The Era of Average is Over!

outcomes system softwareAn RCT reporting reliable and clinically significant change instills a high degree of confidence in the results. So why does strictly adhering to a manualized EBP, with multiple published RCT’s in top tier journals, often fail to translate into even noticeable improvements in clinical settings? Experience suggests that the real world is more heterogeneous than the world imagined by RCTs and it can be confusing and disappointing when individuals you are trying to help fail to benefit.

MyOutcomes® is a response to these findings, offering a way to identify when treatment is and is not working with an individual person. Back in 2007, when MyOutcomes first began offering the convenience of digital administration and reporting treatment outcomes, we used a set of mathematic equations that plotted the expected treatment response or ETR of a client based on their Outcome Rating Scale (ORS) score. At the time is was cutting edge, few people were even measuring outcomes let alone trying to provide benchmarks for guiding clinical practice. For the first time therapists and clients had a simple and feasible way to compare outcomes from session to session to the ETR benchmark.

Originally, the ETR plotted the average progress of all clients, since then we have upgraded several times, today offering equations that provide benchmarks for comparing individual progress to both successful and unsuccessful treatment episodes. In MyOutcomes modeling system, predictions are made at the individual level, versus feedback delivered in the form of an Average ETR, providing a far more accurate assessment of reliable and clinically significant change at the individual client level. If your clients are all average than by all means use a Reliable Change Index, if they are not and your EBP has let you down too many times, consider adding a patient-centred measure of treatment effectiveness like MyOutcomes. If you have already been using MyOutcomes and are ready to raise your effectiveness to the next level; Improve your ability to engage, retain, and help a more diverse clientele then consider joining me this March in Chicago for the Advanced FIT Intensive. It will help you develop and sustain a lifelong, professional development plan.

The Path to Successful Implementation Winds On

ImplementationInterpreting MyOutcomes Data

Having completed the first step in implementing the Feedback Informed Treatment (FIT) system and the MyOutcomes software into your organization, you are probably feeling ready to begin the next step. After all, you and your staff have been using MyOutcomes for several months. You now find your coffers filled with FIT data.

So, what are you to do now?

As you certainly know by now, routinely measuring client feedback is vital for building and sustaining a more efficient and effective practice. But numbers from this measurement laid out on a spreadsheet don't mean much without also having the ability to interpret and apply the data to real cases, to real clinicians, to real practices, and to a real agency.

Where do you get the training and guidance to dig into the data so that it will inform your clinician's therapy and contribute to their professional growth?

We have the answer to that question. We have a number of training options available to you. You will want to talk with our staff to see what is best for you. On the other hand, if you have already purchased training, e.g. our On Track program, you may be already set to go. You need only schedule a meeting with your training consultant.

Here is a short list of what a consultation can provide to you:

1) Connect the data to deliberate practice and ongoing session adjustments. This, in turn, will help facilitate reducing no shows, decreasing dropouts, and creating opportunities for more service recipients to have success;

2) Find out what the graphs tell you in a glance;

3) Understand individual practitioner and organizational/agency effect size for sessions;

4) Discover how to use the data to inform funders and oversight agencies; 5) Use the average number of sessions and the percentage meeting Expected Treatment Response to create professional growth opportunities while increasing morale and offsetting vicarious trauma.

If you are ready to continue on your path to becoming an evidence-based practice, we are here to walk that path with you. If you are ready for your agency to move to the next level, please reach out to us or contact your consultant/trainer to schedule a consultation.

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The Mobile Approach to ORS/SRS Rescoring

MO Mobile ORS SRS

 

It is inevitable that at least one of your clients will want to, at least one time, revise their ORS (Outcome Rating Scale) and/or SRS (Session Rating Scale) score. The mechanisms for doing this in the web application are probably familiar to most folk. What you may not be aware of is that there two mechanisms available in the Mobile App itself for revising scores. Using either of these mechanisms can help you avoid the need to log into your web account via the MO Web icon at the bottom of the Mobile app page.

The first mechanism available to your clients is also the simplest. After completing either the ORS or the SRS, the client will have a page to review their choice for positioning of each item slider. If they want to change, they can backspace and readjust the sliders for each item. If they agree with the positions, they can commit their selection, and they will see the graph/summary. This opportunity to change the values prior to committing is available whether they are using your device (logged into your account) or if they log into their own devices, using the login credentials that you have provided to them.

