Blomqvist receives 2.9 million crown grant for RCT on feedback in Sweden

October 20, 2009 By scottdm 2 Comments

If you’ve been following me on Twitter, then you know that last week I was touring and teaching in different spots around Europe.  First, I presented two days in Copenhagen.  Then I keynoted the British Association of Counseling and Psychotherapy Conference in Newcastle, England.  Early Saturday morning, I flew from London to Stockholm.  My long time friend and associate, Gunnar Lindfelt picked me up at Arlanda airport and drove me back to his lovely home in the city.  There, we gorged on smoked salmon, “svensk godies” (small candies, my favorite of which is “skum bananer”–dark chocolate covered marshmellow in the shape of a banana) and Cider–a non-alcoholic fizzy apple drink that is an old time Swedish favorite.

It was Gunnar Lindfeldt, a gifted clinician and expert in the treatment of drug and alcohol problems, who first introduced me to the work of Swedish psychologist Jan Blomqvist.  In 1998, Blomqvist published a book entitled, “Beyond Treatment? Widening the Approach to Alcohol Problems and Solutions“ in which he made the provocative argument that common rather than specific factors held the key to effective care.  Since writing the book, Jan Blomqvist has continued his research and is currently a full professor at SORAD, the Centre for Social Research on Alcohol and Drugs at Stockholm University.

Anyway, I had the pleasure of meeting with Professor Blomqvist at his home in Uppsala, Sweden this last week.  Over homemade spinach soup, freshly-baked bread and cheese, we chatted about the state of the field.  The pièce de résistance, however, was hearing about the 2.9 million Swedish crown grant he had just been awarded for a 4 year long study of outcome-informed treatment of alcohol problems, called “Putting the Client in the Driver’s Seat.”

The study to be conducted by Professor Blomqvist will be the largest, most comprehensive, randomized clinical trial on client-directed outcome informed clinical work.  A centerpience of the study will be the routine use of the ORS and SRS and provision of feedback in the delivery of treatment services.  Importantly, unlike all other studies to date, this project completely avoids claims of “allegiance effects” as no developers of measures or supporters of CDOI are participating.  Stay tuned to the “Top Performance” blog for additional updates!  While you are waiting, take a moment and read Professor Blomqvist’s provocative take on “addiction” in slide viewer below.

J Blomqvist 3 from Scott Miller

Filed Under: Drug and Alcohol, evidence-based practice, Feedback, Feedback Informed Treatment - FIT Tagged With: addiction, behavioral health, brief therapy, cdoi, continuing education, evidence based practice, icce, Jan Blomqvist, ors, post traumatic stress, randomized clinical trial, SORAD, srs, sweden

On the Path of the Supershrinks: An Article by Bill Robinson

September 24, 2009 By scottdm 1 Comment

Not too long ago, my colleagues and I published some preliminary thoughts and findings from our research into “Supershrinks.”

That differences in effectiveness exist between clinicians is neither surprising or new.  Indeed, “therapist effects”–as they are referred to in the research literature–have been documented for decades and rival the contribution of factors long known to influence successful psychotherapy (e.g., the therapeutic alliance, hope and expectancy, etc.).  Personally, I believe that studying these super-effective clinicians will help practitioners improve the outcome of their clinical work.

Aside from research documenting the existence of “supershrinks,” and our own articles on the subject, little additional information exists documenting how superior performing clinicians achieve the results they do.

Enter Bill Robinson, manager, counselor, and a senior supervsor with Relationships Australia based in Mandurah, Western Australia.  I’m also proud to say that Bill is one of a highly select group of clinicians that have completed the necessary training to be designated an ICCE Certified Trainer.

In any event, in the last issue of Psychotherapy in Australia–a treasure of a publication that every clinician dedicated to improving their work should subscribe to–Bill explores the topic of therapist effects, suggesting possible links between effectiveness and clinicians’ abilities to connect with the phenomenological worlds of the people they work with.  Trust me, this peer reviewed article is worth reading.  Don’t forget to post a comment, by the way, once you’ve finished!

