Becoming a Better Practitioner (BBP) Assignment (40 points) Monitoring clients’ perceptions of the change process and their own improvement is central to clientcentered social work practice. It is also a key ingredient in improving the skills and expertise of the social worker. The purpose of this assignment is for you to monitor your work with clients and use the feedback to improve your social work practice skills. The term “client” here refers broadly to the individuals or groups that you are serving or engaging in change efforts with. Specifically, you will use the Outcomes Rating Scale (ORS) and the Session Rating Scale (SRS) (Duncan, 2010) on a regular basis (5- 9 weeks) with 2 or more clients this semester. Administering the scales over time is critical to observing client progress and your own skill development. Administering the scales to more than one client is necessary in order for you to consider the impact of client characteristics on your effectiveness. Using the ORS/SRS Recording Form, you will record data from these two instruments and takes notes about clients’ feedback in relation to their scores (including quotes when possible). You will also record the changes you make in your practice in response to this feedback. Your descriptions of these changes should be specific and concrete. You will then integrate the numerical data, client feedback, and your practice changes in a final report. Modifications can be made to adapt the scales to diverse practice settings (see Appendix A: Modification for BBP Assignment). You can also choose an alternative measurement tool with prior instructor approval. The main body of the final report should be no more than 6,000 words and should include the following: Part 1 (5 points) Due Week 5 1. Introduction to field setting and your role (2 paragraphs). 2. Client Case Summaries (client demographic information, presenting concern, primary goal(s) of your work) (1 paragraph each). For students reporting on single contact roles and groups, please provide an overall summary across clients or distinct groups of clients. 3. Completed SRS/ORS Recording Form (at least once for your clients). Only the form needs to be submitted and not the SRS/ORS scales themselves. It can either be handwritten or typed. (See example Appendix B: Sample ORS/SRS Recording Form) 4. Optional: Include a thorough description of all modifications that you intend to make to the measurement tools or evaluation process. Part 2 (35 points) Due Week 14 5. Summary of Data a. Combined SRS and ORS graphs for each client. For single-contact roles, compare scores across two or more “types” of clients over time (e.g., children vs. adults, cancer patients vs. mothers in ICU, men vs. women). b. Visual interpretation of graphs (2-3 sentences). c. Interpretation of clinical cutoff scores and Reliable Change Indices (RCI). Alternative cutoffs and change indices must be developed and described if scales are modified. (2-3 sentences) 6. Pract.

1. Becoming a Better Practitioner (BBP) Assignment (40 points)
Monitoring clients’ perceptions of the change process and their
own improvement is central to clientcentered social work
practice. It is also a key ingredient in improving the skills and
expertise of the social worker. The purpose of this assignment is
for you to monitor your work with clients and use the feedback
to improve your social work practice skills. The term “client”
here refers broadly to the individuals or groups that you are
serving or engaging in change efforts with. Specifically, you
will use the Outcomes Rating Scale (ORS) and the Session
Rating Scale (SRS) (Duncan, 2010) on a regular basis (5- 9
weeks) with 2 or more clients this semester. Administering the
scales over time is critical to observing client progress and your
own skill development. Administering the scales to more than
one client is necessary in order for you to consider the impact
of client characteristics on your effectiveness. Using the
ORS/SRS Recording Form, you will record data from these two
instruments and takes notes about clients’ feedback in relation
to their scores (including quotes when possible). You will also
record the changes you make in your practice in response to this
feedback. Your descriptions of these changes should be specific
and concrete. You will then integrate the numerical data, client
feedback, and your practice changes in a final report.
Modifications can be made to adapt the scales to diverse
practice settings (see Appendix A: Modification for BBP
Assignment). You can also choose an alternative measurement
tool with prior instructor approval. The main body of the final
report should be no more than 6,000 words and should include
the following: Part 1 (5 points) Due Week 5 1. Introduction to
field setting and your role (2 paragraphs). 2. Client Case
Summaries (client demographic information, presenting
concern, primary goal(s) of your work) (1 paragraph each). For
students reporting on single contact roles and groups, please
provide an overall summary across clients or distinct groups of

