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Progress Feedback and the OQ-System

The Past and the Future


A serious problem in routine clinical practice is clinician optimism about the benefit clients derive from the therapy that they offer compared to measured benefits. The consequence of seeing the silver lining is a failure to identify cases that, in the end, leave treatment worse-off than when they started or are simply unaffected. It has become clear that some methods of measuring, monitoring, and providing feedback to clinicians about client mental health status over the course of routine care improves treatment outcomes for clients at risk of treatment failure (Shimokawa, Lambert, & Smart, 2010) and thus is a remedy for therapist optimism by identifying cases at risk for poor outcomes. The current article presents research findings related to use of the Outcome Questionnaire-45 and Clinical Support Tools for this purpose. The necessary characteristics of feedback systems that work to benefit client’s well-being are identified. In addition, suggestions for future research and use in routine care are presented.

Keywords: progress monitoring and feedback, Outcome Questionnaire-45, clinical support tools, effects of feedback, prevention of treatment failure

Michael J. Lambert, Ph.D., is a Professor of Psychology and holds the Susa Young Gates University Professorship at Brigham Young University, teaching in the Clinical Psychology Program. He is also holds an honorary Professorship at the University of Queensland School of Psychology, Brisbane Australia. He has been in private practice as a psychotherapist throughout his career. His research spans 40 years and has emphasized psychotherapy outcome, process, and the measurement of change. He was the recipient of the Distinguished Psychologist Award from Division 29 (psychotherapy) of the American Psychological Association. He is editor of Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change (6th edition, 2013), the most authoritative summary of the effects of psychological treatments.

Cite This Article

Lambert, M. J. (2015).  Progress feedback and the OQ-System: The past and the future. Psychotherapy, 52(4), 381–390.



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