Did you know that clinicians who routinely obtain feedback on the progress and the status of the relationship with their individual clients have outcomes that are much better, and dropout rates that are much less, that Treatment As Usual (TAU)? In fact, numerous studies actually confirm this. In the research literature that process is known as Feedback-Informed Treatment (FIT). Scott D. Miller, PhD, is one of the pioneering scientists behind the FIT movement. He and I recently worked together to create this brief video to explain what FIT is and how developing a culture of feedback and incorporating the Outcome and Session Rating Scales (ORS & SRS) into your clinical practice can improve your treatment outcomes.
Feedback-Informed Treatment, explained by Scott D. Miller in under five minutes.
Interested in learning Feedback-Informed Treatment Best Practices from Scott D. Miller?
Whether you’re an individual practitioner or part of a larger organization, FIT eLearning is designed to help you develop a culture of feedback and incorporates the Outcome and Session Rating Scales (ORS & SRS) into your clinical practice.
FIT eLearning is based on the most up-to-date research in talk therapy and behavioural health sciences.
MyOutcomes® FIT eLearning program is centered on the four core competencies developed by Dr. Scott D. Miller and colleagues at the International Center for Clinical Excellence (ICCE)
Turns out it’s more than just a common quality of highly effective therapists, humility is actually a prerequisite!
Studies confirm “professional self-doubt” is not only a strong predictor of both alliance and outcome but actually aprerequisite for acquiring therapeutic expertise. Speaking specifically to the field of psychotherapy in, Humility: The paradoxical foundation for psychotherapy expertise, the authors, Hook, Watkins, Davis, and Owen , define humility as “valuing input from the other (or client) … and [a] willingness to engage in self-scrutiny.”
Does this sound like you?
We all profess humility and I know as an ethics bound professional that you already ask for feedback and have likely already encountered some negative feedback from a client. When you have received negative feedback about treatment progress or experienced a rupture in the therapeutic alliance, ask your self how ofter you were able to:
1: Fix the problem?
2: Learn from the feedback and apply it in future encounters?
Did you confidently answer yes, all the time to both questions, because this is the path your colleagues are taking to go from average to excellent. Only you know how far down this journey you have gone, or are willing to go, but what I do know is that both MyOutcomes® and The International Center for Clinical Excellence (ICCE) are dedicated to providing you with the tools and training you need to see noticeable improvements in treatment results.
Take the Path to Better Results
On January 15, 2021 MyOutcomes is releasing a new series of Better Results with Scott Miller Interviews. The series is full of stories and free practical advice and resources to help you develop a more feedback informed practice. This four-part Netflix style series can be binge watched in under two hours.
If you have participated in the past, then you know that besides free giveaways, MyOutcomes will also be including a great bonus package. The Get FIT Now bonus package will be available for the first 100 Mental Health Professionals who sign up between January 15th and 31st, 2021.
Without giving to much away, I have to tell you that the first 10 participants to sign up online for MyOutcomes or FIT eLearning will be receiving a free paperback copy of Better Results: Using Deliberate Practice to Improve Therapeutic Effectiveness! This step-by-step guide demonstrates how to collect and use client outcome data to create an individualized professional development plan and measure improvements in the quality of the service you provide.
This is my favourite quote from the live Q&A section of #EPT2020 Great Conversations, A Bolder Model: How Should We Be Training the Next Generation of Therapists? with William R. Miller, PhD and Scott D. Miller, PhD.
The question was “How can we shift therapist training from a pathology/diagnosis oriented model, towards a helping patients solve problems in life orientation?”There was a pause and then they both smiled. It was so affirming to hear them both echo, “I think the shift has already occurred.”
Watch these five minutes of gold from day two of the Evolution of Psychotherapy 2020 virtual experience.
Are you attending #EPT2020? I will be live in MyOutcomes virtual booth after both of these events.
Dec 12th, 2:45-3:45PM Pacific Better Results: using Deliberate Practice to Improve Therapeutic Effectiveness
Dec 12th, 2020 4:15-5:15PM Pacific The initial interview – with Ellyn Bader, PhD – The Couples Institute and Otto F. Kernberg, MD, FAPA – Weill Cornell Medical College
I hope you will stop by Saturday during the break from 3:45 pm -4:15 PM and from 5:15- 5:45 Pacific and share your highlights with us.
If you are not attending, you are still free to join us in the Evo’20 Portal and take part in the live giveaways. Scott Miller will be joining me from 3:45 pm -4:15 to answer questions and announce winners in our Better Results Give away.
Join from your computer, tablet or smartphone with this link: https://www.gotomeet.me/CindyHansen/myoutcomes-evo20-live-portal
“I know we can help you successfully collect outcome data, the trick is learning to use that data to inform and improve care”, a phrase I often repeat during implementation consultations.
That being said, just being able to successfully collect outcome data seems to have become the unofficially minimum standard. Believe me, I get it, just having everyone routinely collect patent self-report measures is difficult enough.
