Individualized Patient-Progress Systems: Why We Need to Move Towards a Personalized Evaluation of Psychological Treatments Ce ´lia M. D. Sales Universidade Auto ´noma de Lisboa (CIP-UAL) and Centro de Investigac  a ˜o e Intervenc  a ˜o Social (CIS, ISCTE-IUL) Paula C. G. Alves Centro de Investigac  a ˜o e Intervenc  a ˜o Social (CIS, ISCTE-IUL) Patient-focused psychotherapy research refers to the monitoring, prediction, and evaluation of patient progress in therapy. This is traditionally based on repeated standardized measurement and followed by the provision of nomothetic feedback to both therapists and patients based on those measures. Patient progress throughout therapy can also use idiographic assessments, which involve using personalized instruments to elicit information that is truly specific to each patient. This article introduces the concept of individualized progress research, which combines nomothetic and idiographic measures, and presents the individualized patient-progress system (IPPS; Sales et al., 2011, 2011a, 2011b), a hybrid patient- progress system. There are benefits to using a hybrid approach: Nomothetic instruments compare clients whereas idiographic assessments provide a better understanding of each clinical case. Preliminary feedback of therapists piloting the IPPS suggests that this system is helpful to clinical tasks such as monitoring individual–family– group psychotherapy change, assisting clinicians in addressing patients’ realistic needs, and stimulating patients’ self-reflection about therapy. Keywords: idiographic assessment, individualized patient progress, tracking systems, routine evaluation, personalized evaluation, metric–frequency similarity, MF calculator, IPPS, hybrid outcome, literature review The relevance of patient monitoring has been acknowledged by both psychotherapy researchers and professional organisations. According to the Recommendations of the American Psychologi- cal Association’s Division 29 Task force on Evidence-Based Ther- apy Relationships chaired by Norcross (2011), Practitioners are encouraged to routinely monitor patients’ responses to the therapy relationship and ongoing treatment. Such monitoring leads to increased opportunities to reestablish collaboration, improve the relationship, modify technical strategies, and avoid premature termination. (http://www.div12.org/task-force-evidence-based- therapy-relationships) Theoretically rooted in the patient-focused approach, tracking systems traditionally follow a nomothetic approach. These systems use standardized, quantitative self-report questionnaires (e.g., Out- come Questionnaire System; Lambert, Hansen, & Harmon, 2010; Treatment Outcome Package; Kraus & Castonguay, 2010; Clinical Outcome Routine Evaluation (CORE)–PC; Barkham, Mellor- Clark, Connell, Evans, & Margison, 2010). They also provide therapists with nomothetic feedback, such as progress charts or tables that include patient scores throughout therapy, in compari- son with clinical and nonclinical populations (clinical cutoffs). Some also include alerts, or clinical flags, to highlight areas of major concern such as a brief red note stating that the patient presents signs of deterioration in a certain area (e.g., interpersonal problems; CORE-PC; Barkham et al., 2010). Numerous studies have demonstrated that providing therapists with nomothetic feedback may potentially reduce symptomatology and improve treatment outcomes, including patient functioning and well-being (e.g., Bickman, Andrade, Kelley, Breda, & Riemer, 2011; Dyer, Page, & Hooke, 2011; Jong & Timman, 2011; Lambert et al., 2003; Miller, Duncan, & Sorrell, 2006; Reese, Toland, Slone, & Norsworthy, 2010; Witold, Harris, & Lambert, 2011). Feedback may also influence the therapists’ clinical deci- sions, such as selecting topics for discussion with patients or determining the dosage of treatment to be administered (Kelley et al., 2011; Lutz et al., 2009). Research has shown that therapists find feedback from nomo- thetic measures useful for approximately 60% of their caseload (Rottger, Rubel, & Lutz, 2011). The feedback assisted clinicians in tasks such as enhancing treatment motivation, supporting patient strengths and the therapeutic relationship, and discussing informa- tion with patients when unfavourable progress was observed. However, patient progress in therapy can also be evaluated and monitored with idiographic assessments. Idiographic Assessment Measures Idiographic assessments rely on instruments to elicit informa- tion that is specific to each patient and give answers to questions such as, “What are the specific problems of this patient? What exactly does he want to achieve with therapy? How is he experi- encing treatment? and What has been helpful or hindering?” Ce ´lia M. D. Sales, Universidade Auto ´noma de Lisboa (CIP-UAL), Lisboa, Portugal, and Centro de Investigac ¸a ˜o e Intervenc ¸a ˜o Social, ISCTE- Instituto Universita ´rio de Lisboa (CIS, ISCTE-IUL), Lisboa, Portugal; Paula C. G. Alves, Centro de Investigac ¸a ˜o e Intervenc ¸a ˜o Social, ISCTE- Instituto Universita ´rio de Lisboa (CIS, ISCTE-IUL), Lisboa, Portugal. The authors thank the editor, Dr. M. Drapeau, and the guest editor, Dr. M. Fitzpatrick, for their help in editing this paper. Correspondence concerning this article should be addressed to Ce ´lia M. D. Sales, Universidade Auto ´noma de Lisboa - Departamento de Psi- cologia e Sociologia, Rua de Santa Marta, 47 - 3  , 1169-023 Lisboa, Portugal. E-mail: celiasales@soutodacasa.org Canadian Psychology / Psychologie canadienne © 2012 Canadian Psychological Association 2012, Vol. 53, No. 2, 115–121 0708-5591/12/$12.00 DOI: 10.1037/a0028053 115