It was not what outcome measurement taught me so much as how do I get my supervisees and staff in my practice to implement it? 

My original interest in outcome measurement for my own work came out of feeling a bit lost as to “what to do with whom and when” in therapy, and contemplating whether I did any good at all. 

I would have occasions when I felt I was in a state of flow with the client, but I realised that was only MY experience. And what was more interesting was what the client had thought or experienced. 

Not everyone perceived the session the way I did. 

I had supervisees and employees who loved to learn and attended many seminars each year. They weren’t necessarily the most effective therapists though. 

A few of them had Doctorates and PhDs—they were better qualified than me, but their outcomes were not superior to others. 

What was common to those who had better results with clients was a combination of

  • creating hope and expectancy with the client, and 
  • adjusting the therapy to meet the agreed goals and preferences for how to reach those goals through therapy and in life. 

They were able to work with a broader range of client presentations and they reviewed their cases regularly and asked the questions themselves about transference and countertransference, engagement with clients who they found difficult, and so on. 

Their interpersonal skills were excellent, but they were most interested in the clients who they struggled with or who didn’t respond to their usual repertoire.

I realised that outcome measurement is a type of truth-telling which is not easy to face, but if you can as a therapist, it may create a moment where you can face what did or did not happen with a client (particularly if you had a recording of the session and outcome measures) as a process question that can unlock learnings that otherwise are illusive.

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