Let me introduce you to Scott Miller. Scott is a friend and colleague of CityU in Canada. As well as a great therapist Scott is an amazing outcome researcher. What makes for therapy that works best for the client is his continual quest and what makes therapists actually get better at what they do is his recent preoccupation. Here are some recent words of wisdom about therapy from Scott:
Evidence from randomized clinical trials indicates that, on average, clinicians achieve a reliable change–that is, a difference not attributable to chance, maturation, or measurement error–with approximately 50% of people treated. For the most effective therapists, it’s about 70%. Said another way, all of us fail between 30-50% of the time.
Of greater concern, however, is the finding that we don’t see the failure coming. Hannan and colleagues (2005) found, for example, that therapists correctly predicted deterioration in only 1 of 550 people treated, despite having been told beforehand the likely percentage of their clients that would worsen and knowing they were participating in a study on the subject!/about/our-faculty/
It’s one thing when “the magic doesn’t work”–nothing is 100%–but it’s an entirely different matter when we go on believing that something is working, when it’s not. Put bluntly, we are a terminally, and forever hopeful group of professionals!
What to do? Hannan (2005) et al. found that simple measures of progress in therapy correctly identified 90% of clients “at risk” for a negative outcome or dropout. Other studies have found that routinely soliciting feedback from people in treatment regarding progress and their experience of the therapeutic relationship as much as doubles effectiveness while simultaneously reducing dropout and deterioration rates.
Check Scott out at his web site at The International Center for Clinical Excellence.
Scott recently visited a class at CityU in Vancouver via a Skype conference from his office in Chicago.