Robinson from Scott Miller

 

Filed Under: Top Performance Tagged With: addiction, australia, brief therapy, conferences, ors, outcome rating scale, session rating scale, srs, supershrinks, theraputic alliance

The Debate of the Century

August 27, 2009 By scottdm

doubt_diceWhat causes change in psychotherapy?  Specific treatments applied to specific disorders?  Those in the “evidence-based” say so and have had a huge influence on behavioral healthcare policy and reimbursement.  Over the last 10 years, my colleagues and I have written extensively and traveled the world offering a different perspective: by and large, the effectiveness of care is due to a shared group of factors common to all treatment approaches.

In place of “evidence-based” practice, we’ve argued for “practice-based”evidence.  Said another way, what really matters in the debate is whether clients benefit–not the particular treatment approach.  Here on my website, clinicians can download absolutely free measures that can be used to monitor and improve outcome and retention (click Performance Metrics).

bruce-wampold-364px

Anyway, the message is finally getting through.  Recently, uber-statistician and all around good guy Bruce Wampold, Ph.D. debated prominent EBP proponent Steve Hollon.  Following the exchange, a vote was taken.  Bruce won handily: more than 15:1.

Scroll down to “Closing Debate” (Thursday)

Filed Under: Behavioral Health, Practice Based Evidence Tagged With: bruce wampold, cdoi, evidence based medicine, evidence based practice, ors, outcome rating scale, PCOMS, performance metrics, practice-based evidence, psychotherapy, session rating scale, srs, steve hollon

Expertise and Excellence: What it Takes to Improve Therapeutic Effectiveness

April 2, 2009 By scottdm 1 Comment

downloadIf you’ve been following my website and the Top Performance Blog you know that my professional interests over the last couples of years have been shifting, away from psychotherapy, the common factors, and feedback and toward the study of expertise and excellence.

Studying this literature (click here for an interesting summary), makes clear that the factors responsible for superior performance are the same regardless of the specific endeavor one sets out to master. The chief principle will come as no surprise: You have to work harder than everyone else at whatever you want to be best at.

In other words, you have to practice.

Hard work is not enough, however.  Research shows that few attain international status as superior performers without access to high levels of support and detailed instruction from exceptional teachers over sustained periods of time. In the massive “Cambridge Handbook of Expertise and Expert Performance,” Feltovich et al. note, “Research on what enabled some individuals to reach expert performance, rather than mediocre achievement, revealed that expert and elite performers seek out teachers and engage in specifically designed training activities…that provide feedback on performance, as well as opportunities for repetition and gradual refinement” (p. 61).

What makes for a “good” teacher? Well, in essence, that is what the “Top Performance” blog is all about. I’m going on a journey, a quest really.  I’ve decided to take up two hoppies–activities I’ve always had a interest in but never had to the time to study seriously–magic and the ukelele.

Practicing is already proving challenging.  Indeed, the process reminds me a lot of when I started out in the field of psychology.  In a word, its daunting.  There are literally thousands of “tricks” and “songs,” (as there are 100’s of treatment models), millions of how-to books, videos, and other instructional media (just as in the therapy world), as well as experts (who, similar to the field of psychotherapy, offer a wide and bewildering array of different and oftentimes contractory opinions).

By starting completely over with subjects I know nothing about, I hope to put into practice the insights gleaned from our study of expertise and expert performance, along the way reporting the challenges, triumphs and failures associated with learning to master new skills.  I’ll review performances, instructional media (live, printed, DVD, etc), and the teachers I met.  Stay tuned.

Filed Under: Behavioral Health, deliberate practice, excellence, Top Performance Tagged With: Feltovich, ors, outcome rating scale, session rating scale, srs

Superior Performance as a Psychotherapist: First Steps

April 1, 2009 By scottdm Leave a Comment

So what is the first step to improving your performance?  Simply put, knowing your baseline.  Whatever the endeavor, you have to keep score.  All great performers do.  As a result, the performance in most fields has been improving steadily over the last 100 years.

