• Leading for a Change: The Training of Trainer’s (TOT) Chicago

    I’m writing tonight from my hotel room at the River Rock Inn in Rockland, Ontario, Canada.  For those of you who are not familiar with the area, it is a biligual (French & English) community of around 9,000 located about 25 km west of Ottawa.  Today through Thursday, I’m working with the staff, supervisors, and agency administrators of… — read more

    Mar 9, 2010

  • Addressing the Financial Crisis in Public Behavioral Healthcare Head On in Chesterfield, Virginia

    If you are following me on Twitter (and I hope you are), you know the last month has been extremely busy.  This week I worked with clinicians in Peterborough, Ontario Canada.  Last week, I was in Nashville, Tennessee and Richmond Virginia.  Prior to that, I spent nearly two weeks in Europe, providing training and consultations in the… — read more

    Mar 5, 2010

  • Deliberate Practice, Expertise, & Excellence

    Later today, I board United flight 908 on my way to workshops scheduled in Holland and Belgium.  My routine in the days leading up to an international trip is always the same.  I slowly gather together the items I’ll need while away: computer (check); european electric adapter (check); presentation materials (check); clothes (check).   And, oh yeah, two decks of playing cards… — read more

    Feb 3, 2010

  • The Future of Behavioral Health: Integrated Care & Entrepreneurship

    Nicholas Cummings, Ph.D. Sometime in late 1986 I wrote a letter to Dr. Nicholas Cummings.  As a then student-member of the American Psychological Association (APA), I was automatically subscribed to and receiving the American Psychologist.  In the April issue, Dr. Cummings published an article, provocatively titled, "The Dismantling of Our Health System: Strategies for the Survival of Psychological Practice." … — read more

    Feb 2, 2010

  • The Turn to Outcomes: A Revolution in Behavioral Health Practice

    Get ready.  The revolution is coming (if not already here).  Whether you are a direct service provider (psychologist, counselor, marriage and family therapist), agency, broker, or funder, you will be required to measure and likely report the outcomes of your clinical work.   Jay Lebow, Ph.D. Just this month, Dr. Jay Lebow, a professor of psychology at the… — read more

    Feb 1, 2010

  • Behavioral Healthcare in Holland: The Turn Away from the Single-payer, Government-Based Reimbursement System

    Several years ago I was contacted by a group of practitioners located in the largest city in the north of the Netherlands–actually the capital of the province known as Groningen.  The "Platform," as they are known, were wondering if I’d be willing to come and speak at one of their upcoming conferences.  The practice environment was undergoing dramatic change,… — read more

    Jan 26, 2010

  • Accountability in Behavioral Health: Steps for Dealing with Cutbacks, Shortfalls, and Tough Economic Conditions

    As anyone who follows me on Twitter knows, I get around.  In the past few months, I visited Australia, Norway, Sweden, Denmark (to name but a few countries) as well as criss-crossed the United States.  If I were asked to sum up the state of public behavioral health agencies in a single word, the word–with very… — read more

    Jan 25, 2010

  • Outcomes in the Artic: An Interview with Norwegian Practitioner Konrad Kummernes

    Dateline: Mosjoen, Norway The last stop on my training tour around northern Norway was Mosjoen.  The large group of psychologists, social workers, psychiatrists, case managers, and physicians laughed uproariously when I talked about the bumpy, "white-knuckler" ride aboard the small twin-engine airplane that delivered me to the snowy, mountain-rimmed town. They were all to familiar with the… — read more

    Jan 21, 2010

  • Practice-Based Evidence in Norway: An Interview with Psychologist Mikael Aagard

    For those of you following me on Twitter–and if you’re not, click here to start–you know that I was traveling above the artic circle in Norway last week.  I always enjoy visiting the Scandanavia countries.  My grandparents immigrated from nearby Sweden.  I lived there myself for a number of years (and speak the language).  And I am married… — read more

    Jan 19, 2010

  • Evidence-based practice or practice-based evidence? Article in the Los Angeles Times addresses the debate in behavioral health

