This study examined the effects of using client feedback, known as the Partners for Change Outcome Management System (PCOMS), with couples undergoing psychotherapy. 46 heterosexual couples were randomly assigned to either a treatment as usual (TAU) condition or to a feedback condition where therapists received feedback on client progress and the therapeutic alliance at each session via the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). It was hypothesized that couples receiving feedback would have better outcomes, improve more quickly, and be more likely to meet the criteria for clinically significant change. Results from this study aimed to replicate previous research finding client feedback beneficial for couples therapy.
The Partners for Change Outcome Management System: Duncan & Reese, 2015Barry Duncan
Despite overall psychotherapy efficacy (Lambert, 2013), many clients do not benefit (Reese, Duncan, Bohanske, Owen, & Minami, 2014), dropouts are a problem (Swift & Greenberg, 2012), and therapists vary significantly in success rates (Baldwin & Imel, 2013), are poor judges of negative outcomes (Chapman et al., 2012), and grossly overestimate their effectiveness (Walfish, McAlister, O'Donnell, & Lambert, 2012). Systematic client feedback offers one solution (Duncan, 2014). Several feedback systems have emerged (Castonguay, Barkham, Lutz, & McAleavey, 2013), but only two have randomized clinical trial support and are included in the Substance Abuse and Mental Health Administration’s National Registry of Evidence based Programs and Practices: The Outcome Questionnaire-45.2 System (Lambert, 2010) and the Partners for Change Outcome Management System (PCOMS; Duncan, 2012). This article presents the current status of the Partners for Change Outcome Management System, the psychometrics of the PCOMS measures, its empirical support, and its clinical and training applications. Future directions and implications of PCOMS research, training, and practice are detailed. Finally, we propose that systematic feedback offers a way, via large scale data collection, to re-prioritize what matters to psychotherapy outcome, reclaim our empirically validated core values and identity, and change the conversation from a medical model dominated discourse to a more scientific, relational perspective.
This study investigated whether providing client feedback data to supervisors for use in supervision would influence supervision and counselor self-efficacy. Trainees were assigned to either a continuous feedback condition, where feedback was provided to supervisors, or a no-feedback condition. Results showed that trainees in both conditions improved client outcomes over the year, but those in the feedback condition improved more. However, ratings of supervisory alliance and satisfaction did not differ between conditions. The relationship between counselor self-efficacy and outcomes was stronger for those in the feedback condition, suggesting feedback may facilitate a more accurate assessment of skills.
The original validation of the CORS for kids and the ORS for adolescents. Allowed the benefits of client based outcome feedback to expand to youth and family and paved the way to the current RCT with kids in the schools.
The document discusses research on whether using a continuous feedback system called the Partners for Change Outcome Management System (PCOMS) can improve psychotherapy outcomes. PCOMS involves clients completing brief measures after each session to assess treatment progress and the therapeutic relationship. Studies found that clients who used PCOMS with their therapists demonstrated statistically significant treatment gains compared to those receiving usual treatment and were more likely to experience reliable change in fewer sessions.
Although many of you may not be interested in the psychometric details of the ORS and SRS, it does bear importantly on whether there are seen as credible. Jeff Reese and I (Duncan & Reese, 2013) recently exchanged views with Halstead, Youn, and Armijo (2013), debating when a measure is too brief and when it is too long. Here is our paper. First regarding when a measure is too brief: There is no doubt that 45 items, 30 items, or even 19 items is psychometrically better than 4 items, and that the increased reliability and validity of longer measures likely result in better detection, prediction, and ultimate measurement of outcome. But how much better is the really the question. Are these differences clinically meaningful and do they offset the low compliance rates and resulting data integrity issues from missing data? These are the questions that require empirical investigation to determine how brief is too brief, although from my experience, the verdict has already been rendered. But when is a measure too long? The answer is simple: When clinicians won’t use it.
This study examined the effects of using client feedback, known as the Partners for Change Outcome Management System (PCOMS), with couples undergoing psychotherapy. 46 heterosexual couples were randomly assigned to either a treatment as usual (TAU) condition or to a feedback condition where therapists received feedback on client progress and the therapeutic alliance at each session via the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). It was hypothesized that couples receiving feedback would have better outcomes, improve more quickly, and be more likely to meet the criteria for clinically significant change. Results from this study aimed to replicate previous research finding client feedback beneficial for couples therapy.
