Intensive Structural Therapy

For a number of years, Charles Fishman has been working with Dr. Mark Friedman to incorporate some of the major tenants of Results Based Accountability into Intensive Structural Therapy (IST.)

If you can’t count it, you can’t manage it.
Peter Drucker

Results Based Accountability (RBA) was developed by Dr. Mark Friedman (2005) and has been influential in public systems. It is currently being used in ten countries and 48 states; in governments from local to federal levels; and in philanthropic organizations, non-profits, and community partnerships.

To our knowledge, this is the first application of RBA in a front-line clinical setting.

One of the major tenants of RBA is the practice of the project team agreeing on the desired outcome at the onset. All clinical work is then organized and directed by the common agreement on the agreed upon outcome.

Then the team agrees on the measurements that will be utilized to track progress. These are short-term and long-term measurements, which are reported numerically. For example, one such measurement tool is the Child and Adolescent Functional Assessment Scale (CAFAS, Hodges,2011).

Two other important component of the approach the team agreeing on targets for progress such a 20% decrease in CAFAS points in a 3 month period. Also, the team determines what are the barriers to progress. In IST terms, the Homeostatic Maintainers.

Using RBA and IST principles the team charts the course and monitors progress.

For questions, please contact Charles Fishman