Session Rating Scale

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:

Feedback-Informed Treatment in the Time of Corona

Feedback-Informed Treatment in the Time of Corona

Feedback-Informed Treatment in the Time of CoronaThe Better Results with Scott D. Miller Live Meet Up was held yesterday.

Feedback-Informed Practitioners, from around the world, joined in to listen and participate in a discussion about Feedback-Informed Treatment and FIT Deliberate Practice. FIT Trainer and MyOutcomes Executive Director, Cindy Hansen was the host and moderator for this event.

Scott D. Miller is the co-founder of the Center for Clinical Excellence, an international consortium of clinicians, researchers, and educators dedicated to promoting excellence in behavior health. He is the author of numerous articles and co-author of the soon to be released, Better Results: Using Deliberate Practice to Improve Therapeutic Effectiveness (APA, 2020).

This opportunities to interact, one-on-one in a live training session, with Scott was part of the Better Results…with Scott D. Miller Training Series. This training is complete but a waitlist is available, for the next session this summer. you can sign up here:


This video clip covers the first question that came from Daniel Rosen, who asked, “So, we have a worldwide, real world dramatic change that we speculate has increased distress overall. Question: do we have an numbers on ORS scores changing historic patterns? Question 2: We have a real world mass movement to telehealth and remote video therapy: What is happening with SRS scores as well. I hope the number crunchers have something here!”

Do you want to know Scott’s answer? I know I did.

Listen and see if you agree. Love to hear your comments.


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

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 to receive free access for one month.

Learn more about affordable monthly subscription options:

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 or call us on 1-877-763-4775

Improve Outcomes

Which is More Expensive Cloud or On-Premise Purchased CRM

MyOutcomes: HIPAA compliant feedback system

MyOutcomes: cloud-based HIPAA compliant feedback system

….another reason why you should go with MyOutcomes.

Are you sold on the benefits of evidence-based treatment but are not sure whether to go with the conventional pen and paper forms or with the new generation online tools? And in case you are going for an online version, then which tool should you go with? Are you debating on whether to design your tool in-house or go with a SaaS (Software as a Service) provider?

Here is an attempt to quell all your doubts.

First things first, here are some of the main advantages an online evidence-based tool provides:

  • automation of the Partners for Change Outcomes Management System
  • simplified administration and scoring, eliminating papers and rulers
  • detailed reports and instant analysis of client's responses
  • at a glance identification of at risk cases

The answer to the second one is much easier as there is not much choice there. There are only two tools that have been placed on SAMHSA's National Registry of Evidence-based Practices and Programs (NREPP) and they are MyOutcomes and the OQ Analyst.  OQ Analyst is much lengthier ( 45 times) and is administered at the beginning of the therapeutic session whereas MyOutcomes consists of two ultra-brief measures comprising of four items each that are administered at the beginning and the end of each therapeutic session. In the time it takes for the average person to inhale and exhale twelve times, the therapist can administer either the ORS or SRS and have their client's score plotted on a graph for immediate integration into the therapeutic session.

Then there is this third option as well of designing your own online feedback tool in-house. Businesses think that it is better to have their own software, especially the ones used for housing client's data. They do it for multiple reasons among which the top ones are cost and security. But it has been substantiated in a study done by Yankee Group TCO that on-premise systems were shown to be more expensive to operate annually than their cloud-based counterparts, with the overall cost 60% higher on an annual basis.

Moreover, expertise wise as well, it is often better to go with someone who specializes in just creating the software so that you can focus on the core specialty of your business!

And with all the legislation and rules applicable for companies handling the client data, a cloud-based system is actually more secure than any server-based or paper system. In addition, these cloud-based systems comply with the Health Insurance Portability and Accountability Act (HIPAA) and its sophisticated encryption requirements.

A cloud-based system also allows you to function efficiently from any device that has an internet connection, anywhere in the world. This feature is of much use for mental health practitioners as they need to use Personal Health Information to track and improve treatment outcomes and to compare client outcomes to normative standards.

So if you are ready to go the evidence-based way, then MyOutcomes is the cloud-based HIPAA compliant feedback system for you.

For more information, please visit or call us on toll-free 1-877-763-4775.

MyOutcomes Help Desk

TOMS, a simple Therapy Outcomes Management System

Therapy Outcomes Management System (TOMS)The Therapy Outcomes Management System (TOMS) is a simple way for you to keep session notes and outcome data using the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS).  This app for iPad/iPhone/iPod is used to provide instant feedback on outcomes of counseling and therapy, client by client.

Why the TOMS? It’s simple–research has demonstrated that providing instant feedback on psychotherapy sessions improves the quality of care that clients receive.

Because the TOMS database (Parse, owned by Facebook) is being retired in January, 2017, some changes were necessary to allow the TOMS to continue working. As of as of January 1, 2017 the  TOMS application is now being maintained by MyOutcomes.

There are two parts of the TOMS: The Client Manager and the Session Manager. In the Client Manager, you maintain a list of all your clients and their contact information. In the Session Manager, you keep session notes and outcome data using the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS).

Then you can track ORS and SRS scores overtime on a graph to provide instant feedback on your client’s progress in therapy and the progress of your therapeutic relationship. By incorporating the client feedback into your therapy sessions you can identify clients at risk for drop out or deterioration as well as adjust treatment to better serve the needs of your clients.