Particularly, if the Team is just following standards and requirements they must meet in order to practice and get paid. Helping your Team embrace the logic behind routinely measuring session feedback from clients is no small feat and for many it is understandable that this is the first and only step they ever take towards a feedback-informed approach. Creating a culture of feedback is hard.
If you have tried to adopt a feedback informed approach, did you find it awkward to make it fit into the accepted documentation requirements of your practice? Would you take a moment now and consider your current practices and related documentation requirements.
Do your current documentation practices and requirements improve outcomes?
Will you share your response on this simple four-item scale? You can answer anonymously and it takes less than a minute to complete.
If you question the value of your current requirements or have found that they seem to stand in the way of improving outcomes and being able to fully use the Measures to inform and improve care, you will appreciate this brief cartoon video clip (2:36).
The following video with Scott D. Miller illustrates the fundamental shift that is required to create a culture of feedback and provides some helpful documentation resources to support your service delivery transformation.
This video and the survey questions above are both pulled from Module 10 – FIT Skills: Documentation. This is a sample of the FIT eLearning Program we have developed to walk you through the process of using FIT in your clinical setting. Each model has a series of videos, interspersed with awareness profile questions. Awareness profile questions (like the survey question above) are designed to help you further engage with the lesson content. Plus, there is a quiz at the end of each module, to make sure you master each section before you move on.
If you have tried, or are thinking of trying to move beyond just collecting outcome data have a look at our training program. This ICCE accredited, basic training in Feedback-Informed Treatment program includes 12 documented online training hours on psychotherapy (2 hours), outcome measurement (8 hours), performance improvement (2 hours).
Are you sheltering in place? Feeling Locked down? A few weeks ago Scott was asked in a group chat if he could offer some kind of live support, now that his workshop and training events have for now all been postponed or cancelled. Since he can’t come to you, the ICCE has begun offering this chance to connect and meet with colleagues from around the world in a live web event.
Feedback Informed Treatment & Deliberate Practice Meetup THREE is a free discussion/question and answer sessions on Feedback Informed Treatment and FIT Deliberate Practice.
Apr 29, 2020
Time: 12:00 PM in Central Time (US and Canada)
Scott D. Miller, Director and co-Founder of the International Center for Clinical Excellence, will be taking your questions from ICCE Director of Professional Development, and ICCE trainer…since its inception, Cynthia Maeschalck.
As before, no cost. Space is limited for this live event.
MyOutcomes offers accredited training in Feedback-Informed Treatment for only $179.00. Whether you’re an individual practitioner or part of a larger organization, FIT eLearning helps you develop a culture of feedback and incorporate the Outcome & Session Rating Scales (ORS&SRS) into your clinical practice.
No one could have anticipated how our world circumstances would change, and with it our mode of how we operate in it. In order to protect each other, we need to do things differently, and fast. For most, if not all, distance therapy will need to be the norm for some time.
In a recent blog post, Telehealth Options for Feedback-Informed Practitioners, I shared some tutorials MyOutcomes has made to help ease the transition to online therapy, but soon I was asked, “What about when the client doesn’t have internet access or a data plan on their cell phone, and a line line is the only form of communication?”
Last week, Karl Peuser, PhD, published a video specifically on how to collect ORS and SRS feedback over the phone. Today FIT Trainers, Brooke Mathewes and Stacy Bancroft published guidance for Oral administration of the Outcome Rating Scales and the Session Rating Scale. For your reference the documented Oral scripts are included below.
In addition to tutorials, thought leaders in our field are also reaching out to help.
Scripting for Oral Version of the Outcome Rating Scale
I’m going to ask some questions about four different areas of your life, including your individual, interpersonal, and social functioning. Each of these questions is based on a 0 to 10 scale, with 10 being high (or very good) and 0 being low (or very bad). Thinking back over the last week (or since our last conversation), how would you rate: How you have been doing personally? (On the scale from 0 to 10). If the client asks for clarification, you should say “yourself,” “you as an individual,” “your personal functioning.”If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”. If the client gives one number for one area of personal functioning and offers another number for another area of functioning, then go with the lowest score.
How have things been going in your relationships? (On the scale from 0 to 10). If the client asks for clarification, you should say “in your family,” “in your close personal relationships.” If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?” If the client gives one number for one family member or relationship type and offers another number for another family member or relationship type, then go with the lowest score.
How have things been going for you socially? (on the scale from 0 to 10). If the client asks for clarification, you should say, “your life outside the home or in your community,” “work,” “school,” “church.” If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”. If the client gives one number for one aspect of his/her social functioning and then offers another number for another aspect, then go with the lowest score.
So, given your answers on these specific areas of your life, how would you rate how things are in your life overall?. The client’s responses to the specific outcome questions should be used to transition into counselling. For example, the counselor could identify the lowest score given and then use that to inquire about that specific area of client functioning (e.g., if the client rated the items a 7, 7, 2, 5, the counsellor could say, “From our responses, it appears that you’re having some problems in your relationships. Is that right?) After that, the counselling proceeds as usual.
