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Objective Routine outcome monitoring (ROM) of psychotherapy improves client outcomes and reduces premature terminations. Two ROM systems with the most empirical support are the OQ System (Lambert, 2010) and the Partners for Change Outcome Management System (PCOMS; Duncan, 2012; Miller et al., 2005). We evaluated if the global distress measures, the Outcome Rating Scale (ORS; PCOMS) and the Outcome Questionnaire–45.2 (OQ-45; OQ System) show similar outcome trajectories and rates of reliable and clinically significant change when completed by the same clients. Method Participants (N= 290) were clients from archived data collected in a training clinic for a psychology doctoral program in the western United States, who completed both the ORS and OQ-45 across treatment. Results Bi-variate correlations between the ORS and OQ-45 were highly correlated at the first session (r = -.73), and for later sessions linear and quadratic estimates were only moderately related (rs = -.31 to -.57). Statistically significantly more clients indicated both reliable change and clinically significant change on the ORS compared to the OQ-45. Discussion The results indicate that these measures are correlated but not interchangeable in relation to the conclusions they generate about treatment outcomes. Measurement tools should be carefully considered given the potential for different conclusions to be drawn regarding treatment progress and outcomes. [ABSTRACT FROM AUTHOR]

In this clinical paper, the focus is on the use of questionnaires in family therapy practice. Psychotherapy research has indicated that the quality of the therapeutic relationship is the most robust predictor of therapeutic change. While the therapeutic relationship is even more important in family therapy than in individual therapy, it is also more complex. As will be illustrated in this paper, questionnaires can be useful in clinical practice to deal with the complex alliances in family therapy. In this paper, we will introduce two questionnaires: the Worries Questionnaire and the Dialogical Feedback Questionnaire. As illustrated in detailed case stories, we use these questionnaires in our practice as conversational tools rather than measuring instruments. They serve as the starting point for the therapist's reflection and for dialogues with family members. [ABSTRACT FROM AUTHOR]

Issues Approach Key Findings Conclusions Routine outcome monitoring (ROM) involves regularly measuring clients' outcomes during treatment, which can then be fed back to clinicians and/or clients. In the mental health field, ROM and feedback have been shown to improve client outcomes; however, no systematic reviews have examined whether improvement is also seen in alcohol and other drug (AOD) treatment outcomes. This review examines whether feedback to clients and/or clinicians of ROM data in AOD treatment improves future client outcomes.This systematic review of papers identified in Medline, PsycInfo and Scopus examines the effect on client outcomes of feeding back ROM data to clinicians and/or clients in AOD treatment settings. Key client outcomes included substance use, treatment attendance and wellbeing measures.Ten studies were included—five randomised controlled trials and five pre–post within‐subjects designs. Six studies were deemed good‐ or fair‐quality. Of these six, three provided feedback to clinicians only, one to clients only, and two to both clients and clinicians. Only one of the six found feedback was associated with significant reductions in substance use and only among off‐track clients. Four of the six found feedback improved other outcomes, including treatment retention, global functioning, therapeutic alliance and mood symptoms.There may be some positive effects for clients of providing feedback to clients and/or clinicians; however, the small number of randomised trials and the heterogeneity of methods, outcome measures and findings, mean that firm conclusions cannot be drawn about the efficacy of feedback until larger randomised studies are conducted. [ABSTRACT FROM AUTHOR]

Introduction: Engaging communities in the design, implementation and monitoring of health services is critical for delivering high‐quality, person‐centred services that keep people living with HIV engaged in care. The USAID‐funded Integrated HIV/AIDS Project in Haut‐Katanga (IHAP‐HK) integrated an electronic client feedback tool into continuous quality improvement (CQI) processes. We aimed to demonstrate this system's impact on identifying and improving critical quality‐of‐care gaps. Methods: Through stakeholder and empathy mapping, IHAP‐HK co‐designed a service quality monitoring system—comprising anonymous exit interviews and ongoing monitoring through CQI cycles—with people living with HIV, facility‐based providers and other community stakeholders. IHAP‐HK trained 30 peer educators to administer oral, 10‐ to 15‐minute exit interviews with people living with HIV following clinic appointments, and record responses via the KoboToolbox application. IHAP‐HK shared client feedback with facility CQI teams and peer educators; identified quality‐of‐care gaps; discussed remediation steps for inclusion in facility‐level improvement plans; and monitored implementation of identified actions. IHAP‐HK tested this system at eight high‐volume facilities in Haut‐Katanga province from May 2021 through September 2022. Results: Findings from 4917 interviews highlighted wait time, stigma, service confidentiality and viral load (VL) turnaround time as key issues. Solutions implemented included: (1) using peer educators to conduct preparatory tasks (pre‐packaging and distributing refills; pulling client files) or escort clients to consultation rooms; (2) limiting personnel in consultation rooms during client appointments; (3) improving facility access cards; and (4) informing clients of VL results via telephone or home visits. Due to these actions, between initial (May 2021) and final interviews (September 2022), client satisfaction with wait times improved (76% to 100% reporting excellent or acceptable wait times); reported cases of stigma decreased (5% to 0%); service confidentiality improved (71% to 99%); and VL turnaround time decreased (45% to 2% informed of VL results 3 months after sample collection). Conclusions: Our results showed the feasibility and effectiveness of using an electronic client feedback tool embedded in CQI processes to collect client perspectives to improve service quality and advance client‐responsive care in the Democratic Republic of Congo. IHAP‐HK recommends further testing and expansion of this system to advance person‐centred health services. [ABSTRACT FROM AUTHOR]