2. clients. 3. Completed SRS/ORS Recording Form (at least once
for your clients). Only the form needs to be submitted and not
the SRS/ORS scales themselves. It can either be handwritten or
typed. (See example Appendix B: Sample ORS/SRS Recording
Form) 4. Optional: Include a thorough description of all
modifications that you intend to make to the measurement tools
or evaluation process. Part 2 (35 points) Due Week 14 5.
Summary of Data a. Combined SRS and ORS graphs for each
client. For single-contact roles, compare scores across two or
more “types” of clients over time (e.g., children vs. adults,
cancer patients vs. mothers in ICU, men vs. women). b. Visual
interpretation of graphs (2-3 sentences). c. Interpretation of
clinical cutoff scores and Reliable Change Indices (RCI).
Alternative cutoffs and change indices must be developed and
described if scales are modified. (2-3 sentences) 6. Practice
Decision: For each client, state whether you feel the client has
deteriorated, remained the same, improved only slightly,
improved a great deal, or achieved all treatment goals. Draw
your conclusions based on the pattern of the clients’ ORS scores
and comments. Further, state your recommendation for
continued services. How do you think services should proceed?
If the scales are modified, alternative criteria for determining
client change will need to be developed and described. (1
paragraph) 7. Please describe three occasions in which you
allowed client feedback to guide your intervention (Refer to
specific sessions or dates). For each occasion, please describe:
1) What feedback the client gave you. 2) How you replied in
that moment. And 3) What changes you made to
treatment/services as a result of their feedback. Be VERY
SPECIFIC here about what was said and what you changed. I
need to be able to “see” what you changed. Global phrases such
as “I became more sensitive” will not work here. (3 paragraphs)
8. Conclusions regarding the evaluation processes a. Barriers:
What factors made the evaluation process difficult (e.g., client,
agency, personal)? (1 paragraph) b. Process: How did using
these tools impact your relationship with your clients? Include

3. both positive and negative impacts. (1 paragraph) 9. Briefly,
discuss your observations of your own practice during this
semester. Consider the following (1-2 paragraphs): a. Your
ability to ‘read’ your clients b. Your ability to make changes to
your approach in response to feedback. c. What skills and
abilities have you developed this semester? Be very specific and
concrete. Scoring Rubric: Part 1 will be graded on a scale akin
to the rubric used for Competency Assessments. Part 2 is
divided into 5 points (numbered 5 through 9). Each of the five
items will be awarded up to 7 points, for a total of 35 points
available for Part 2. The scores for Parts 1 and 2 will be
combined for an overall grade on this assignment.
283
OUTCOME RATING SCALE (ORS)
Name: ______________________________________ Age
(Yrs): __________ Sex: M/F
Session #: ________________ Date:
________________________
Who is filling out this form? Please check one: Self __________
Other __________
If other, what is your relationship to this person?
____________________________
Looking back over the last week, including today, help us
understand how you
have been feeling by rating how well you have been doing in the
following areas

4. of your life, where marks to the left represent low levels and
marks to the right
indicate high levels. If you are filling out this form for another
person, please fill
out according to how you think he or she is doing.
Individually
(Personal well-being)
I------------------------------------------------------------------------I
Interpersonally
(Family, close relationships)
I------------------------------------------------------------------------I
Socially
(Work, school, friendships)
I-------------------------------------------------------------------------I
Overall
(General sense of well-being)
I-------------------------------------------------------------------------I
A P P E N D I X
Outcome Measures and Forms
International Center for Clinical Excellence
_________________________________________
Source: www.centerforclinicalexcellence.com
© 2000 Scott D. Miller & Barry L. Duncan