The second mechanism is only available when you, the provider, are logged into the Mobile app. After the initial ORS (first session) has been completed, the icon with the curved arrow will become available…just as what happens in the web app. The appearance of this icon indicates that, other than that initial ORS survey, you now have available the option to delete the previous ‘session.' In other words, if your client decides during their session, or some later time, that they want to change their ORS, they will be able to do so if you delete that session. Deleting the session means that your client will then be able to redo the ORS. If they haven't completed the SRS at the time that the issue of changing the ORS arises, you can access the Skip SRS function by clicking on the curved arrow icon. Once the app shows that the next ORS session is available, click the curved arrow icon and then select delete previous session. Both the SRS (skipped or otherwise) and the ORS that your client wants to be changed will be removed. They can then complete the ORS for the original session as they wish and then complete the SRS.

If you have any functionality questions, please don't hesitate in contacting our customer support team. Our goal is to provide unparalleled service.

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Teach Them to Fish Instead

myoutcomes feedback informed appIn education, we focus on mastery of a skill, rather than the psychological experience of using that skill.

When skill development is associated with a tool, we assume that skillset mastery leads directly to tool engagement. A reasonable assumption given that avoiding doing things that don't reinforce our sense of competence is normal.

We can give a hungry person a fish dinner. Alternatively, to get them eating regularly, we could give them a fishing rod to go fish with. But that alone won't suffice. We also need to teach them to fish. After all, we do things, not just to do them, but because they inform us about ourselves. It'd be the rare person who would purposefully seek out proof of their incompetence.

Sounds like common sense. Yet, it's often overlooked in healthcare. The Arch Collaborative study found the best predictor of a clinician's user experience with their agency's EHR was their training. Put differently, clinicians reported high levels of satisfaction with their EHR if they've received training. Low levels of satisfaction were associated with no training. Less satisfaction translates to less engagement. It's sad that an agency's investment into implementing new tools should fail to yield the promise of increased effectiveness and efficiency simply because of the lack of user training.

While providing implementation support to MyOutcomes' customers, I've often noticed how significant a role FIT eLearning can play in producing successful implementations. Relative to agencies that don't provide training to their providers, agencies, requiring the successful completion of FIT eLearning by their clinicians, show remarkably faster implementation.  It is easy to understand why.MyOutcomes FIT eLearning

Successful implementations of new tools require buy-in by users. Users, who find satisfaction in using the tool, are more likely to engage in its use, while those, who are dissatisfied, are going to resist using the tool. If clinicians are provided training with MyOutcomes, they will see their experience of using MyOutcomes more positively. Positive experiences mean more engagement which means a successful implementation.

 

Within The Therapist Lies The Key

Therapeutic alliance

“The establishment of a therapeutic alliance can be a daunting task, even for those therapists who are generally successful…”

For some time now, it has been well-established that the alliance between the therapist and the client plays a significant role in predicting successful therapeutic outcomes. A strong alliance is predictive of successfully achieving therapeutic goals, whereas a poor alliance is seen as resulting in increased dropouts and missed sessions. It should be obvious to everyone that missing therapeutic sessions and dropping out of therapy are not optimal strategies for obtaining successful outcomes.

Although therapist characteristics are seen as essential for establishing a strong therapeutic alliance, attempts to understand the alliance are generally focused on the client and the client's perception. Of course, this only makes sense given that the perception of a therapeutic alliance or lack thereof begins and ends with the client. It is the role of the therapist to reach out to the client and engage in activities that will create and strengthen a bond between the therapist and the client. However, It is only the client who knows whether that outreach has been successful or not. A smiling client does not necessarily translate into a trusting client. And without the trust resulting from a strong therapeutic alliance, work toward achieving the client's therapeutic goals will be compromised.

The establishment of a therapeutic alliance can be a daunting task, even for those therapists who are generally successful in creating rapport with their clients. After all, each client is unique and, thus, all clients won't respond equally to all therapist alliance-building behaviors. Most therapists would adjust their strategies for creating a therapeutic alliance if needed. The trick is knowing if such adjustments are necessary. Although the key to building therapeutic alliances lies within the therapist, the therapist needs some insight into the client's perceptions of their relationship in order to determine if they are using the right key. In an ideal universe, the therapist could simply ask the client. Unfortunately, “seeing” the client's perceptions is more complex. Luckily, it isn't necessary to use complex tools to solve the problem of the client communicating their perceptions.