Although studies have shown that client feedback can improve treatment outcome, little is known about which factors might possibly moderate the effects of such feedback. The present study investigated potential therapist variables that might influence whether frequent client feedback is effective, including the Big Five personality traits, internal/external feedback propensity and self‐efficacy. Data from two previous studies, a quasi‐experimental study and a randomized controlled trial, were combined. The sample consisted of 38 therapists and 843 clients (55.4% females, mean age = 42.05 years, SD = 11.75) from an outpatient mental health institution. The control condition consisted of cognitive‐behavioural therapies combined with low frequency monitoring of clients' symptoms. In the experimental condition, high‐intensity (i.e., frequent) client feedback as an add‐on to treatment as usual was provided. Outcomes were measured as adjusted post‐treatment symptom severity on the Symptom Checklist‐90 and drop out from treatment. The final model of the multilevel analyses showed that therapists with higher levels of self‐efficacy had poorer treatment outcomes, but when high‐intensity client feedback was provided, their effectiveness improved. Furthermore, higher self‐efficacy was associated with a higher estimation of therapists' own effectiveness, but therapists' self‐assessment of effectiveness was not correlated with their actual effectiveness. The results of this study might indicate that therapists with high levels of self‐efficacy benefit from client feedback because it can correct their biases. However, for therapists with low self‐efficacy, client feedback might be less beneficial, possibly because it can make them more insecure. These hypotheses need to be investigated in future research. [ABSTRACT FROM AUTHOR]

This paper explores the use of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) in clinical practice through the perspective of the client. These assessment tools are designed to provide clinicians with direct feedback from clients about the client’s views on progress in therapy and their views on the quality of each session provided by the clinician. In this qualitative study, 13 clients were interviewed to explore their perceptions of the use of the ORS and SRS in their sessions. Results indicate generally highly favorable reactions to use of these assessment tools with some exceptions. There is a discussion of the implications of these findings for clinical practitioners who wish to use the ORS and SRS.

Abstract Introduction Engaging communities in the design, implementation and monitoring of health services is critical for delivering high‐quality, person‐centred services that keep people living with HIV engaged in care. The USAID‐funded Integrated HIV/AIDS Project in Haut‐Katanga (IHAP‐HK) integrated an electronic client feedback tool into continuous quality improvement (CQI) processes. We aimed to demonstrate this system's impact on identifying and improving critical quality‐of‐care gaps. Methods Through stakeholder and empathy mapping, IHAP‐HK co‐designed a service quality monitoring system—comprising anonymous exit interviews and ongoing monitoring through CQI cycles—with people living with HIV, facility‐based providers and other community stakeholders. IHAP‐HK trained 30 peer educators to administer oral, 10‐ to 15‐minute exit interviews with people living with HIV following clinic appointments, and record responses via the KoboToolbox application. IHAP‐HK shared client feedback with facility CQI teams and peer educators; identified quality‐of‐care gaps; discussed remediation steps for inclusion in facility‐level improvement plans; and monitored implementation of identified actions. IHAP‐HK tested this system at eight high‐volume facilities in Haut‐Katanga province from May 2021 through September 2022. Results Findings from 4917 interviews highlighted wait time, stigma, service confidentiality and viral load (VL) turnaround time as key issues. Solutions implemented included: (1) using peer educators to conduct preparatory tasks (pre‐packaging and distributing refills; pulling client files) or escort clients to consultation rooms; (2) limiting personnel in consultation rooms during client appointments; (3) improving facility access cards; and (4) informing clients of VL results via telephone or home visits. Due to these actions, between initial (May 2021) and final interviews (September 2022), client satisfaction with wait times improved (76% to 100% reporting excellent or acceptable wait times); reported cases of stigma decreased (5% to 0%); service confidentiality improved (71% to 99%); and VL turnaround time decreased (45% to 2% informed of VL results 3 months after sample collection). Conclusions Our results showed the feasibility and effectiveness of using an electronic client feedback tool embedded in CQI processes to collect client perspectives to improve service quality and advance client‐responsive care in the Democratic Republic of Congo. IHAP‐HK recommends further testing and expansion of this system to advance person‐centred health services.

