Assessment considerations in the identification of failing psychotherapy: Bringing the negatives out of the darkroom.

Abstract

Although failures in psychotherapy are widely acknowledged, minimal attention has been given to their assessment. However, early detection of failing psychotherapy is essential if harmful and cost-ineffective outcomes are to be avoided. Prior approaches to the study of psychotherapy failure are considered and a conceptual framework for detecting failing treatment is presented. The identification of failing psychotherapy requires the use of assessment practices that are theory-based, ongoing, have treatment utility, and are sensitive to intermediate outcomes and individual change. It is recommended that specific strategies for the detection of failing treatment, and an integration of assessment and treatment practices more generally, can be advanced through the development of an assessment infrastructure that is sensitive to both clinical and research needs

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