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Consumer privilege, partnership, and outcome accountability scored a victory today! The Partners for Change Outcome Management System (PCOMS), as disseminated by the Heart and Soul of Change Project, is now included in the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence Based Programs and Practices (NREPP).

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  1. 1. www.heartandsoulofchange.com January 26, 2013 PCOMS: A SAMHSA Evidence Based Practice P ti Barry Duncan, Psy.D. Psy.D. www.heartandsoulofchange.com 561.561.3640 barrylduncan@comcast.netbarrylduncan@comcast.net 1
  2. 2. www.heartandsoulofchange.com January 26, 2013 Consumer Privilege, Partnership, & Outcome Accountability Score a Victory  The Partners for Change Outcome Management System (PCOMS), as disseminated by the Heart and Soul of Change Project, is now included in the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence Based Programs and Practices (NREPP)  PCOMS incorporates the most robust predictors of therapeutic success into an outcome management system that th t partners with t ith clients while honoring the daily pressures of front-line clinicians.barrylduncan@comcast.net 2
  3. 3. www.heartandsoulofchange.com January 26, 2013 Partners  The NREPP process is an arduous one that includes both a research and dissemination review. All 3 RCTs that enabled our application for evidence pp based practice status were conducted by Partners of the Heart and Soul of Change Project. The 3 RCTs Resulting in SAMHSA EBP Statusbarrylduncan@comcast.net 3
  4. 4. www.heartandsoulofchange.com January 26, 2013 Anker, Duncan, & Sparks, 2009 Norwegian/American Team •Largest RCT of Couple Therapy •Random assignment to feedback v. no feedback groups •Same pool of p therapists; served as own controls •Variety of orientations •Variety of disciplines Becoming Better Isn’t It Good, Norwegian Wood  Feedback v TAU; Both persons reliable or sig. change— 50.5% v. 22.6%; ES: .50; 4 xs # of clin. sig. change li i h  FU: TAU-34.2% v. 18.4% Feedback Anker, M., Duncan, B., & Sparks, J. (2009). Using client feedback to improve couple therapy outcomes: A randomized clinical trial in a sep./divorce rate naturalistic setting. Journal of Consulting and Clinical Psychology, 77(4), 693-704.barrylduncan@comcast.net 4
  5. 5. www.heartandsoulofchange.com January 26, 2013 Reese, Norsworthy, & Rowlands (2009) Reese, Toland, Slone, & Norsworthy, 2010 Reese, R., Norsworthy, L., &  N=148: Feedback group Rowlands, S. (2009) Ro lands S (2009). Does a continuous feedback model doubled d bl d controls (10.4 t l (10 4 vs. 5.1 pts); ES: .48 improve psychotherapy outcomes? Psychotherapy,46, 418-431. Reese, R., Toland, M., Slone, N.,  Like Norway study, clients, regardless of risk & Norsworthy, L. (2010). Effect of client feedback on couple status, b t t benefit f fit from psychotherapy outcomes. Psychotherapy, 47, 616-630. continuous feedback  2010 study is replication of Norway Trial Meta-analysis by Lambert & Shimokawa (2011) of PCOMS (the ORS and SRS) Those in feedback group had 3.5 higher odds of experiencing reliable change Those in feedback group had less than half the odds of experiencing deterioration Feedback attained .48 ES Lambert, M. J., & Shimokawa, K. (2011). Collecting client feedback. Psychotherapy, 48, 72-79.barrylduncan@comcast.net 5
  6. 6. www.heartandsoulofchange.com January 26, 2013 The Project  Is committed to client feedback & to the values of consumer privilege, partnership, and service accountability, and we put our efforts in proving ff that a value-based client feedback system can really make a difference Morten and Me  When Morten Anker & I were first talking about the design of the first RCT, the Norway Feedback Trial, b k i 2005 T i l back in 2005, the possibility of PCOMS attaining EBP status was born.barrylduncan@comcast.net 6
  7. 7. www.heartandsoulofchange.com January 26, 2013 Blue in the Face  I knew that we could talk about these ideas & values values, even though empirically supported, until we were blue in the face, but that they would never be widely known until we attained k til tt i d RCT credibility. The SAMHSA designation accomplishes this in spades. Consumer Voice and Partnership in All Decisions  Thanks to all those who made the RCTs happen, including but not limited to the Norway Outcome King, Morten Anker (and Geir Skauli, Berger H id A Sk li B Hareide, Ann Kristin Stapnes, leaders at Bufetat who helped make the project happen)barrylduncan@comcast.net 7
  8. 8. www.heartandsoulofchange.com January 26, 2013 Thanks to  UK superstar, Jeff Reese (& Jeff’s coauthors: Larry Norsworthy, Steve Rowlands, Michael Toland, & Norah Slone), and the irrepressible d th i ibl client and social justice advocate, Jacqueline Sparks. Thanks Also To Those Who Have Successfully Implemented  Bob Bohanske, Mary Haynes, and Dave Claud believed in this stuff long before the RCTs. They proved that PCOMS made a difference in the real world. Without these pioneers who had the vision to bring the ideas and values to fruition, none of this would have been possible.barrylduncan@comcast.net 8
  9. 9. www.heartandsoulofchange.com January 26, 2013 Consumer Driven Outcomes Management Long Ago in a Galaxy Far Away  Before the validation studies demonstrated the psychometrics  Before RCTs demonstrated the power of feedback to improve outcomes  Before the science…  There was the desire to give consumers a voice in their own care, to bring them into the inner circle—that’s what started itbarrylduncan@comcast.net 9