Feedback Informed Treatment

Routine Outcome Monitoring in Group Therapy can Improve Outcomes and Reduce Costs

Group Therapy


Today, we’re seeing numerous organizations and groups competing for a slice of the finite financial pie that has been designated to address some of the most vital concerns facing us today. Mental health, increasingly seen as one of those concerns, has begun, in the last several years, to get a small slice of that pie. Unfortunately, the increase in worldwide mental health issues is outpacing the resources available. This trend is likely to continue in the coming decades. Those funds dedicated to mental health will need to be spread thinner than they already are. Although one possible solution, increasing available funding is a political issue that will be decided by politicians. As such, we can’t count on seeing any significant solution any time soon.

There is only one practical solution for those working in the trenches and confronting the challenges that poor mental health brings. Those limited funds need to be utilized as efficiently and effectively as possible.

One way to increase the effectiveness and efficiency of mental health resources is through the integration of MyOutcomes into the clinical setting. MyOutcomes pioneered the first valid and reliable digital measures of treatment progress and therapeutic alliance known to:

  1. strengthen client engagement in the clinical setting,
  2. increase the number of successful outcomes and
  3. reduce early drop out.

Integrating Feedback-Informed Treatment best practices into the therapeutic session enables MyOutcomes to assist the clinician and the client to mutually identify the clinical goals and see when goals have been reached. Routine Outcome Monitoring (ROM) is simple and feasible with a standardized Outcome Rating Scale (ORS) that predicts session outcomes and red flags clients, who may superficially appear to be benefiting from treatment, but are, in fact, deteriorating and are at risk for dropping out. The therapist can use the feedback elicited by MyOutcomes each session to identify their struggling clients and adjust therapy to better meet the clients’ therapeutic needs.

Another strategy for increasing effectiveness and efficiency is to use group therapy. There are numerous advantages to group therapy, two of which are:

1) an enhanced use of clinic time

2) a reduction in cost for services.

With the right clients, group therapy can improve the effectiveness and efficiency of services provided.  One of the main downsides, however, is that the client may not form a strong therapeutic relationship. We have known for several decades that a strong therapeutic alliance is predictive of successful outcomes. Without this alliance, the client may not feel engaged with the therapist or the group. At the very least, any strengths that group therapy could provide may be cancelled out. At its worst, the client may be inclined to drop out without reaching their therapeutic goals.

Not only does MyOutcomes’ ORS integrate into group therapy as easily as it does individual therapy, but it also enables the provider to monitor the therapeutic alliance when using the Group Session Rating Scale (GSRS). Integrating a group therapy alliance measure into every group therapy session may not seem feasible but with all the administration and reporting options that MyOutcomes has developed, it is really quite simple.


Read MyOutcomes® Group Therapy Solutions Guide to learn more:



Feedback-Informed Treatment, explained by Scott D. Miller in under five minutes

FIT eLeaning

Did you know that clinicians who routinely obtain feedback on the progress and the status of the relationship with their individual clients have outcomes that are much better, and dropout rates that are much less, that Treatment As Usual (TAU)? In fact, numerous studies actually confirm this. In the research literature that process is known as Feedback-Informed Treatment (FIT). Scott D. Miller, PhD, is one of the pioneering scientists behind the FIT movement. He and I recently worked together to create this brief video to explain what FIT is and how developing a culture of feedback and incorporating the Outcome and Session Rating Scales (ORS & SRS) into your clinical practice can improve your treatment outcomes.

Feedback-Informed Treatment, explained by Scott D. Miller in under five minutes.


Interested in learning Feedback-Informed Treatment Best Practices from Scott D. Miller?

Whether you’re an individual practitioner or part of a larger organization, FIT eLearning is designed to help you develop a culture of feedback and incorporates the Outcome and Session Rating Scales (ORS & SRS) into your clinical practice.

FIT eLearning is based on the most up-to-date research in talk therapy and behavioural health sciences.

FIT eLeaning

MyOutcomes® FIT eLearning program is centered on the four core competencies developed by Dr. Scott D. Miller and colleagues at the International Center for Clinical Excellence (ICCE)



Free Resource Reveals the True Path to Better Results


Turns out it’s more than just a common quality of highly effective therapists, humility is actually a prerequisite!

