{"id":6274,"date":"2025-07-22T14:52:11","date_gmt":"2025-07-22T06:52:11","guid":{"rendered":"https:\/\/darylchow.com\/frontiers\/?p=6274"},"modified":"2025-08-11T14:40:37","modified_gmt":"2025-08-11T06:40:37","slug":"fitevidence","status":"publish","type":"post","link":"https:\/\/darylchow.com\/frontiers\/fitevidence\/","title":{"rendered":"What&#8217;s the Evidence for Feedback-Informed Treatment (FIT)"},"content":{"rendered":"\n<p>Today, we will look at the cumulative evidence regarding Feedback Informed Treatment (FIT).&nbsp;<\/p>\n\n\n\n<p><strong>Research:&nbsp;<\/strong><a href=\"https:\/\/www.researchgate.net\/publication\/349879141_Using_progress_feedback_to_improve_outcomes_and_reduce_drop-out_treatment_duration_and_deterioration_A_multilevel_meta-analysis\">\u200b<strong>Latest Meta Analysis<\/strong>\u200b<\/a><strong>.<\/strong>&nbsp;Can you believe it that there\u2019s now&nbsp;<em>nine<\/em>&nbsp;meta-analyses being done on examining studies on the effects of feedback tools? The latest MA is published by&nbsp;<a href=\"https:\/\/www.researchgate.net\/publication\/349879141_Using_progress_feedback_to_improve_outcomes_and_reduce_drop-out_treatment_duration_and_deterioration_A_multilevel_meta-analysis\">\u200bKim de Jong and colleagues\u200b<\/a>&nbsp;in Netherlands.&nbsp;<\/p>\n\n\n\n<p>They looked at&nbsp;<strong>58 studies<\/strong>&nbsp;(over 21,000 clients) in total, using a broader inclusion criteria and more sophisticated statistical analysis (multi-level modeling).&nbsp;<\/p>\n\n\n\n<p><strong>Key Graf:<\/strong><\/p>\n\n\n\n<p>&#8211; Small positive effect on symptom reduction. <\/p>\n\n\n\n<p>\u2013 Reduction in dropout rates.<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/embed.filekitcdn.com\/e\/m4ApxUuh6u76wgADqpiUv3\/gj8H8wTJAnheRZEfw6pDwS\/email\" alt=\"\"\/><figcaption class=\"wp-element-caption\"><strong>Effects of feedback in full group (On-Track and Not-On-Track cases combined).<\/strong>&nbsp;<em>Note<\/em>: This forest plot is a graphical representation of the average effect sizes per study. Data was analyzed in a multilevel model, in which effect sizes per outcome<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/embed.filekitcdn.com\/e\/m4ApxUuh6u76wgADqpiUv3\/vykYVz3Dm5Fge7HMB2vNC1\/email\" alt=\"\"\/><figcaption class=\"wp-element-caption\"><strong>Effect of feedback in Not-On-Track subgroup i.e., Cases at risk for negative outcomes.&nbsp;<\/strong><em>Note<\/em>. This forest plot is a graphical representation of the average effect sizes per study. Data was analysed in a multilevel model, in which effect sizes per outcome measure were nested within studies. The&nbsp;<strong>Random Effects (RE)<\/strong>&nbsp;model summary represents the outcome of this model. A random effects model in this study refers to a statistical approach used in meta-analysis to account for different sources of variability in effect sizes observed across multiple studies<\/figcaption><\/figure>\n\n\n\n<p><strong>Secondary Findings:&nbsp;<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Over Time:&nbsp;<\/strong>The study found that the effect of feedback on symptom reduction slightly reduced over time, with an average 0.02 lower effect size per year.<\/li>\n\n\n\n<li><strong>Deterioration<\/strong>: There was no significant effect of feedback on the rate of deteriorated cases. On average, 5.4% of patients in control conditions deteriorated, compared to 4.6% in feedback conditions<\/li>\n\n\n\n<li><strong>No. of Sessions:&nbsp;<\/strong>The study found no significant overall effect of feedback on the number of sessions (d = -0.04), nor were there significant effects for &#8220;On Track&#8221; (OT) or Not-On-Track (NOT) cases specifically<\/li>\n\n\n\n<li><strong>Feedback Systems<\/strong>: Studies using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS) i.e., PCOMS system had significantly larger effects compared to the Outcome Questionaire (OQ)-45. The researchers noted that ORS is more sensitive to change and might overestimate effect sizes of feedback. However, the OQ System seemed more effective in NOT cases, especially with Clinical Support Tools (CSTs).