“PCOMS will remain a clinical measuring tool embedded in the complex interpersonal process called psychotherapy”
Have you ever wondered how we can tell that therapy works or whether clients are satisfied with their services?
Many clinicians and mental health organizations are asked these questions and have few answers about how to show that they are effective. Thanks to our long-standing relationship with Our Lady of the Lake University (OLLU), HGI has become involved in learning to use the Partnership for Change Outcome Management System (PCOMS). Though it is not always necessary to use paper and pen measures to talk to clients about their perceptions of and progress in therapy, the use of PCOMS ensures that these conversations are taking place. Feedback is discussed with clients from session to session. Additionally and importantly for HGI, this process insures that HGI is looking at outcomes for funders and other community stakeholders. PCOMS has been shown to reduce “no shows” and length of service, thereby reducing costs and allowing agencies to serve more clients.
The PCOMS, developed by Barry Duncan and Scott Miller in 2000 (Duncan, 2012) includes two measurements: the Outcome Rating Scale (the ORS) and the Session Rating Scale (the SRS). PCOMS has been identified as an evidence-based practice by SAMHSA, and has been normed for both adults and children as young as six years of age. The ORS looks at how the client perceives their own “well-being” using four scales that measure: 1) individual well-being/distress; 2) interpersonal functioning specific to intimate/family relationships; 3) social functioning/distress indicating issues in school/work/friend relationships, and 4) a general overall measure. The SRS also use four scales to measure the client’s perception of the session and the relationship with the therapist, often called the “alliance”. Importantly, this process lets the therapist know the client’s perception of several indicators of success in therapy: 1) the relational bond; 2) the degree of agreement between the therapist and client about the goals and tasks of therapy; 3) the fit between the therapist’s approach and the client’s expectations; and 4) how the client perceived the outcome of the session.
The implementation of these two measures is incredibly simple once the therapist has been trained, understands the underlying reason for using them and has practiced using them. At a recent workshop hosted by OLLU in San Antonio, Dr. Duncan demonstrated that each of these measures can be explained and used in less than three minutes. They become an important anchor for feedback each session, giving important information to the therapist about the progress or lack thereof, and the therapeutic relationship. Once trained, therapists can use this data, comparing it to the thousands of data points collected by Dr. Duncan and his colleagues, to have some of the difficult conversations that are critical to improving and sustaining effective therapeutic process.
To summarize in Barry Duncan’s words; “Although the over 300,000 administrations of the ORS/SRS has yielded invaluable information regarding the psychometrics of the measures, trajectories, algorithms, etc., PCOMS remains a clinical intervention embedded in the complex interpersonal process called psychotherapy [emphasis added]. For successful implementation and ongoing adherence, PCOMS must appeal to therapists in ways that the numbers or data or even the research never can.”
If you would like to know more about PCOMS or about MyOutcomes, the web-based application of PCOMS, please visit our website www.myoutcomes.com or contact us toll free on 1-877-763-4775
This article first appeared on the web on Houston Galveston Institute’s website. It was written by Sue Levin and she can be contacted by mail at firstname.lastname@example.org or by phone at 713 526-8390.