Studies confirm “professional self-doubt” is not only a strong predictor of both alliance and outcome but actually a prerequisite for acquiring therapeutic expertise. Speaking specifically to the field of psychotherapy in, Humility: The paradoxical foundation for psychotherapy expertise, the authors, Hook, Watkins, Davis, and Owen , define humility as “valuing input from the other (or client) … and [a] willingness to engage in self-scrutiny.”

Does this sound like you?

We all profess humility and I know as an ethics bound professional that you already ask for feedback and have likely already encountered some negative feedback from a client. When you have received negative feedback about treatment progress or experienced a rupture in the therapeutic alliance, ask your self how ofter you were able to:

1: Fix the problem?

2: Learn from the feedback and apply it in future encounters?

Did you confidently answer yes, all the time to both questions, because this is the path your colleagues are taking to go from average to excellent. Only you know how far down this journey you have gone, or are willing to go, but what I do know is that both MyOutcomes® and The International Center for Clinical Excellence (ICCE) are dedicated to providing you with the tools and training you need to see noticeable improvements in treatment results.

Take the Path to Better Results

On January 15, 2021 MyOutcomes is releasing a new series of Better Results with Scott Miller Interviews. The series is full of stories and free practical advice and resources to help you develop a more feedback informed practice. This four-part Netflix style series can be binge watched in under two hours.

If you have participated in the past, then you know that besides free giveaways, MyOutcomes will also be including a great bonus package. The Get FIT Now bonus package will be available for the first 100 Mental Health Professionals who sign up between January 15th and 31st, 2021.

Without giving to much away, I have to tell you that the first 10 participants to sign up online for MyOutcomes or FIT eLearning will be receiving a free paperback copy of Better Results: Using Deliberate Practice to Improve Therapeutic Effectiveness! This step-by-step guide demonstrates how to collect and use client outcome data to create an individualized professional development plan and measure improvements in the quality of the service you provide.

Sign up now

To make sure you don’t miss out, get on the wait list now: This free Feedback-Informed Treatment Webinar Series will only be available for download from Jan 15-31. More free resources and exclusive content will be revealed on the release date!

Share with your colleagues so they don’t miss out on advanced notice.

Get on the waitlist for premier access, Friday, January 15th

Feedback Informed Treatment in Group Settings

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:

Struggling to administer the ORS and SRS in remote sessions?

I do not know of any other time in modern history where the need for access to mental health care in the world has been greater and, with the constraints of mitigation, harder to access. It’s no wonder this year’s World Mental Health Day campaign is Move for mental health: let’s invest.

In the announcement, Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization said, “We are already seeing the consequences of the COVID-19 pandemic on people’s mental well-being, and this is just the beginning. Unless we make serious commitments to scale up investment in mental health right now, the health, social and economic consequences will be far-reaching.”

For myself and the Team at MyOutcomes, the early months were very busy helping agencies and private practice therapists adjust to Social Distancing and Telehealth service delivery models.  We are all still adjusting and many Feedback-Informed Practitioners are still trying to use paper and pencil to receive client Outcome and Session Ratings.  Yes, it saves money, but it’s awkward and unfortunately many are reporting giving up on this important client engagement and quality improvement initiative. We understand that an annual subscription of $228.00 may not feel like a worthwhile investment, but if Therapists could only try out MyOutcomes with some of their clients they would find it is money well spent.

Plus, to help overcome the cost barrier that stops some professionals offering their clients access to the gold standard Outcome and Session Rating tool, I am pleased to announce that we are reducing the price of our online subscription from $228.00 to $199.00. That’s less than $20.00 a month, well worth it if it helps more clients help, more often.

I challenge all Behavioural and Mental Health professions to try it out for free for 2 months, no hidden fees, no strings. This is my Move for Mental Health: Let’s Invest Challenge! 

If you accept this challenge, we will also give you a one-on-one consult with Dr Karl Peuser on how to best utilize MyOutcomes 120 PCOMS assessment options and hundreds (lost count) of outcome and session reporting features.  Plus, a coaching session with a seasoned Feedback-Informed Treatment trainer (that’s me) for FREE. That’s our investment in you!

Curious? here are two new brief videos we just published. They can be sent to new clients to explain how to login to one of our secure web applications (US, CAN, INT) or download MyOutcomes App from Google Play or the App Store . The app offers a user interface in 8 different languages. MyOutcomes is used in 27 countries around the world to routinely monitor and improve therapy outcomes and treatment effectiveness.  It is normed for all ages, and with 20 language translations it works with diverse populations resulting in more meaningful reporting of treatment efficacy.