    January 11th, 2010 "Debate over Cognitive & Traditional Mental Health Therapy" by Eric Jaffe The fight debate between different factons, interest groups, scholars within the field of mental health hit the pages of the Los Angeles Times this last week. At issue?  Supposedly, whether the field will become "scientific" in practice or remain mired in traditions of… — read more

    Jan 18, 2010

  • "What Works" in Norway

    Dateline: Tromsø, Norway Place: Rica Ishavshotel For the last two days, I’ve had the privilege of working with 125+ clinicians (psychotherapists, psychologists, social workers, psychiatrists, and addiction treatment professionals) in far northern Norway.  The focus of the two-day training was on "What Works" in treatment, in particular examining what constitutes "evidence-based practice" and how to… — read more

    Jan 13, 2010

  • Are all treatments approaches equally effective?

    Bruce Wampold, Ph.D.   Late yesterday, I blogged about a soon-to-be published article in Clinical Psychology Review in which the authors argue that the finding by Benish, Imel, & Wampold (2008) of equivalence in outcomes among treatments for PTSD was due to, "bias, overgeneralization, lack of transparency, and poor judgement."  Which interpretation of the evidence is correct?  Are there… — read more

    Jan 9, 2010

  • DODO BIRD HYPOTHESIS PROVEN FALSE! Study of PTSD finally proves Wampold, Miller, and other "common factor" proponents wrong

    Researchers Anke Ehlers, Jonathon Bisson, David Clark, Mark Creamer, Steven Pilling, David Richards, Paula Schnurr, Stuart Turner, and William Yule have finally done it!  They slayed the "dodo." Not the real bird of course–that beast has been extinct since the mid to late 17th century but rather the "dodo bird" conjecture first articulated by Saul Rozenzweig, Ph.D.… — read more

    Jan 8, 2010

  • Why ongoing, formal feedback is critical for improving outcomes in healthcare

    Not long ago, I had a rather lengthy email exchange with a well-known, high profile psychotherapist in the United States.  Feedback was the topic.  We both agreed that feedback was central to successful psychotherapy.   We differed, however, in terms of method.  I argued for the use of simple, standardized measures of progress and alliance (e.g., ORS and SRS).  In support… — read more

    Jan 8, 2010

  • Research on the Outcome Rating Scale, Session Rating Scale & Feedback

    "How valid and reliable are the ORS and SRS?"  "What do the data say about the impact of routine measurement and feedback on outcome and retention in behavioral health?"  "Are the ORS and SRS ‘evidence-based?’"  These and other questions regarding the evidentiary support for the ORS, SRS, and feedback are becoming increasingly common in the workshops… — read more

    Jan 7, 2010

  • Magical Moments in Kansas

    Registrations are already coming in for the first International Conference on "Achieving Clinical Excellence."  Earlier on this blog, I announced that internationally known researcher K. Anders Erickson, Ph.D.–the "expert on experts"–had agreed to present at the event.  At that time, I also indicated that a number of internationally accomplished performers from a variety of professions (including psychology, business, medicine,… — read more

    Jan 2, 2010

  • New Year’s Resolutions: Progress Report and Future Plans

    One year ago today, I blogged about my New Year’s resolution to "take up the study of expertise and expert performance."  The promise marked a significant departure from my work up to that point in time and was not without controversy.  "Was I no longer interested in psychotherapy?"  "Had I given up on the common factors?  The… — read more

    Jan 1, 2010

  • The Study of Excellence: A Radically New Approach to Understanding "What Works" in Behavioral Health

      "What works" in therapy?  Believe it or not, that question–as simple as it is–has and continues to spark considerable debate.  For decades, the field has been divided.  On one side are those who argue that the efficacy of psychological treatments is due to specific factors (e.g., changing negative thinking patterns) inherent in the model of… — read more

    Dec 24, 2009

  • Holidays and Suicide: Tis’ the Season NOT!

