What Your Therapist Doesn’t Know, Cont’d


First, I want to say thank you for your thoughtful comments on my article “What Your Therapist Doesn’t Know,” on how data can make therapists more effective. I am honored that the article sparked so much thought.

Some readers raised questions about the applicability of metrics to therapy, and in particular whether FIT (feedback-informed treatment) can benefit therapy. These questions are valid. FIT is nothing close to a “cure-all.” Although a lot of studies have shown that FIT can benefit therapy, it is still very limited, and only works when therapists are invested in the process.  Like a thermometer, it only helps with some patients, and only when used correctly.  Its primary benefit is helping therapists identify their own blind-spots with clients at risk of deterioration.  That said, I think it is important for us to continue experimenting with new tools and methods to improve our work. This forthcoming book has excellent guidance on using FIT. This website by therapist and researcher Barry Duncan, also has lots of great resources on FIT, including studies on using FIT with children, families, and group therapy.

Many readers raised two important questions. First, they questioned whether some psychotherapy models are more effective than others. One commenter points to a study:

A pretty extensive 2013 meta-analysis was conducted and published in the Journal of Consulting and Clinical Psychology that showed that methods actually do matter concerning patient outcomes, as one would expect. The study showed that clients treated using specific methods had better patient outcomes than those that received treatment based solely around the therapeutic relationship.

When looking at patients six months after ending therapy, it appears “that added specific ingredients may contribute modestly to treatment outcomes.” In other words, at six months post-therapy, patients that received specific treatments generally fared better long-term than patients who received general treatment. This is hugely important because it suggests that the value of therapy goes beyond merely the relationship between therapist and patient, and that specific treatments DO matter.