Are you ready to take me up on my Move for Mental Health: Lets Invest Challenge?

Visit and request a Free Trial or if you want to take up this challenge for your Team you may want to Request a Quote first to find out about addition cost savings and implementation support available during your pilot.

What Makes a Super Shrink?

Thanks to the seminal work of K. Anders Ericsson, and growing body of FIT Deliberate Practice research, we know it’s not just ‘good genes’ or the ‘right’ therapeutic model that make the difference, it’s effort spent in a reflective practice of looking for ways to improve performance.

Over the years, I know MyOutcomes different dashboard reporting parameters and graphical representations have contributed to the identification of growth areas and provided incremental measures of micro improvements in performance for many…we help create super shrinks.

If you have never had the opportunity to have all of your client sessions tracked and reported for you in real time, you may not understand how quickly MyOutcomes data can help you gain insights into client progress and treatment outcomes.

To help you imagine how the MyOutcomes experience can help track and improve treatment outcomes, we have populated a read-only account with made up cases. You can gain instant access for free. Try out the tools others are using to power their quality improvement initiatives and meet accountability requirements.

Access your temporary login credentials here: //





Does Documentation Improve Treatment Outcomes?

“I know we can help you successfully collect outcome data, the trick is learning to use that data to inform and improve care”, a phrase I often repeat during implementation consultations.

That being said, just being able to successfully collect outcome data seems to have become the unofficially minimum standard. Believe me, I get it, just having everyone routinely collect patent self-report measures is difficult enough.

Particularly, if the Team is just following standards and requirements they must meet in order to practice and get paid. Helping your Team embrace the logic behind routinely measuring session feedback from clients is no small feat and for many it is understandable that this is the first and only step they ever take towards a feedback-informed approach. Creating a culture of feedback is hard.

If you have tried to adopt a feedback informed approach, did you find it awkward to make it fit into the accepted documentation requirements of your practice? Would you take a moment now and consider your current practices and related documentation requirements.

Do your current documentation practices and requirements improve outcomes?

Will you share your response on this simple four-item scale? You can answer anonymously and it takes less than a minute to complete.

If you question the value of your current requirements or have found that they seem to stand in the way of improving outcomes and being able to fully use the Measures to inform and improve care, you will appreciate this brief cartoon video clip (2:36).

The following video with Scott D. Miller illustrates the fundamental shift that is required to create a culture of feedback and provides some helpful documentation resources to support your service delivery transformation.

This video and the survey questions above are both pulled from Module 10  –  FIT Skills: Documentation. This is a sample of the FIT eLearning Program we have developed to walk you through the process of using FIT in your clinical setting. Each model has a series of videos, interspersed with awareness profile questions. Awareness profile questions (like the survey question above) are designed to help you further engage with the lesson content. Plus, there is a quiz at the end of each module, to make sure you master each section before you move on.

If you have tried, or are thinking of trying to move beyond just collecting outcome data have a look at our training program. This ICCE accredited, basic training in Feedback-Informed Treatment program includes 12 documented online training hours on psychotherapy (2 hours), outcome measurement (8 hours), performance improvement (2 hours).

To Learn more: //

ORS & SRS Telehealth Support

myoutcomes evidence based therapy

myoutcomes evidence based therapy No one could have anticipated how our world circumstances would change, and with it our mode of how we operate in it. In order to protect each other, we need to do things differently, and fast. For most, if not all, distance therapy will need to be the norm for some time.

In a recent blog post, Telehealth Options for Feedback-Informed Practitioners, I shared some tutorials MyOutcomes has made to help ease the transition to online therapy, but soon I was asked, “What about when the client doesn’t have internet access or a data plan on their cell phone, and a line line is the only form of communication?”

Last week, Karl Peuser, PhD, published a video specifically on how to collect ORS and SRS feedback over the phone. Today FIT Trainers, Brooke Mathewes and Stacy Bancroft published guidance for Oral administration of the Outcome Rating Scales and the Session Rating Scale. For your reference  the documented Oral scripts are included below.

In addition to tutorials, thought leaders in our field are also reaching out to help.

Scott D. Miller, PhD has offered to host a free discussion on Feedback Informed Treatment and FIT Deliberate Practice, Mar 31, 2020 12:00 PM Central Time (US and Canada).

