Founder of the International Center for Clinical Excellence and originator of Feedback-Informed Treatment. Writes about what actually makes therapists effective, usually against the field's own assumptions.
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What makes a treatment work is the process it sets in motion and the person delivering it, not the name on the box. Compare the mechanism and the practitioner, not the brand.
Scott D. MillerFounder of the International Center for Clinical…Over the last 50 years, treatment methods have proliferated despite a lack of evidence of differential effectiveness between approaches. And even when a randomized controlled trial indicates a particular approach works, none show practitioners become more effective when they are trained in that modality.↗How to (and not to) become a more effective therapistwritings.scottdmiller.com · 2 Jul 2024
Their wordsOver the last 50 years, treatment methods have proliferated despite a lack of evidence of differential effectiveness between approaches. And even when a randomized controlled trial indicates a particular approach works, none show practitioners become more effective when they are trained in that modality.
Their wordsIt turns out that therapists who perform well on the FIS establish stronger relationships and are more effective (2). More to the point, the evidence shows FIS-related skills are trainable and that such training leads to better results (3, 4, 5).
Therapy needs two people who can work together. Whether the alliance causes good outcomes or merely reveals a patient who could form one is an open question.
Their wordsIt turns out that therapists who perform well on the FIS establish stronger relationships and are more effective (2). More to the point, the evidence shows FIS-related skills are trainable and that such training leads to better results (3, 4, 5).
A label like evidence-based can describe what was studied rather than what works. Who was compared with what, and how long the treatment ran, decide what a trial can show.
Scott D. MillerFounder of the International Center for Clinical…If one really wanted to know whether a treatment (e.g., CBT, IPT, ACT, EMDR) was more effective, it had to be directly compared to an approach intended to help - what Wampold and colleagues termed, a "bona fide" treatment. Doing otherwise, they argued, conflated artifacts of research design with actual research results.↗Results from the first bona fide study of deliberate practicewritings.scottdmiller.com · 11 Sept 2024
Their wordsIf one really wanted to know whether a treatment (e.g., CBT, IPT, ACT, EMDR) was more effective, it had to be directly compared to an approach intended to help - what Wampold and colleagues termed, a "bona fide" treatment. Doing otherwise, they argued, conflated artifacts of research design with actual research results.