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: https://www.myoutcomes.com/fit-elearning

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 MyOutcomes.com 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.

PCOMS Therapist Survey

PCOMS Therapist Survey

Examining the Influence of Feedback Orientation and Feedback Environment on Clinician Processing of Feedback from Client Outcome Measures.

Dear Readers of the Effective Therapist Blog,

My name is Logan Rife and I am a doctoral candidate in the Collaborative Program in Counseling Psychology at The University of Akron. As a student, my use of the Partners for Change Outcome Management System or PCOMS helped inspire my dissertation which specifically seeks to examine therapists' responses to client outcomes measures such as PCOMS.

I am reaching out to you in the hope that you will help me with my data collection by participating in an online survey. The survey takes, at most, 15 to 20 minutes to complete. At no point during the completion of the survey will actual client data be accessed. My research project has been approved by The University of Akron Institutional Review Board.

Here is the link to the survey: https://akron.qualtrics.com/SE/?SID=SV_24VAJDTUskssUxD

In addition to helping me complete my dissertation, your participation will provide valuable data that can further inform practitioners and mental health agencies on how to optimize their use of PCOMS to improve service delivery.

Thank you for your time and help in this matter as I know all of you are exceedingly busy in your work as therapists. Please do not hesitate to contact me at glr8@zips.uakron.edu if you have any questions regarding participating in this study.

Best Regards, Logan Rife G. Logan Rife M.A. Doctoral Candidate Collaborative Program in Counseling Psychology, The University of Akron

PCOMS – A Clinical Measuring Tool

PCOMS - A Clinical Measuring Tool

“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 sue@talkhgi.com or by phone at 713 526-8390.

Can a wheel draw in more clients? – Therapist Marketing Tip #1

Marketing hubDrew McLellan wrote an excellent article called “Build your digital footprint in a hub and spoke model”. He suggests that every business needs a hub that all their online and offline content point back to. He explains how using a hub/spoke model will increase your visibility on the web. Studies show over 70% of people check out a health care practitioner online before booking an appointment.  Therefore, having a website easily found by clients and search engines is now central to a therapist drawing in clients.

Your website is where you most effectively present your skills, training, unique offerings, contact information and valuable content (articles or blog posts). The logic of have everything you do point back to your website is pretty straightforward as Drew explains: Continue reading…

Training of Trainers Conference 2015 in Florida

Barry Duncan, Partners for Change Outcome Management System (PCOMS) Implementation

Partners for Change Outcome Management System (PCOMS) Implementation

Now that you are convinced that the first and foremost way to become a better therapist is to add feedback to your work, The Heart and Soul of Change Project is pleased to announce an extra 2015 Training of Trainers conference from August 31 to September 4 in West Palm Beach, Florida.

These 27 hours of an intensive training experience is the first step in becoming a Heart and Soul of Change Project Certified Trainer. It intends to give you all you need to train others and implement the Partners for Change Outcome Management System (PCOMS).

Conference will be lead by Dr Barry L Duncan, a therapist, trainer and researcher with over 17000 hours of clinical experience. He is director of the Heart and Soul of Change Project. His work regarding consumer rights and client feedback, the PCOMS, has been implemented across the US and in 20 countries including national implementation in couple and family centers in Norway. PCOMS is included in SAMHSA's National Registry of Evidence-based Programs and Practices.

During the five day conference, a variety of information-packed presentations and skill-building exercises will cover topics like:
1. In depth coverage of the rationale for and research supporting PCOMS
2. How to train others in the clinical nuances of using the ORS and SRS
3. Data collection and management
4. Secrets of agency implementation
5. Four step supervisory process that ensures successful implementation while simultaneously improving outcomes

Participants will receive:
1. $120 worth subscription to the member site including 50 webinars and client videos
2. Barry's powerpoint presentation for the whole week to guide you through training and implementation of PCOMS
3. Administration and scoring manual of the ORS/SRS valued $39.95
4. The second edition of PCOMS manual covering the whole gamut from clinical implementation to supervision and agency implementation worth $39.95
5. Certificate of attendance and 27 hours of Florida CEUs for counsellors, social workers and MFTs and 27 CEs for psychologists provided by the Training Institute

Cost of training is $1195 for 27 hours of small group intensive sessions.