The Partners for Change Outcome Management System: Duncan & Reese, 2015Barry Duncan
Despite overall psychotherapy efficacy (Lambert, 2013), many clients do not benefit (Reese, Duncan, Bohanske, Owen, & Minami, 2014), dropouts are a problem (Swift & Greenberg, 2012), and therapists vary significantly in success rates (Baldwin & Imel, 2013), are poor judges of negative outcomes (Chapman et al., 2012), and grossly overestimate their effectiveness (Walfish, McAlister, O'Donnell, & Lambert, 2012). Systematic client feedback offers one solution (Duncan, 2014). Several feedback systems have emerged (Castonguay, Barkham, Lutz, & McAleavey, 2013), but only two have randomized clinical trial support and are included in the Substance Abuse and Mental Health Administration’s National Registry of Evidence based Programs and Practices: The Outcome Questionnaire-45.2 System (Lambert, 2010) and the Partners for Change Outcome Management System (PCOMS; Duncan, 2012). This article presents the current status of the Partners for Change Outcome Management System, the psychometrics of the PCOMS measures, its empirical support, and its clinical and training applications. Future directions and implications of PCOMS research, training, and practice are detailed. Finally, we propose that systematic feedback offers a way, via large scale data collection, to re-prioritize what matters to psychotherapy outcome, reclaim our empirically validated core values and identity, and change the conversation from a medical model dominated discourse to a more scientific, relational perspective.
This study investigated whether providing client feedback data to supervisors for use in supervision would influence supervision and counselor self-efficacy. Trainees were assigned to either a continuous feedback condition, where feedback was provided to supervisors, or a no-feedback condition. Results showed that trainees in both conditions improved client outcomes over the year, but those in the feedback condition improved more. However, ratings of supervisory alliance and satisfaction did not differ between conditions. The relationship between counselor self-efficacy and outcomes was stronger for those in the feedback condition, suggesting feedback may facilitate a more accurate assessment of skills.
The original validation of the CORS for kids and the ORS for adolescents. Allowed the benefits of client based outcome feedback to expand to youth and family and paved the way to the current RCT with kids in the schools.
The document discusses research on whether using a continuous feedback system called the Partners for Change Outcome Management System (PCOMS) can improve psychotherapy outcomes. PCOMS involves clients completing brief measures after each session to assess treatment progress and the therapeutic relationship. Studies found that clients who used PCOMS with their therapists demonstrated statistically significant treatment gains compared to those receiving usual treatment and were more likely to experience reliable change in fewer sessions.
Although many of you may not be interested in the psychometric details of the ORS and SRS, it does bear importantly on whether there are seen as credible. Jeff Reese and I (Duncan & Reese, 2013) recently exchanged views with Halstead, Youn, and Armijo (2013), debating when a measure is too brief and when it is too long. Here is our paper. First regarding when a measure is too brief: There is no doubt that 45 items, 30 items, or even 19 items is psychometrically better than 4 items, and that the increased reliability and validity of longer measures likely result in better detection, prediction, and ultimate measurement of outcome. But how much better is the really the question. Are these differences clinically meaningful and do they offset the low compliance rates and resulting data integrity issues from missing data? These are the questions that require empirical investigation to determine how brief is too brief, although from my experience, the verdict has already been rendered. But when is a measure too long? The answer is simple: When clinicians won’t use it.
This article discusses applying research on psychotherapy outcomes, which has shown that common factors like the therapeutic relationship are more influential than theoretical approach or techniques. The article proposes intentionally using the client's frame of reference to enhance common factors and collaboration. It suggests emphasizing the client's perceptions of their relationship with the therapist and understanding of their issues over theoretical perspectives. A client-directed process is outlined that de-emphasizes theory and maximizes common factors and the client's involvement.
This document summarizes a study that analyzed written responses from clients who had completed couple therapy. The study explored how clients experienced therapy through their responses to open-ended questions about therapy at a 6-month follow-up. The responses were analyzed thematically and compared between clients whose therapists did or did not use systematic feedback. Most clients found personable, active therapists who maintained neutrality to be helpful. Some expressed dissatisfaction with lack of structure or challenge from therapists. Lack of flexibility in scheduling was also problematic. Clients who used feedback generally found it very helpful.
PCOMS: A Viable Quality Improvement Strategy for Public Behavioral HealthBarry Duncan
This is the latest from the research team of the Heart and Soul of Change Project, published in the Journal of Consulting and Clinical Psychology. This study demonstrated that PCOMS is not only a viable quality improvement strategy but also that services to the poor and disenfranchised provided in a public behavioral setting, contrary to earlier research, can be as effective as those delivered in randomized clinical trials.
