I'm Walking, Yes Indeed. I'm Talking, ‘Bout MyOutcomes and Me

| February 5, 2014
therapy feedback system, outcome measures, feeback informed treatment, therapy feedback for successful outcomes

The importance of therapy feedback for successful outcomes

Walking from one end of a room to some specific point on the opposite side of the room would be a simple task for most individuals. Even adding a couple of obstacles to step over or around wouldn't make the task that much more difficult. But what strikes us as a seemingly simple task is, in reality, a very difficult and complex task.

Basic walking involves muscles specializing in flexion, extension, abduction, and adduction. We might use rotator muscles for stepping around objects or we might use elevator and depressor muscles for stepping over objects. If that wasn't complicated enough, we have to keep our torso from significantly wobbling to either side, thereby causing us to change our trajectory to the left or the right or, even worse, falling down.

The perfect timing for the contraction and relaxation of all of these muscle groups is maintained by signals sent from our brain to the neuromuscular junctions. And once the initial command to move to the other side of the room is given, what controls everything is…feedback. To maintain our balance, we use feedback from our equilibrioceptors. The beginning and end of muscle contraction and relaxation is influenced by feedback from our proprioceptors. Keeping on target and knowing when we approach obstacles if provided by visual feedback. Other important feedback about our environment may be provided by our tactile senses.

Without this continuous feedback, we would find it very difficult to successfully walk to a target point across the room. Feedback is critical to so many parts of our lives.

That inner voice for many of us is important because it acts as a moral compass that alerts us if we are wandering off our path of doing what's right. When our behaviors are socially inappropriate, others in our social group will provide feedback with various mechanisms such as frowning, comments and ostracization.  When we learn a musical instrument, a martial art, mathematics or golf, we get feedback to tell us how we are doing and give us an opportunity to improve. This feedback may come by soliciting it from those more skilled than our selves or we may simply look at how our behaviour impacts other factors in our environment and compare our actual performance to our ideal performance. One thing we aren't good at is providing ourselves with feedback. We need measurements that don't depend upon our own personal impressions.

Technically, those teaching evaluations that college and university students fill out at the end of each semester are supposed to provide feedback to the professors. In an ideal world, the feedback is supposed to help the professor develop their courses and their teaching of the material. The majority of the time, however, these evaluations are seen as and used as nothing more than “customer satisfaction” surveys. The university administration only looks at them to insure that instruction is being provided, while professors hope to read comments like “A brilliant teacher” or “The best class I've ever had” rather than comments like “The professor dressed poorly” or “The professor looked stoned.”

Two other pseudo-feedback measures used by businesses are exit surveys and suggestion boxes. Although not all businesses provide such opportunities to their customers, those that do neither actively nor consistently attempt to get their customers to provide information about their experiences. The truth is that the exit surveys and suggestion boxes are nothing more than customer satisfaction measures that allow customers to vent their frustrations or express their happiness. Customer satisfaction measures aren't designed to help individuals improve or achieve their goals.

Even those who are the best at what they do, need to continually work to maintain and improve their skills. Olympic skiers continually practice and seek feedback before any competition. Musicians continually practice and get feedback before a performance. Put another way, those that excel never rest on their laurels, but they continue doing those things that helped them to excel in the first place.

As part of their training, all students, who aspire to become psychotherapists, receive feedback on their skills from various sources. Those psychotherapists, who strive for excellence, continue seeking feedback throughout their careers to help them achieve their goal. After completing their training program, their internship and their residencies, obtaining feedback, however, becomes difficult.

The one person who is ideally situated to provide the therapist with feedback is the person that the therapist works with. In other words, the therapist's client is the ideal source for feedback. This is so obvious that it is mindboggling that it has only recently begun to be realized. It seems strange that other therapists, e.g. physiotherapists, solicit feedback about their clients' progress and physical pain, but psychotherapists, who work hard at developing equally important but significantly more subtle skill sets, don't. But that has begun to change. The leader in this change is the Partners for Change Outcomes Management System (PCOMS). PCOMS is not a customer satisfaction measure. Instead, if used correctly, it is a powerful feedback tool that consistently measures the client's progress and the management of their psychological pain.

MyOutcomes, which is the web-based application for PCOMS, is the ideal system for administering the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS), thereby bringing the client's voice into therapy. For those psychotherapists, who want to successfully cross the room or develop Olympic-level skills, MyOutcomes is the best partner for soliciting that necessary feedback that they will be able to use to achieve those goals.


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Category: Agencies, Feedback, MyOutcomes, ORS / SRS, Outcome Rating Scale, PCOMS, Private Practice, Session Rating Scale

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