Psychotherapy Research 11(1) 49–68, 2001
© 2001 Society for Psychotherapy Research
THE EFFECTS OF PROVIDING THERAPISTS WITH
FEEDBACK ON PATIENT PROGRESS DURING
PSYCHOTHERAPY: ARE OUTCOMES ENHANCED?
Michael J. Lambert
Jason L. Whipple
David W. Smart
David A. Vermeersch
Stevan Lars Nielsen
Eric J. Hawkins
Brigham Young University
This research was supported by research grants from Brigham Young University (Office of the Aca-
demic Vice-President; College of Family, Home, and Social Sciences; and the Office of the Student Life
Vice-President) and the German-American Academic Council Foundation.
Correspondence concerning this article should be addressed to Michael J. Lambert, Department of
Psychology, 272 TLRB, Brigham Young University, Provo, Utah 84602. E-mail: michael_lambert@byu.edu.
49
Patient-focused research attempts to provide information that answers the
question: Is this treatment benefiting this patient? Although several sys-
tems have been developed to monitor and provide feedback about a
patient’s response to psychotherapy, few if any have been tested empiri-
cally. The current study divided 609 patients into four groups (two ex-
perimental and two control) to determine if feedback regarding patient
progress, when provided to a therapist, affected patient outcome and
number of sessions attended. Results showed that feedback increased the
duration of treatment and improved outcome relative to patients in the
control condition who were predicted to be treatment failures. Twice as
many patients in the feedback group achieved clinically significant or
reliable change and one-third as many were classified as deteriorated by
the time treatment ended. For those patients who were predicted to have
a positive response to treatment, feedback to therapists resulted in a re-
duction in the number of treatment sessions without reducing positive
outcomes.
While both clinical trials and effectiveness studies have provided an abundance of
evidence that psychotherapies of various kinds are effective treatments for a variety
of psychological disorders (Lambert & Bergin, 1994), clinicians have remained rather
skeptical about the relevance and value of psychotherapy process and outcome re-
search, looking elsewhere for guidance in directing their clinical practice. At the same
time, questions have been raised about the quality of services offered to patients
undergoing psychological interventions, especially under the limits placed on ser-
vices by managed care organizations. Andrews (1995) has suggested that the push
for outcome research is a worldwide phenomenon independent of any specific pay-