The FIT Academy

Feedback Informed Treatment (FIT) defined

Feedback Informed Treatment is a pan-theoretical approach for evaluating and improving the quality and effectiveness of behavioral health services. It involves routinely and formally soliciting feedback from consumers regarding the therapeutic alliance and outcome of care and using the resulting information to inform and tailor service delivery. Feedback Informed Treatment (FIT), as described and detailed in the ICCE manuals, is not only consistent with but also operationalizes the American Psychological Association's (APA) definition of evidence-based practice. To wit, FIT involves “the integration of the best available research…and monitoring of patient progress (and of changes in the patient's circumstances – e.g., job loss, major illness) that may suggest the need to adjust the treatment…(e.g., problems in the therapeutic relationship or in the implementation of the goals of the treatment)" (APA Task Force on Evidence-Based Practice, 2006, pp. 273, 276-277).

The ICCE FIT Academy is a collaborative effort. The development team included: Scott D. Miller, Rob Axsen, Susanne Bargmann, Robbie Babbins-Wagner, Bob Bertolino, Cynthia Maeschalck, Bill Robinson, Jason Seidel, Brendan Madden, and Julie Tilsen.

FIT Academy Authors:

What Works in Therapy: A Primer

Bob Bertolino, Susanne Bargmann, Scott D. Miller

Feedback-Informed Clinical Work: The Basics

Susanne Bargmann, Bill Robinson

Feedback-Informed Supervision:

Cynthia Maeschalck, Susanne Bargmann, Scott D. Miller, Bob Bertolino

Documenting Change: A Primer on Measurement, Analysis, and Reporting:

Jason Seidel, Scott D. Miller

Feedback-Informed Clinical Work: specific populations and service settings:

Julie Tilsen, Cynthia Maeschalck, Jason Seidel, Bill Robinson, Scott D. Miller

Implementing Feedback-Informed Work in Agencies and Systems of Care:

Bob Bertolino, Rob Axsen, Cynthia Maeschalck, Scott D. Miller, Robbie Babbins-Wagner

Author Biographies

Scott D. Miller

Scott D. Miller, Ph.D. is the founder of the International Center for Clinical Excellence: an international consortium of clinicians, researchers, and educators dedicated to promoting excellence in behavioral health services. Dr. Miller conducts workshops and training in the United States and abroad, helping hundreds of agencies and organizations, both public and private, to achieve superior results. He is one of a handful of "invited faculty" whose work, thinking, and research is featured at the prestigious "Evolution of Psychotherapy Conference." His humorous and engaging presentation style and command of the research literature consistently inspires practitioners, administrators, and policy makers to make effective changes in service delivery.

Cynthia Maeschalck

Cynthia has over three decades of experience as a counsellor, clinical supervisor and manager in mental health and addiction services. She has used Feedback Informed Treatment (FIT) in her practice and has been training clinicians in the use of FIT since 2005. She has successfully led agencies through pilot projects and implementation of FIT and has provided training and consultation in FIT to clinicians and agencies from around the world. Her practical experience is an asset in helping clinicians, supervisors, managers and agencies effectively implement Feedback Informed Treatment (FIT) into practice. Cynthia has been a Senior Associate and Certified Trainer with the ICCE since its inception. She is also an ICCE faculty member, developing curriculum and co-facilitating ICCE training events. She has written several articles about FIT, helped to develop the ICCE Core Competencies and is co-author of 3 of the 6 ICCE FIT manuals.

Bob Bertolino

Bob Bertolino, Ph.D., is an Associate Professor of Rehabilitation Counseling at Maryville University in St. Louis, Missouri. He is also Sr. Clinical Advisor at Youth In Need, Inc. Bob has taught over 400 workshops throughout the United States and internationally. He has authored or co-authored 13 books including Strengths-Based Engagement and Practice: Creating Effective Helping Relationships, and The Therapists Notebook on Positive Psychology, and Thriving on the Front Lines: Strengths-Based Youth Care Work. Bob is licensed as a marital and family therapist and professional counselor in the state of Missouri, is a National Certified Counselor, a Certified Rehabilitation Counselor, a National Board Certified Clinical Hypnotherapist, and a clinical member of the American Association for Marriage and Family Therapy.

Jason Seidel

Jason Seidel is a Denver psychologist in private practice, and has worked in psychological and counseling services for over 20 years. Jason is one of the first psychotherapists to ever report his outcomes in rigorous detail on the Internet. He has demonstrated best-in-class psychotherapy outcomes for adults since he began formally tracking client progress in 2004. Clinically, he specializes in the integration of intolerable emotions and healing the impact of extreme experiences, having deliberately practiced helping others in the deep end of the pool since he was a teenager. He has also worked in the fields of biopsychiatry, business development, and mythopoetic initiation and mentoring. In addition to practicing what he preaches with his own therapy clients, Jason brings his open heart, brutal honesty, and quick sense of humor to consultations with individuals and organizations, helping them massively improve outcomes and service quality.

