Scott D. Miller
Founder of the International Center for Clinical Excellence and originator of Feedback-Informed Treatment. Writes about what actually makes a therapist effective, usually against the field's own assumptions about training and experience.
Scott D. Miller did not write this page. ppll compiled it from their own words, each linked to the source. Is this you? · Report a mistake
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What they believe
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A therapy is only shown to be more effective if it is compared against another treatment intended to help, not against a control nobody expected to work.
If one really wanted to know whether a treatment (e.g., CBT, IPT, ACT, EMDR) was more effective, it had to be directly compared to an approach intended to help - what Wampold and colleagues termed, a "bona fide" treatment. Doing otherwise, they argued, conflated artifacts of research design with actual research results.
writings.scottdmiller.comSaid 11 Sept 2024This on korrents
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Therapists overestimate their own effectiveness by about 65%, and it is not a Western cultural artifact.
Since 2012 when the first study appeared in the literature, others have been published documenting the tendency of practitioners to overestimate their effectiveness - on average, by 65% (1, 2).
writings.scottdmiller.comSaid 21 Aug 2024This on korrents
The bold line is korrents’ wording; the quote is theirs. These 2: what they wrote before what they said aloud, one per source, newest first.
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As its own page →Hiding
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Recommendstheir ownrcmnd.app
Outcome Rating Scale (ORS)Their words
The ORS is a brief, 4-item measure designed to assess areas of life functioning known to change as a result of therapeutic intervention. It takes less than one minute to complete and score.
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Recommendstheir ownrcmnd.app
Session Rating Scale (SRS)Their words
The SRS is a brief, 4-item measure designed to assess the therapeutic alliance. It provides immediate feedback on the quality of the relationship and allows for course correction in real time.
26 August 2025
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9 February 2025
24 January 2025
14 January 2025
Nothing matches.
Beliefs
Korrents What they believe 6 beliefs — each backed by an exact quote.
Each is a — compiled by korrents.com, not by them: the one-line wordings are korrents', the quotes are theirs.
Recent
A therapy is only shown to be more effective if it is compared against another treatment intended to help, not against a control nobody expected to work.
If one really wanted to know whether a treatment (e.g., CBT, IPT, ACT, EMDR) was more effective, it had to be directly compared to an approach intended to help - what Wampold and colleagues termed, a "bona fide" treatment. Doing otherwise, they argued, conflated artifacts of research design with actual research results.
Results from the first bona fide study of deliberate practice Said 11 Sept 2024
Therapists overestimate their own effectiveness by about 65%, and it is not a Western cultural artifact.
Since 2012 when the first study appeared in the literature, others have been published documenting the tendency of practitioners to overestimate their effectiveness - on average, by 65% (1, 2).
Alas, it seems everyone comes from Lake Wobegon Said 21 Aug 2024
Training a therapist in a treatment model does not make them more effective, however well the model performs in a trial.
Over the last 50 years, treatment methods have proliferated despite a lack of evidence of differential effectiveness between approaches. And even when a randomized controlled trial indicates a particular approach works, none show practitioners become more effective when they are trained in that modality.
How to (and not to) become a more effective therapist Said 2 Jul 2024
Show 3 more
What does make a therapist more effective is trainable interpersonal skill, not treatment technology.
It turns out that therapists who perform well on the FIS establish stronger relationships and are more effective (2). More to the point, the evidence shows FIS-related skills are trainable and that such training leads to better results (3, 4, 5).
How to (and not to) become a more effective therapist Said 2 Jul 2024
Therapists do not improve with experience: on average they become less effective, and their clients drop out more the longer they have practised.
Indeed, as I've reported in previous posts, research not only shows therapists do not improve with time and experience in the field, but on average become less effective (1, 2, 3, 4).
What therapist experience, a nickel, and cup of coffee have in common Said 21 May 2024
The field should stop attributing benefits to clinical experience, because believing in it is itself what stops therapists improving.
It's time for the field to stop attributing benefits to clinical experience. Beyond the obvious ethical concerns, doing so actually prevents us from improving our effectiveness!
What therapist experience, a nickel, and cup of coffee have in common Said 21 May 2024
What is a korrent?
A korrent is a belief a person has stated in their own words: one sentence stating the claim, backed by a quote and a source, kept at korrents.com.