The Session Rating Scale (SRS) is a widely used clinical tool to measure the client-therapist working alliance. This study investigated the psychometric properties, the cut-off value, and longitudinal invariance of the SRS in a Chinese clinical population. The analyses were conducted separately in a sample of college students in counseling (n = 403) and in a sample of clients in outpatient therapy (n = 246). Participants completed the Outcome Rating Scale (ORS) before each session and the SRS after each session. To test concurrent validity, a subset of participants also completed the Working Alliance Questionnaire at the end of each session. In both samples, the results indicated high internal consistency (α =.92 ~ 0.97) and adequate test-retest reliability over four sessions (university sample: r =.69 ~.78; outpatient sample: r =.52 ~.66). Construct validity was evident in a one-factor structure, and concurrent validity was established based on a strong correlation with the Working Alliance Questionnaire (r =.64 ~.70). In addition, regression analysis indicated that early alliance ratings (at the third session) on the SRS predicted post-ORS scores. The cut-off value for the SRS in the Chinese context was established as 34. The longitudinal measurement invariance was tested by a longitudinal confirmatory factor analysis. Full scalar invariance of the SRS was supported. This study supported the use of the SRS in China and that a single-factor solution stayed stable over time, providing preliminary evidence for subsequent mean comparisons. [ABSTRACT FROM AUTHOR]

Introduction: We investigated the value of systematic client feedback in youth mental health and addiction care. In the present study, we examined whether a client feedback intervention would result in improved therapeutic alliance and treatment outcomes. Methods: Two hundred and four adolescents participated in the study using a – non-randomized – between-group A/B design. In the first study group, 127 patients were offered 4 months of treatment as usual (TAU), and in the second study group, 77 patients received the client feedback intervention as an add-on to TAU during 4 months. Results: Youths who received systematic client feedback in addition to TAU did not show better treatment outcomes or better alliance ratings after 4 months than youths receiving TAU only. Sensitivity analyses, in which we compared the more adherent patients of the second study group with patients receiving TAU, did not show significant beneficial effects of client feedback either. Also, the client feedback intervention did not result in lower rates of early treatment drop-out. Discussion/Conclusion: Our results cautiously suggest that client feedback does not have incremental effects on alliance and the treatment outcome for youth in mental health and addiction treatment. Moreover, our study highlights the challenges of implementing client feedback in clinical practice and the need for additional research addressing these challenges. [ABSTRACT FROM AUTHOR]

The Western Philippines University – College of Education’s Project MATHEMATICS (Mathematics Enhanced Mentoring, Assistance, and Training to In-need and Challenged Students) was implemented as part of the Adopt-a-School Program to address the mathematical needs of Laura Vicuña Center – Palawan youths. To evaluate the extent of the project implementation, the study assessed its impact through the feedback gathered from the clients served. It specifically described the quality of project implementation, determined the attainment of project objectives, and enumerated client feedback. A concurrent triangulation mixed-method research design was used with 32 clientele samples selected purposively. The study utilized a survey, problem set test, and focus-grouped interview to obtain data pertinent to the study’s objectives. The findings revealed an aspirational quality of the implemented project, improved mathematical performance, and the client’s desire for ongoing mentoring. The implications and limitations of the study are discussed, along with recommendations for future extension projects, monitoring and evaluation, and re-planning activities.

The aim of the study was to investigate the effectiveness of the Partners for Change Outcome Management System (PCOMS) in improving the retention rate and reducing drug use in a clinic for drug use treatment. One-hundred outpatients with cannabis use as the primary presenting problem were randomized to either the PCOMS (n = 51) or treatment as usual (TAU; n = 49). Eight weekly psychotherapy sessions were planned in both conditions. The primary outcome was treatment retention measured as the rate of attendance to planned treatment sessions and dropout. The secondary outcomes were current cannabis and other drug use assessed with the European Addiction Severity Index (EuropASI). Several explorative outcomes were analyzed. Blind assessments of drug use were conducted three and six months after baseline. Outcome analyses were conducted on both the treated sample with at least one psychotherapy session (n = 82) and the intention-to-treat sample (n = 100). The results showed no incremental effect of the PCOMS compared to the TAU condition, for neither treatment retention, drug use, or therapeutic alliance. The main findings align with previous studies that have found no effect of the PCOMS when employing outcome measures independent from the PCOMS intervention. The results are interpreted with caution due to implementation difficulties, which at the same time suggest challenges when employing the PCOMS in large outpatient clinics for drug use treatment. [ABSTRACT FROM AUTHOR]

Formative feedback is likely to improve performance, which has encouraged executive coaches to seek accreditation and supervision. However, many coaches do not consider their clients as suitable providers of formative feedback, due, in part, to a lack of shared knowledge about effective behaviours. The study addressed the issue by developing a client behavioural feedback instrument for the executive coach. The article summarises the key findings of the mixed-methods approach which informed the instrument, highlighting differences and similarities with scales developed by accrediting bodies and experts.

