Feedback Informed Treatment

Feedback-Informed Treatment (FIT) is a pantheoretical approach for evaluating and improving the quality and effectiveness of Counselling and behavioral health services. It involves routinely and formally soliciting feedback from clients regarding the therapeutic alliance and outcome of care and using the resulting information to inform and tailor service delivery.

Feedback-Informed Treatment is consistent with and operationalizes the American Psychological Association’s (APA) definition of evidence-based practice. To wit, FIT involves “the integration of the best available research…and monitoring of patient progress (and of changes in the patient’s circumstances – e.g., job loss, major illness) that may suggest the need to adjust the treatment… (e.g., problems in the therapeutic relationship or in the implementation of the goals of the treatment)” (APA Task Force on Evidence-Based Practice, 2006, pp. 273, 276-277).

In February 2013, FIT was designed as an Evidence Based Treatment by the Substance Abuse and Mental Health Services Administration (SAMSHA). Dr.Robbie Babins-Wagner, our CEO, was the lead in developing one of the six manuals: Implementing Feedback Informed Work in Agencies and Systems of Care.

At Calgary Counselling Centre we are focused on ensuring that clients achieve the results they are looking for when they register for counselling services. We realize the importance of measuring the success of our counselling services. Having a reliable, accurate and credible system of measurement ensures that clients receive the highest level of service quality we can provide.

In September 2004 we began using the Outcome Questionnaire 45.2 (OQ 45) and the Session Rating Scale 2.1 (SRS) on a session by session basis to track client change on a session by session basis. In this way, we’re able to ensure our clients are receiving the best possible service.

Results from our on-going assessment of the feedback gathered from clients support several important conclusions:

  • Counselling experienced by clients at the Centre is effective in producing positive change.
  • The model of counselling per se doesn’t necessarily impact counselling outcomes.
  • Good counselling promotes positive change; no matter what treatment model is used.

Routine outcome monitoring

In 1996, Howard et. al.15 pioneered the use of session-to-session measures of client progress to evaluate and improve treatment outcomes. Since that time many studies have been published that provide strong support for routine outcome monitoring (ROM) in clinical practice. When implemented:

  • The risk of patient deterioration is significantly decreased16
  • Effect sizes are enhanced16
  • Detection of slight improvements reassures clients that they are making progress and improves the counsellor-client alliance17
  • Off-track alerts are available to the counsellor to indicate if the current course of treatment is ineffective or even harmful17

Numerous outcome measurement systems exist. The degree to which CCC has integrated routine outcome monitoring agency-wide in counselling, counsellor training, supervision and research is what makes us truly unique and an international leader in our field.