Monthly Archives: March 2016

Outcome measures to reduce drop off

This post is one in a series of guest blogs from bacpac user, psychotherapist, coach and consultant, Barry McInnes, exploring the benefits of recording and analysing outcome measures as part of therapy. Click here to read the first part, second part and third part in the series.


Reason number 2 to for considering taking outcome measures with clients as part of your therapy session…

Measures might well save your (therapy) relationship

The therapeutic relationship which we prize and which figures so highly in successful outcomes is fragile and can be easily damaged.

In a revealing blog post, Tony Rousmaniere recounts how he systematically went about gathering feedback from clients about their experience of therapy with him:

“You understand me thirty percent of the time.”
“I need to you to slow down.”
“I was sad and you cut me off.”

“These words of dissatisfaction are from my clients. They weren’t easy to hear, but they have changed how I practice psychotherapy and have significantly reduced my dropout rate.”

I’m sure we’d all like to think this couldn’t possibly apply to us. On a different blog however, Scott Miller highlights studies which show that in 19-42% of sessions clients report tensions or actual breakdowns in the therapeutic relationship, figures which rise to 41-100% of sessions when trained observers are used to identify ruptures between clients and therapists.

Without measures, can we ever really know how our clients experience us in sessions? Of your last five clients that dropped out, is there anything that you could have anticipated? Anything that, had you had been aware, might have resulted in a different outcome?

Is it possible that using a short measure of how your client experiences sessions with you, like the Session Rating Scale (SRS) or the ARM-5, might help you to better understand and perhaps avoid the unexpected empty chair?

I’d welcome your thoughts and your feedback. Drop me a line by emailing You can also read more about what works in therapy from a research perspective on my website.

If you are a practising therapist in private practice and would like to contribute to the bacpac blog yourself, please get in touch using the contact form.