What your therapist doesn't know

Big Data has transformed everything from sports to politics to education. It could transform mental-health treatment, too—if only psychologists would stop ignoring it.

Inspired by Moneyball, a book that recounts the story of the Oakland Athletics radical use of performance metrics, psychologist Tony Rousmaniere became curious as to whether data and analytics applied to psychotherapy could help improve his ability to measure the progress of patients.

Imagine a surgeon or dancer learning without someone observing their work. That's the predicament therapists are in.

Surgeons entrust a variety of instruments - stethoscopes, tests, scalpels - to assist the outcome of their work. But therapists are the instrument of their work, which puts a lot of strain on one person to deliver consistent results. How can those instruments—the therapists themselves—be improved?

A close correlation can be pulled from a rather unusual activity. Professional dance has greatly improved since the introduction of slow-motion video technology.

In 2015, Wired argued that "for dancers, it's become an incredibly useful tool for honing their craft. The newfound affordability of slow motion has enabled them to improve their technique, spruce up their audition reel, and isolate aspects of their performance that were once intangible."

Is there another industry that faces larger obstacles to integrating performance feedback than psychotherapy? Hypersensitive qualities - protected by rules and regulations - mean that therapists are often sheltered from objective feedback. Now imagine a doctor, airline pilot or athlete honing their craft without someone checking their work for errors. That's the dilemma many therapists are in.

Over the past few decades, Michael Lambert, a researcher at Brigham Young University, has developed a system in which therapy clients take a 45-question survey before each appointment, and a computer tabulates their responses. The results are then displayed as a graph that quantifies the trajectory of each client’s symptoms, allowing his or her therapist to track the progress being made.

Today, these surveys and algorithms are known as feedback-informed treatment or FIT. The system aids therapy in two primary ways. First, it provides an element of blunt performance feedback that therapists too often lack. Many clients are more willing to report worsening symptoms to a computer—even if they know that their therapist will see the results—than disappoint their therapist face-to-face.

What I've written here only scratches the surface on what is a fascinating subject. This superbly written article in The Atlantic goes into depth on an emotional story that explains the future of Psychotherapy and Technology.

Joe Pack