Scripting for Oral Administration of Session Rating Scale
I’m going to ask some questions about our session today, including how well you felt understood, the degree to which we focused on what you wanted to talk about, and whether our work together was a good fit. Each of these questions is based on a 0 to 10 scale, with 10 being high (or very good) and 0 being low (or very bad). Thinking back over our conversation, how would you rate: On a scale of 0-10, to what degree did you feel heard and understood today, 10 being completely and 0 being not at all? If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”. If the client gives one number for heard and another for understood, then go with the lowest score.
On a scale of 0-10, to what degree did we work on the issues that you wanted to work on today, 10 being completely and 0 being not at all? If the client asks for clarification, you should ask, “did we talk about what you wanted to talk about or address? How well on a scale from 0 – 10?”. If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”
On a scale of 0-10, how well did the approach,the way I/we worked, make sense and fit for you? If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”. If the client gives one number for make sense and then offers another number for fit, then go with the lowest score.
So, given your answers on these specific areas, how would you rate how things were in today’s session overall, with 10 meaning that the session was right for you and 0 meaning that something important that was missing from the visit? If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”
Recently, therapist and researcher, Scott D. Miller, PhD sat down and shared his personal journey to attain better treatment results. At one point stating “…I wanted to help people. Throughout my training and now 30 plus years as a clinician, I’ve struggled with the deep sense of responsibility that accompanies that objective.” Can you relate? I know I can.
This interview was so informative and engaging, it is now being turned into an exclusive training event.
The Better Results series containing cutting edge research and practical, step by step instructions to help you:
have clients stay in therapy, rather than drop out
see outcomes improve, rather than having clients stay the same or worse, get worse
reduce complaints and provide supporting evidence of treatment effectiveness
For the next few days, the have made the entire series available for free.Watch the first video now and register to have the rest of the series delivered to your inbox. Each week, we will send you another video interview of Scott’s story, as he shares what he has learned about how to achieve better results. We will also be looking for your feedback and comments and offering some cool resources and perks along the way.
As your first added bonus, just for registering, you will have a 1-100 chance to win a copy of the much anticipated and soon to be released book: Better Results: Using Deliberate Practice to Improve Therapeutic Effectiveness.
An RCT reporting reliable and clinically significant change instills a high degree of confidence in the results. So why does strictly adhering to a manualized EBP, with multiple published RCT’s in top tier journals, often fail to translate into even noticeable improvements in clinical settings? Experience suggests that the real world is more heterogeneous than the world imagined by RCTs and it can be confusing and disappointing when individuals you are trying to help fail to benefit.
MyOutcomes® is a response to these findings, offering a way to identify when treatment is and is not working with an individual person. Back in 2007, when MyOutcomes first began offering the convenience of digital administration and reporting treatment outcomes, we used a set of mathematic equations that plotted the expected treatment response or ETR of a client based on their Outcome Rating Scale (ORS) score. At the time is was cutting edge, few people were even measuring outcomes let alone trying to provide benchmarks for guiding clinical practice. For the first time therapists and clients had a simple and feasible way to compare outcomes from session to session to the ETR benchmark.
Originally, the ETR plotted the average progress of all clients, since then we have upgraded several times, today offering equations that provide benchmarks for comparing individual progress to both successful and unsuccessful treatment episodes. In MyOutcomes modeling system, predictions are made at the individual level, versus feedback delivered in the form of an Average ETR, providing a far more accurate assessment of reliable and clinically significant change at the individual client level. If your clients are all average than by all means use a Reliable Change Index, if they are not and your EBP has let you down too many times, consider adding a patient-centred measure of treatment effectiveness like MyOutcomes. If you have already been using MyOutcomes and are ready to raise your effectiveness to the next level; Improve your ability to engage, retain, and help a more diverse clientele then consider joining me this March in Chicago for the Advanced FIT Intensive. It will help you develop and sustain a lifelong, professional development plan.
Tracking Patient Outcomes, Dr. Scott D Miller says that looking at the dropout rate in MyOutcomes Version14 is useful, as it gives the therapist time to reflect on what to do so as to keep the client engaged in the therapy for longer, thereby helping the client to maintain the change/progress afterwards.
Join Dr. Scott Miller and his team for a 3 intensive days focused on supervision strategies designed to improve clinician skills.
If you understand that supervision is a key component in the successful and sustainable implementation of Feedback Informed Treatment as an evidence based practice then you should make plans to attend the next FIT Supervision Intensive Training to held in Chicago, Illinois (USA) from March 13-15, 2017.
Through a combination of didactic presentations, skill building exercises and feedback, participants will learn:
What differentiates FIT supervision from conventional supervision
How to use client feedback to guide clinical supervision practice and help clinicians achieve superior outcomes
What the most common challenges are in FIT supervision and how to overcome them
Strategies to identify and address â€œat riskâ€ cases in supervision
The training venue is situated along the beautiful “Magnificent Mile,” near Northwestern University Hospital, atop a beautiful tall building, steps from the best retail therapy and blues bars in Chicago.