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Events in Therapy: The Good and the Bad



Forms for Eliciting Client Feedback

Barry Duncan's Heart and Soul of Change: Articles, videos and other resources about client-directed outcome informed practices

Additional resources on Outcome Questionnaires and the work of Michael Lambert (note: many of these resources are not free)


Articles on Significant Moments

When Your Therapist Cries

Altimir, C., Krause, M., de la Parra, G., Dagnino, P., Tomicic, A., Valdés, Perez, NJ, Echávarri. O. & Vilches, O. (2010). Clients', therapists', and observers' agreement on the amount, temporal location, and content of psychotherapeutic change and its relation to outcome, Psychotherapy Research, 20(4), 472-487

Binder, P.E, Holgersen, H., Nielsen, G. (2009). Why did I change when I went to therapy? A qualitative analysis of former patients' conceptions of successful psychotherapy, Counselling and Psychotherapy Research, 9(4), 250-256

Hardy, G., Rees, A., et. al. (1998). Whingeing Versus Working: Comprehensive Process Analysis of A "Vague Awareness" Event in Psychodynamic-Interpersonal Therapy, Psychotherapy Research, 8(3), 334-353

Levitt, H. & Piazza-Bonin, E. (2011). Therapists' and clients' significant experiences underlying psychotherapy discourse, Psychotherapy Research, 21(1), 70-85

McLeod, John (2012). What do clients want from therapy? A practice-friendly review of research into client preferences, European Journal of Psychotherapy and Counseling, 14 (1), 19-32

Rees, A., Hardy, G.E. et.al. (2001). It's Like Catching a Desire Before it Flies Away': A Comprehensive Process Analysis of a Problem Clarification Event in Cognitive-Behavioral Therapy for Depression, Psychotherapy Research, 11(3), 331-351


Supervision and Feedback Articles

Freeman, Edith (1985). The Importance of Feedback in Clinical Supervision: Implications for Direct Practice, The Clinical Supervisor 22 (1), July 2004, 21-33

Heckman-Stone, Carolyn (2004) Trainee Preferences for Feedback and Evaluation in Clinical Supervision

Reese, Robert J.; Usher, Ellen L.; Bowman, Derek C.; Norsworthy, Larry A.; Halstead, Jackie L.; Rowlands, Steven R.; Chisholm, Rachael R. (2009) Using client feedback in psychotherapy training: An analysis of its influence on supervision and counselor self-efficacy Training and Education in Professional Psychology, Vol 3(3), 157-168.


Client Feedback Articles

Anker, M.G., Duncan, B.L., & Sparks, J.A. (2009). Using client feedback to improve couple therapy outcomes: A randomized clinical trial in a naturalistic setting. Journal of Consulting and Clinical Psychology, 77, 693–704.

Asay, T.P., Lambert, M.J., Gregersen, A.T., & Goates, M.K. (2002). Using patient focused research in evaluating treatment outcome in private practice. Journal of Clinical Psychology, 58, 1213–1225.

Bordin, E.S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research and Practice, 16, 252–260.

Brown, J., Dreis, S., & Nace, D.K. (1999). What really makes a difference in psychotherapy outcome? Why does managed care want to know? In M.A. Hubble, B.L. Duncan, & S.D. Miller (Eds.), The heart and soul of change: What works in therapy (pp. 389–406). Washington, DC: American Psychological Association Press.

Duncan, B.L., Miller, S.D., Sparks, J.A., & Claud, D.A. (2003). The Session Rating Scale: Preliminary psychometric properties of a "working" alliance measure. Journal of Brief Therapy, 3, 3–12.

Lambert, M.J. (2007). Presidential address: What we have learned from a decade of research aimed at improving psychotherapy outcome in routine care. Psychotherapy Research, 17(1), 1–14.

Lambert, M.J. (2010). Yes. It is time for clinicians to routinely monitor treatment outcome. In B.L. Duncan, S.D. Miller, B.E. Wampold, & M.A. Hubble (Eds.), The heart and soul of change (2nd ed., pp. 239–268). Washington, DC: American Psychological Association.