The Session Rating Scale (SRS) is a conceptually simple, easy-to-use tool that measures the client's perception of the therapeutic alliance. One of two powerful tools offered by MyOutcomes, the web-based application of the Partners for Change Outcome Management System (PCOMS), the SRS takes seconds to administer at the end of each session and informs the therapist of the strength of the therapeutic alliance and whether the alliance is deteriorating. The insight provided by the SRS enables the therapist to identify any challenges and to make adjustments accordingly. The key to strong therapeutic alliances may lie within the therapist, but it is MyOutcomes that has the power in assisting the therapist to unlock that key.

For more information, please watch our on demand demo video or speak with someone now call us toll-free 1-877-763-4775

Collecting Client Feedback from Your Phone

MyOutcomes MobileTry our new MyOutcomes Mobile App, the perfect clinical tool to help you manage and support patient outcomes conveniently, securely.

MyOutcomes Mobile brings a truly native experience to your mobile device, supporting both Android and Apple iOS.

Every day, all over the world, providers of talk therapy services use MyOutcomes to measure session by session outcomes and easily identify when clients are not on track.

MyOutcomes Mobile is a powerful partner in the therapeutic process, allowing psychotherapists and their clients to complete and review standardized assessments anywhere, anytime.

What New?

– Add Client function has been linked to the provider dashboard.
Session Rating Scale can now be accessed from the Outcome Rating Scale results page.
– Interactive graph legend for custom views.
– No need to log in and out with 4 hour auto timeout feature.

Options to administer surveys:

-Offline mode.
-Children, teen and adult scales.
-Individual, couple and group therapy settings.
-7 languages: English, French, Spanish, Norwegian, Swedish, German, Danish and Dutch.

Tracking client progress and treatment effect size has never been easier, more secure or more convenient.

Free Download

Don’t have a MyOutcomes Login? Contact Customercare@myoutcomes.com to receive free access for one month.

Learn more about affordable monthly subscription options: https://www.myoutcomes.com/myoutcomes-essentials/

Advancing Outcome Informed Therapy – Reach your Pinnacle of Success

Outcome Informed Therapy

How to Reach your Pinnacle of Success in Therapy?

Should therapists continually seek training in order to be able to make any significant difference to their client's outcomes and reach their pinnacle of success as a therapist? What role do training and experience actually play in therapy?

Being a therapist is not easy! It involves years of hard work, perseverance, and diligence before someone becomes a behavioural health professional. So what is it in the profession that draws people towards it?

Research shows that most therapists get into the profession in order to help people. The pleasure and satisfaction they get from seeing their clients’ quality of life improve as they overcome their psychological problems gives their lives added meaning.

Research also shows that about 90% of the therapists consider themselves to be in the top 25% -which clearly cannot be true. How do therapists objectively rate themselves and what should they do to ensure that their clients experience positive change?

To find answers to these questions and achieve your career goal of improving as a therapist and helping more people, more often, watch MyOutcomes' video series with Kelly Ross. This six-part series includes:

  1. There is no such thing as a “Mental Health Holy Grail”
  2. An Eye-Opening Lesson on the Value of Training and Experience
  3. The Pinnacle of Therapists Development is Healing Involvement
  4. The Three Sources of Healing Involvement
  5. Therapists Need their Clients Help just as Clients need Theirs
  6. Track your Cumulative Career Development by Collecting Outcome Data.

For any additional information, feel free to contact us via the website www.myoutcomes.com or call us at Toll Free: 1-877-763-4775.

I Can See Clearly From High Up On a Rocky Mountain Top

myoutcomes evidence based therapy
therapy effectiveness

How therapists can attain their summit by regularly taking client feedback

The other day, I told my wife that the two most important things I learned in graduate school were: 1) how little I know; and that 2) I had doomed myself to a life of perpetual student-hood. Put another way, every time I reached a perceived intellectual summit, I discovered that there were much higher summits of knowledge on the distant horizon. Unless I was content with achieving and remaining at the level of mediocre expertise that I had just attained, I would have to set forth and climb the next mountain. And then, there would be the next mountain, and the next, and so forth, and so on. There would never be a final summit to climb because there is always something more to learn. And to acquire that knowledge, one must remain a student, with a student's endless list of questions.