Consider, for instance, the Olympics. Over the last century, the best performance for every event has improved–in some cases by 50%!  The Gold Medal winning time for the marathon in the 1896 Olympics was just one minute faster than the entry time currently required just to participate in the Chicago and Boston marathons.

By contrast, the effectiveness of psychological therapies has not improved a single percentage point over the last 30 years.  How, you may wonder, could that be?  During the same time period: (1) more than 10,000 how-to books on psychotherapy have been published; (2) the number of treatment approaches has mushroomed from 60 to 400; and (3) there are presently 145 officially approved, evidenced-based, manualized treatments for 51 of the 397 possible DSM IV diagnostic groups.  Certainly, given such “growth,” we therapists must be more effective with more people than ever before.  Unfortunately, however, instead of advancing, we’ve stagnated, mistaking our feverish peddling for real progress in the Tour de Therapy.

Truth is, no one has been keeping score, least of all we individual practitioners. True, volumes of research now prove beyond any doubt that psychotherapy works.  Relying on such evidence to substantiate the effectiveness of one’s own work, however, is a bit like Tiger Woods telling you the par for a particular hole rather than how many strokes it took him to sink the ball.  The result on outcome, research indicates, is that effectiveness rates plateau very early in most therapists careers while confidence level continue to grow.

In one study, for example, when clinicians were asked to rate their job performance from A+ to F, fully two-thirds considered themselves A or better. No one, not a single person in the lot, rated him or herself as below average. As researchers Sapyta, Riemer, and Bickman (2005) conclude, “most clinicians believe that they produce patient outcomes that are well above average” (p. 146). In another study, Deirdre Hiatt and George Hargrave used peer and provider ratings, as well as a standardized outcome measure, to assess the success rates of therapists in a sample of mental health professionals. As one would expect, providers were found to vary significantly in their effectiveness. What was disturbing is that the least effective therapists in the sample rated themselves on par with the most effective!

The reason for stagnant success rates in psychotherapy should be clear to all: why try to improve when you already think your the best or, barring that, at least above average?

Here again, expanding our search for excellence beyond the narrow field of psychotherapy to the subject of expertise and expert performance in general can provide some helpful insights. In virtually every profession, from carpentry to policework, medicine to mathematics, average performers overestimate their abilities, confidently assigning themselves to the top tier. Therapists are simply doing what everyone else does. Alas, they are average among the average.

Our own work and research proves that clinicians can break away from the crowd of average achievers by using a couple of simple, valid, and reliable tools for assessing outcome. As hard as it may be to believe, the empirical evidence indicates that performance increases between 65-300% (click here to read the studies). Next time, I’ll review these simple tools as well as a few basic methods for determining exactly how effective you are. Subscribe now so you’ll be the first to know.

One more note, after posting last time, I heard from several readers who had difficulty subscribing. After doing some research, we learned that you must use IE 7 or Firefox 3.0.7 or later for the subscribe function to work properly.  Look forward to hearing from you!

In the meantime, the transcript below is of a recent interview I did for Shrinkrap radio.  It’s focused on our current work:

Supershrinks: An Interview with Scott Miller about What Clinicians can Learn from the Field’s Most Effective Practitioners from Scott Miller

 

Filed Under: Behavioral Health, excellence, Top Performance Tagged With: cdoi, evidence based practice, excellence, mental health, outcome measures, psychology, psychotherapy, srs, supershrinks

My New Year’s Resolution: The Study of Expertise

January 2, 2009 By scottdm Leave a Comment

Most of my career has been spent providing and studying psychotherapy.  Together with my colleagues at the Institute for the Study of Therapeutic Change, I’ve now published 8 books and many, many articles and scholarly papers.  If you are interested you can read more about and even download many of my publications here.

Like most clinicians, I spent the early part of my career focused on how to do therapy.  To me, the process was confusing and the prospect of sitting opposite a real, suffering, client, daunting.  I was determined to understand and be helpful so I went graduate school, read books, and attended literally hundreds of seminars.

Unfortunately, as detailed in my article, Losing Faith, written with Mark Hubble, the “secret” to effective clinical practice always seemed to elude me.  Oh, I had ideas and many of the people I worked with claimed our work together helped.  At the same time, doing the work never seemed as simple or effortless as professional books and training it appear.

