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Partners for Change Outcome Management System
==Introduction==
The Partners for Change Outcome Management System (PCOMS) is a behavioral health outcomes management system for counseling and therapy services, developed by Barry Duncan and Scott Miller.〔Lambert, M.J. & Vermeersch, D.A. (2008). Measuring and improving psychotherapy outcome in routine practice. In S.D. Brown & R.W. Lent (Eds.), Handbook of counseling psychology (4th ed, pp. 233-248). Hoboken, NJ: John Wiley & Sons.〕 The approach was inspired by Michael J. Lambert’s research regarding the use of consumer feedback during the therapeutic process with the Outcome Questionnaire 45.2 (OQ) and is designed to be a briefer method to measure therapeutic outcome.〔Gillaspy, J.A., Murphy, J.J. (2012). Incorporating outcome and session rating scales in solution-focused brief therapy. In C. Franklin, T.S. Trepper, E.E. McCollum, & W.J. Gingerich (Eds.), Solution-Focused Brief Therapy: A Handbook of Evidence-Based Practice. New York, NY: Oxford.〕〔Green, D. & Latchford, G. (2012) Maximising the Benefits of Psychotherapy: A Practice-based Evidence Approach, Wiley-Blackwell: Malden, MA.〕 PCOMS employs two brief, 4-item scales, the Outcome Rating Scale (ORS) and Session Rating Scale (SRS).〔Cormier, S., Nurius, P.S., & Osborn, C.J. (2012). Interviewing and Change Strategies for Helpers (7th Ed.), Brooks/Cole: Belmont, CA.〕〔Egan, G. (2010). The Skilled Helper: A Systematic Approach to Effective Helping (9th Ed.), Brooks/Cole Publishing Company: Monterey, CA.〕〔Campbell, A., & Hemsley, S. (2009). Outcome Rating Scale and Session Rating Scale in psychological practice: Clinical utility of ultra-brief measures. Clinical Psychologist, 13, 1–9.〕 The ORS is designed to monitor therapeutic outcome and is given to the client at the beginning of each counseling session. The ORS focuses on what has happened for the client between sessions and provides an early warning system for clients at risk for a negative outcome.〔Whiston, S.C. (2012) Principles and Applications of Assessment in Counseling (4th Ed.), Brooks/Cole, Cengage Learning: Belmont, CA〕 The results are discussed in a transparent manner to promote collaboration between the client and therapist in planning the next step especially when there is no progress.〔De Jong, P. & Berg, I.K. (2012). Interviewing for Solutions (4th Ed.), Brooks/Cole: Belmont, CA.〕 The second form, the SRS, monitors how the session has gone for the client, and is given at the end of each therapy session. The SRS is designed to measure the therapeutic alliance given its importance in leading to positive treatment outcome〔〔〔 Using PCOMS in clinical practice has been shown to result in a three and a half times more likelihood of achieving reliable change and half the likelihood of deterioration during treatment services.〔Lambert, M.J. & Shimokawa, K. (2011). Collecting client feedback. In Norcross, J.C. (Ed.), Psychotherapy relationships that work: evidence-based responsiveness (2nd ed, pp. 203-223). New York, NY: Oxford.〕 PCOMS is part of a growing trend in psychotherapy towards monitoring and managing clinical outcomes and is only one of two systems (the other is the OQ 45.2) with randomized clinical trial support.〔〔〔Lambert, M. J. (2010). “Yes, it is time for clinicians to monitor treatment outcome.” In B. L. Duncan, S. C., Miller, B. E. Wampold, & M. A. Hubble (Eds.), Heart and soul of change: Delivering what works in therapy (2nd ed., pp. 239–266). Washington, DC: American Psychological Association.〕
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