title: Improving the efficiency of cognitive-behavioural therapy by using formal client feedback.
abstract: Feedback from clients on their view of progress and the therapeutic relationship can improve effectiveness and efficiency of psychological treatments in general. However, what the added value is of client feedback specifically within cognitive-behavioural therapy (CBT), is not known. Therefore, the extent to which the outcome of CBT can be improved is investigated by providing feedback from clients to therapists using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS).
  
  
  
  Outpatients (n = 1006) of a Dutch mental health organization either participated in the "treatment as usual" (TAU) condition, or in Feedback condition of the study. Clients were invited to fill in the ORS and SRS and in the Feedback condition therapists were asked to frequently discuss client feedback.
  
  
  
  Outcome on the SCL-90 was only improved specifically with mood disorders in the Feedback condition. Also, in the Feedback condition, in terms of process, the total number of required treatment sessions was on average two sessions fewer.
  
  
  
  Frequently asking feedback from clients using the ORS/SRS does not necessarily result in a better treatment outcome in CBT. However, for an equal treatment outcome significantly fewer sessions are needed within the Feedback condition, thus improving efficiency of CBT.
authors.affiliation: a HSK Groep , Arnhem , The Netherlands.
authors.forename: Pauline D
authors.initials: PD
authors.lastname: Janse
authors.affiliation: b Department of Clinical Psychology , Leiden University , Leiden , The Netherlands.
authors.forename: Kim
authors.initials: K
authors.lastname: De Jong
authors.affiliation: c Dimence , Deventer , The Netherlands.
authors.forename: Maarten K
authors.initials: MK
authors.lastname: Van Dijk
authors.affiliation: d Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands.
authors.forename: Giel J M
authors.initials: GJM
authors.lastname: Hutschemaekers
authors.affiliation: d Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands.
authors.forename: Marc J P M
authors.initials: MJPM
authors.lastname: Verbraak
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods* / Q000592:standards; D005246:Feedback; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D000071066:Patient Reported Outcome Measures
keywords: Outcome Rating Scale; Session Rating Scale; client feedback; cognitive-behavioural therapy