Feedback Enhanced Therapy--Good Success

Had a great therapists meeting on Saturday.  The therapists at Bergen and Associates Counselling get together every so often for lunch on a Saturday.  After going over the mundane usual matters (clean up your dishes, this is where the new form is kept, blah, blah, blah), we spent some time talking with each other about the Feedback Enhanced Therapy (FET) that we use.  While some of us have been using it for a while, everybody has been using this system for about 3 months now, and it was a chance to explore therapists’ experiences of what it is like.

The literature has found that not only does FET increase the effectiveness of therapy, it also substantially decreases the possibility of counselling having a negative outcome. Unfortunately, while our field has been really good at researching improving the positive outcomes for clients, our profession hasn’t always looked at the other end of the continuum to see if we are harming people and making them worse. Feedback Enhanced Therapy catches possible harm very quickly, and allows us to make appropriate changes or to find the right resources for the person before significant damage occur.  To me, that's a huge relief as a therapist...it's not a comfortable feeling knowing that statistically therapy harms a small percentage of people, and having no way to catch that and prevent it. Research has shown that it increases the likelihood of divorce prevention when working with couples, can double the effect size of therapy for individuals…all with a brief inventory that takes less than a minute at the beginning and end of session. More and more research is emerging all the time that says FET is substantially significant.

Of course, it’s not just taking the inventory—anymore than merely owning a vaccum cleaner would ensure you have clean carpets. The significant thing is to use the information gleaned from the Feedback Enhanced Process and use it to adjust what is happening in the counselling to make it more beneficial.

So…what I was really interested in hearing was what it was like for the therapists to incorporate Feedback Enhanced Therapy into their work.  Are we using the process to impact on therapy--are we allowing it to make a difference in our work with clients? It was a fun conversation. (No one makes specific reference to clients to breech any confidentiality), but each therapist talked how they have made FET their own.  What came up:

• For some clients and therapists who “click” immediately and almost effortlessly, and the FET reinforces that this, has in fact happened. 
• When we work with couples or families, and we as therapists need to work to make the experience effective for more than each person--a tricky challenge when sessions are an hour, and there is so much to talk about.  FET allows us to check in with each person each session in a way that enhances therapy rather than derails it. Each person’s experience of therapy and the effect it is having on that person is valued. Of course, all therapy seeks to value the experience of therapy for each person, and the effect it has…but FET allows us to give more than “lip service” to the idea. 
  
• FET allows us to check in with each person at the end of a session, and figure out what it takes to “get it right”, so that the next session is launched in the right direction from the “get go”.
• When things aren’t going well, it gives opportunity and space for a client to say that something isn’t working, and the therapist and client can figure out the proper change of course. 
• Sometimes it allows for a profound review of what happened in the session as the feedback allows for a time of reflection which further solidifies important “change moments” of the therapy. 

Feedback Enhanced Therapy has allowed very clear "course direction changes" for me that have allowed me to feel like I can be more effective with the people I work with.

• I know that FET has at various times prompted me to be more direct with clients who desire it.
• We changed appointment length from 60 to 90 minutes upon mutual agreement to allow for a client’s style.  Some people just need more time than 60 minutes to "warm up, work, and wrap up". 
  
• It’s taught me that with some clients the action of hearing themselves process aloud in the presence of another is what is most beneficial and so there are times when attentive listening and “being a mirror” is the way I can be most helpful.
  
• When we have had a difficult session that has really poked at a person's soul (e.g. looked candidly at the effects of drinking alcohol on their lives), it has given us a way to talk about how even really hard and painful sessions can have value.  It also lets us figure out what to do with the conversation and the "sting" that remains at the end of session.
  

I get to find these things out via FET. I am a better therapist with each client because the individual client and I teach each other how to enhance the therapy via this feedback.

No one would go to the store and buy the exact same pair of shoes as everyone else if they had no shoes—why would we think every client would benefit from the exact same approach with the therapist. FET allows the therapist to “adjust the size, model and material of the therapy” to get each person the result that will "fit" their sole soul.  (Sorry that pun was really corny)

I’m thrilled with how much this has enhanced our ability to work effectively with clients…I believe (and the research literature backs this up) that this will allow clients to get more improvement than they might otherwise have, and it will happen faster. 

Therapy—it’s all about helping people remove the barriers that interfere with them living the lives they were created to live…anything that we can do to do this better is great.