Measuring Therapeutic Progress: A Performance Based Model
In the mental health field, we have become too comfortable focusing on the how not to. We evaluate the mental health symptoms someone is having and work with them to develop a plan on how not to have those symptoms or behavior. We then evaluate our progress based on how often they do not do these symptoms or behaviors. While I am completely on board with symptom reduction, I think we are missing the mark in our approach. What if we flipped our focus from spending so much time and energy on how not to and we began to put attention on how to; the areas of people’s life they want to perform better. Our evaluation of the effectiveness of therapy would then naturally shift from measuring success based on people doing less of something, but rather doing more, measuring the increase not the decrease.
Let’s use depression as an example: depression is one of the most common mental health diagnoses that brings people to therapy. Some of the most common symptoms include isolation, lack of motivation, loss of sleep, feeling sad, etc. These symptoms can be difficult to manage which can lead to a decrease in performance in areas that are important. Focusing on the increase for depression would be asking the question, what is your depression keeping you from? What are you not able to manage as effectively as you are dealing with these symptoms? How has depression symptoms affected your performance in the areas of your life that you value? How will you know if you are performing in these areas at your highest level? We will then measure your success in therapy by the increase in these areas.
What are the areas in your life you want to increase? Bring a better version of yourself to? Achieve or accomplish? For some these areas involve relationships, for others it may involve their career, education, or athletics. Whatever it is, lets start there. We will use these areas as the measure of therapeutic progress and work together to achieve and perform.