Feedback Informed Treatment – FIT

Deliberate practice is hot.  More workshops and trainings are being offered on the topic than ever before.  In the last year, a veritable slew of books has also appeared, with many being tied to a specific therapeutic modality.  Given that the topic was introduced to the field a mere 15 years ago (see Miller, Hubble — read more

“Why don’t more therapists do FIT?” a grad student asked me during a recent consultation.  Seated nearby in the room were department managers, supervisors, and many experienced practitioners. “Well,” I said, queuing up my usual, diplomatic answer, “Feedback informed treatment is a relatively new idea, and the number of therapists doing it is growing.” Unpersuaded, the student persisted, — read more

Ever see the film, Sliding Doors? It’s an older movie with a familiar plot.  Life can change in an instant — in this case, depending on whether or not lead character, Helen (played by Gwyneth Paltrow), catches a train.   Both possibilities are explored, the results being dramatically different. Now, consider the pictures to the left.  Chances — read more

The last two years have been difficult.  Whether through illness, death of loved ones, job loss, economic insecurity, or social isolation, few have escaped the consequences of the worldwide pandemic. While government and media attention has been focused on physical health, rates of anxiety and depression have soared (1).  Younger people have been particularly impacted.  — read more

Therapists want to improve.   In the largest, most comprehensive survey conducted to date, 86% of clinicians reported being “highly motivated” to transcend their current level of performance (1). No wonder the arrival of deliberate practice on the professional scene has attracted so much interest.   Always hungry for guidance and direction about helping their clients, most — read more

Deliberate Practice is hot.  Judging from the rising number of research studies, workshops, and social media posts, it hard to believe the term did not appear in the psychotherapy literature until 2007. The interest is understandable.  Among the various approaches to professional development — supervision, continuing education, personal therapy — the evidence shows deliberate practice is — read more

“We don’t do ‘treatment,’ can we use FIT?” It’s a question that comes up with increasing frequency as use of the Outcome and Session Rating Scales in the helping professions spreads around the globe and across diverse service settings. When I answer an unequivocal, “yes,” the asker often responds as though I’d not heard what — read more

Amateurs have goals.  Experts have a system. Bold statements to be sure, both supported by research on deliberate practice — the one activity documented to improve clinicians’ therapeutic effectiveness. Much is made in the self-improvement and therapy literature about the importance of setting goals.  Unless you’ve been hiding under a rock, I’m sure you’ve heard — read more

Criticizing umpires is as much a part of watching baseball as eating hotdogs and wearing team jerseys on game day.  The insults are legion, whole websites are dedicated to cataloging them: “Open your eyes!” “Wake up, you are missing a great game!” “Your glasses fogged up?” “Have you tried eating more carrots?” “I’ve seen potatoes — read more

Take a look at the graphic to the left.  It shows the use of the Outcome and Session Rating Scales (ORS & SRS) from the beginning of this year to the present by users of one of the three , authorized FIT software programs. What do you see? A couple of things stand out for me.  — read more

It’s rarely good news when the phone rings in the wee hours of the morning.  This time, it was a colleague calling to let me know that Rich Simon — the founder and editor of the Psychotherapy Networker and long time friend — had died. To say the news came as a shock would be a — read more

Eighty three million, six hundred fifty thousand, thirty seven. Can you guess what this number represents? No, its not the net worth of the latest tech millionaire.  Neither is it the budget of a soon-to-be released Hollywood blockbuster. Guess again. Give up? It’s the number of adults in the U.S. who reported struggling with mental — read more

Here’s an interesting dilemma.   In December 1799, three physicians were summoned to the Mount Vernon estate to treat the former first president of the United States for a sore throat.  The accepted therapy of the day was administered skillfully and competently multiple times.  Several hours later, the president was dead.  Historians agree George Washington likely did — read more

I remember exactly where I was on April 4th, 1968 — in a pool doing laps.  I was a junior member of my hometown’s swim team.   I’d barely started when the coach blew his whistle calling the practice to an abrupt halt.  As we toweled off, he told us something terrible had happened.  It was — read more

Bad therapy. Are you guilty of it?  A quick internet search turned up only 15 books on the subject.  It’s strange, especially when you consider that between 5 and 10% of clients are actually worse off following treatment and an additional 35-40% experience no benefit whatsoever!  (Yep, that’s nearly 50%) And what about those numerous “micro-failures.”  You — read more

With the outbreak of the coronavirus, much of mental health service delivery shifted online. Regulations regarding payment and confidentiality were scaled back in an effort to deal with the unprecedented circumstances, allowing clinicians and their clients to meet virtually in order to reduce the spread of the illness.   But is teletherapy helpful?   Listening — read more

One warm, summer June day, Marietta Jaeger, her husband Bill, and their five children packed into their borrowed R.V. for a cross-country road trip touring the American west.  “This was going to be the adventure of a lifetime, a grand family vacation, the one we were going to talk about for the rest of our lives,”  — read more

This blogpost comes with a “trigger warning.”  For most, the last 60 days have been witness to the complete disruption of daily life.  Many people have died — nearly 250,000 worldwide, 70,000 in the United States — from a virus that the majority of us had never heard of just three, short months ago.  Looking — read more

A recording of a live meeting with professionals around the world interested in FIT and Deliberate Practice. Topics covered are listed below along with times when particular questions are addressed. How to incorporate deliberate practice (DP) into supervision? (3:10) How to use DP to address personal issues of the therapist? (12:37) When and how to — read more

When I was around 11 years old, a gag quickly circulated through my school. Cornering an unsuspecting chum, you’d ask, “Hey, have you seen my hammerfor?” “What’s a hammerfor?” they’d invariably ask, a quizzical look glued to their face. “Pounding nails!” you’d then scream, followed by paroxysms of laughter. Funny in a sad, underhanded kind — read more