Using outcome data on a continual basis to monitor treatment progress has been identified as a way to enhance psychotherapy outcome. The purpose of this study was to investigate the use of a continuous feedback assessment system, the Partners for Change Outcome Management System (PCOMS; Miller & Duncan, 2004). Findings from 2 client samples that attended individual therapy at a university counseling center (N = 74) or a graduate training clinic (N = 74) indicated that clients who used PCOMS with their therapists (feedback condition) demonstrated statistically significant treatment gains when compared to clients receiving treatment as usual (no-feedback condition). Clients using PCOMS were also more likely to experience reliable change and in fewer sessions. A survival analysis demonstrated that approximately 50% of the clients in the feedback condition demonstrated reliable change after the 7th (graduate training clinic) or 9th session (university counseling center). Further findings, limitations of the study and ideas for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Using outcome data to monitor the progress of treatment and the therapeutic alliance, also known as "client feedback" or "patient-focused research," has yielded impressive results in individual psychotherapy. Client feedback has demonstrated reductions in premature terminations and improved psychotherapy outcomes. However, little research has been conducted using this paradigm with couples receiving therapy. The purpose of this study was to investigate whether the effectiveness of client feedback would extend to couple therapy. Results from a randomized couple clinical trial conducted in a naturalistic setting indicated that couples in a client feedback condition demonstrated statistically significantly more improvement compared with couples receiving treatment as usual and that improvement occurred more rapidly. Also, 4 times as many couples in the feedback condition reported clinically significant change by the end of treatment.
Tracking client outcome and the therapeutic relationship across treatment (i.e., client feedback) has become a recommended practice for clinicians. This study investigated whether the utility of this practice would extend to trainees if the data gained from clients was provided to their supervisor for use within supervision. Trainees (N ϭ 28) were assigned to a continuous feedback condition or no-feedback condition for 1 academic year. Results indicated that trainees in both conditions demonstrated better client outcomes at the end of their practicum training than at the beginning, but those in the feedback condition improved more. However, those in the feedback condition did not rate the supervisory alliance or satisfaction with the supervision process differently. The relationship between counselor self-efficacy and outcome was stronger for trainees in the feedback condition than for those in the no-feedback condition, perhaps indicating that feedback may facilitate a more accurate assessment of one's skills. Implications of how counseling self-efficacy, the supervisory alliance, and satisfaction with supervision are related to effective supervision are addressed.
This study investigated whether routine monitoring of client progress, often called "client feedback," via an abbreviated version of the Partners for Change Outcome Management System (PCOMS) resulted in improved outcomes for soldiers receiving group treatment at an Army Substance Abuse Outpatient Treatment Program (ASAP). Participants (N = 263) were active-duty male and female soldiers randomized into a group feedback condition (n = 137) or a group treatment-as-usual (TAU) condition (n = 126). Results indicated that clients in the feedback condition achieved significantly more improvement on the outcome rating scale (d = 0.28), higher rates of clinically significant change, higher percentage of successful ratings by both clinicians and commanders, and attended significantly more sessions compared to the TAU condition. Despite a reduced PCOMS protocol and a limited duration of intervention, preliminary results suggest that the benefits of client feedback appear to extend to group psychotherapy with clients in the military struggling with substance abuse.
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