Two Chairs Publishes First-of-Its-Kind Study Showing Measurement-Based Care Training Improves Outcomes by 24% at Scale

As payers demand proof of quality, new peer-reviewed data shows rigorous MBC implementation can drive meaningful improvements in care

SAN FRANCISCO, CA, UNITED STATES, December 4, 2025 /EINPresswire.com/ -- Two Chairs, the leading provider of integrated therapy and psychiatry, today announced the publication of new peer-reviewed research demonstrating that its Measurement-Based Care (MBC) training and implementation program for clinicians produced significant and sustained improvements in patient outcomes. Two Chairs clinicians delivered improved patient outcomes after six months of training, further demonstrating the company's industry-leading approach to measurement-based care.

The peer-reviewed study, published in Frontiers in Health Services, is one of the largest real-world evaluations of MBC in outpatient behavioral health. It analyzed outcomes from 18,721 Two Chairs patients and 755 clinicians following a six-month MBC implementation program.

Key Findings:
- Clinical outcomes improved by 24% after the six-month MBC implementation
- 95% of clinicians with who were present across the training period showed improved patient outcomes
- Therapeutic discussions of measures in sessions rose from 79.8% to 96.2%

In addition to measurable changes in outcomes and behavior, clinicians reported greater confidence using MBC tools and described the program as strengthening their ability to deliver high-quality care, noting that the combination of ongoing supervision, structured training, and purpose-built technology made MBC easier to integrate into therapy sessions — which is essential for its effectiveness.

A shift to MBC at this scale requires a deep organizational commitment. Because Two Chairs employs clinicians in a W2 model, it can make long-term investments in both technology and training that 1099 models can’t support. And that investment shows up in the data: 100% of Two Chairs clinicians use MBC, and patient outcome measures are collected in 95% of sessions. That consistency carries through in patient behavior and outcomes. The company’s infrastructure includes dedicated clinical leadership, structured supervision, real-time dashboards, workflow-integrated prompts, and guided training on how to use symptom scores and alliance data in session. This foundation provides the accountability needed to drive sustained adoption of MBC across a large workforce.

“Payers want outcomes, and they want proof—not marketing fluff,” said Alex Katz, Founder and CEO of Two Chairs. “This study shows what’s possible when you build a real clinical organization with employed therapists, deep training investment, and technology that reinforces evidence-based care. A 1099 network simply cannot deliver this level of consistency or clinical behavior change. The next era of behavioral health will be defined by accountability and transparency, and this research raises the bar for what quality should look like in our industry.”

As health plans increasingly expect measurement-based care from mental health providers, many companies have begun marketing MBC as part of their model. But with large 1099 contractor networks, adherence is nearly impossible to enforce. Without employment relationships, training infrastructure, and data accountability, most organizations cannot meaningfully operationalize MBC, leading to inconsistent practices and unreliable outcomes. Two Chairs’ findings offer a clear contrast: when MBC is implemented with the right structure, results follow.

Colleen Marshall, MA, LMFT, Chief Clinical Officer at Two Chairs, emphasized the clinical significance of the findings. “Changing clinical behavior is hard, even under ideal conditions. To see a 24% improvement in outcomes across tens of thousands of clients—and to see 95% of therapists improve—is extraordinary,” she said. “This isn’t theoretical or single-clinic data. It’s real-world evidence that a focused MBC program, delivered within an employed therapist model, can meaningfully improve depression and anxiety outcomes in a short period of time. It’s exactly the kind of progress our patients, families, and partners deserve.”

This paper showcases what is possible when MBC is implemented with rigor: clinicians gain better tools to support their patients, training is reinforced by technology and supervision, and outcomes improve at scale. For health plans looking to invest in quality, the findings provide rare evidence that MBC can drive meaningful clinical impact—when done well and within the right organizational model.

Led by the Two Chairs in-house research team, the study evaluated a six-month structured MBC training program developed by the Quality and Clinical Innovation teams team. The program included asynchronous training, clinical skills development and supervision, real-time data dashboards, and workflow-integrated prompts, all of which supported clinicians in incorporating weekly MBC feedback into therapy sessions. Data were analyzed before and after implementation to track changes in clinician behavior and client outcomes.


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About Two Chairs
Two Chairs is setting a new standard in mental health care with seamlessly integrated therapy and psychiatry delivered by highly trained clinicians, powered by smart technology, and measured for real impact. The company combines fast access, personalized care, and proven outcomes to create a system that works — for patients, providers, health plans, and clinicians alike. Two Chairs is in-network with national and regional health plans including Aetna, Kaiser Permanente, and Florida Blue, serving over 30 million covered lives. They are also the employer of choice for licensed clinicians across more than 90 areas of expertise and have been widely recognized for both workplace and clinical excellence, including designations such as Great Place to Work, Fortune Best Workplaces in Healthcare, Fast Company Best Workplaces for Innovators, and Inc. Best in Business.

Britta Franson
Two Chairs
britta.franson@twochairs.com

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