Susanne Bargmann

Susanne Bargmann is a licensed psychologist and specialist in psychotherapy, has over 8 years of experience working with CDOI / FIT with various populations. She has specialized in treating eating disorder problems, and is part of organizing and teaching a national education for professionals in Denmark working with eating disorder problems. She had written several articles about CDOI / FIT in Danish and has recently published an article discussing the idea of Evidence Based Practice, and how CDOI / FIT can contribute to another way of understanding this concept. Susanne works with clinical practice, supervision, training and agency implementation of CDOI / FIT and formalized client feedback is an integrated part of her practice. Besides CDOI / FIT she does trainings on a variety of topics, among other narrative therapy, eating disorder treatment and understanding teenagers. Susanne is dedicated to influencing the way professionals think about therapy and diagnosis.

Bill Robinson

Bill Robinson is based in Mandurah Western Australia and is an accredited counselor with twenty five years experience. He is a senior supervisor with Relationships Australia, a nationwide organization specializing in counseling, mediation and education services. He provides training and consultancy in Client Directed Outcome Informed practice and has published articles on the subject in professional journals. Bill is committed to exploring how CDOI / FIT can be applied more widely in the Australian context to make services more effective and to enhance accountability to clients and funding bodies.

Julie Tilsen

Highly regarded for her creative and interactive teaching style, Julie is known for her ability to integrate theory and practice in accessible, meaningful and fun ways. Since 1985, she has worked in settings ranging from psychiatric hospitals to community health clinics, private practice to residential treatment, university counseling centers to youth shelters and street outreach. In addition to her therapy practice, Julie provides clinical supervision, training and consultation to a variety of agencies, therapists, and youthworkers. Julie is an in-demand presentor and publishes on a variety of topics related to socially just/anti-oppressive practices, narrative therapy, and constructionist approaches to practice and research. During trainings, she is likely to throw candy and/or change at participants. Julie is a Licensed Psychologist in Minnesota and holds a Masters in Counseling Psychology and a PhD in Social Sciences.

Robbie Babins-Wagner

Robbie Babins-Wagner, MSW, PhD (C) is an AAMFT Approved Supervisor with over 31 years experience as a therapist and clinical supervisor having worked in the Health, Mental Health and Nonprofit sectors in Canada. Robbie has taught in the Faculty of Social Work, University of Calgary since 1982. She is currently the CEO of Calgary Counselling Centre, the largest community based provider of counselling services in Calgary, where she implemented CDOI / FIT practice. Robbie has spearheaded the development of the Calgary Centre for Counselling Research in partnership with the Faculty of Social Work, University of Calgary, which will explore and develop ways to encourage a closer integration of counselling education, research and practice. With a passion for training clinicians, Robbie has presented at conferences and workshops, locally, provincially, nationally and internationally. In 2006, the Calgary Herald named Robbie as one of Calgary's new pioneers who will shape our future.

Rob Axsen

Spanning nearly 30 years in the helping field, Rob has worked in corrections, youth, mental health and addictions programs. Rob has over 25 years experience as a clinical supervisor and consultant, and is also an accomplished addictions trainer in private practice and at the Justice Institute of British Columbia. He currently works half-time as an Adult Addiction Counsellor for Vancouver Coastal Health, at an inner-city Primary Care clinic, and is the Clinical Lead for implementation of CDOI / FIT practice. Rob is known for his ability to offer practice-oriented information in an experiential format, encouraging training participants to quickly integrate new material into their current practice.

© 2015, International Center for Clinical Excellence

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The International Center for Clinical Excellence (ICCE) is an international online community designed to support helping professionals, agency directors, researchers, and policy makers improve the quality and outcome of behavioral health service via the use of ongoing consumer feedback and the best available scientific evidence. The ICCE launched in December 2009 and is the fastest growing online community dedicated to excellence in clinical practice. Membership in ICCE is free. To join, go to:

The ICCE FIT Academy on Feedback-Informed Treatment (FIT) consist of a series of guides covering the most important information for practitioners and agencies implementing FIT as part of routine care. The goal for the series is to provide practitioners with a thorough grounding in the knowledge and skills associated with outstanding clinical performance, also known as the ICCE Core Competencies. ICCE practitioners are proficient in the following four areas:

  • Competency 1: Research Foundations
  • Competency 2: Implementation
  • Competency 3: Measurement and Reporting
  • Competency 4: Continuous Professional Improvement

The ICCE FIT Academy covers the following content areas:

  • What Works in Therapy: A Primer
  • Feedback-Informed Clinical Work: The Basics
  • Feedback-Informed Supervision
  • Documenting Change: A Primer on Measurement, Analysis, and Reporting
  • Feedback-Informed Clinical Work: Specific Populations and Service Settings
  • Implementing Feedback-Informed Work in Agencies and Systems of Care