Better outcomes for therapy clients

Below is a protocol used at the University of Rhode Island by Dr. Jacqueline Sparks to help her students with cases. You can learn more about ASIST at or

It is particularly important that “at risk” clients be identified as soon as possible to prevent dropout or a negative outcome. Any case indicated as “at risk” (yellow or red in ASIST) requires priority supervision. Students will identify priority cases by completing and turning in each week the Weekly Case Status Report. Supervisees must bring all feedback forms and graphs for each case discussed in supervision. Prior to supervision, supervisees should consider the following questions:


  1. What does the client say about the lack of progress?
  2. What is the status of the alliance?
  3. What have you done so far?
  4. What can be done differently now?
  5. What other resources can be rallied?


The following are additional supervision discussion points based on case status:


Client Progressing as Expected  (no color for ASIST listing).


–       Identify what the client/s and therapist are doing well

–       Continue with current strategies

–       Discuss termination or spacing of sessions as appropriate


Client Not Progressing as Expected (yellow or red for ASIST listing).


–       Examine and discuss alliance, including fit of goals with current work

–       Identify family or community resources

–       Brainstorm new directions*

–       Utilize in-house resources*


*New directions can include:


–       Different activities or methods

–       Inviting others to sessions

–       Role of extended family

–       Barriers (financial, social, etc.)

–       Community resources and/or other venues for help

–       Different schedule of meetings


*In-House resources can include:


–       Use of current practicum team

–       Variation of team input (reflecting team, etc.)

–       Use of new team (different students, supervisor)

–       Use of consultant (program faculty not supervising the case)

–       Groups

–       Educational materials


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