Participants will be limited to 20 so that maximum interaction, discussion and learning can occur. Register now to book your spot by mailing: Barry Duncan at barrylduncan@comcast.net

PCOMS: The Science Behind MyOutcomes

improve outcomes software, measurable outcomes, feedback system MyOutcomes

Dr. Barry L. Duncan, director of the Heart & Soul of Change Project, gets into the science that forms the backbone of MyOutcomes' web-based tool. Partners for Change Outcome Management System or PCOMS as it is commonly known is a continuous monitoring and feedback model that has shown increased efficiency in randomized clinical trials (RCTs). PCOMS is an evidence-based practice that involves a transparent discussion of the feedback with the client and involves collaboration with the client. It thus gives the client the power to be involved in his treatment.

The Outcome Rating Scale (ORS) assesses four dimensions; Individual, Interpersonal, Social and Overall whereas the Session Rating Scale (SRS) simply translates what is known about the alliance between the therapist and the client.

MyOutcomes takes this approach to the next level by providing a web-based system that graphically depicts these two scales and compares the client's progress to the Expected Treatment Response (ETR) of clients with the same intake score. It is the best way to continue the primary vision to make clients partners in change.

Dr. Barry Duncan, in this brief video clip, tells you about the science behind the MyOutcomes tool and how it can increase outcomes in therapy. To see the entire webcast CLICK HERE


Can We Be Technically Secure in Our Technological Security?

Technological Security

“For Technological Security, MyOutcomes uses encryption for storage of client data as well as for transmitting data to and from their customers”

Technological advances typically bring improvements in the way humans can live. They also bring new threats pertaining technological security and anxieties. The domestication of the horse allowed our ancestors to travel greater distances in shorter periods of time. It also allowed small bands of men to quickly raid villages and getaway before a response could be mustered. The invention of the wheel allowed our ancestors to carry larger amounts of supplies over vast distances. It also resulted in the development of chariots, those state-of-the-art killing machines of the ancient world. That was a threat that would have made anybody anxious.

Today, we have computers, mobile phones and the internet. These advances have led to more effective and efficient ways to store and share data, as well as to communicate with each other. It is only during the last decade or so that we have begun to truly mine the capacity of these technologies to inexpensively provide services such as MyOutcomes, which offers PCOMS Outcome Rating Scale (ORS) and Session Rating Scale (SRS) software to psychotherapists who desire to be more successful in helping clients reach their treatment goals.

Along with these advances, also come new threats. Over the last couple of years, we have become aware that governments have been sponsoring cyber-attacks and hacking activities, not just against other governments, but also against the private sector in order to steal research and private information. Organized criminal gangs are likewise finding that hacking into systems can be extremely profitable as they steal credit information. And then there are the little wannabe hackers who wish only to prove how clever they are.

The problem is not a small one. According to the security software company Symantec, over a half of a billion people had their identities stolen in 2013. The US Department of Health and Human Services reports that during that same time period, an average of 25,000 Americans had sensitive health information breached each day.

Much of the electronic threats come in the form of malicious software. These programs come in the form of viruses, Trojan horses, worms and backdoor programs. Some of this software is designed to acquire information. Spyware, for example, monitors your activity and is often used for gathering information for marketing. Phishing refers to software that monitors your activity in an attempt to collect more private information such as passwords. Other software might create a “trapdoor” that allows someone to sneak into your system or imitate you so that they can gain access. Finally, there is software with the sole purpose of destroying your data or corrupting your system!

