Counselling & psychotherapy are often helpful.  In fact they are more effective than, for example, many interventions in cardiology or ...  .  Worryingly though ... despite a wealth of emerging research ... there has been little improvement in the outcomes we achieve.  The same, of course, could be said about pharmacological approaches to mental health problems.  Training, qualifications & years of experience make surprisingly little difference to the results therapists achieve.  Yet there is considerable variation in the success rates of different therapists ... although therapists themselves are poor judges of their own effectiveness.  In this situation, methodical, skilful use of feedback on client progress holds arguably more promise than any other way of improving therapist success rates.  More to follow.