The Question Everyone Asks
"How do I know if therapy is working?" It is one of the most legitimate and important questions a patient can ask. For decades, psychotherapy was seen as a subjective art whose results were difficult to measure. Today, we know it does not have to be that way.
At Illuminare, we follow an Evidence-Based Practice approach that includes the systematic monitoring of therapeutic outcomes. Not because we doubt the effectiveness of psychotherapy — the scientific evidence is overwhelming — but because we believe every patient deserves to know they are making progress.
Why Monitor Outcomes?
Research shows that therapists who systematically monitor their patients' outcomes achieve better clinical results. Why?
Early detection of deterioration: Around 5 to 10% of patients get worse during therapy. Monitoring makes it possible to detect this pattern early and adjust the approach before the situation escalates.
Feedback for the therapist: Therapists, like all professionals, have blind spots. Systematic feedback from the patient corrects biases and strengthens the therapeutic alliance.
Motivation for the patient: Seeing results on a chart — even when progress is gradual — is motivating and reinforces commitment to the therapeutic process.
Mutual accountability: Monitoring creates a culture of shared responsibility between therapist and patient.
The Tools We Use
OQ-45 (Outcome Questionnaire)
The OQ-45 is a 45-item questionnaire that assesses three domains: symptoms (anxiety, depression), interpersonal functioning and social role (work, leisure). It is administered at the start of each session and takes only 5 minutes to complete.
PHQ-9 (Patient Health Questionnaire)
A 9-item scale for assessing the severity of depression. It allows depressive symptoms to be tracked over time with clinical precision.
GAD-7 (Generalised Anxiety Disorder Scale)
A 7-item scale for assessing generalised anxiety. Widely used in clinical and research settings.
SRS (Session Rating Scale)
An assessment of the therapeutic alliance at the end of each session. It measures four dimensions: the relationship, goals and topics, approach or method, and an overall rating of the session.
Condition-Specific Scales
For specific disorders, we use validated instruments: the PCL-5 for PTSD, the Y-BOCS for OCD, the BDI-II for depression, and the SPIN for social anxiety.
What the Data Show
The research on the effectiveness of psychotherapy is consistent:
- Psychotherapy is effective for the vast majority of common mental disorders
- The average effect size of psychotherapy (d = 0.80) is comparable to that of the best medical treatments
- Therapeutic gains tend to be lasting — superior to medication alone in terms of relapse prevention
- Combining psychotherapy and medication is more effective than either treatment alone for moderate to severe conditions
When Results Do Not Appear
If there is no measurable improvement after 8 to 10 sessions, it is a sign that something needs to change. The possibilities include:
- The therapeutic approach may not be the most suitable for that particular patient
- There may be an unidentified comorbidity (e.g. a personality disorder, complex trauma)
- External factors may be hindering progress (life situation, relationships, working conditions)
- The therapeutic alliance may need work
At Illuminare, this conversation happens openly. There is nothing wrong with adjusting the approach, referring to another professional or exploring complementary modalities.
Transparency as a Value
Outcome monitoring is, at its core, an expression of respect for the patient. It is a way of saying: "Your time, your investment and your well-being matter. Let's measure progress together."
We believe that quality psychotherapy is not afraid of being evaluated. On the contrary — it is strengthened by it.
