Risk alerts [derived from clients' feedback] allow therapists to adjust treatment, and can help them compensate for natural overconfidence and clinical blind spots. In one study, 48 therapists, seeing several hundred clients at a single clinic, were asked to predict which of their patients would “get worse.” Only one of the therapists accurately identified a client at risk. What your therapist doesn't know, Tony Rousmaniere, 'The Atlantic', April 2017Dr Rousmaniere points out that for the therapist merely to ask clients how they think they're doing doesn't work. Clients aren't willing to tell therapists face-to-face that their treatment isn't working, but they are more honest when completing a questionnaire before appointments. Metrics derived from these performance feedback questionnaires 'significantly improve the effectiveness of psychotherapy, reducing dropout rates and shortening the length of treatment.'
In our large and complex societies metrics, with all their potential flaws, are the only really robust way in which we can measure outcomes and progress toward them. I've wondered about the use of metrics in mental health, but this article points to the ways in which carefully crafted and aggregated metrics and their aggregation (big data) can be used not only to measure outcomes objectively, in what one would think would be an inescapably subjective field, but also to help improve those outcomes.