Feedback-informed treatment

Domain VI · Brief, integrative, trauma, hypnosis & coaching · Scott D. Miller, Barry Duncan · 2000

What it is

FIT is not a therapy model. It is a pantheoretical practice framework laid over whatever therapy you already do: at every session the client rates their wellbeing (ORS, start of session) and the alliance (SRS, end of session), the scores are discussed openly, and the clinician changes the work when…

Format

• FIT has no fixed number of sessions or phases of therapy; it is a recurring per-session routine plus decision points keyed to the client's progress. Length of service is meant to be set individually from ORS data.
• Per-session format (every session, every client):

Who practises it, and how they are trained or regulated

• Origins: the ORS was developed by Miller and Duncan (2000) as a brief alternative to the OQ-45; the SRS was adapted from Johnson's (1995) longer scale and built on Bordin's alliance concept plus the client's theory of change. Miller leads the ICCE and uses the term FIT; Duncan's Heart and Soul of Change Project uses the same measures under the name PCOMS. How and when the two lines diverged organisationally is.…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• supervision drifting back to case narrative only.
• ending prematurely when only one domain has improved.
• rushing it as the client stands up; leave time to talk about it.
• treating the alert as a verdict; it signals risk, not certainty.
• billing, IT or funding barriers that make feedback hard to act on.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.