"When we talk about our work with clients or professionals, their first reaction is often “where’s the proof?”, or from academics, “where are the evidence-based studies?”.
When we reply that we have a ‘pay for results’ policy so there is no need for it, there is a momentary pause, eyes glaze for a second, then they usually repeat themselves as if we hadn’t spoken. Apparently the leap to results-oriented treatment billing is simply too foreign a concept to comprehend at first."
"Why is this? Well, clients sometimes confuse this concept with some kind of scam, where people ‘guarantee’ a product, don’t deliver and then keep the money. Or they simply don’t believe that you are serious, because this is so far outside their previous experience. Academics tend to have a different issue, one that strikes at the heart of the practice of psychology and medicine. Currently, a great deal of statistical tools are used (often incorrectly) in research because investigators are not designing for a binary solution set of ‘it worked, or it didn’t work’. Instead, test outcomes are usually so vague or contradictory the best they can hope for is often only slightly above the threshold of the placebo effect. This mindset can also lead to completely bizarre situations like I saw in my own doctoral training, where we were taught measurement scales that ignored the specific client problem we were treating, and instead rated ‘overall improvement’ – sadly, because there really were no effective treatments for specific problems."
"When Frank Downey and I designed the structure of the Institute in the 1990s, we fully expected that our first generation techniques simply would not always work (or work partially) for some clients. We were developing something entirely new, there was a lot we didn’t yet understand, and people’s problems are often very complex. However, we were only interested in full elimination of symptoms (note that we use this phrase because is socially and often legally unacceptable to talk about ‘cures’). Partial successes were valuable from a research viewpoint, but with ‘pay for results’ the only meaningful outcome is “what we agreed upon is done”. This means that therapists have to actually deliver; and if they can’t, that they are not financially penalizing clients because of their (or the Institute’s) own limitations. This also has the tremendous advantage that we don’t have to do extremely costly third-party studies – after all, the client is the one who really knows if the problem is gone and stays gone."