Lambert, M.J. (2001). The status of empirically supported therapies: Comment on Western and Morrison's (2001) multidimensional meta-analysis. Journal of Consulting and Clinical Psychology, 69, 910–913.

Lambert, M.J., & Cattani-Thompson, K. (1996). Current findings regarding the effectiveness of counseling: Implications for practice. Journal of Counseling and Development, 74, 601–608.

Lambert, M.J., Hansen, N.B., & Finch, A.E. (2001a). Patient-focused research: Using patient outcome data to enhance treatment effects. Journal of Consulting and Clinical Psychology, 69, 159–172.

Lambert, M.J., Harmon, C., Slade, K., Whipple, J., & Hawkins, E. (2005). Providing feedback to psychotherapists on their patients' progress: Clinical results and practice suggestions. Journal of Clinical Psychology, 61, 165–174.

Lambert, M.J., Hansen, N.B., Umphress, V., Lunnen, K., Okiishi, J., & Burlingame, G.M. (1996). Administration and Scoring Manual for the OQ-45.2. Stevenson, MD: American Professional Credentialing Services.

Lambert, M., Whipple, J., Hawkins, E., Vermeersch, D., Nielsen, S., & Smart, D. (2003). Is it time for clinicians to routinely track patient outcome? A Meta-Analysis. Clinical Psychology: Science and Practice, 10, 288–301.

Lambert, M.J., Whipple, J.L., Smart, D.W., Vermeersch, D.A., Nielsen, S.L., & Hawkins, E.J. (2001b). The effects of providing therapists with feedback on client progress during psychotherapy: Are outcomes enhanced? Psychotherapy Research, 11, 49–68.

Lambert, M.J., Whipple, J.L., Vermeersch, D.A., Smart, D.W., Hawkins, E.J., Nielsen, S.L., & Goates, M.K. (2002). Enhancing psychotherapy outcomes via providing feedback on client progress: A replication. Clinical Psychology and Psychotherapy, 9, 91–103.

Miller, S.D., & Duncan, B.L. (2004). The Outcome and Session Rating Scales: Administration and scoring manual. Chicago: Institute for the Study of Therapeutic Change.

Miller, S.D., Duncan, B.L., Brown, J., Sorrell, R., & Chalk, M.B. (2006). Using informal client feedback to improve retention and outcome: Making ongoing, real-time assessment feasible. Journal of Brief Therapy, 5, 5–22.

Miller, S.D., Duncan, B.L., Brown, J., Sparks, J.A., & Claud, D.A. (2003). The Outcome Rating Scale: A preliminary study of the reliability, validity and feasibility of a brief visual analogue measure. Journal of Brief Therapy, 2, 91–100.

Miller, S.D., Duncan, B.L., Sorrell, R., & Brown, G.S. (2005). The Partners for Change Outcome Management System. Journal of Clinical Psychology: In Session, 61, 199–208.

Sundet, R. (2009). Therapeutic collaboration and formalized feedback: Using perspectives from Vygotsky and Bakhtin to shed light on practices in a family therapy unit. Clinical Child Psychology and Psychiatry, 15, 81–85.

Sundet, R. (2011). Collaboration: Family and therapist perspectives of helpful therapy. Journal of Marital and Family Therapy, 37, 236–249.

Swift, J.K., Callahan, J.L., & Vollmer, B.M. (2011). Preferences. Journal of Clinical Psychology, 67, 155–165.

Tryon, G.S., & Winograd, G. (2011). Goal consensus and collaboration. Psychotherapy, 48, 50–57.


Books on Client Feedback in Psychotherapy

Duncan, B.L., Miller, S.D., & Sparks, J.A. (2004). The Heroic Client: A revolutionary way to improve effectiveness through client-directed outcome-informed therapy. San Francisco, CA: John Wiley & Sons Inc.

Lambert, Michael J. Prevention of treatment failure: The use of measuring, monitoring, and feedback in clinical practice. Washington: American Psychological Association

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