In the face of all of this, what can the average agency or psychotherapist do? The bad news is not much. The cost for cutting-edge technology to protect against these powerful threats would be prohibitive. The good news is that the average small business or individual are not primary targets. They aren't worth the effort. So, the Chinese military and the Russian mafia won't be expending tremendous energy to crack into your system…unless you have sensitive information on high profile individuals.

That doesn't mean that if you leave your system vulnerable that they won't take a look and see what they can get. Nor does it mean that someone who likes to snoop around won't make an attempt to see how far they can get. And, of course, if you don't protect yourself from the malicious software, you leave yourself open to all sorts of problems.

HIPAA, of course, requires covered entities e.g. psychotherapists, as well as business associates e.g. MyOutcomes®, to do what they can to protect the privacy of their clients and make their protected health information secure against those who want it, but should never see it. Ultimately though, agencies and psychotherapists, who take the necessary steps needed to protect the privacy of their clients and secure their information, are making a good business decision. So, what can be done?

First, make sure that those tech companies you do business with e.g. your server company, the Cloud-based company you use for data storage or backup, and the software companies whose products you use, take security seriously. One way this is demonstrated is by keeping security patches up-to-date. Another way is the use of encryption. For example, MyOutcomes uses encryption for storage of client data as well as for transmitting data to and from their customers.

A second step that can be taken is to put good security software on your own system. There are quite a few products that are available in providing real-time security. These programs run in the background, monitoring any interaction via the internet for threats. An additional source for protection is on-demand security software. Not being part of the system operations, these programs can be run periodically from the “outside” to determine if anything unwanted has slipped through. Of course, it is important to keep your system updated, especially in regards to security patches, as well has keep your security software updated.

A third step, and a critical one at that, is to create hard to crack passwords. This is the place that all data is most vulnerable, so it makes sense that by making it difficult to gain entry, your data will become more secure. Unfortunately, a lot of people don't create good passwords. Instead, they use things like dates of birthdays or number sequences like the first five numbers or some have been known to use all zeroes.

There are two tricks to creating difficult to crack passwords. First, the more characters that are used, the greater the challenge for would be hackers. A minimum of seven characters is now suggested. However, more is even better. I know a security expert who creates haikus for his passwords. Not only does this significantly increase the number of characters used, but it satisfies the second trick which is to make a password that isn't predictable. An ideal password is made up of letters, digits and symbols. For example, MyOutcomes passwords, whether for staff or customers, need to be at least seven characters with at least one upper-case letter, one lower-case letter, one symbol, and one number.

Randomly generated passwords can be ideal but they can also be difficult to remember. However, security programs are beginning to offer virtual “lock boxes” where you can store all of your passwords. Of course, you will still need to remember your password for accessing the lock box. Even if you take the steps to create and store passwords, it is still recommended that you periodically change all of your passwords.

MyOutcomes, as your partner, works diligently to insure the security of your clients' personal information. MyOutcomes is also working to stay ahead of the game, so to speak, in order to insure that security in the future. As our partners, our clients also need to do what they can as they are the first line of defense against attempts at intrusion. This means having up-to-date security software, strong passwords with a schedule for changing them on a regular basis and, as simplistic as it seems to say, never leaving your computer on and unattended.

For more information, please get in touch with MyOutcomes on www.myoutcomes.com or call us toll-free on 1-877-763-4775.

A webinar on “Just Talk”… PCOMS as Political Action


Dr. Jacqueline Sparks

At the recent Heart and Soul of Change Conference, the gentle and powerful Jacqueline Sparks, PhD gave a moving keynote on how:

  • Psychotherapy itself is a political act.
  • What we do in our daily practice, within the sphere of psychotherapy talk or within the confines of our work setting, either supports or undermines systems of injustice and oppression.
  • PCOMS is “Just Talk”; PCOMS systematically includes clients' voices to guide all treatment decisions
  • Transforming mental health paperwork, policies to give clients the loudest voice in determining goals and methods for therapy is political action.
  • PCOMS provides a safety net for ensuring we do not replicate oppressive practices of the past (and present), especially when clients differ from their therapists along lines of culture, ethnicity, race, gender, social location, and other aspects of identity.