    The notion that suicides increase during the holiday season is as traditional as "Santa Claus"–and, according to statistics dating back at least a decade, just as illusory.  In fact, research actually shows suicide rates to be the lowest in December!  According to Dan Romer, a researcher at the Annenberb Public Policy Center at the University… — read more

    Dec 21, 2009

  • The Effects of Feedback on Medication Compliance and Outcome: The University of Pittsburgh Study

    A number of years ago, I was conducting a workshop in Pittsburgh.  At some point during the training, I met Dr. Jan Pringle, the director of the Program Evalutation Research Unit in the School of Pharmacy at the University of Pittsburgh.  Jan had an idea: use outcome feedback to improve pharmacy practice and outcome.  Every… — read more

    Dec 18, 2009

  • The Evolution of Psychotherapy: Meeting Michael Hoyt

    I’m still reeling from the experience in Anaheim this last week.  I met so many leaders in the field, heard so many presentations on cutting edge clinical practice–as well as was reminded of some "classic" principles of effective psychotherapy. One of the people I met was colleague and friend, Michael F. Hoyt, Ph.D.  Michael and… — read more

    Dec 16, 2009

  • Five Incredible Days in Anaheim

    From December 9-13th, eight thousand five hundred mental health practitioners, from countries around the globe, gathered in Anaheim, California to attend the "Evolution of Psychotherapy" conference.  Held every five years since 1985, the conference started big and has grown only larger.  "Only a few places in the US can accomodate such a large gathering," says Jeffrey K.… — read more

    Dec 15, 2009

  • Evolution of Psychotherapy and the International Center for Clinical Excellence

    Dateline: Chicago, Illinois December 7, 2009 I’ve just finished packing my bags and am heading for the airport.  Tomorrow the "Evolution of Psychotherapy" begins.  Nearly 25 years after volunteering at the first "Evolution" conference, I’m back a second time to present.  Tomorrow, I’ll be talking about "Achieving Clinical Excellence."  On the days that follow, I’m… — read more

    Dec 9, 2009

  • Climate Change in Denmark

    Hans Christian Andersen, the author of such classic stories as The Ugly Duckling and the Emperor’s New Clothes, once wrote, "Life iteself is the most wonderful fairytale 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 trainings and providing consultation.  Each year, I meet… — read more

    Dec 5, 2009

  • Outcomes in OZ III

    Dateline: November 28, 2009 Brisbane, Australia Crown Plaza Hotel Pelican Waters Golf Resort & Spa As their name implies, LifeLine Australia is the group people call when they need a helping hand.  During the last leg of my tour of eastern Australia, I was lucky enough to spend two days working with Lifeline’s dedicated and talented clinicians on improving… — read more

    Dec 4, 2009

  • Outcomes in Oz II

    Sitting in my hotel room in Brisbane, Australia.  It’s beautfiul here: white, sandy beaches and temperatures hovering around 80 degrees.  Can’t say that I’ll be enjoying the sunny weather much.  Tomorrow I’ll be speaking to a group of 135+ practitioners about "Supershrinks."  I leave for home on Saturday.  While it’s cold and overcast in Chicago,… — read more

    Nov 25, 2009

  • Outcomes in Oz

    Greetings from beautiful Melbourne, Australia!   For the next couple of weeks, I’ll be traveling the up and down the east coast of this captivating country, conducting workshops and providing consultations on outcome-informed clinical work. Actually, I’ve had the privilege of visiting and teaching in Australia about once a year beginning in the late 1990’s. Back then, Liz… — read more

    Nov 20, 2009

  • Where is Scott Miller going? The Continuing Evolution

    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.  The training was sponsored by Solutions, an organization directed by Henrik and Mette Pedersen that… — read more

    Nov 16, 2009

  • Leading Outcomes in Vermont: The Brattleboro Retreat and Primarilink Project

    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 criss-crossed the state, promoting outcome-informed clinical work and organizing… — read more

    Nov 8, 2009

  • Common versus Specific Factors and the Future of Psychotherapy: A Response to Siev and Chambless

    Early last summer, I received an email from my long time friend and colleague Don Meichenbaum alerting me to an article published in the April 2009 edition of the Behavior Therapist–the official "newsletter" of the Association for Behavioral and Cognitive Therapies–critical of the work that I and others have done on the common factors.  Briefly, the article,… — read more

    Oct 31, 2009
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