You are not going to believe me when I say it. Fifty percent. It’s true. Even in studies where carefully selected therapists who receive copious amounts of training, support, and supervision, and treat clients with a single diagnosis or problem, between 5 and 10% get worse and 35-40% experience no benefit whatsoever! That’s half, or more.
What happens to these people?
Well, as readers of this blog know, if the therapist formally and routinely solicits feedback regarding the quality of the relationship and progress in care, drop out and deterioration rates fall, and outcome improves.
Still, a significant percentage of people do not improve—as many as 25%! What can we do? The ethical standards for all of the professional mental health organizations require clinicians both monitor and end ineffective treatments as well as suggest helpful alternatives to clients (ACA [C2.d], APA [10.10]). But what?
Enter Lynn D. Johnson, Ph.D., a psychologist whose work and thinking is always a step ahead. I’ve known Lynn for 30 years, met him when I was a graduate student. As I blogged previously about, it was Lynn who in 1996 first suggested routinely measuring outcomes. He is also responsible for the creation of the original Session Rating Scale–a 10-item version that I later shortened to four. For several years, Lynn pushed me to do research on top performing therapists, believing they held clues to improving the practice of psychotherapy in general.
Well, my long time colleague and mentor is at it again, once more seeing “over the horizon.” Based on the latest findings on “human flourishing,” he says that lifestyles provide a pathway to health for the non-responders. True to form, he’s freely sharing what he knows, offering online courses on “Lifestyle secrets of the happy and healthy.”
Click here if you are you interested in learning more. Lynn claims that these ideas and techniques are the next thing in both physical medicine and psychotherapy. Let me know what you think.
Until next time, wishing you a healthy and happy life,
Scott D. Miller, Ph.D.
Director, International Center for Clinical Excellence