Objective: The aims of the study were to evaluate the effects of using the Partners for Change Outcome Management System (PCOMS) in psychotherapy and to explore potential moderators of the effect. Method: A comprehensive literature search including grey literature was conducted to identify controlled outcome studies on the PCOMS, randomized (RCTs), or non-randomized trials (N-RCT). Results: The literature search identified 18 studies, 14 RCTs, and four N-RCTs, including altogether 2910 participants. The meta-analysis of all studies found a small overall effect of using the PCOMS on general symptoms (g = 0.27, p =.001). The heterogeneity of the results was substantial. Moderation analyses revealed no effect of the PCOMS in psychiatric settings (g = 0.10, p =.144), whereas a positive effect was found in counseling settings (g = 0.45, p <.001), although almost all of these studies were characterized by a positive researcher allegiance and using the PCOMS Outcome Rating Scale (ORS) as the only outcome measure. Conclusion: The meta-analysis revealed a small overall effect of using the PCOMS, but no effect in psychiatric settings. The positive results in counseling settings might be biased due to researcher allegiance and use of the ORS as the only outcome measure. [ABSTRACT FROM AUTHOR]

The aims of the present study were to investigate the effect of implementing the Partners for Change Outcome Management System (PCOMS) in the Danish Student Counseling Service and to explore both between-condition moderators and within-condition predictors of outcomes. The study was a nonrandomized controlled study, comparing the outcome of individual and group student counseling for 634 PCOMS clients to that of 740 clients having started treatment as usual (TAU) 2 years before the PCOMS data collection began. The primary outcome measure was the Global Severity Index on the Symptom Checklist 90-Revised. Main analyses were conducted with multilevel models on the intention-to-treat sample. The results demonstrated no effect of the PCOMS compared with the TAU condition, neither for the primary outcome nor for the number of dropouts or clients experiencing deterioration. The PCOMS effect was not predicted by the counselors' adherence to the PCOMS protocol. Because the counselor level explained less than 1% of the variance in outcome, the counselor factors (i.e., attitude to feedback, reactions to negative feedback, and deliberate practice) were not analyzed as predictors. In conclusion, this study does not align with previous studies finding a positive effect of the PCOMS in counseling settings. However, all previous studies relied on the PCOMS Outcome Rating Scale as the only measure of outcome, maybe indicating a measure-specific effect. This study was not able to confirm the positive effect of using the Partners for Change Outcome Management System (PCOMS) as a feedback tool in student counseling when using an outcome measure independent of the PCOMS intervention. Routine outcome monitoring does not necessarily improve client outcome, even when it has been acceptably implemented. [ABSTRACT FROM AUTHOR]

The use of client feedback in clinical supervision provides a way for supervisors to access clients' experiences of the treatment process and monitor clinical progress of their trainees' cases. The present qualitative study investigated a marriage and family therapy training programme's early experience of introducing the Systemic Therapy Inventory of Change (STIC®; Pinsof et al., 2009) into clinical supervision. Supervisors (N = 8) and trainees (N = 14) were interviewed to elicit their experience using the STIC in supervision with a focus on understanding the frequency of use as well as the facilitators and constraints to implementation. The analysis of the narratives resulted in the development of five themes (time, supervisors' expectations, broader training system influences, client feedback training, and perceived helpfulness) that contributed to decreased usage over time. Recommendations to the field for integrating client feedback into empirically informed training and supervision are provided. Practitioner points: Training programmes should consider the potential benefits of utilizing client feedback measures for outcome‐based training and supervisionTraining programmes adopting a client feedback measure need to be aware of the potential challenges of implementationThe additional time needed to use a client feedback measure in the clinical supervision process must be considered as it is the most notable constraint to implementation [ABSTRACT FROM AUTHOR]

Objective: Research supports an association between regularly administering standardised measures to assess client progress (progress monitoring) and improved treatment outcomes. However, some research suggests clinicians often rely heavily and solely on clinical judgement when making treatment decisions. This study was the first to explore psychologists' implementation of progress monitoring, within an Australian clinical context. Method: A self‐report survey investigated Australian psychologists' (N = 208; gender and age proportional to national representation) attitude, awareness, use, motives, and barriers towards implementing standardised assessment and progress monitoring. The survey comprised of the Attitudes towards Standardised Assessment Scales, and existing literature on progress monitoring implementation. Results: Ninety‐eight per cent of psychologists were aware of progress monitoring measures, and 69% reported using them in practice. Majority of progress monitoring users rated these measures as very useful (51%) and over one third (39%) used them with most of their clients. Contrary to the hypothesis, a t‐test demonstrated that attitude towards standardised assessment did not differ between progress monitoring users and non‐users. Among the clinicians who have not implemented progress monitoring, time barriers were rated as most important. Conclusion: This study demonstrates that although awareness of progress monitoring may be widely known, perceived barriers may outweigh the potential benefits for some. It is also concluded that further qualitative research is needed to adequately understand these barriers and their importance. Future interventions may then promote evidence‐based recommendations and focus on the practicality, utility, and workflow difficulties associated with incorporating progress monitoring. [ABSTRACT FROM AUTHOR]

Although client feedback has been demonstrated to improve psychotherapy outcomes in over a dozen randomized clinical trials, no studies to date have investigated the feedback effect outside of the United States or Europe. This study examined the impact of a client feedback intervention, the Partners for Change Outcome Management System, in a college counseling center in Wuhan, China (N = 186). Using a randomized design within routine care, treatment as usual (TAU; n = 85) was compared with a feedback condition (n = 101) in which therapists had access to client-generated outcome and alliance information at each session. Clients in the feedback condition demonstrated significantly greater improvement than those in the TAU condition at posttreatment. Not-on-track (n = 60) clients also demonstrated significantly more improvement at 6 times the rate of reliable change compared with the TAU condition. Survival analysis revealed that 66.7% of the clients in the feedback condition achieved reliable and clinically significant change after a median of 4 sessions whereas 57.0% of the clients in the TAU condition achieved reliable and clinically significant change after a median of 6 sessions. Alliance scores improved significantly more across treatment and were higher at posttreatment in the feedback condition. Although preliminary, this study suggests that the positive effects of improved outcomes and increased efficiency associated with systematic client feedback can also occur in a college counseling setting in China. [ABSTRACT FROM AUTHOR]