Under a name here, the quoted block is what they actually said. The korrent beneath it is the claim those words support, in korrents' wording — tap it to see the record, its source, and who else holds it.
Nobody here wrote their own korrents. They are compiled from public statements, and a person can change their mind, which is recorded too.
Recommends rcmnd
rcmnd What they recommend 2 things — each backed by an exact quote.
Compiled by rcmnd.app, not by them: the quotes are theirs, and each links to the post it was copied from.
Recent
Recommends Session Rating Scale (SRS)
The SRS is a brief, 4-item measure designed to assess the therapeutic alliance. It provides immediate feedback on the quality of the relationship and allows for course correction in real time.
scottdmiller.com 25 Jan 2026
their own
Recommends Outcome Rating Scale (ORS)
The ORS is a brief, 4-item measure designed to assess areas of life functioning known to change as a result of therapeutic intervention. It takes less than one minute to complete and score.
scottdmiller.com 25 Jan 2026
their own
Where they publish
Site scottdmiller.com The International Center for Clinical Excellence, which he directs, and the Feedback-Informed Treatment materials.
The home of Feedback-Informed Treatment: the measures, the training, and the research he cites when he argues that therapists do not improve with experience unless they measure what they are doing.
Link verified 3 Sept 2026.
Blog writings.scottdmiller.com The archive of the old blog. Dormant since January 2025 and says so at the top of every page.
Years of posts on therapist effectiveness — the Lake Wobegon studies, the nickel-and-a-cup-of-coffee piece on clinical experience, the first bona fide deliberate-practice trial. Kept online as an archive; new writing moved to the Substack.
Open writings.scottdmiller.com
Link verified 3 Sept 2026.
Newsletter Scott D. Miller Where he writes now, since the old blog was archived at the start of 2025.
The current writing: new outcome research, deliberate practice, and the field's habit of selling training that does not change results.
Open scottdmiller.substack.com
Recent
- Fans 6 Aug 2026 “I don’t think she will.”
- Walmart 1 Jul 2026 “I’m not sure how …,” the man in front of me mumbled.
- The Fish 16 Jun 2026 “Do we really have to wait 30 minutes?” my brother Marc and I whined in unison.
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- Playboy 24 May 2026
- Grilled Cheese 10 May 2026 “Can we have grilled cheese and tomato soup?” I asked, a hopeful smile glued to my face.
- The Accidental Therapist 3 May 2026 “So …,” I asked, “I’m wondering, would you like to schedule another appointment?”
- Dollars & Sense 19 Apr 2026 “That’ll be one dollar and forty-five cents” the tall, older man said.
- Fragments 12 Apr 2026 After tethering our canoe to the ‘nearest cleat, Tom and I walked across the wooden walkway bridging the gap between the dock and navy-grey store.
- Bull 28 Mar 2026 It’s not that we weren’t allowed.
- Raspberries 26 Aug 2025 “These are the last of the season,” she said, spooning all the plump, bright red raspberries into my bowl.
- Breach 17 Apr 2025 “Ask them if they’re interested in a game,” my dad said, pointing in the direction of the pool table.
- Talisman 20 Feb 2025 So much has changed over the years – easily visible in recordings of my clinical work spanning the last four decades.
- Blinds 9 Feb 2025 Four decades ago, I was a graduate student, plodding through my few remaining classes and gathering dissertation data while surviving on a combination of student loans and money earned from a university assistantship.
- Sticky 24 Jan 2025 Certain memories have a kind of stickiness, frequently coming to mind, evoking familiar feelings, and easily connecting to other life experiences.
- Agape 14 Jan 2025 At six and a half feet in height, and 250 pounds, Gerrard was an imposing figure.
- Nonstop 5 Jan 2025 The evening news always had a segment about the war – at times longer, others shorter, but always with a report comparing the deaths of enemy combatants to American soldiers.
- Obedience 29 Dec 2024 Despite her imposing size and booming voice, it was always a good day when Mrs.
- Favor 7 Dec 2024 From the oversized bag resting on my office floor, she produced a VHS video cassette.
- BFF 29 Nov 2024 “Dear Scott,” he began (this was when “you’ve got mail” meant paper, pen, and postage).
- Abandon 21 Nov 2024 “Wanna play blocks?” my brother Marc asked.
Link verified 3 Sept 2026. Recent items update automatically from the channel.
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