Session Notes and Outcome reports can be printed or sent via e-mail. Please note that the TOMS only tracks and plots ORS and SRS scores, if you intend to use session feedback to report the effectiveness of treatment, we recommend you upgrade to the MyOutcomes Mobile application. MyOutcomes provides advanced behavioural algorithms that allow for accurate reporting of treatment effectiveness for children, teens, and adults. It includes multiple language translations, as well as couple and group session options.

Using MyOutcomes® and Feedback Informed Treatment to create a culture of continuous performance improvement

Feedback Informed Treatment

This webinar will help you use MyOutcomes to facilitate a culture of continuous performance improvement through Feedback Informed Treatment (FIT).

Specifically you will learn how:

  • MyOutcomes‘ session feedback signals facilitate therapist self-evaluation
  • Data from the SRS and ORS can be used to inform and direct clinical supervision
  • Analysis of data helps practitioners discover the qualities, personal biases and gaps in understanding that might adversely effect client outcomes

Click here to access free recording

The webinar was presented by Randy Moss, PhD.

Dr. Moss is a certified FIT trainer who has spent the last thirty years practicing psychotherapy, as well as working as a researcher, presenter and implementation consultant. His primary focus now is using translational research and implementation science along with local adaptations to help make the transition to evidence based practices in large agencies/organizations.

Feedback Informed Treatment, Dr Randy Moss
MyOutcomes is currently implemented in a variety of service settings including: outpatient, inpatient, case-management, prison-based, child protection, in home and at work

MyOutcomes successfully serves providers globally, every day, as they administer well over half a million surveys into our secure, U.S. and Canadian-based servers

MyOutcomes is the only registered web-based version of the ORS and SRS included in SAMHSA's National Registry of Evidence-based Programs and Practices

Click here to access free recording


MyOutcomes Sings the Client's Aria

myoutcomes feedback informedHow can therapists determine when recovery is achieved?

“It ain't over ‘til the fat lady sings” is an operatic reference to the rather large Valkyrie, Brunhilde, who, wearing her horned cap and holding her sword and shield, sings an aria signalling the end of a Wagnerian opera. In the English language, we have a number of cautionary colloquialisms, such as this one, warning against jumping the gun, because nothing is a foregone conclusion while a process or activity is still ongoing.

The flipside of counting your chickens before they hatch is not recognizing the end when it's staring you in the face. It's a fine balancing act between knowing that the future isn't written in stone and knowing that the future has arrived.

In the health field, it used to be easier to determine the end of treatment. Or, at least, health practitioners believed so. Those were the days when the treatment model was to cure the patient. The end of treatment was when the illness was eliminated and the person was returned to a pre-morbid state.

The conditions for this treatment approach are quite simple. First, you need to know the etiology of the illness. More specifically, in order to eliminate the illness, you need to eliminate the cause of the illness. Second, you need to have a treatment approach that has the effectiveness in cutting away the cause with the precision of a surgical knife. Third, you have to assume that any changes wrought by the illness are only temporary and can be reversed.

The problem is that in both medicine and psychotherapy, we often don't know the etiology or have a highly precise treatment protocol. In medicine, this is the reason why physicians will provide the patient and their family with outcome probabilities. Even those who wield surgical knives, the surgeons, give probabilities for successful endings. As for the changes caused by the illness, they are typically permanent. The most we can hope for is that those “scars” will fade with time.

For these reasons, compounded with the rising costs of healthcare, the health field has been moving away from the old model and moving towards a recovery model of treatment. With the recovery model, the therapeutic goal is two-fold. First, get the patient to a pre-morbid state of functioning and, second, address the antecedents of the problem so that they can no longer disrupt the person's life.

Although recovery as a goal is more readily achieved than a cure is, the therapeutic goal can be much more elusive with the recovery model. For example, what exactly was the pre-morbid level of functioning for a particular client? In order to help a patient recover, some knowledge of this is necessary. Goals based upon normative data can play a vital role in getting into the ballpark, but is the ballpark sufficient? Each patient has their own idiosyncrasies which can influence where the actual goal of recovery may lie. The source for this individualistic information is the patient. Therefore, recovery is ultimately determined by the patient's own perception of their functioning.

In medicine, it is much easier for physicians to determine whether change is occurring and whether recovery has occurred because physical changes are readily observed and measured. Psychotherapists, on the other hand, are faced with a greater challenge, because they work with the mind; something that can't be directly observed or measured.

Because psychotherapists aren't able to directly measure their client's mind, they need tools that can indirectly provide them insight into the mental health of their client. Such tools measure established indices of functioning, such as personal well-being, interpersonal relationships, and social interactions, which enable the therapist to make inferences regarding the mental health of their client. Because of the individualistic nature of recovery of something that can't be directly observed, it is critical that these tools are capable of enabling the therapist to determine whether change is occurring or not. These tools need to be able to provide the therapist with the power to “see” that recovery has been achieved. In short, the tool needs to be a Brunhilde, whose aria announces the end of treatment.

MyOutcomes, the web-based application of PCOMS, is the Brunhilde of psychotherapy. However, instead of delivering an aria, MyOutcomes provides the ORS, or Outcome Rating Scale. The ORS easily brings the client's voice into the therapeutic session, allowing the client to share their perception of their own functioning on a personal level, interpersonal level and social level. With regular use of the ORS, the psychotherapist and the client have the power to observe whether recovery is occurring and whether recovery has been achieved.

Yogi Berra used to say, “It ain't over ‘til it's over.” By incorporating MyOutcomes into their practice, therapists can be confident that recovery has been achieved.

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