What is Therapy Meets Numbers? Assuming that therapy and numbers don’t already meet …why would they want to? If they do meet … what could possibly happen? Here we try to answer all those questions and more …
I’ll come to the story of how we came to be later, but I’ll start with what we’re about. At its heart, TMN is about three things:
Making research accessible
Making routine measurement doable
Making therapy remarkable
Now, each of these three statements could be read to imply that there is a problem which it’s trying to solve, so I’ll come right out and say ‘Yes, I think there are problems, to some extent at least.’ Let me expand a little on each.
Making research accessible:
There is much research evidence for what works in therapy, including how we can enhance both client engagement and outcomes. Despite this wealth of evidence, however, much of therapy practice seems relatively untouched by it.
There are perhaps two key reasons for this disconnect. First, research barely figures in most foundation level therapy training. Unlike the discipline of psychology, where research and measurement is in the DNA of professional training, counsellors and psychotherapists are not routinely grounded in research methods.
Second, researchers tend to write with other researchers in mind, partly in order fulfil the requirements of peer reviewed publication processes. While those processes might deliver better quality research, however, their key messages are often shrouded in language which can seem incomprehensible to many therapists.
For research to influence practice, and vice versa,
there has to be a place where the two can meet in dialogue.
Making routine measurement doable:
There is also clear evidence that routinely measuring key aspects of client experience, such as their outcomes and the strength of the therapeutic alliance, can lead to better experiences of therapy and better outcomes for clients. Despite this evidence, however, many of us view measurement as an unwelcome intrusion into our practice, rather than a valuable opportunity to gain additional feedback from clients about their experience.
How many of us were ever properly trained in using routine outcome measurement? How many of us have had measurement imposed upon us, often in a clumsy and ill-prepared way? For many therapists, routine measurement seems a dark and complex art, whereas, in reality, its basics are remarkably straightforward.
Implementing and using routine measurement is a skill.
Like any skill, it needs to be learned.
But it is not, and neither should it be, complex. If I can do it, so can you.
Making therapy remarkable:
I know, and if you’re a therapist, you know, that therapy at its best can be a powerfully transformative experience. We also know that our seeming inability to help a client effect change can leave us feeling incompetent and powerless. Sometimes the therapy that we provide can feel remarkable, and sometimes it can feel anything but.
One key message from research is how poor we appear to be at predicting which clients are going to benefit from therapy, and which are not. It seems, also, that we routinely over-estimate how effective we are relative to our peers, and also relative to our clients’ actual outcomes.
Consistent, deliberate practice is the key to improvement.
The day you hear me say ‘I’m now good enough’, please put me out to therapist pasture.
Making the remarkable, unremarkable
I’ve spent a good part of the last twenty years involved in trying to work out how we can make more of our clients’ experiences of therapy remarkable. I’ve looked at research, I’ve implemented and used routine evaluation in my own practice and service settings, and I’ve helped many other practitioners and services in that process. I’ve seen and been part of what’s possible.
Therapist variables, including the quality of the therapeutic alliance, contribute between 5 – 9 times as much to client outcome as the therapeutic model we practice
It is who and how we are, and what we do, that makes the vastly bigger difference. Oftentimes, we make this difference uninformed by research and by routine evaluation. What additional difference could we make to our clients’ experience if our practice were informed by clear evidence from research, and client feedback from routine evaluation?
At TMN our aim to make research accessible and make routine measurement doable
We’ll do that by highlighting relevant research and putting it across in a way that makes sense. We’ll aim to demystify the dark arts of routine measurement with practical guidance, and we’ll share our own stories of success and failure, as well as the stories of other practitioners and services. If we do that right we hope we’ll be helping you, in some small way, to make therapy just a little more remarkable.
We want TMN to be a community, and we want you to feel it’s your community
It can be nothing without you. We’d love to hear your stories, and to have your feedback. Tell us what you like, what you don’t, and what do you want us to cover that we’re not. Don’t be a stranger, and be sure to sign up for our newsletter to keep up to date.