Isn’t the ORS and SRS just a patient satisfaction measure?

| January 25, 2013

“Isn't it really just a patient satisfaction measure and what do they tell you anyway?” is one of the three typical questions asked regarding the ORS and SRS, according to Scott Miller, who along with Barry Duncan, developed these two therapeutic tools. This is actually a two-part question that attempts to challenge the validity of the MyOutcomes tools.

The first part of the question, “Isn't it really just a patient satisfaction measure,” not only misses the mark but its underlying sentiment is disturbing. Although it probably isn't intended, the question seems to suggest that the client's subjective experience of the clinical process is of little consequence. The therapeutic process, however, is about the patient and the patient's goals. It is the client's subjective state that brings the clinician and the client together and it will be the client's subjective state that will determine when that relationship comes to an end. Any information that can provide insight into the client's ongoing experiences toward achieving their goals should be considered of high value to the therapist. Furthermore, patient satisfaction is critical to the success of an agency or a clinician's practice. Satisfied patients can mean continued funding for an agency because that agency is achieving their raison d’être. Patients who are happy with their treatment will tell others; others who are potential clients. An increased amount of clients translates into a growing practice for the individual clinician.

Success is not simply a matter of clients achieving their therapeutic goals. It is also measured by retention of the more difficult cases.It might sound pretty impressive for a therapist to claim that 95% of their clients are successful in achieving their goals. If, however, that same therapist has an attrition rate of 40%, an entirely different light is shed upon that therapist's practice and claimed success.

It is one thing to be successful with the easy cases. It is an entirely different situation when that success is measured against the more difficult cases.

The ORS and the SRS are easy-to-use tools that provide critical information that will help the clinician assist their clients achieve their therapeutic goals, whether easy or difficult. The second part of the question asks what do these instruments “tell you”? The ORS, or Outcomes Rating Scale, is a four-question scale administered at the beginning of each session that provides the clinician with a subjective snapshot of what the patient is currently experiencing. This information can help the clinician determine whether the therapy is on track or whether there is a need for tweaking it. The SRS, or Session Rating Scale, is a four-question scale administered at the end of each session. The SRS tells the clinician the subjective impression the patient has of the therapist-client alliance. The therapist-client alliance is a strong predictor of retention as well as the likely success of therapy. If the bond between the clinician and the patient is weak, there is a risk of the patient dropping out of therapy without achieving their goals. Rarely are there situations where we are given an opportunity to measure the strength of our relationships and then given the immediate opportunity and means to strengthen them. The SRS provides such a situation. The SRS, as well as the ORS, are instruments whose primary purpose is to enable the clinician to become more effective with all of their clients.

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Category: Agencies, MyOutcomes, ORS / SRS, ORS/SRS, Outcome Rating Scale, Scott Miller, Session Rating Scale

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