title: Collecting client feedback.
abstract: While highly effective, psychotherapy outcome studies suggest 5-14% of clients worsen while in treatment and that therapists are unable to identify a substantial portion of such cases. Methods to systematically collect feedback from psychotherapy clients are discussed and two systems for monitoring treatment response, feeding back this information, and assisting in problem-solving with such cases are described. Within these systems, obtaining client ratings of their relationship appear to be highly important. We summarize meta-analyses of the effects of these feedback systems (The combined weighted random effect size for the Partners for Change Outcome Management System was r = .23, 95% CI [.15, .31], p < .001, k = 3, n = 558; the effect size for the Feedback condition of the Outcome Questionnaire (OQ) system among not-on-track patients was r = .25, 95% CI [.15, .34], p < .001, k = 4, n = 454; the effect size for the Patient/Therapist Feedback condition of the OQ system among not-on-track patients was r = .25, 95% CI [.15, .34], p < .001, k = 3, n = 495; the effect size for the Clinical Support Tools feedback condition among not-on-track patients was r = .33, 95% CI [.25, .40], p < .001, k = 3, n = 535). The number of psychotherapy patients who deteriorate can be cut in half by use of these systems. We conclude with a series of practice implications, including that clinicians seriously consider making formal methods of collecting client feedback a routine part of their daily practice.
authors.affiliation: Department of Psychology, Brigham Young University, Provo, UT 84602, USA. michael_lambert@byu.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lambert
authors.forename: Kenichi
authors.initials: K
authors.lastname: Shimokawa
mesh_terms: D005246:Feedback; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000592:standards*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome