• Outcomes of Our Work in the Therapy Room

    Many of us have heard the number one positive predictor for therapeutic outcomes is the therapeutic relationship. Do you know where this data point came from? Scott Miller. Scott is the director at the International Center for Clinical Excellence.

    I love following Scott’s work because his research really helps ground me, particularly when I either swing to believing I have the one way of working with clients that’s truly beneficial or there is nothing I can do to support my clients. Scott’s research has found that outcomes in the therapy room do not change over time no matter how much experience or expertise you have (Scott, 2021). Our confidence improves, but not our outcomes, and this may be why we believe our outcomes are improving. Scott (2021, para 4) also stated, “Because so much of what affects the outcome of individual clients at any given moment in care is random — that is, either outside of our direct control or not part of a recurring pattern of therapist errors.” I don’t know about you, but when I read that I feel some anxiety. I have limited control over the outcome of my work with my clients? Yikes!

    Another piece of information coming from Scott that I hold dearly is the number two predictor of a positive therapeutic outcome. We all know number one; do you know number two? It’s the clinician’s ability to instill hope in the client. Here at the The Whole Therapist Institute, we speak so often about holding hope for our clients until they can. How can we instill hope in our clients if we don’t have hope for them? We all have challenging clients, but it is our duty to be doing our own work so we have the capacity to hold hope for them. If most of what effects the outcomes of therapy is random, but we know the relationship and instilling hope are two things that we can control why are we so focused on more trainings and more knowledge? I’m asking myself this as well.

    I’m not sure in this short blog I can give Scott Miller justice, but if you’re interested in learning more head over to his website, or take some time to read over the article that inspired me to write this.



    Miller, S. (2021, March 2). Do We Learn from Our Clients? Yes, No, Maybe So…https://www.scottdmiller.com/do-we-learn-from-our-clients-yes-no-maybe-so/

    Scot Miller