&nbsp;<\/li>\n\n\n\n<li><strong>Therapist Training (for deteriorated cases):<\/strong>&nbsp;Studies where therapists received&nbsp;<strong>training in the feedback system<\/strong>showed larger effects in reducing deteriorated cases compared to studies without training.<\/li>\n\n\n\n<li><strong>Country:&nbsp;<\/strong>Interestingly, studies conducted in the US showed significantly larger effects of feedback for symptom reduction and dropout rates compared to studies conducted in other countries<\/li>\n<\/ul>\n\n\n\n<p>In short, measurement by itself isn&#8217;t a silver bullet. It is what we do with the feedback to feed-forward into the treatment process that really counts.<\/p>\n\n\n\n<p>Next week, we will look at some of the critique and issues with implementation of FIT.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Related Articles<\/strong><\/h2>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><a href=\"https:\/\/darylchow.substack.com\/p\/ff204\"><img decoding=\"async\" src=\"https:\/\/embed.filekitcdn.com\/e\/m4ApxUuh6u76wgADqpiUv3\/sqFuej6ToqaKThgXDFEDXR\" alt=\"\"\/><\/a><figcaption class=\"wp-element-caption\"><strong><a href=\"https:\/\/darylchow.substack.com\/p\/ff204\">When The Pill Model Doesn&#8217;t Work<\/a><\/strong><br><br>What&#8217;s right may not be right for you, and the trappings of misreading research.&nbsp;<\/figcaption><\/figure><\/div>\n\n\n<p><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><a href=\"https:\/\/darylchow.substack.com\/p\/8-theres-a-really-good-reason-why-56a\"><img decoding=\"async\" src=\"https:\/\/embed.filekitcdn.com\/e\/m4ApxUuh6u76wgADqpiUv3\/gY8RwkazdE7JL17ZV7kMRy\" alt=\"\"\/><\/a><figcaption class=\"wp-element-caption\"><strong><a href=\"https:\/\/darylchow.substack.com\/p\/8-theres-a-really-good-reason-why-56a\">Why We Need Adjustable Seats<\/a><\/strong><br><br>Fit the individual and not the average.<\/figcaption><\/figure><\/div>\n\n\n<p><strong><em>If you would like to learn more on how to improve your work, subscribe to the Frontiers of Psychotherapist Development (FPD). Each week, we serve you highly curated recommendations and insights straight into your Inbox.<\/em><\/strong><br><\/p>\n\n\n\n<center> <embed> <iframe src=\"https:\/\/darylchow.substack.com\/embed\" width=\"480\" height=\"320\" style=\"border:1px solid #EEE; background:white;\" frameborder=\"0\" scrolling=\"no\"><\/iframe> <\/embed> <\/center>\n\n\n\n<p><br><\/p>\n","protected":false},"excerpt":{"rendered":"<p>What&#8217;s the evidence for FIT? Let&#8217;s dive into the weeds.<\/p>\n","protected":false},"author":1,"featured_media":6201,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[115],"tags":[63,201,135,48],"class_list":["post-6274","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fit","tag-feedback-informed-treatment","tag-fit","tag-research","tag-routine-outcome-monitoring"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>What&#039;s the Evidence for Feedback-Informed Treatment (FIT) - Frontiers of Psychotherapist Development<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/darylchow.com\/frontiers\/fitevidence\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What&#039;s the Evidence for Feedback-Informed Treatment (FIT) - Frontiers of Psychotherapist Development\" \/>\n<meta property=\"og:description\" content=\"What&#039;s the evidence for FIT? 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