Measuring Progress…
A Letter From a Therapist: Issue 12
How do we respond to the question “how are you”? The most typical response in our societal culture is to say “I’m good” or “I’m fine”, then default back to the asker - but what if we were expected to give a more accurate response? What if the placated expectations of societal norms were not at play and you were prompted to truly recount how you have been managing? This is a common practice within therapeutic treatment modalities but surprisingly, it is a practice that many clients find themselves unfamiliar with. How do we appropriately assess the progression and effectiveness of our therapeutic efforts? How do we quantitatively measure the effectiveness of our current treatment track?
When clients consider therapeutic interventions to enhance and improve psychiatric management, there is the process (often during their intake/evaluation) in which the conversation of what they hoped to achieve unfolds. This is an independent assessment from the client that helps the therapist to determine clinical goals that can be measured in accordance with achievement. For some clients, the process of determining their treatment goals can be a newfound exposure as they have limited their perception of what achievement looks in managing long-term (sometimes chronic) symptoms and conditions. It is recommended that clients consider and give some thought to what they hope to progress on within their clinical experience - whether that translates as reducing depressed mood and developing enjoyment in tasks they previously found fulfilling, mitigating environments that trigger panic or anxious distress, enhancing the ability to return to a workplace during which they endured trauma, etc. This will be unique to how the client sees their mental health factors influencing their life.
Once the treatment goals and objectives have been established, the methods for tracking progress can be considered. For some clients there are measurable methods to utilize that involve actual documented re-assessments for acknowledging frequency of symptom or episode presentations. Other measurements might be more subjective. Subjective progress measurements may include considering the client’s reflection on their ability to maintain consistent work, task completion, relational improvement, or even prioritization for self-care activities. Symptom tracking tools can often be very helpful if completed consistently and can appear in many different forms. For clients mitigating bipolar related conditions, episode and mood charting can be vastly helpful in considering patterns associated with episodic changes. For those managing depression or attention deficit symptoms, task completion lists can assist with accountability and recognition of patterns that contribute to avoidance behaviors. Clients can come to a decision with their therapists to determine what would be most useful and helpful in measuring their progress in treatment. One thing to keep in mind though is that these tools don’t have to be fancy! Keeping a simple checklist/note in one’s phone can sometimes help to provide a brief account on how they are doing so that when they reflect back they can see evidence of progression or regression.
The methods and practice of tracking therapeutic progress is unique and individual for each person as it is structured and developed to best align with their clinical presentations, as well as personal goals for attending and maintaining treatment. The wonderful result of this practice is that even following completion of therapy, a client can continue their own self assessments to reflect upon the skills and interventions they may want to enhance independently to prevent decompensation and exacerbation of symptoms. This process can create a lifestyle change in which an individual can feel confident advocating for themselves and their needs, as well as seek appropriate support networks when necessary.
Best Regards,
Amanda J. Nowak, LPC, LMHC
October 30, 2023
