Medicine:Feedback informed treatment

From HandWiki

Feedback Informed Treatment (FIT) is an empirically supported, pantheoretical approach for evaluating and improving the quality and effectiveness of behavioral health services, originally developed by psychologist Scott D. Miller.[1][2] It involves routinely and formally soliciting feedback from clients regarding the therapeutic relationship and progress of care and using the resulting information to inform and tailor service delivery.:[1]

FIT utilizes empirically validated, client rated measurement tools at each session. Although any validated measures could be used, due to their brevity, the Outcome Rating Scale (ORS)[3] and Session Rating Scale (SRS) are commonly employed by FIT Practitioners. The ORS measures the client’s therapeutic progress while asking about their level of distress and functioning. The SRS measures the quality of the therapeutic relationship.[1]

A number of studies and meta-analyses have demonstrated the benefit of routinely monitoring and using client outcome data and feedback to inform care.[4] Studies using the ORS and SRS document:

  • Improved client outcomes (27%)[5]
  • Increased client retention
  • Reduction of deterioration rates (50%)[5]
  • Shortening the lengths of time spent in care

Additional Readings

  • Prescott, D. Maeschalck, C & Miller, S.D. (eds.) (2017). Feedback Informed Treatment in Clinical Practice. Washington, D.C.: American Psychological Association Press. ISBN 9781433827747.
  • Miller, S.D., Hubble, M.A. & Chow, D. (2021). Better Results: Using Deliberate Practice to Improve Therapeutic Effectiveness. Washington, D.C.: American Psychological Association Press. ISBN:9781433833441.

External links


  1. 1.0 1.1 1.2 Prescott, D., Maeschalck C., and Miller, S. (2017). Feedback Informed Treatment in Clinical Practice: Reaching for Excellence. Washington, D.C.: American Psychological Association. ISBN 9781433827747. 
  2. Miller, Scott (2013). "The outcome of psychotherapy: Yesterday, Today, and Tomorrow". Psychotherapy 50(1): 88–97. 
  3. Seidel, J. A., Andrews, W. P., Owen, J., Miller, S. D., & Buccino, D. L. (2016). "Preliminary Validation of the Rating of Outcome Scale and Equivalence of Ultra-Brief Measures of Well-Being.". Psychological Assessment 29 (1): 65–75. doi:10.1037/pas0000311. PMID 27099979. 
  4. Dulark & Dupre as cited in the Brattland, H., Koksvik, J.M., Burkeland, O., Gråwe, R. W., Klöckner, C., Linaker, O. M., Ryum, T., Wampold, B., Lara-Cabrera, M. L., & Iverson, V. C. (2018). "The effects of Routine Outcome Monitoring (ROM) on therapy outcomes in the course of an implementation process: A randomized clinical trial.". Journal of Counseling Psychology (65)5: 641–652. 
  5. 5.0 5.1 Miller, S.D., Duncan, B.L., Brown, G.S., Sorrell, R., & Chalk, M.B. (2006). "Using formal client feedback to improve retention and outcome: Making ongoing, real-time assessment feasible". Journal of Brief Therapy 5 (1): 5–22.