Each book and paper I’ve authored and co-authored over the last 20 years has been an attempt to mine the “mystery” of how psychotherapy actually works.  Along the way, my colleagues and I have paradoxically uncovered a great deal about what contributes little or nothing to treatment outcome! Topping the list, of course, are treatment models.  In spite of the current emphasis on “evidence-based” practice, there is no evidence that using particular treatment models for specific diagnostic groups improves outcome.  It’s also hugely expensive!  Other factors that occupy a great deal of professional attention but ultimately make little or no difference include: client age, gender, DSM diagnosis, prior treatment history; additionally, therapist age, gender, years of experience, professional discipline, degree, training, amount of supervision, personal therapy, licensure, or certification.

In short, we spend a great deal of time, effort, and money on matters that matter very little.

For the last 10 years, my work has focused on factors common to all therapeutic approaches. The logic guiding these efforts was simple and straightforward. The proven effectiveness of psychotherapy, combined with the failure to find differences between competing approaches, meant that elements shared by all approaches accounted for the success of therapy. And make no mistake, treatment works. The average person in treatment is better off than 80% of those with similar problems that do not get professional help.

In the Heart and Soul of Change, my colleagues and I, joined by some of the field’s leading researchers, summarized what was known about the effective ingredients shared by all therapeutic approaches. The factors included the therapeutic alliance, placebo/hope/expectancy, structure and techniques in combination with a huge, hairy amount of unexplained “stuff” known as “extratherapeutic factors.”

Our argument, at the time, was that effectiveness could be enhanced by practitioners purposefully working to enhance the contribution of these pantheoretical ingredients.  At a minimum, we believed that working in this manner would help move professional practice beyond the schoolism that had long dominated the field.

Ultimately though, we were coming dangerously close to simply proposing a new model of therapy–this one based on the common factors.  In any event, practitioners following the work treated our suggestions as such.  Instead of say, “confronting dysfunctional thinking,” they understood us to be advocating for a “client-directed” or strength-based approach.  Discussion of particular “strategies” and “skills” for accomplishing these objectives did not lag far behind.  Additionally, while the common factors enjoyed overwhelming empirical support (especially as compared to so-called specific factors), their adoption as a guiding framework was de facto illogical.  Think about it.  If the effectiveness of the various and competing treatment approaches is due to a shared set of common factors, and yet all models work equally well, why would anyone need to learn about the common factors?

Since the publication of the first edition of the Heart and Soul of Change in 1999 I’ve struggled to move beyond this point. I’m excited to report that in the last year our understanding of effective clinical practice has taken a dramatic leap forward.  All hype aside, we discovered the reason why our previous efforts had long failed: our research had been too narrow.  Simply put, we’d been focusing on therapy rather than on expertise and expert performance.  The path to excellence, we have learned, will never be found by limiting explorations to the world of psychotherapy, with its attendant theories, tools, and techniques.  Instead, attention needs to be directed to superior performance, regardless of calling or career.

A significant body of research shows that the strategies used by top performers to achieve superior success are the same across a wide array of fields including chess, medicine, sales, sports, computer programming, teaching, music, and therapy!  Not long ago, we published our initial findings from a study of 1000’s of top performing clinicians in an article titled, “Supershrinks.”  I must say, however, that we have just “scratched the surface.”  Using outcome measures to identify and track top performing clinicians over time is enabling us, for the first time in the history of the profession, to “reverse engineer” expertise.  Instead of assuming that popular trainers (and the methods they promote) are effective, we are studying clinicians that have a proven track record.  The results are provocative and revolutionary, and will be reported first here on the Top Performance Blog!  So, stay tuned.  Indeed, why not subscribe? That way, you’ll be among the first to know.

Filed Under: Behavioral Health, excellence, Top Performance Tagged With: behavioral health, cdoi, DSM, feedback informed treatment, mental health, ors, outcome measurement, psychotherapy, routine outcome measurement, srs, supervision, therapeutic alliance, therapy

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