Dodo Bird Findings
The emphasis on identifying particular evidence-based therapies was challenged by the “Dodo Bird findings”. The saying is a quote from the Dodo bird in Alice in Wonderland that “Everybody has won and all must have prizes? The Dodo Bird Findings suggests that all psychotherapies are equally effective, explained by common factors such as the therapeutic alliance. The conclusion is that therapeutic success is not about choosing the right therapy (and therapist). Rather, research tells us that it is driven by other factors such as how well you and the therapist work together; your own commitment, life history and current life situation.
Practice-based evidence
Practice-based evidence asks, “Is this treatment, however constructed, delivered by this particular provider, helpful to this client at this point in time?”. Practice-based evidence is powered by real-time measurement of client progress, and real-time feedback to clients and therapist. It might seem pretty obvious given what we know about improving performance in sport (think footballers and Olympic athletes) and music (think professional musicians and dancers) who have a very deliberate approach to training. Deliberate Practice (Miller) calls for a cycle of
- determining a baseline level of effectiveness;
- obtaining systematic, ongoing, formal feedback; and
- repeatedly engaging in activities specifically designed to refine and improve performance.
Improving as you go
Done well, this approach fits naturally around the therapy session. At first session, completing some brief self-report baseline measures of
- where you are with your therapy goals, and your life overall
- progress and obstacles to living your preferred life,
- current levels of common psychological distress symptoms (e.g. depression, anxiety and stress and anything specific that is the focus of therapy)
- typical things that might get in the way of being more flexible in responding to every day situations.
Plus, brief measures of progress at each subsequent session, collaborative discussion and finessing the therapeutic approach based on that feedback.
Pausing to re-calibrate
Occasionally (say at session 6 and 10), it is useful to re-do the self-reports from the first-session to inform a more detailed reflection on progress and responding with actions to refine and improve therapy effectiveness.
