An article by Margarita Tartakovsky, M.S., details the client feedback experiences of Dr. Jason Seidel, PsyD, founder and director of the Colorado Center for Clinical Excellence. Seidel has been using a client feedback system to inform his method of treatment in private practice since 2004. This, according to him, “involves routinely and most importantly formally soliciting feedback from clients about the process of therapy, working relationship (with the therapist) and overall well-being.”
The heart of Feedback-Informed Treatment (FIT) is using information generated though routine monitoring of the therapeutic relationship and progress in treatment to adjust service delivery.
With MyOutcomes® the standard Outcome Rating Scale (ORS) is used to measure progress reported by group members. To monitor the quality of the alliance, the Group Session Rating Scale (GSRS) has been developed and has proven to be a reliable and valid measurement tool, capable of predicting early treatment response (a known determinant of engagement and outcome).
The following cartoon is based on a video excerpt from MyOutcomes FIT eLearning Program. It provides an example of strategies for introducing and administering the GSRS.
When a client’s response to treatment is measured using the GSRS the interpretation of the measures, the meaning and use of the client’s response pattern in general indicates:
• GSRS scores that start and remain low are associated with higher dropout rates and poor or negative treatment outcomes;
• GSRS scores that start and remain high are associated with positive treatment outcomes;
• GSRS scores that start low but improve are associated with lower dropout rates and superior outcomes;
• GSRS scores that start high but decrease are associated with higher dropout rates and poorer treatment outcomes.
The key to using the GSRS effectively in groups is ensuring that the process facilitates open discussion among the members. MyOutcomes not only offers the tools needed to simplify the collection of client outcome and session ratings, we also offer Nationally accredited training in Feedback-Informed Treatment.
To learn more visit: https://www.myoutcomes.com/fit-elearning
Researchers have found that providing clinicians with feedback about client progress relative to the norm can improve outcomes for clients. Clinicians can use this vital information as a training tool and to improve their responsiveness to a lack of clinical change.
Our last blog highlighted two reasons why therapists benefit when they get ahead of the evidence-based outcomes measurement curve. In an incisive and insightful article from 2011, Tony Rousmaniere, PsyD, suggested that measuring outcomes increases awareness, maximizes feedback, and helps make therapists better at what they do. He also noted that by embracing outcomes measurement, therapists end up having a stronger hand in designing the process, thus reducing the risk of having a flawed or faulty system foisted upon them.
Are ORS/SRS forms too brief and simple to be valid?
The history of science adequately illustrates that whenever there is any shift in paradigms, there tends to be, for a variety of reasons, resistance to the change that the new paradigm heralds. One notable point of resistance focuses upon the new tools or the modification of old tools that are developed by the new paradigm. Though the motivation behind these challenges to the new tools tends to be diverse, the more scientific questions focus upon issues of validity and reliability.
“It is the most effective and successful therapists who have incorporated CDOI approach into their therapeutic sessions so that they can continue the process of â€œbecoming.â€”
Life is a process, not a goal. As a psychotherapist, you would know the truth of this. You know that just as sharks need to keep constantly on the move in order to live; human beings need to continuously grow. Goals are only temporary way stations on the road to somewhere else.
Psychotherapy is a challenging dynamic situation where individuals with different goals come temporarily together in order to achieve those goals. Ultimately, the solution to achieving their personal goals is to become involved, to varying degrees, and help achieve the goals of the other. The goal of a psychotherapist is to provide effective therapy. By so doing, the client achieves their therapeutic goal, which, in turn is critical for the psychotherapist attaining their goal of clinical efficacy.
One of the things that make an effective and successful therapists, effective and successful is that they know that their effectiveness is only as good as their clients' last successful outcome. In other words, demonstrations of therapeutic efficacy are only way stations on the path of becoming an effective therapist. The most effective psychotherapists know that their effectiveness is a continual process of â€œbecoming,â€ rather than a goal that is achieved and then replaced by some other transitional goal. It is something that needs continual nurturing so that the therapist can continue to grow. In short, it is the most effective and successful therapists who have incorporated the client-directed, outcome-informed (CDOI) approach into their therapeutic sessions so that they can continue the process of â€œbecoming.â€
This is also why effective therapists and behavioural health practitioners use MyOutcomes, the most powerful therapy outcome measure available. By offering the Outcome Rating Scale (ORS), a tool that provides the therapist with reliable and valid measures of their client's progress, and the Session Rating Scale (SRS), a tool that gives the therapist insight into the therapeutic alliance, MyOutcomes is the partner whose only goal is to help therapists to continue to grow their clinical effectiveness.
So the choice is up to you, the psychotherapist. Do you see yourself as an effective therapist, fully grown and ready to move on to some other challenge? Or do you see yourself as an effective, successful therapist striving to continually grow? If you see growth in your future, then MyOutcomes is the partner that you have been looking for.
How can you become a Feedback Informed System of care?
Our clients around the world have proven MyOutcomes' client driven, feedback-informed approach significantly enhances service effectiveness and leads to a reduction in the overall cost of treatment; but if you can't get your service providers to embrace a Feedback Informed System of Care, implementation of any outcomes measurement will be difficult. To insure your success, we have created this short 10 Steps to Success guide to assist you.
Whatever stage of implementation your organization is currently at the 10 Steps to Success: A Guide to Becoming a Feedback Informed System of Care will become a valuable resource for you and your team. To download the 10 Steps to Success: A Guide to Becoming a Feedback Informed System of Care, click here
If you haven't already done so, now would be a great time for your team to schedule a 30 minute online demonstration to further explore how our system can best meet your needs. To Request a 30 minute MyOutcomes Pro Demonstrations (Agencies with minimum 5 providers) click here
For agencies with over 25 providers, additional support is available at this point. MyOutcomes has experienced implementation consultants available to assist you and your team. Please call me toll free at 877-763-4775
One of the three most commonly asked questions about the ORS and SRS scales is â€œHow can patients really give honest feedback to their therapists sitting right in front of them?â€
This question, like so many posed towards innovative tools like MyOutcomes, is really a question about reliability and validity. Though the question isn't very scientific, the author is asking if the ORS and the SRS are reliable and valid instruments. They want to know if the information from the tools can be trusted and used. There are, of course, numerous studies that have clearly demonstrated the reliability and validity of the ORS and the SRS.
The difficulty of this question, though, isn't whether it is an unscientific question asking for scientific information. The author of this question is probably unaware that what they are asking threatens the very foundation of psychotherapy. One of the basic premises of psychotherapy is that, in order to achieve successful outcomes, it is essential to create an environment where honest and intimate discussions can take place. These discussions involve the client's past and current feelings and experiences. Of course, all memories, whether of recent events or more distant moments, are â€œtaintedâ€ by the subjective interpretations of the client. It would be great, particularly for the therapist, to get a purely objective view of the past. But that can never happen. Psychotherapy, by its very nature, is a subjective experience.
Do clients hesitate in providing feedback to their therapists?
Most clients have a hard time expressing how they really feel about the therapeutic process — their progress or lack of it, as well as their sense of connectedness to the therapist. But this certainly isn’t a problem in the clip below:
Times are always changing, and professions with them. One of the most persistent and pervasive of recent developments in the world of work has been the trend toward implementing meaningful measurements. As budgets shrink and competition grows, organizations of all kinds are asking: “How do we know we’re being effective? And who in our organization is performing and who’s not?”