Feedback Informed Treatment Feedback Informed Treatment Principles: Couples, Families, Groups, and Mandated Clients Where is the distress? To whom does the feedback refer? Multiple voices in the room Systemic questioning 1
Feedback Informed Treatment Collateral Ratings If the client scores above the cut-off and is there because other people think they should be there (mandated clients): Get the client to fill out the ORS as they think the referral source would rate them. If the client is in the service because she is concerned for her child: Get the client to fill out the ORS to rate the child s functionning I would like you to fill out the scale as you think your mother would see you Feedback Informed Treatment 2
Feedback Informed Treatment Navn: Thomas, 14 år Familie: Bor alene med mor og lillesøster (8 år). Ingen kontakt med far siden Thomas var 7 år. Henvendelsesårsag: Spiller gradvist mere og mere computer og isolerer sig på sit værelse Omgås dårligt selskab. Træt og uoplagt i skolen, mere fravær Mor og skolen er bekymrede for hans udvikling Behandling: Familiesamtaler 40 35 30 25 20 15 10 5 Thomas Sagsbehandler om Thomas Mor om Thomas 5 5 5 5 3
40 35 30 25 20 15 10 5 Thomas Sagsbehandler om Thomas Mor om Thomas Skolelærer om Thomas Klubpædagog om Thomas 40 35 30 25 20 15 10 5 Thomas Sagsbehandler om Thomas Mor om Thomas Skolelærer om Thomas Klubpædagog om Thomas 4
Feedback Informed Treatment Talk in groups of 3: How would the use of collateral rating make sense in your context? Who would you need to include as collateral raters in your settings? Putting Data to Work Integrating Outcome into Care Utility: Payer Administrator Program Manager Supervisor Intake Worker Summary Statistics Session-by-Session Line Staff 5
Farvel til Janteloven 6
Achieving Clinical Excellence Achieving Clinical Excellence 7
8
Achieving Clinical Excellence You have to seek out situations where you get feedback [about your performance]. It's a myth that you get better when you just do the things you enjoy.. Elite performers engage in 'deliberate practice' - an effortful activity designed to improve target performance. Unlike play, deliberate practice is not inherently motivating; and unlike work, it does not lead to immediate social and monetary rewards. In addition, engaging in [it] generates costs. 9
Bevidst, målreyet træning 10
Family Therapy Future How do you know how effec\ve you are? How does your effec\veness compare to other family therapists? 11
Achieving Clinical Excellence 12
Family Therapy Future What kind of feedback mayers? Clients Colleagues / peers Coach/ Mentors 13
Achieving Clinical Excellence Psykolog Daryl Chow Associate ICCE Ph.D. projekt i samarbejde med Sco5 Miller og William Andrews: Inves@ga@ng the development and prac@ces of highly effec@ve psychotherapists Achieving Clinical Excellence Solitary Prac<ce dvs. udover almindeligt arbejde Tid væk fra arbejde <l at reflektere over arbejdet. Supervision Læse eller gen-læse basis lieeratur om kerne terapi-færdigheder. Læse <dsskrifer Sagsgennemgang med mentor eller supervisor. Studere mester-terapeuters færdigheder Gennemgå case-eksempler 14
Achieving Clinical Excellence At lade sig overraske af feedback Den øverste 1/3 af terapeuterne beskrev langt oaere at de blev overrasket over den feedback de modtog fra deres klienter. De beskrev en åbenhed overfor feedback og en villighed \l at korrigere på baggrund af feedback They seek out to be disconfirmed Var ikke sammenhængende med at de var konsistente i deres brug af SRS det kunne også være på baggrund af uformel feedback det væsentligste var deres holdning \l feedback. 63,8% af varia\onen imellem terapeuter ser ud \l at kunne forklares på baggrund af denne holdning. 15
16