There’s over 3 million sessions entered in MyOutcomes. The science behind the measures can be divided into 2 parts, a 1 minute, 4 question survey given to clients before the session called the ORS. And, another 1 minute, 4 question survey called the SRS after the session. The results are tabulated, which creates a (red, yellow, green) signal for the counsellor.
What is the Outcome Rating Scale?
Outcome Rating Scale (ORS) – measures the client’s perspective of change or improvement (or lack thereof) in relation to where they started. For two decades, the Outcome Rating Scale (ORS) has repeatedly been proven to be a reliable and valid therapeutic instrument that can be easily and effectively incorporated into any therapist-client session (Miller, Duncan, Brown, Sparks, & Claud, 2003; Bringhurst, Watson, Miller, & Duncan, 2006; Campbell & Hemsley, 2009). Further evidence has been accumuating that demonstrates the generalizability of the ORS to a variety of clinical populations and settings: couples, addictions, adolescents, groups, and much more (Anker, Duncan, & Sparks, 2009). With MyOutcomes®, the ORS takes less than a minute to administer, and the results can then be compared to a predicted score derived from calculations based on data from nearly three-quarters-of-a-million other administrations. The brevity of our ORS makes for an extremely feasible tool that can easily be completed by clients at the beginning or end of each therapeutic session. Although feedback does lead to improved outcomes, it has been demonstrated that regular solicitation of feedback is significantly more effective (Reese, Norsworthy, & Rowlans, 2009).
Using four visual scales, the ORS is a brief outcome measure that enables clients to provide feedback on their perceptions of their progress in achieving their therapeutic goals. Specifically, the four scales allow the client to provide a quantifiable measure of how they are functioning on a personal level, in their interpersonal relationships (friends and family), their general social interactions, as well as a more global measure of their overall functioning. MyOutcomes® automatically plots each session’s ORS on a continuous graph so that the therapist can determine if the trajectory of change is on or off track.
Duncan, B., Miller, S., Sparks, J., Claud, D., Reynolds, L., Brown, J., & Johnson, L. (2003). The Session Rating Scale: preliminary psychometric properties of a “working” alliance measurement. Journal of Brief Therapy, 3(1), 3-12. Anker, M. G., Duncan, B. L., & Sparks, J. A. (2009). Using client feedback to improve couple therapy outcomes: A randomized clinical trial in a naturalistic setting. Journal of Consulting & Clinical Psychology, 77, 693–704. doi:10.1037/a0016062. APA Task Force on Evidence-Based Practice (2006). Evidence-based practice in psychology. American Psychologist, 61, 4, 271-285. Bringhurst, D.L., Watson, C.W., Miller, S.D. & Duncan, B.L. (2006). The reliability and validity of the Outcome Rating Scale: A replication study of a brief clinical measure. Journal of Brief Therapy, 5, 1, 23-30. Campbell, A & Hemsley, S. (2009). Outcome Rating Scale and Session Rating Scale in psychological practice: Clinical utility of ultra-brief measures. Clinical Psychologist, 13, 1, 1-9. Miller, S.D., Duncan, B.L., Brown, J., Sparks, J.A. & Claud, D.A. (2003). The Outcome Rating Scale: A preliminary study of the reliability, validity, and feasibility of a brief visual analog measure. Journal of Brief Therapy, 2, 2, 91-100. Norcross, J.C. & Wampold, B.E. (2011). Evidence-based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 1, 98-102. doi: 10.1037/a0022161. Reese, R., Norsworthy, L., & Rowlands, S. (2009). Does a Continuous Feedback Model Improve Psychotherapy Outcome?Psychotherapy: Theory, Research, and Practice, 46, 418-431.
What is the Session Rating Scale?
Session Rating Scale (SRS) – is a four-item measure of the therapeutic alliance that includes gathering information about how the client feels about the relationship, the goals and topics, the approach to treatment, and an overall rating. Evidence-based practices are effective in consistently producing positive outcomes in psychotherapy (APA Task Force on Evidence-Based Practice, 2006; Norcross & Wampold, 2011). Being included on SAMHSA’s National Registry of Evidence-based Programs and Practices means that the Session Rating Scale (SRS) is a valuable tool for any practice that wishes to improve the likelihood of clients achieving their therapeutic goals. The therapist-client bond, known as the therapeutic alliance, has long been seen to be a good predictor of successful outcomes. Evidence supporting the efficacy of this relationship continues to accumulate (Baldwin, Wampold, & Imel, 2007). Along with its companion measure, the Outcome Rating Scale (ORS), the SRS was developed by Dr. Scott D. Miller and Barry L. Duncan over a decade ago. It quickly demonstrated to be a valid and reliable measure of the therapeutic alliance (Duncan, Miller, Sparks et al., 2003).
MyOutcomes® SRS is a four-item scale that enables the therapist to obtain a quantitative measure of the client’s assessment of the therapist-client relationship. Specifically, the SRS asks the client to use a sliding scale to assess their relationship with the therapist, whether the goals and topics cover what the client feels they need, how well the therapist’s approach fits the client’s needs, and an overall general assessment of the most recent session. Based upon the individual item scores, and the composite score of these measures, the therapist can determine whether the alliance is threatened. If so, the therapist is able to devote time to explore issues that will strengthen the relationship like shifting goals or changing approach, and so on. Evidence suggests (e.g. Campbell & Hemsley, 2009) even those therapists who express a desire to solicit feedback from their clients are unlikely to do so if the process is burdensome and time-consuming. This means that a tool like MyOutcomes® SRS, which takes less than a minute to administer and obtain a score, is quite easy to incorporate into each therapeutic session.
APA Task Force on Evidence-Based Practice (2006). Evidence-based practice in psychology. American Psychologist, 61, 4, 271-285. Baldwin, S., Wampold, B., & Imel, Z. (2007). Untangling the alliance Outcome correlation: Exploring the relative importance of therapist and patient variability in the alliance. Journal of Consulting and Clinical Psychology, 75, 842–852. Campbell, A & Hemsley, S. (2009). Outcome Rating Scale and Session Rating Scale in psychological practice: Clinical utility of ultra-brief measures. Clinical Psychologist, 13, 1, 1-9. Duncan, B., Miller, S., Sparks, J., Claud, D., Reynolds, L., Brown, J., & Johnson, L. (2003). The Session Rating Scale: preliminary psychometric properties of a “working” alliance measurement. Journal of Brief Therapy, 3(1), 3-12. Norcross, J.C. & Wampold, B.E. (2011). Evidence-based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 1, 98-102. doi: 10.1037/a0022161. Reese, R., Norsworthy, L., & Rowlands, S. (2009). Does a Continuous Feedback Model Improve Psychotherapy Outcome?Psychotherapy: Theory, Research, and Practice, 46, 418-431.