Couple and family therapy has well‐established benefits. Although the majority of clients benefit, some worsen, some show no positive change, and some drop out early. This suggests that existing treatment modalities require further advancement. One promising avenue to achieve advancement involves instituting, as the standard of care, formalized client feedback, which has been shown to improve outcomes. This paper is a non‐systematic review that outlines several formalized feedback systems currently available and highlights each system's utility with application to couple and family therapy. While couple and family therapists have unique obstacles in therapy due to multiple therapeutic alliances, the use of formalized feedback has potential to strengthen alliances and improve outcomes for all clients who participate. We advocate for the use of formalized feedback in the training of new therapists and to augment the supervision process. Practitioner points: Encourage the couple and family therapy field to implement the use of formalized client feedback systems both clinically and in researchDemonstrate the importance of implementing formalized client feedback systems to decrease premature termination and improve client outcomesProvide information about existing client feedback systems to give practitioners the opportunity to choose a method that most benefits their clients [ABSTRACT FROM AUTHOR]

Objective: To explore how therapists experience, react to, and learn from negative feedback from their clients. Method: Eighteen experienced therapists' written descriptions of episodes where they had received negative verbal feedback from clients were analyzed according to the Consensual Qualitative Research methodology. Results: Receiving feedback was experienced as challenging, but educational. Learning was manifested in different ways: (a) Immediately Applied Learning--therapists improved the following therapy process by changing their behavior with the client, (b) Retrospectively Applied Learning--therapists made changes in their way of working with subsequent clients, and (c) Non-Applied Learning--new ideas generated by the experience had not been translated into behavior. We compared cases describing these manifestations of learning and found differences in the nature of the feedback and how therapists understood, reacted, and responded to it. Conclusions: The therapists benefitted from obtaining and being open to specific feedback from their clients, regulating their own emotional reactions, accommodating dissatisfied clients, and considering how they themselves contributed to negative therapy processes. [ABSTRACT FROM AUTHOR]

Valuation judgement bias has been a research topic for several years due to its proclaimed effect on valuation accuracy. However, little is known on the emphasis of literature on judgement bias, with regard to, for instance, research methodologies, research context and robustness of research evidence. A synthesis of available research will establish consistency in the current knowledge base on valuer judgement, identify future research opportunities and support decision-making policy by educational and regulatory stakeholders how to cope with judgement bias. This article therefore, provides a systematic review of empirical research on real estate valuer judgement over the last 30 years. Based on a number of inclusion and exclusion criteria, we have systematically analysed 32 relevant papers on valuation judgement bias. Although we find some consistency in evidence, we also find the underlying research to be biased; the methodology adopted is dominated by a quantitative approach; research context is skewed by timing and origination; and research evidence seems fragmented and needs replication. In order to obtain a deeper understanding of valuation judgement processes and thus extend the current knowledge base, we advocate more use of qualitative research methods and scholars to adopt an interpretative paradigm when studying judgement behaviour. [ABSTRACT FROM PUBLISHER]

Objective: Feedback from clients on their view of progress and the therapeutic relationship can improve effectiveness and efficiency of psychological treatments in general. However, what the added value is of client feedback specifically within cognitive-behavioural therapy (CBT), is not known. Therefore, the extent to which the outcome of CBT can be improved is investigated by providing feedback from clients to therapists using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS).Method: Outpatients (n = 1006) of a Dutch mental health organization either participated in the “treatment as usual” (TAU) condition, or in Feedback condition of the study. Clients were invited to fill in the ORS and SRS and in the Feedback condition therapists were asked to frequently discuss client feedback.Results: Outcome on the SCL-90 was only improved specifically with mood disorders in the Feedback condition. Also, in the Feedback condition, in terms of process, the total number of required treatment sessions was on average two sessions fewer.Conclusion: Frequently asking feedback from clients using the ORS/SRS does not necessarily result in a better treatment outcome in CBT. However, for an equal treatment outcome significantly fewer sessions are needed within the Feedback condition, thus improving efficiency of CBT. [ABSTRACT FROM PUBLISHER]

User involvement in therapy includes some form of feedback from the clients. The feedback guides the therapist and the clients toward a best possible result through a best possible therapy process. In recent years many different procedures for collecting feedback have been developed. In a previous study presented in this journal we explored the expectations therapists had before including the comprehensive clinical feedback procedure, Systemic Therapy Inventory of Change ( STIC), in their clinical practices. Our aim with this present study is to explore couples' and family therapists' experiences with STIC from the perspective of user involvement. We found that the term 'using STIC' represented many different variations both between therapists and between the families each therapist worked with. Likewise user involvement, combined with a feedback procedure like STIC, was also a many faceted area. We discuss how therapists' experiences may relate to the different aspects of user involvement in therapy. [ABSTRACT FROM AUTHOR]