Duncan & Sparks Ch 5 of Cooper & DrydenBarry Duncan
THIS CHAPTER DISCUSSES
•
Systematic feedback and the Partners for Change Outcome Management System (PCOMS)
•
PCOMS as a way to truly privilege clients, include them as full partners in decision-making and operationalize social justice and a pluralistic approach
Slone, N. C., Reese, R. J., Mathews-Duvall, S., & Kodet, J. (2015). Evaluating the Efficacy of client feedback in group psychotherapy. Group Dynamics: Theory, Research, and Practice, 19, 122-136. doi:10.1037/gdn0000026
The first quasiexperiemental study of the ORS/SRS in a telephonic EAP company. Doubled outcomes and improved retension. Set the stage for the RCTs that followed
Our recent article about therapist effects in couple therapy. So what distinguished one therapist from another? Demographics didn’t matter but 2 other things did. First, that tried and true but neglected old friend, the alliance accounted for 50% of the differences among therapists. Those who formed better alliances across clients got better outcomes. And therapist specific experience with couples accounted for 25% of the differences. So, experienced therapists can take some solace that getting older does have its advantages—as long as it is specific to task at hand.
PCOMS works with kids too!
Cooper, M., Stewart, D., Sparks, J., Bunting, L. (2013). School-based counseling using systematic feedback: A cohort study evaluating outcomes and predictors of change. Psychotherapy Research, 23, 474-488.
Feedback condition achieved nearly four times the amount of clients reaching reliable or clinically significant change. Nearly a 50% less separation/divorce at rate at follow up.
Summary of SAMHSA's review of and listing of feedback Informed Treatment as an evidence-based practice. The International Center for Clinical Excellence received perfect scores for readiness for dissemination materials
This study examined the psychometric properties of Dutch translations of the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). Data was collected from 126 clients who completed a total of 1005 ORS and SRS assessments over multiple therapy sessions. Results found the Dutch translations had good internal consistency and test-retest reliability, similar to previous American studies. Scores on the ORS and SRS also converged with therapist satisfaction ratings. Additionally, SRS scores predicted later ORS scores, supporting the validity of both measures. Overall, the study provides preliminary support for using the Dutch ORS and SRS in cross-cultural settings.
This document summarizes a study on implementing a systematic client feedback protocol into a marriage and family therapy training program to improve trainee competence and accountability. The study describes how the program integrated continuous client feedback into coursework, clinical training, and supervision using an Outcome Management system. Research shows that incorporating client feedback improves client outcomes and therapist effectiveness. The program believes this approach will train therapists to be more accountable to clients and enhance services provided at their family therapy clinic.
The Norway Couple Project: Lessons LearnedBarry Duncan
The document discusses lessons learned from studies on using client feedback to improve outcomes in couple therapy. A large randomized clinical trial in Norway found that routinely collecting and discussing client feedback on progress and the therapeutic alliance using brief measures led to better outcomes compared to treatment as usual. Specifically, couples receiving feedback showed greater improvement in their relationships and were less likely to deteriorate over time. The findings suggest incorporating systematic client feedback into routine practice can help therapists improve outcomes for couples across different therapy approaches.
This article, "Casting a Wider Net in Behavioral Health Screening in Primary Care" found that the ORS identified more clients for behavioral healthcare consultation than the PHQ-9. A first step toward the upcoming RCT with PCOMS in an integrated setting.
This 2 page article, which appeared in The Iowa Psychologist, provides an ultra brief summary of what makes therapy effective (the common factors) and how we can get better at what do: namely, add PCOMS, harvest client existing resources, and rely on that neglected old friend, the therapeutic alliance.
When children and teens present with behaviour and emotional problems the lure of a quick fix is
understandable and drugs present a ready-made solution. Therapists are often hesitant to talk about
medication and defer to medical professionals. In this paper DUNCAN, SPARKS, MURPHY and MILLER
highlight the explosion in the use of psychotropic medications for children and teens. This trend flies in the
face of the American Psychological Association’s recommendation of the use of psychosocial interventions
as the first intervention of choice with children and teens. The reliability and validity of psychiatric diagnoses is
questioned, in particular against a background of fluctuations in child development and social adaptations,
and a compelling critique is provided of the current research findings on the effectiveness of psychotropic
medications including antidepressants and ADHD medications. Therapists are urged to shed their timidity
and discuss openly the risks and benefits of medication with the knowledge that there is empirical support
for psychosocial interventions as a first line approach. Recommendations are offered to engage clients as
central partners in developing solutions—medical or non-medical—that fit each child and each situation.
This is the validation study of the Group Session Rating Scale (GSRS). In a nutshell, this study found more than acceptable reliability and validity with not only an alliance measure but also with group climate and cohesiveness scales. The GSRS was also predictive of last session outcomes. An RCT comparing PCOMS to TAU in group therapy has been submitted.
PCOMS as an Alternative to Psychiatric Diagnosis (Duncan, Sparks, & Timimi, 2...Barry Duncan
Part of an incredible series about diagnostic alternatives by the Journal of Humanistic Psychology edited by Sarah Kamens, Brent Dean Robbins, & Elizabeth Flanagan
The article discusses the development and research supporting the Partners for Change Outcome Management System (PCOMS). PCOMS uses two brief measures - the Outcome Rating Scale (ORS) and Session Rating Scale (SRS) - to collect feedback from clients at each session on their progress and the therapeutic alliance. The ORS and SRS were developed to be brief and feasible for routine use. Research shows providing therapists feedback based on these measures improves client outcomes compared to treatment as usual. The article outlines how PCOMS was developed and refined, presents supporting research on the measures' psychometrics and clinical usefulness, and discusses examples of implementing PCOMS in behavioral health settings.