5. Copyright Springer Publishing Company. All Rights Reserved.
From: Effective Counseling and Psychotherapy
DOI: 10.1891/9780826141132.ap01
SESSION RATING SCALE (SRS V.3.0)
Name: ______________________________________ Age
(Yrs): __________ Sex: M/F
Session #: ________________ Date:
________________________
Please rate today’s session by placing a mark on the line nearest
to the descrip-
tion that best fits your experience.
Relationship
I------------------------------------------------I
Goals and Topics
I------------------------------------------------I
Approach or Method
I------------------------------------------------I
Overall
I------------------------------------------------I
I did not feel
heard,

6. understood,
and respected.
I felt heard,
understood,
and respected.
We did not work
on or talk about
what I wanted
to work on and
talk about.
We worked on and
talked about
what I wanted
to work on and
talk about.
The therapist’s
approach is not
a good fit for
me.
The therapist’s
approach is a
good fit for me.
There was
something
missing in the
session today.
Overall, today’s
session was
right for me.

7. International Center for Clinical Excellence
_________________________________________
Source: www.centerforclinicalexcellence.com
© 2002 Scott D. Miller, Barry L. Duncan, & Lynn Johnson
286 A P P E N D I X
ORS/SRS Recording Form
Social Worker:
Client (use pseudonym for class):
Session (Date)
ORS score
SRS score
Client Descriptions: You will follow up on scores that improve
or decline from week to week.
Please record clients’ clarifications and explanations here.
Social Worker Response: Describe the changes you made (or
plan to make) to your approach in response to the client’s
feedback. Be very specific!

8. Single-System Design #2 – Group 4
Group Members: Tonya Barkley, Lou Sorrells, Alaina Petty,
Anna Ponds, Tara Hayes
Date Due: 11/22/2022
Stated Problems:
1) Jason reports he does not have the best grades in school (C’s
and some D’s) and that “he could do better.”

9. 2) Jason reports feeling lost, that he is drifting through life, that
he felt broken, that something is wrong with him if he needs
therapy, and that he needs to be fixed (He scored a 13 on the
PHQ-9).
3) Jason reports that he desires stable relationships/attachment -
he feels like he “disappears” inside the home with his
grandmother because of all the people in and out of the home,
often other underage family members.
Consideration of Guardian Goals:
4)
Jason reports substance use. He uses cannabis more
than half the days each week and occasionally consumes alcohol
when it’s available. He stated his grandma would probably want
him “not to smoke anymore” (he scored Higher Risk on the
S2B1 – Screening to Brief Intervention).
5) Jason reports his grandmother wanting him to “do better” in
school. He also reports wanting to feel more engaged in school.
Target Problem: Creating more stable attachments and feelings
of safety in Jason’s life and home environment resulting in
decreased depression symptoms, as indicated by Jason’s PHQ-9
scores.
How did you prioritize? Jason reported multiple times during
the session that he did not feel that he mattered, he felt invisible
at his home when others were around, and he did not feel that
he was safe. He described “safe” meaning there were consistent
people in his life who he could count on. He reported that he
had a big family with cousins, a mom, a dad, and half-siblings;
however, he barely knows them, does not feel close to them, and
rarely sees his parents. Jason has low support systems in his
life. His grandma is the only adult he feels he can depend on,
but he described her love for him as “putting a roof over” his
head, making sure he had food to eat, and raising him rather