I believe this experience and perspective is common to most, if not all, of those who strive for an advanced degree in any field. There are, of course, those few who may feel that they can set aside the student cap and robes and rest on their laurels. But it won't take long before they are left behind in the proverbial dust of their rapidly progressing field. They become intellectual dinosaurs, largely forgotten and ignored except by curious schoolchildren on a field trip that allows them to escape the tedious boredom of their classroom. I know that this might sound depressing, but the truth is that it is depressing. And, potentially dangerous.

An attitude that a diploma indicates that learning has been completed is particularly dangerous in fields where the primary purpose is to help people. There is nothing potentially more hazardous than someone trying to apply ideas that are not supported by the evidence. This is why the medical field adopted the evidence-based practice as its standard bearer. Not long after, for much the same reasons, the field of psychotherapy adopted its own version of evidence-based practice. According to the American Psychological Association, a psychotherapy practice needs to use the best available research and clinical expertise “in the context of patient characteristics, culture, and preferences” in order to be considered as evidence-based.

MyOutcomes, with its web-based Outcome Rating Scale (ORS) and Session Rating Scale (SRS), is included in SAMHSA's National Registry of Evidence-based Programs and Practices because it helps the therapist integrate the client's characteristics and preferences. The ORS and the SRS provide the client a voice to provide constant feedback to the therapist about the progress being made and the therapist-client relationship.

Being a student in psychotherapy can be challenging. Not only does the therapist need to keep up with the research and continually hone their clinical skills, but they need to be constantly learning about their client, who is not a single-dimensional cut-out of a human being. Rather, the client is a multidimensional person with characteristics that are in a state of flux as well as being relatively constant over time. When you include the therapist's characteristics, culture and preferences, you have a very complex situation with multiple factors that have the potential of affecting whether successful outcomes will be achieved or not.

Two such important factors are early change and the therapeutic alliance. If change does not begin early and/or there isn't a strong alliance between the therapist and the client, the chances of the client deteriorating or dropping out of treatment are increased.

Obviously, there are various variables that can influence these two factors. Things such as empathy, group cohesion, goal consensus and collaboration, coping style, counter-transference, genuineness, and positive regard are among a long list of variables that can impact the therapeutic alliance and affect the direction of therapeutic change.

But before the therapist can respond and make appropriate alterations to how any of these variables come into play, the therapist needs to  know that something needs to be changed. Stated differently, before the therapist can bring any needed change to their therapeutic approach, they need to know that the desired change isn't happening or that the therapeutic alliance is threatened or non-existent.  By providing information regarding changes in the client's subjective experience of distress or the strength of the therapeutic alliance, the ORS and the SRS, respectively, can alert the therapist to the very real possibility that the client isn't showing any improvement or the therapeutic alliance is deteriorating.

As students, particularly if we're lucky, we have good teachers and mentors to help guide us and provide us insight into the challenges we need to surmount in order to achieve our goals. For many psychotherapists who desire to continue improving their effectiveness, teaching and mentoring comes in the form of clinical supervision. Although case notes, diagnostic scores, the supervisor's knowledge of the research and the supervisor's clinical skills play a valuable role in clinical supervision, little to nothing of the client's preferences, expectations and views of the therapeutic process and their own progress might ever find its way into supervision, even though these factors have been demonstrated to play a vital role in successfully achieving the therapeutic goals. Of course, if MyOutcomes has been effectively integrated into the therapist's practice, this information is available. By using MyOutcomes, the client's ORS and SRS scores can play a vital role in directing clinical supervision and help all those involved in identifying at-risk clients prior to those clients dropping out.

Ultimately, MyOutcomes' value lies in its ability to facilitate the therapist reaching the summit.