In this qualitative research study, the authors use grounded theory analysis to examine the experiences of clinicians in training and use client feedback to inform treatment. Twenty-six marriage and family therapy graduate students in their first or second semester of clinical practicum participated in this study. Participants were trained in eliciting and responding to client feedback at the end of every therapy session. At the end of the semester, participants reflected on their learning experience. Participant experiences reflected a developmental learning process beginning with significant challenges followed by positive clinical changes and positive clinician changes, culminating in overall buy-in regarding the importance of client feedback for nearly all clinicians. The results support the literature that client feedback directly informs the therapeutic process while suggesting important recommendations for training new clinicians in learning to use client feedback. [ABSTRACT FROM PUBLISHER]

The current study used a dismantling design to investigate the relative efficacy of components of the Partners for Change Outcome Management System (PCOMS; Duncan, 2012). Clients (n = 94) from a university counseling center were randomly assigned to 1 of 3 conditions: PCOMS Full, Outcome Rating Scale (ORS)-only, or Session Rating Scale (SRS)-only and nested within therapists (n = 12). Results from hierarchical linear modeling and a 2-way analysis of variance indicated no statistically significant differences in outcome or rate of change on the Behavior Symptom Checklist-18 (BSI-18; Derogatis, 2001) across all 3 conditions. These findings suggest that using either the ORS or SRS component of the PCOMS may yield equivalent outcomes to that of the full PCOMS. Additional dismantling studies with various populations and settings are needed to further clarify the relative influence of the ORS, SRS, and full PCOMS on client outcomes. [ABSTRACT FROM AUTHOR]

Little information exists on the specific reflective processes that precede therapists' choice of including or not including a structured feedback procedure in their established practice. In the present study, we aim to describe and explore experienced couple and family therapists' expectations for how the comprehensive therapy feedback procedure Systemic Therapy Inventory of Change might influence their practices. Through a thematic analysis of six focus group interviews, two main themes were elicited. The first main theme involved values embedded in current practice, with the following subthemes: (1) balance between the therapist's expert knowledge and the client's experience-based knowledge; and (2) making time to build alliances. The second main theme concerned the presumed influence on current practice, with the following subthemes: (1) 'Systemic Therapy Inventory of Change will disturb the therapist's capacity to stay present'; (2) 'Systemic Therapy Inventory of Change will shape conversations'; and (3) 'Systemic Therapy Inventory of Change will contribute to increased qualitative depth'. We discuss these results in relation to the notion of Systemic Therapy Invention of Change as a 'third party in the room'. We also discuss the results in relation to implications for collaborative practices, and for client and therapist autonomy. [ABSTRACT FROM AUTHOR]

Training in counseling psychology has evolved to emphasize both evidence-based practice (EBP) and social justice, though these two dimensions have often seemed disconnected, or even at odds in the practice of psychotherapy. The Partners for Change Outcome Management System (PCOMS), an EBP that monitors treatment outcomes and the therapeutic alliance across treatment (often called “client feedback”), may offer a means to connect evidence-based and socially just practices. The purpose of this article was to outline how the use of PCOMS in psychotherapy and supervision can serve as a useful training tool that is a form of EBP and also promotes a socially just paradigm in psychotherapy. We also offer an implementation example from a counseling psychology doctoral program to demonstrate how PCOMS can be used with clients in psychotherapy and included within the supervisory process. [ABSTRACT FROM PUBLISHER]

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. [ABSTRACT FROM PUBLISHER]

Monitoring progress in psychotherapy routinely (i.e., client feedback) has yielded positive results for improving both outcome and retention in individual and couple therapy; however, evidence of client feedback efficacy in a group format is limited. Using a randomized cluster design, group therapy participants (N = 84) were assigned to a client feedback or treatment-as-usual (TAU) condition in a university counseling center. Clients in the feedback condition used the Partners for Change Outcomes Management System (PCOMS; Duncan, 2011). Feedback participants had significantly larger pre-post group therapy gains (d = 0.41) and higher rates of reliable and clinically significant change when compared to TAU participants on the Outcome Rating Scale (Miller & Duncan, 2000). Clients in the feedback condition also attended more group sessions compared to TAU participants. Study implications and future recommendations are provided. [ABSTRACT FROM AUTHOR]

While highly effective, psychotherapy outcome studies suggest 5?14% of clients worsen while in treatment and that therapists are unable to identify a substantial portion of such cases. Methods to systematically track client mental health functioning over the course of treatment and adjust treatment through the use of problem-solving tools are described. We summarize meta-analyses of the effects of a feedback system indicating that the number of psychotherapy patients who deteriorate can be cut in half. We conclude with a series of practice implications, including that clinicians seriously consider making formal methods of collecting client feedback a routine part of their daily practice.

