18. Using Feedback-Informed Therapy (FIT) to Build a Premium-Service, Private-Pay Practice

  1. Chris E. Stout
  1. Jason A. Seidel

Published Online: 24 SEP 2012

DOI: 10.1002/9781118089972.ch18

Getting Better at Private Practice

Getting Better at Private Practice

How to Cite

Seidel, J. A. (2012) Using Feedback-Informed Therapy (FIT) to Build a Premium-Service, Private-Pay Practice, in Getting Better at Private Practice (ed C. E. Stout), John Wiley & Sons, Inc., Hoboken, New Jersey. doi: 10.1002/9781118089972.ch18

Publication History

  1. Published Online: 24 SEP 2012
  2. Published Print: 27 JUL 2012

ISBN Information

Print ISBN: 9780470903988

Online ISBN: 9781118089972



  • private pay;
  • self-pay;
  • cash-based practice;
  • feedback-informed treatment;
  • outcomes;
  • outcome measurement;
  • pay for performance;
  • therapeutic alliance;
  • reliable change;
  • effect size


The premium-service private-pay practice serves clients who seek particular providers, who prefer to pay privately, or who lack the insurance coverage that would allow them to consult with an insurance-based psychotherapist. Downward market pressures on fees require therapists who wish to earn a good income from a traditional private practice to position themselves for a premium market. Today's consumers are experienced in the selective purchase of premium services and products that matter to them, even while they shop for bargains in other categories. The practitioner who can define what premium means in the psychotherapy category and perform at a premium level will succeed in this market and avoid the “death in the middle” between premium-level and commodity-level business models.

The most promising development in the past decade for creating new opportunities for the premium-service practitioner is feedback-informed treatment, which provides data to the therapist to track and improve treatment outcomes regardless of approach or modality. Until the past decade or two, there were no practical, valid, and pantheoretical methods for gauging clinical change without internecine squabbles about which treatment approach or which definition of improvement was most appropriate. Researchers, practitioners, and organizational trainers on several continents, using a variety of tools, have shown consistent results from these methods for improving the value and effectiveness of treatment. Solo practitioners and small groups who are focused and rigorous in the methodology and marketing of feedback-informed therapy can become well positioned as premium-service private-pay therapists who actually earn and account for their premium fees.