10. than as a close emotional support. He reported not having any
close friends, just people he “hung out with.” Jason reported
that he could be a good friend, stating that he is a good listener,
non-judgmental, and enjoys “just being there to play and hang
out with”, and he wishes to have a friendship like that but does
not currently have that type of relationship. Jason reported
constantly having people in and out of his life home. When
asked the miracle question, he stated that he wanted support and
safety in his life.
The Social Worker briefly assessed Jason’s substance abuse
using the Screening to Brief Intervention (S2BI) measurement
tool, reporting a “higher risk overall” according to S2BI. The
Social Worker believes that Jason’s substance use is related to
his levels of depression and low social support network,
recognizing that Jason desires close friendships, so his use may
be opportunistic within his current social circles. While his
substance use may be exacerbating his other problems, the
Social Worker does not believe that this is the primary concern
with the client. (Please note that the S2BI asks about substance
use within the last year and was only used during assessment, so
it is not included in “Dimensions Measured” since it will not be
repeated; however, a copy of the assessment is included at the
end of the SSD for reference).
When considering attachment theory, Jason’s childhood
attachment injuries from his parents, as well as his grandmother
serving as matriarch to multiple children in the family, have left
Jason feeling isolated and without a stable emotional support
system from his caregiver. As a result, he has shown indicators
of externalizing behaviors such as using substances, poor
performance in school, and escaping through video games. By
directly addressing attachment to his grandmother, Jason will
build a stronger, more stable relationship with her. This will
result in fewer externalizing behaviors in an attempt for
connection and attention.

11. Jason’s PHQ-9 Answers in initial assessment:
Target Goal: Target goal is to increase attachment by spending
quality time and talking to his grandmother daily about things
that are important to him. This will allow him to feel secure and
build a relationship with his grandmother, which will alleviate
his depressive symptoms. Jason also stated that he would like to
make friends that have similar interests (gaming, etc.) who do
not need to use substances to “have a good time.”
What dimensions will you measure? (Underline:
behaviors,
thoughts,
feelings,
attitudes, intensity,
frequency, duration)
Who?
What? (Description of measure)
Where?
When?
1
Therapist & Jason
PHQ-9 – Patient Health Questionnaire 9
At the therapy office
Completed in first session; continue to repeat biweekly* to
monitor Comment by Ponds, Margaret: I wrote to continue
administering monthly instead of weekly since weekly could be
burdensome to Jason, and I'm thinking monthly would be
regular enough to monitor progress well - what do y'all think?
2
Jason
Self-report feelings of support
At home, review with therapist & Grandmother each week

12. during session
Daily before bed, completed individually
3
Therapist and Jason
Columbia Suicide Severity Rating Scale (C-SSRS) administered
verbally
At the therapy office
Weekly during one-on-one session, prior to grandmother joining
the session if a joint session
*Bi-weekly: every other week
Intervention:
Attachment-Based Family Therapy (ABFT) will be conducted
with Jason and his grandmother, who is his guardian and has
raised him. The goal of the ABFT will be to promote a secure
attachment, open communication, feelings of mutual support,
and new patterns of interaction that will increase Jason’s
feelings of safety, security, and belonging. Before his
grandmother joins the session, Jason will complete the C-SSRS
with his therapist to assess safety and suicide risk. Jason will
complete the PHQ-9 biweekly with his therapist to monitor his
depression symptoms. Between sessions, Jason will be given a
self-monitoring worksheet to record instances where he felt
supported by his grandmother during the week. Jason will report
his findings about what made him feel supported with his
therapist and grandmother so that his grandmother will be aware
of what activities, words, etc. will help Jason to continue
feeling support.
ABFT is a process-oriented, trauma-focused approach that
involves 5 structured therapeutic tasks to be completed across
7-23 sessions. Task 1 (one session) is the Relational Reframing
task to help refocus the family from the patient’s symptoms to a