Background: Obsessive Compulsive Disorder (OCD) can have a debilitating effect on the sufferer, their family and quality of life. Despite an evidence-based treatment for OCD, it is recognised as one of the hardest psychological problems to treat. CBT and in particular ER-P has also been associated with high drop out rates as some clients found it too stressful to engage in exposure interventions. There is a need, therefore, to consider other ways of enhancing expositing treatment. This article presents client experiences of an OCD group which incorporated Mindfulness as a central part of the intervention. Methodology: Fifteen clients who attended an OCD group over the last six years were contacted and interviewed by Research Assistant. Although this was a routine part of evaluating the service, specific questions about Mindfulness and techniques in the group were asked. Results: Twelve of the clients described Mindfulness as helpful and it was the most remembered skill from the group. It was and continued to be practiced by a majority of participants. Client reported improvements included, general focusing, concentration, helping with exposure, noticing awareness, challenging anxiety, acceptance, challenging the need to repeat behaviours, slowing down thinking, helping to relax and improving sleep. Conclusion: The influences of Mindfulness on possible mechanisms for change in OCD are discussed in particular a process of experiential engagement is explored in relation to concepts of 'reperceiving' and 'affective reactivity'. The contribution of Mindfulness to the therapeutic relationship is also discussed, and the importance of relational process in understanding outcome. [ABSTRACT FROM AUTHOR]

Researchers show that the integration of continuous client feedback mechanisms provides many benefits to treatment including enhanced effectiveness and a reduction in early terminations. Although practitioners in the field are increasing their use of this evidence-based practice, counselor educators may not be promoting it. The author suggests that as counselor educators introduce evidence-based practices to their students, they should examine the potential benefits of teaching and practicing continuous client feedback. The article provides both the reasoning behind and recommendations for integrating continuous client feedback into the curriculum of counseling programs. [ABSTRACT FROM AUTHOR]

To attain information about divergent agendas in family therapy, as well as incorporate client feedback, we present the Client Feedback Note ( CFN). The CFN elicits information about each family member's feelings, learning, dislikes, and wishes for each session. Anecdotal feedback after each session may help the therapist have better insight into the clients' perceptions and experience of the therapy and the therapist. Sensitivity to information generated by the CFN can help both therapist and client work to coconstruct a therapeutic process that is relevant to the diverse needs of the client system. This manuscript will (a) discuss literature supporting the use of client feedback in therapy; (b) present the CFN and rationale for its development; (c) discuss our experiences utilizing the CFN along with case examples that illustrate its use; and (d) identify practical applications, limitations, and potential research with using the CFN in systemic therapy. [ABSTRACT FROM AUTHOR]

Treatment results can be improved by obtaining feedback from clients concerning their progress during therapy and the quality of the therapeutic relationship. This feedback can be rated using short instruments such as the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS), which are being increasingly used in many countries. This study investigates the validity and reliability of the Dutch ORS and SRS in a large sample of subjects (N = 587) drawn from the clients of an outpatient mental healthcare organization. The results are compared to those of previous Dutch and American studies. While both the ORS and the SRS exhibited adequate test-retest reliability and internal consistency, their concurrent validity was limited (more for the SRS than for the ORS). New standards are proposed for the Dutch ORS and SRS. The scores obtained with these standards are intetpreted differently than those obtained using American standards. The clinical implications of the limited validity of the ORS and the SRS are discussed, as is the use of different standards in conjunction with these instruments. [ABSTRACT FROM AUTHOR]

Objective: To examine demand characteristics, social desirability on clients' rating of working alliance using the Session Rating Scale (SRS; Miller, Duncan, & Johnson, 2000). Method Clients ( N = 102) at two sites were randomly assigned to one of three alliance feedback conditions: (a) IF-SRS completed in presence of therapist and the results discussed immediately afterward; (b) Next Session Feedback-SRS completed alone and results discussed next session; or (c) No Feedback-SRS completed alone and results not available to therapist. Clients completed the SRS for the first three sessions of treatment. Results: No statistically significant differences in SRS scores across the feedback conditions were found. Additionally, the analysis showed that SRS scores were not correlated with a measure of social desirability but were correlated with an established alliance measure. Conclusions The results indicate that alliance scores were not inflated due to the presence of a therapist or knowing that the scores would be observed by the therapist. [ABSTRACT FROM AUTHOR]

The outcomes of school-based counseling incorporating the Partners for Change Outcome Monitoring System (PCOMS) were evaluated using a cohort design, with multilevel modeling to identify predictors of change. Participants were 288 7–11 year olds experiencing social, emotional or behavioral difficulties. The intervention was associated with significant reductions in psychological distress, with a pre-post effect size (d) of 1.49 on the primary outcome measure and 88.7% clinical improvement. Greater improvements were found for disabled children, older children, and where CBT methods were used. The findings provide support for the use of systematic feedback in therapy with children. [ABSTRACT FROM PUBLISHER]

