Which evidence-based practice in psychotherapy is the best?

July 20, 2021 at 11:00 AM

Evidence-based treatments play a significant role in evidence-based practices (EBP) in psychotherapy and general health care. A long laundry list of EBP has been developed with the goal of ensuring treatment efficacy and patient safety. The United States Substance Abuse and Mental Health Services Administration (SAMHSA) even created a National Registry for Evidence-Based Programs and Practices (NREPP). Only the most effective, well-researched, and broadly disseminated evidence-based practices were included. 

Did inclusion prove those were the best? Did any of it really make a difference in the quality of care and the effectiveness of the treatment clients received from their psychotherapist? The results are mixed and one of the main confounding variables is the provider effect. Turns out there is more variability in the outcomes of treatment between treatment providers than which treatment is used. 

Evidence suggests clients of top therapists experience 50% more improvement, are 50% less likely to drop out, need therapy for a lesser duration, and are significantly less likely to deteriorate during the course. So, if you are a therapist the question to ask is not which EBP, but how do you ensure you’re in the better part of the statistics.

Here are some simple tips developed by Dr. Scott D. Miller, founder of the International Center for Clinical Excellence.

1. Do doubt yourself

Doubting has its benefits. He, who doesn’t doubt himself, is missing out on a chance for improvement. Top therapists demonstrate professional self-doubt. They are less sure about their work and how it will turn out. To most, this will seem like a deterrent, but it does anything but that. It propels the therapist to learn what’s working and what isn’t, basis which they course correct. This is where monitoring and measuring your results become crucial. Rather than just relying on your clinical judgment, validating it with reliable feedback allows you to take effective measures and improve outcomes. What a few could do, now most can, since routine monitoring has become quick and easy with the MyOutcomes® Outcome Rating Scale. This tool takes less than 1 minute to administer and can be easily completed by clients at the beginning or end of each therapeutic session. It’s easy to get instant real-time feedback to improve your work. 

2. Strengthen relationships

The single factor that impacts outcomes between therapists is the therapeutic relationship. Over 97% of the difference in outcome is based on the alliance between client and therapist. This implies that top therapists are better at connecting with their clients and more so with a wider and diverse set of clients. To work on your relationship with the client becomes imperative and to do so you need to understand what’s working for your client. MyOutcomes® keeps track of all your client feedback which helps you serve them better and increase the chances of successful outcomes. 

3. Consistency is key

There’s no shortcut to success and the best therapists understand that improving outcomes and clinical abilities is a daily investment that compounds over time. Routine monitoring as part of a deliberate practice helps improve therapist performance and client outcomes. To get better results, you need to assess your performance baseline and develop a plan with small, measurable goals and objectives for improving your skills and your client outcomes.

Monitoring progress with real-time feedback on treatment progress and the strength of the therapeutic relationship is the EBP that helps you achieve your goals and objectives. A powerful approach for developing such an effective evidence-based practice is Feedback-Informed Treatment (FIT). FIT is one of only two psychotherapy measurement systems included in the NREPP. 

Although there may be other online FIT tools to choose from today, they all model themselves on MyOutcomes, which is not only the first electronic version, but continues to be the leader in the field.

MyOutcomes is not only the original electronic application of standardized FIT tools (originally known as the Partners for Change Outcome Management System (PCOMS), developed by Scott D. Miller and Barry Duncan decades ago), but it is the only such electronic tool to be included in the NREPP. The 2012 National Registry of Evidence-based Programs and Practices listing provides a detailed look at the psychometrics of the scales as well as a review of the evidence and tools available to support a feedback-informed approach to psychotherapy.

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