She had graciously agreed to present “Just Talk” …PCOMS as Political Action, as a MyOutcomes webinar on Wednesday, September 17th at 11:30 EST. If you are interested in hearing what she has to say, but missed the Live Broadcast, contact MyOutcomes and we will send you a link to the full recording. Interested professionals will include: social workers, psychologists, mental health workers, nurses, psychiatrists, primary care physicians, school counselors, marriage and family therapists, addiction workers, occupational therapist, physical therapist, and correction workers.

Dr. Sparks is an associate professor of family therapy in the Department of Human Development and Family Studies at the University of Rhode Island and Project Leader of the Heart and Soul of Change Project.Dr. Sparks has been involved and a key player in the development of PCOMS since its inception and has collaborated on most of the PCOMS publications, including Heroic Clients, Heroic Agencies: Partners for Change (2010), the six studies from the Norway Couple Project, as well as a chapter in the 2nd edition of On Becoming a Better Therapist, to mention a few.Her primary interests include teaching accountability via PCOMS, researching feedback and change in couple and family therapy, transforming systems of care to privilege client goals and promote social justice, and critical analysis of child psychotropic medication. Jacqueline is co-founder of the Heroicagencies Listserv.

PCOMS at Your Convenience

myoutcomes evidence based therapy

Join Heart and Soul of Change's affordable online training program that provides 24/7 support and tells you everything you wanted to know about implementing PCOMS into your practice.

Einstein once said, “Intellectual growth should commence at birth and cease only at death.” The world around us is constantly changing. In order to keep up with those changes, all we need to do is “continually learn”.

As more and more therapists and agencies around the world are embracing PCOMS or Partners for Change Outcome Management System, a SAMHSA-approved, evidence-based practice, it has been repeatedly shown to be capable of producing positive results in a variety of clinical settings. The Heart & Soul of Change Project, in order to quench your thirst for knowledge about PCOMS has come up with its affordable training program that is available anytime, anywhere. The Heart & Soul of Change project is a practice-driven, training and research initiative that focuses on the practical implementation of PCOMS and is therefore, the undisputed leader in the field.

Training includes members' only access to over 50 exclusive webinars and client videos that are hosted by Dr. Barry Duncan and other renowned names in the field. New study materials are routinely added. All offerings are presented by project leaders, certified trainers and special guests.

Your year-long subscription has no limitations on renewal. It includes online access to client videos, webinars, and other training materials. Your membership provides you with the independence and flexibility to learn at your own pace and in a setting that you are comfortable with. The rates for membership are:

–    Regular: $120 USD
–    Student: $70 USD
–    Small agency (49 members or less): $499 USD
–    Large agency (50 or more members): $999 USD
–    Professor: $299 USD

Agency memberships, whether small or large, include 24/7 staff access to all learning material. Professor memberships include unlimited student access and the flexibility to structure courses around the webinars for in-class presentation.

More and more therapists, private practitioners, and agencies have embraced PCOMS for measuring therapy outcomes. As a result, they are seeing an increase in client satisfaction with a reduction in client drop-outs and cancelled appointments. If you are one of today's forward-looking therapists, then please join us and become a member of the Heart & Soul of Change Project.

If you have not yet adopted the PCOMS path but would like to explore in order to enjoy the positive impact that it will have in your therapy, contact MyOutcomes. MyOutcomes is a SAMHSA-approved, web-based, feedback-driven outcomes management and reporting system. It incorporates the research underlying PCOMS with a web-based system that streamlines data entry and interprets results with the help of easy-to-understand graphs and feedback messages.

Click below to schedule a 30 minutes free demo or call us toll free at 1-877-763-4775

book an online demo