Several approaches to couple therapy produce large and clinically significant reductions in relationship distress. However, 25 to 30 per cent of couples show no benefit from couple therapy. Adapted forms of couple therapy can effectively treat some psychological disorders and enhance adjustment to physical health problems. The specific mechanisms underlying the effects of couple therapy on relationship distress are unclear. Current attempts to enhance the efficacy of couple therapy have three foci: (1) identifying the common factors that might account for change across approaches, (2) integrating different approaches to address specific needs of particular partners and couples and (3) monitoring the progress of couples during therapy and using that information to modify couple therapy as required. Given the high prevalence of relationship distress and its association with other problems, clinicians should routinely screen for relationship distress in adults. Couple therapy needs to be considered as the focus, or part of the focus, of treatment for a wide range of adult emotional and behavioural problems. [ABSTRACT FROM AUTHOR]

Clinical audit data has been collected since 1996 from an established National Health Service Nurse-led Psychosexual Counselling Service. An analysis of year-on-year data began to show that increasing numbers of clients were not actively “opting-in” to the service following referral and this became a cause for concern. In order to explore the reason for the increase in non-engagement with the service, a client feedback questionnaire was developed and sent within two weeks to all discharged clients over a twelve-month period. Once the user views coupled with general clinic audit data were analysed, the cause of increasing rates of non-engagement with the service appeared to be linked with increased waiting list times. Further benefit arose from the client feedback data analysis providing evidence from which it was possible to create a number of simple low-cost service developments. Finally, the client feedback data also became a source of affirmation in relation to this complex area of clinical practice - showing 71% of survey returns found the engagement with psychosexual counselling gave them “change for the better” or “great change for the better”. [ABSTRACT FROM AUTHOR]

Feedback plays an important role in valuation behaviour and judgement accuracy. In mortgage-lending related assignments, client feedback can blur the assignment objective and independent nature of valuation judgements. This study investigates the importance of client feedback in relationship to the assignment objective. A survey revealed that 33% of sampled Nigerian estate surveyors and valuers had perceived role perceptions as price validators. However, this perceived role perception was not found to be statistically associated with feedback pressures that clients may apply. [ABSTRACT FROM AUTHOR]

We present a new adaptive and energy-efficient broadcast model to support flexible responses to client queries. Clients do not have to request documents by name, since they may know the characteristics of the documents but not the document names or IDs. In our model, clients specify requirements through attributes, and servers broadcast documents that match client requests at a prespecified level of similarity. A given document may satisfy several clients, so the server broadcasts a minimal set of documents that achieves a desired level of satisfaction in the client population. The server obtains randomized feedback from clients and adapts its broadcast program accordingly. Clients use a selective tune-in scheme based on approximate indexing to conserve energy. Our model captures client interest patterns efficiently and accurately and scales very well with the number of clients while reducing the overall client average waiting times. The selective tune-in scheme reduces client energy consumption greatly, with a modest wait time increase. [ABSTRACT FROM AUTHOR]

Abstract: There are relatively few published studies in the field of child welfare in which client feedback data are reported. Thus, there is a general dearth of information about how those most closely involved with and affected by the child welfare system view their experience in it. This review paper has three goals. The first is to highlight the major methodological problems in studying client feedback, including obtaining a non-biased sample and maintaining confidentiality, collecting data by impartial staff, identifying core constructs, and utilizing reliable and valid measures. The second goal is to explicate the rationale for collecting client feedback data despite these challenges. It is proposed that such data can be a critical component of the child welfare service delivery process and has at least three distinct benefits: service delivery improvement, knowledge building, and empowerment. And, finally, the paper aims to identify critical directions for future research in this area, including continued work in developing reliable and valid measures for collecting client feedback data, codification of standardized systems for administering measures, and utilization of such measures to improve services, build knowledge, and empower families and children served by the child welfare system. [Copyright &y& Elsevier]

The extent of rehabilitation services is adequate, but little feedback is available on these services and service users. This paper is based on a client feedback survey of physiotherapy services conducted in Spring 2000. The purpose of the paper is to compare patients’ perceptions of the physiotherapy instruction they received in a private outpatient facility and in a public physiotherapy facility. The results of the study showed that physiotherapy clients were satisfied with the therapy and instruction they received. They felt they received an adequate amount of instructions and advice. The rehabilitee’s strong commitment to care, high motivation and a support network are important to independent rehabilitation in the future. As for the point of contact, the majority of clients in the private physiotherapy facility were gainfully employed while the health centre had almost as many retired clients. Client instruction was not dependent on the point of contact. [Copyright &y& Elsevier]

This paper reports the results of analyses of the responses of 91 adult clients who reported that their goals had been reached in therapy. The therapy conducted used the Solution Focused Brief Therapy (SFBT) approach developed by de Shazer and colleagues at the Brief Family Therapy Center of Milwaukee, Wisconsin. Clients were asked about what was helpful, what would have been more helpful, if the physical arrangements were adequate, how helpful the therapist was, how they would describe the therapy to friends or relatives, whether between-session suggestions were helpful, and whether they would recommend the therapy to a friend or relative. Results suggest that clients found the therapy helpful, had few suggestions for improvement, found the physical arrangements acceptable, described therapy in terms non-specific to SFBT, found the therapists quite helpful, found the suggestions helpful, and would recommend the therapy to others. Limitations and suggestions for further research are discussed. [ABSTRACT FROM AUTHOR]