What Have We Learned About Treatment Failure in Empirically Supported Treatments? Some Suggestions for Practice

The examination of treatment failure has substantial value in advancing psychological practice as illustrated by the articles in this special issue. Treatment failure is not well defined and includes at least two independent phenomena: nonresponse and deterioration. After discussing the important distinction between nonresponse to treatment and client worsening, some general findings are highlighted. These include client, therapy, and therapist dimensions. The retrospective study of nonresponse to treatment can lead to important modifications in treatment protocols and can influence theory as well as clinical intervention. However, there is a need for methods suitable for routine care that monitor treatment response and make suggestions for changes in real time. A system for accomplishing this task in routine care is briefly described.