13. focus on improving the parent-child relationship. During this
session, the therapist guides the adolescent and parent/guardian
conversation about the impact depression and life traumas have
had on their relationship and focuses on their desire for
closeness. Task 2 (two to four sessions) is the Adolescent
Alliance building task which starts by naming the adolescent’s
strengths and interests. The therapist helps the adolescent to
describe their attachment ruptures, how those impact their
depression, and how these ruptures prevent the adolescent from
turning to their parent/guardian for support. The therapist then
empowers the adolescent to prepare to express their thoughts
and feelings to their parent/guardian in future sessions. Task 3
(two to four sessions) is the Parent/Guardian Alliance task in
which the therapist discusses current stressors in the
parent/guardians’ life. The therapist listens with empathy and
support; helps parents/caregivers see how these stressors are
impacting their parenting practices; and explores how the
parent’s own history of attachment ruptures are impacting their
parenting. The therapist will attempt to activate parental
instincts to motivate them to learn new, emotion-focused,
attachment-promoting parenting skills. Task 4 (one to four
sessions), The Attachment Task, brings the adolescent and
parent(s)/guardian(s) together for the adolescent to express their
attachment ruptures in a mature way. The parent/guardian
provides empathy and understanding to their child which is
meant to provide a “corrective attachment experience” to
strengthen the parent/child bond. The final Task 5 (one to ten
sessions), the Autonomy-Promoting task, provides a space for
the parent/guardian and adolescent to practice new relational
skills to reinforce a new secure attachment base. These sessions
also solidify new patterns within the family interactions, build
skills to navigate future concerns, and assist the
parents/caregivers to find balance between support and
structure.
What forces, other than the intervention, could cause change in

14. the client system’s goal?
1) Family support could change, which could result in either a
positive or negative impact on Jason and the efficacy of
treatment. Examples could include updates around parental
involvement in Jason’s life or other familial emergencies
causing the grandmother to bring another child into the home
full-time.
2) Jason could meet a positive adult or peer in his
neighborhood/school that he bonds with, which can serve as a
protective factor, improving his sense of direction, identity and
belonging.
3) Jason’s grandmother could decide to remove him from
therapy services, to not engage in family therapy, or to not
make changes in her behavior/home environment. Additionally,
there may be an emergency involving the grandmother that
directly impacts his care and may remove him from his home
environment until she recovers.
4) Jason has the autonomy to decide whether to engage in the
services, despite being told to attend by his grandmother.
Single System Design: Please provide a visual of your study
design using notation and time intervals.
A: Baseline
(Assessment – 1 session)
B: Attachment-Based Family Therapy (7-23 Sessions)
“A” represents the baseline of one session in which the therapist
measured Jason’s severity of depression and gathered
information about family dynamics and presenting issues. “B”
represents the start of the intervention, Attachment-Based
Family Therapy, which is completed across five phases of
treatment and will last 7 to 23 sessions, depending on the client
system’s needs.
What are the limitations of your design?

15. 1) Lack of support system – Jason has no close friends or
consistent adults in his life except for his grandmother who is
not spending enough time and attention on Jason to meet his
emotional needs.
2) Self-reporting may not be accurate. Jason may under- or
over-report his feelings.
3)
When asked if Jason wants to be in therapy, he
responded “I guess” with minimal response at each prompting.
He may believe that participating in therapy means that he is
broken, so he may be resistant to engage in therapy or may
pretend things are better in order to be discharged sooner.
Measure #1: Patient Health Questionnaire-9 (PHQ-9)
Measure #2:Self-Monitoring Worksheet to Report Feelings of
Support
Day of the week # of Instances of Support Brief
Description of Support
Monday
Tuesday
Wednesday
Thursday

16. Friday
Saturday
Sunday
Measure #3: Columbia Suicide Severity Rating Scale
S2BI:
S2BI (Continued):
References
Diamond, G. S., Diamond, G. M., & Levy, S. A. (2014).
Attachment-based family therapy for
depressed adolescents. American Psychological Association.
https://doi.org/10.1037/14296-000
Diamond, G., Russon, J., & Levy, S. (2016). Attachment-Based
Family Therapy: A Review of
the Empirical Support.
Family Process,
55(3), 595–610.
https://doi.org/10.1111/famp.12241
image5.png

17. image6.png
image7.png
image8.png
image9.png
image10.png
image11.png
image12.png
image1.png
image2.png
image3.png
image4.png