ACE logo med FIT vänster 150dpi_preview

Feedback-Informed Treatment (FIT)

what is fit?

Feedback-Informed Treatment (FIT) is an empirically supported, pantheoretical approach for evaluating and improving the quality and effectiveness of behavior health services. It involves routinely and formally soliciting feedback from clients regarding the therapeutic alliance and outcome of care and using the resulting information to inform and tailor service delivery.

(Bertolino, Bargmann & Miller. Manual 1: What Works in Therapy: A Primer on Feedback-Informed Treatment, ICCE Manuals on Feedback-Informed Treatment (FIT), (2011). 

how does it work?

FIT utilizes two, brief scales at each treatment session: Outcome Rating Scale (ORS) and Session Rating Scale (SRS). The ORS seeks information from the client’s perspective on their therapeutic progress and perceived benefit of treatment while asking about the person’s level of distress and functioning. The SRS seeks the client’s perception of the therapeutic alliance. 

evidence based?

FIT operationalizes the American Psychological Association’s (APA) definition of evidence-based practice.
Routine use of the ORS and SRS involves “the integration of the best available research…and monitoring of patient progress (and of changes in the patient’s circumstances – e.g. , job loss, major illness) that may suggest the need to adjust the treatment…(e.g., problems in the therapeutic relationship or in the implementation of the goals of the treatment)” 
(APA Task Force on Evidence-Based Practice, 2006, pp. 273, 276-277). 

Partners for Change Outcome Management System (PCOMS) is included in Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence Based Programs and Practices (NREPP). PCOMS is integrated into clinical practice by the International Center for Clinical Excellence through Feedback-Informed Treatment. 

First implemented in 2000 and now used by: 100s of organizations, 1000s of behavioral healthcare professionals in all 50 states, The District of Columbia, 20 countries on 5 continents. 
FIT is utilized with approximately
300,000 clients each year and is available in 23 languages!  

outcomes

(Miller & Schuckard, 2013) 

  • Routine outcome monitoring and feedback as much as doubles the “effect size” (reliable and clinically significant change). 

•  Decreases dropout rates by as much as half (1/2
•  Decreases deterioration by 33% 
• Reduces hospitalizations and shortens length of stay by 66% 
• Significantly reduces cost of care compared to non-feedback groups (which increased costs) 

implementation

FIT [PCOMS] has: “Comprehensive, well-organized and high quality materials are available to provide clear support and guidance to support the entire implementation process."  (Dissemination Strengths from NREPP review 2013) 

  • There are 6 Manuals available through the ICCE which cover the most important information for practitioners and agencies implementing FIT. 
  • The ICCE has developed CORE Competencies for a thorough grounding in the knowledge and skills associated with FIT.
  • The Feedback Readiness Index and Fidelity Measure (FRIFM) is available for agency implementation to guide the process. 
  • The ICCE has a Web Forum dedicated to excellence in clinical practice and provides opportunity for practitioners and administrators access to numerous others in the field for resources and support.