Daryl Chow, PhD has offered to make The First Kiss: Undoing The Intake Model and Igniting Engagement From the First Session in Psychotherapy, audiobook available until Sunday, APRIL 12th, 2020, for FREE! Choose audio book and enter promo code: safeapril

Scripting for Oral Version of the Outcome Rating Scale

I’m going to ask some questions about four different areas of your life, including your individual, interpersonal, and social functioning.  Each of these questions is based on a 0 to 10 scale, with 10 being high (or very good) and 0 being low (or very bad). Thinking back over the last week (or since our last conversation), how would you rate: How you have been doing personally? (On the scale from 0 to 10). If the client asks for clarification, you should say “yourself,” “you as an individual,” “your personal functioning.”If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”. If the client gives one number for one area of personal functioning and offers another number for another area of functioning, then go with the lowest score.

How have things been going in your relationships? (On the scale from 0 to 10). If the client asks for clarification, you should say “in your family,” “in your close personal relationships.” If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?” If the client gives one number for one family member or relationship type and offers another number for another family member or relationship type, then go with the lowest score.

How have things been going for you socially? (on the scale from 0 to 10). If the client asks for clarification, you should say, “your life outside the home or in your community,” “work,” “school,” “church.” If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”. If the client gives one number for one aspect of his/her social functioning and then offers another number for another aspect, then go with the lowest score.

So, given your answers on these specific areas of your life, how would you rate how things are in your life overall?. The client’s responses to the specific outcome questions should be used to transition into counselling.  For example, the counselor could identify the lowest score given and then use that to inquire about that specific area of client functioning (e.g., if the client rated the items a 7, 7, 2, 5, the counsellor could say, “From our responses, it appears that you’re having some problems in your relationships.  Is that right?)  After that, the counselling proceeds as usual.

Scripting for Oral Administration of Session Rating Scale

 I’m going to ask some questions about our session today, including how well you felt understood, the degree to which we focused on what you wanted to talk about, and whether our work together was a good fit.  Each of these questions is based on a 0 to 10 scale, with 10 being high (or very good) and 0 being low (or very bad). Thinking back over our conversation, how would you rate: On a scale of 0-10, to what degree did you feel heard and understood today, 10 being completely and 0 being not at all? If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”. If the client gives one number for heard and another for understood, then go with the lowest score.

On a scale of 0-10, to what degree did we work on the issues that you wanted to work on today, 10 being completely and 0 being not at all? If the client asks for clarification, you should ask, “did we talk about what you wanted to talk about or address?  How well on a scale from 0 – 10?”. If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”

On a scale of 0-10, how well did the approach, the way I /we worked, make sense and fit for you? If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”. If the client gives one number for make sense and then offers another number for fit, then go with the lowest score.

So, given your answers on these specific areas, how would you rate how things were in today’s session overall, with 10 meaning that the session was right for you and 0 meaning that something important that was missing from the visit? If the client gives you two numbers, you should ask, “which number would you like me to put?” or, “is it closer to X or Y?”


Measuring the Therapeutic Alliance just got easier

English, Spanish, French, Norwegian, Swedish & Danish versions of the appWith the release of  V19, MyOutcomes has vastly increased the capacity of the PCOMS Measures to serve as a helpful cross-cutting outcome and alliance measure in settings with people with lots of different problems or who are seeing lots of different professionals.

First, we have made it possible to edit, “The Therapist”s Approach is/is not a good fit for me” scale of the SRS, allowing it to be adapted to reflect a term more suited to your service setting. This feature is accessible under Options at the Owner level.

Second, is the new translations, 20 languages to choose from on the web app and now 10 on the mobile app! Allowing for administration of the ORS/CORS/SRS/CSRS & GSRS in English, Spanish, French, Norwegian, Swedish, Danish, Dutch, German, Italian and Chinese.

Plus, in MyOutcomes Mobile v6 we have moved beyond simply offering multiple translations of the PCOMS Measures, now Providers and Clients will be able to choose from English, Spanish, French, Norwegian, Swedish & Danish versions of the app. To change the language from the default English, in the upper-right corner on the app login screen is a cog icon that will open the list of languages to select from.

If you haven’t tried MyOutcomes v6, now is the time.

Use with up to five clients for free

ORS & SRS app

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.