Besides the specific techniques I can use to help you, I structure each session around feedback, called Feedback Informed Treatment (FIT.) This structure uses deliberate practice, a strategy that professional athletes and Olympians use in their training. Deliberate practice requires breaking up tasks into manageable parts, setting goals, and being provided with in-the-moment feedback. This approach builds on strengths, successes, and stops bad habits from forming. So, what does this have to do with therapy???
Feedback is an important component to a positive and successful outcome. Most therapists use an eclectic approach (including myself), which means we use different strategies based on our personalities, ideas about the human condition and healing, etc. How do we know when to use a specific technique? People are complex. What worked for one will not necessarily work with everyone. Also, therapists are human, so sometimes we make mistakes or missteps. We do our very best, using our training, experience, and intuition, but this is not 100% accurate. What is the best way for me to know if my response and/or approach is helping you?
That’s why Feedback Informed Treatment (FIT) is so powerful. Within each session you’re given the time and structure to talk about what went well, what you liked, and/or didn’t like. How does it work?
Outcome Rating Scale (ORS)
At the beginning of each session you describe how you’ve been doing since your last appointment. On a sheet of paper, there are four lines representing four areas of well-being. For instance, the first line asks about your personal well-being. If your personal well-being has been fantastic without any problems, you’d mark the line on the farthest point to the right. If your well-being has been as bad as its ever been, you’d mark the line farthest to the left. You can mark anywhere on the continuum of that line. For telehealth, you can use a number instead of marking the line. The other areas of well-being to measure are: interpersonal, social, and overall well-being. If you weren’t sure what you wanted to talk about in that day’s session, this process could be a helpful place to start.
As you progress in treatment, this data can guide you and your therapist into a rich and valuable discussion, leading to insights, areas of growth, and topics for improvement. You will be able to practice deliberately, building on the foundation of what you already have, and focusing clearly on what you need to continue to improve. Also, instead of trying to rack your brain to remember how you felt months ago, you will have at your disposal a concise summary of your weekly progress. And if you’re not making the progress you’d like, this is important to talk about. It might be time to make a change, small or large, in your life and/or your treatment plan. Reflecting on the past, and where you’ve been, can help you more clearly determine where you need to go.
With FIT, each session begins with discussing how you’ve been, and ends with the…
Session Rating Scale (SRS)
In the last few minutes of each session, you will be able to discuss the session that just finished. Your honesty is strongly encouraged, because your therapist is here for you, after all. Just like the previous scale, you will describe the current session by marking on a line or using numbers. The questions are on a continuum: “I felt heard or I did not feel heard,” “We did/did not work on or talk about what I wanted to,” “The therapist’s approach is or is not a good fit for me,” “Today’s session was or was not right for me.” Based on your answers, you can discuss what you liked and/or what you didn’t. Based on your honest feedback, tweaks can be made immediately for the next session. What better way to improve the outcome? And, if you have a hard time giving constructive feedback, what better way to practice?
How will this help?
Using this model, you and your therapist will work together to develop a treatment plan that is right for you. Like a basketball player missing shots, a dancer with poor form, or a writer with improper grammar, if you continue making the same mistakes, you are likely to build ingrained patterns in your brain based on what’s not working. Fix it. Change it. Create better, more effective patterns. Improve. Your therapist can help.