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This is question 3 of a series of Q & As about how PCOMS proactively addresses many ongoing struggles of providing mental health and substance abuse services in the public sector. Although Mary Haynes takes the lead, folks from the four largest CMHCs in their respective states provide their insights and experiences. This ongoing conversation can be found at and click on “Public Behavioral Health.”

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  1. 1. PO Box 6157, Jensen Beach., FL 34957; 772.204.2511; 561.239.3640; Dr. Barry L. Duncan, Director_______________________________________________________________________ CDOI Training and Implementation of the Partners for Change Outcome Management System Public Behavioral Health and PCOMS: Questions and Answers 3. Client engagement is also more difficult in PBH because we deal with more difficult clients who have had poor experiences (sometimes many) with therapy and case management in the past. What does CDOI/PCOMS have to offer this problem? CDOI/PCOMS is a perfect fit for clients who are distrusting because of previous negative, perhaps even abusive, experiences with the mental health system. Since CDOI practice/PCOMS emphasizes the alliance, respectful interaction, client empowerment and social justice, skillful practitioners can begin communicating immediately to the client that this mental health service will be different from any that have gone before. Administration of the ORS early in the first session is a powerful way of laying the groundwork for communicating to clients that their goals are paramount and that the provider will do everything possible to help. The skillful weaving of the feedback from the ORS into the sessions, starting with the first meeting, also lets clients know that their marks on the forms are meaningful and will be taken seriously. Soliciting client feedback about the session itself is an almost unheard of experience among clients. Some clients at my agency have cried when they realized that, for the first time in all the years that they have been receiving mental health services, a provider actually wants to know their thoughts about how the meeting went, and how it might be able to be an even better experience in the future. Many clients comment that no one has ever asked their opinion on this before, or would even be likely to care. This is the antidote to the mistrust and fear that many veterans of the mental health care system feel when they come to us. It is only the triumph of hope over experience that has allowed some of our clients to seek further services, and we must be careful stewards of that hope. CDOI practice/PCOMS is our guidepost for creating effective, respectful, safe and empowering services. Written by Mary Haynes, with input from David Hanna, Jodi Daly, & Bob Bohanske. Check out the Public Behavioral Health page on the website for more questions and answers about PCOMS and public behavioral health.