Benjamin E. Caldwell, PsyD
You could get more effective in your work, today, without changing anything at all about how you conceptualize cases or develop interventions with your clients.
All you have to do is measure your outcomes.
It really is that simple. Clients appreciate outcome measurement (and here I mean real, plotting-valid-numbers-on-a-chart measurement, not the softer “how are you feeling this week?” that too many of us mistakenly call “measuring outcomes”). They see us as taking responsibility and becoming accountable for the success of treatment. And measurement by itself — without any other changes in practice — reliably makes therapy more effective.
Measuring outcomes is remarkably easy and inexpensive. There is no good reason not to do so. A number of very useful outcome measures for anxiety, depression, and other issues were introduced with the DSM-5 and are completely free to use. The WHODAS (also free) is a more general measure of functioning that you might also find useful. The Session Rating Scale and Outcome Rating Scale, two other instruments I love, have strong research support and can be used without cost if you simply obtain a license for them (which is free for individual practitioners). And these are only the beginning.
I often ask students, supervisees, and colleagues whether they are good at what they do. Overwhelmingly they say “Yes,” and they say it with confidence. One study showed that a majority of therapists think they produce outcomes that are far above average.
It’s good that we’re confident. But clearly, for some of us that confidence is inaccurate – we can’t all be above average. Those of us who are below average should have the opportunity (and indeed, we all share the obligation) to work on getting better. So the more important question than “Are you good at what you do?” is, “How do you know?”
Measuring your outcomes will give you the answer. It also can tell you where you need to get better, and set you on a path to doing so. If nothing else, download some of those DSM-5 assessments and try them out. You might be surprised at how easy and informative they are.
We’re all in this together. Thanks for all you do.
Benjamin E. Caldwell is a Licensed Marriage and Family Therapist (#42723) in Los Angeles. He is the author of Saving Psychotherapy and Basics of California Law for LMFTs, LPCCs, and LCSWs.