integrating client feedback into solution focused brief...
TRANSCRIPT
Solution Focused World ConferenceAmsterdam June 2016
Integrating Client Feedback into
Solution Focused Brief Therapy
Brendan MaddenBrief Therapy Group & ACE Health
Learning from your client
• Client as the expert in their lives
Adapting to clients individual needs
• Focus on the clients needs and preferences.
Tuning into your client
• Be aware of issues or difficulties early on
Space for client feedback
• Has the client a sense of progress? How are you
getting on together?
Integrating Client Feedback into SFBT
SFBT values
Ensuring engagement in the therapy process
• Be sensitive to the client’s needs and preferences
Attend to the working alliance
• Focus on positive empathetic working alliance and
agreement on goals and tasks
Monitor outcomes
• Receive feedback about our effectiveness by
measuring outcomes
Integrating Client Feedback into SFBT
Supporting positive SFBT outcomes
1. Where are you at?
• What’s the problem?
2. Where do you want to go?
• What do you want to change?
3. How far have you come?
• What’s been working so far? How are things going in
our work together?
4. What is the next step?
• Are we working on the goals that are important to
you? What’s the next step in moving forward?
Integrating Client Feedback into SFBT
Client feedback at each SFBT stage
Setting goals and reviewing
• What’s helpful to talk about? The Miracle question.
Using scaling questions
• Where are you on a scale of 1 - 10
Goal based outcomes (GBOs)
• Simple goal feedback forms
Allowing space for feedback
• Taking a therapeutic break
Integrating Client Feedback into SFBT
Informal feedback
Feedback forms• Give clear feedback quantitative feedbackStructured feedback systems• Easier to use. Comparable scores and expected
treatment responses. Support benchmarking. Positively formulated• Measure emergence of solution thoughts and
behaviours rather than reduction of symptomsAllow real-time feedback in the session• Easily integrated into therapeutic process.
Supportive of the therapeutic process.
Integrating Client Feedback into SFBT
Formal feedback tools
Minimal burden• Not intrusive or hard work
Multiple perspectives• Gather feedback from client, referrer, family
member
Meaningful use• Integrated into clinical practice
Add other missing perspectives
• Incorporate the client’s voice
Integrating Client Feedback into SFBT
Feedback tool requirements
Clinical Context• Interpreted within clinical context• Clinical expertise and judgement necessary
Collaboration• Support shared decision making• Feedback encouraged and facilitated
Curiosity• Which measures and with whom• When and how often• In what way – paper/tablet/mobile
Integrating Feedback into SFBT
Feedback tools and therapy
Valid, reliable and feasible measures• Measures used are valid, reliable and brief enough to be feasibly used in
practiceObjective quantifiable data• Provides objective, quantifiable data on the client’s evaluation of the
effectiveness of the therapy being providedNormative comparisons• Can compare each client’s responses to normative data based on similar
clients to identify clients at risk of poor outcomes and dropout.Engage client preferences• Provides a mechanism for using the client’s ideas and preferences to
guide the choice of therapeutic techniques and practices. Identify early progress and engagement• Solicits feedback regarding factors proven to predict success, the client’s
assessment of early progress and/or perception of the alliance.
Integrating Client Feedback into SFBT
Feedback tool requirements
Client expectations• It’s what client’s and funders want – supports consumer
accountability
Supports collaborative decision making• Client feedback fosters collaboration and shared decision
making
Improved outcomes• Together with deliberate practice client feedback is a vital
practice in supporting clinical excellence and improved outcomes
Reduced dropout• Client feedback on progress and engagement significantly
improves client dropout rates
Why use feedback tools
Integrating Client Feedback into SFBT
Introducing CYP-FIT
• A feedback and engagement smartphone app that’s easy to understand and fun to use
• Captures real-time feedback on service users experience of care and progress in treatment
• Collect aggregate data at a service level by treatment, Child and Adolescent Mental Health Service (CAMHS( worker and agency.
• Supports service integration and quality improvement
Children and Young Person’s Feedback Informed Treatment
CYP-FIT
• Allows CAMHS services to be adjusted to align with young people’s needs and preferences
• Improves service user engagement and allows the goals and views of young people to be included in care planning
• Supports collaborative practice and shared decision making
• Facilitates stepped care and supports more efficient use of CAMHS resources
• Aggregate data can be used to support agency performance and achievement of effectiveness and quality targets
Benefits of CYP-FIT
SOME DOS AND DON’TS OF USING FEEDBACK TOOLS
Dos • Make sure you have the feedback tool you need ready
before the session.• Always explain why you are asking anyone to use a
feedback tool.• Look at the answers.• Discuss the answers with service users.• Share the information in supervision.• Always use information from a feedback tool in
conjunction with other clinical information.
SOME DOS AND DON’TS OF USING FEEDBACK TOOLS
Don’ts • Don’t use a feedback tool if you think the person doesn’t
understand why they are being asked to complete it.• Don’t use any form if you don’t understand why you are
using it.• Don’t insist on someone using a feedback tool if they are
too distressed.• Don’t see the numbers generated from outcome tools as
an absolute fact.• Don’t see your clinical judgement as an absolute fact.
•Real-time analysis of client progress in treatment•Expected treatment response available for each client• Interactive charts provide indication of client progress•At-risk cases quickly identified and highlighted•Feedback from other sources e.g. family members •Access for supervisors and managers •ORS and SRS plus additional outcome measures
Introducing Open-FIT
Tablet based Feedback Informed Treatment System
Introducing Open-FIT
Title here OpenFITIntroducing Open-FIT
Introducing Open-FIT
Introducing Open-FIT
Introducing Open-FIT
Introducing Open-FIT
Introducing Open-FIT
Fig. 4: Sample Chart of the ORS and SRS
Fig. 4: Sample Chart of the ORS and SRS