For more information please visit www.myoutcomes.com or call us on 1-877-763-4775

Improve Outcomes

MyOutcomes Latest Innovations Revealed

MyOutcomes VersionFor more than a decade, MyOutcomes® has consistently proven itself to be the natural partner of agencies, organizations, and clinicians seeking to use client feedback to track and improve treatment outcomes. Taking the responsibility of this alliance seriously, MyOutcomes® has remained at the for the front of technological and scientific advancements by working closely with leaders in the field and remaining responsive to the needs of our international client base. Our latest upgrades to the MyOutcomes line included new reporting features and more customization options, as well as enhancements to our EHR integration capabilities.

Upgrades to MyOutcomes® v18 include:

Two Big Advances in Dashboard Reporting– First, Printable Dashboard Reports- Once the Dashboard Report Parameters are selected just scroll down to the bottom of the page and click on the new Printable Report View. Second, for even more granular analysis of Dashboard Reports, all reports can now be exported to Excel. Go to the Dashboard tab, for each of the 4 report tabs on the Dashboard page, you can generate a report with data. On the bottom of the page, you can click on the Export to Excel link. You will then get an excel file that contains raw results.

More Export Stats Fields– Quality Assurance Managers and Researchers will appreciate the new Export Stats data that can now be export as raw scores: Client ID creation Date, Last ORS score & Last ORS Date.

Read-Only Access is here!- The Read-Only Access for Administrators & Supervisors is available on both the Administrator Home Page and Supervisor Home Page. If the read-only access is enabled- when the read-only Administrators or Supervisors login, they can create clients, couples, feedback sources, supervisors, providers, and client groups. The read-only administrators and supervisors will be unable to update or delete clients, couples, feedback sources, supervisors or client groups. In addition, they will be unable to perform an ORS or SRS on any client, skip any session, or update past session scores.

Custom ORS Feedback– You now have the option to hide the Feedback results page and create a custom message on the results page. It is an Owner level tool available under Options. When you enable Custom ORS Feedback, a text field box will appear. You can enter the message you would like to appear as the results page.

New Couple Functions– We have made it possible to separate the couple and do individual counselling. These functions also allow you to deactivate and reactivate individual couple members.

Transferring clients to a GSRS group just got easier– First create a Client Group and mark it as a GSRS group. Then, transfer a client whose survey type is set to Adult- to that new GSRS group. The client's survey type will be changed to Group automatically.

Hide “Remember Email” on Give Access- To hide the Give Access option to remember clients email, a new Owner tool has been added to Options. Simply click to enable Hide Remember Email on Give Access.

Hide SRS– Another new tool under Owner Options. You can chose to only administer the ORS. Just enable Hide SRS.

Latest Updates to MyOutcomes® Mobile include:

Forgot Password and User ID– Now you and your clients will be able to access Forgot Password and User ID from the MyOutcomes Mobile login page.

Skip Function is Here! The Skip Function has been added to the Home Page. Click on the button below the Skip tab. It will direct you to a page on Skipping a Session. You can choose to Skip ORS, Skip Both ORS and SRS, or Delete Last Session. The Lock ORS/SRS function only applies to the ‘Update Past Session” area of the site. It prevents providers from updating or skipping past sessions. It does not lock delete past session or login information.

Seven Languages– MyOutcomes Mobile now supports English, Spanish, French, Norwegian, Swedish, Danish, Chinese, and Italian languages.

What's New in MyOutcomes Web Services Version 18:

For more comprehensive data retrieval from MyOutcomes® to other systems, we have expanded our existing data pull functions to include:

Get Client Session Data– This function takes the user id as input and returns all client session data including total ORS and SRS scores, any data projection points plus all 4 ORS subscales and all 4 SRS subscale scores available under a given user id.

Get Client Session Data By Date– This function takes the start date, end date and user id as inputs and returns all client session data including total ORS and SRS scores, data projection points plus ORS/SRS subscale scores, available under that user id.

Get All Client Data– Like the existing GetClientData function – this new function will allow you to retrieve all ORS/SRS session data for a single client without having to supply a session number.

With its proven reliability and ease of use, it's no wonder that MyOutcomes®' web-based version of the Outcome Rating Scale and Session Rating Scale is emerging as today's must-have for providers of evidence-based mental and behavioral health services.

To learn more about the benefits MyOutcomes subscribers receive you can read the V18 User Guide, sign up for an Evaluation Account or book your free 30-minute Implementation Consultation now.