Smith, D., Crocker, L., Staton, C., Gillaspy, A., & Charlton, S. (2010). Psychometric properties of the Outcome Rating Scale in a non-clinical sample. Poster presentation at the Heart and Soul of Change Conference, New Orleans.
Poster: Test-Retest Reliability and Equivalence of PRO MeasuresCRF Health
This literature review examined administration intervals used in test-retest reliability and equivalence studies for patient-reported outcome measures. The review found a large variance in intervals, ranging from immediate to 7 years for test-retest studies and from immediate to 1 month for equivalence studies. The most common intervals were 2 weeks for test-retest studies and 1 hour or less for equivalence studies. Intervals varied depending on the medical condition and type of study, with shorter intervals used for equivalence studies compared to test-retest studies for the same conditions.
This article discusses applying research on psychotherapy outcomes, which has shown that common factors like the therapeutic relationship are more influential than theoretical approach or techniques. The article proposes intentionally using the client's frame of reference to enhance common factors and collaboration. It suggests emphasizing the client's perceptions of their relationship with the therapist and understanding of their issues over theoretical perspectives. A client-directed process is outlined that de-emphasizes theory and maximizes common factors and the client's involvement.
This document summarizes a study that analyzed written responses from clients who had completed couple therapy. The study explored how clients experienced therapy through their responses to open-ended questions about therapy at a 6-month follow-up. The responses were analyzed thematically and compared between clients whose therapists did or did not use systematic feedback. Most clients found personable, active therapists who maintained neutrality to be helpful. Some expressed dissatisfaction with lack of structure or challenge from therapists. Lack of flexibility in scheduling was also problematic. Clients who used feedback generally found it very helpful.
PCOMS: A Viable Quality Improvement Strategy for Public Behavioral HealthBarry Duncan
This is the latest from the research team of the Heart and Soul of Change Project, published in the Journal of Consulting and Clinical Psychology. This study demonstrated that PCOMS is not only a viable quality improvement strategy but also that services to the poor and disenfranchised provided in a public behavioral setting, contrary to earlier research, can be as effective as those delivered in randomized clinical trials.
Duncan & Sparks Ch 5 of Cooper & DrydenBarry Duncan
THIS CHAPTER DISCUSSES
•
Systematic feedback and the Partners for Change Outcome Management System (PCOMS)
•
PCOMS as a way to truly privilege clients, include them as full partners in decision-making and operationalize social justice and a pluralistic approach
Slone, N. C., Reese, R. J., Mathews-Duvall, S., & Kodet, J. (2015). Evaluating the Efficacy of client feedback in group psychotherapy. Group Dynamics: Theory, Research, and Practice, 19, 122-136. doi:10.1037/gdn0000026
The first quasiexperiemental study of the ORS/SRS in a telephonic EAP company. Doubled outcomes and improved retension. Set the stage for the RCTs that followed
Our recent article about therapist effects in couple therapy. So what distinguished one therapist from another? Demographics didn’t matter but 2 other things did. First, that tried and true but neglected old friend, the alliance accounted for 50% of the differences among therapists. Those who formed better alliances across clients got better outcomes. And therapist specific experience with couples accounted for 25% of the differences. So, experienced therapists can take some solace that getting older does have its advantages—as long as it is specific to task at hand.
PCOMS works with kids too!
Cooper, M., Stewart, D., Sparks, J., Bunting, L. (2013). School-based counseling using systematic feedback: A cohort study evaluating outcomes and predictors of change. Psychotherapy Research, 23, 474-488.
Feedback condition achieved nearly four times the amount of clients reaching reliable or clinically significant change. Nearly a 50% less separation/divorce at rate at follow up.
Summary of SAMHSA's review of and listing of feedback Informed Treatment as an evidence-based practice. The International Center for Clinical Excellence received perfect scores for readiness for dissemination materials
This study examined the psychometric properties of Dutch translations of the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). Data was collected from 126 clients who completed a total of 1005 ORS and SRS assessments over multiple therapy sessions. Results found the Dutch translations had good internal consistency and test-retest reliability, similar to previous American studies. Scores on the ORS and SRS also converged with therapist satisfaction ratings. Additionally, SRS scores predicted later ORS scores, supporting the validity of both measures. Overall, the study provides preliminary support for using the Dutch ORS and SRS in cross-cultural settings.
This document summarizes a study on implementing a systematic client feedback protocol into a marriage and family therapy training program to improve trainee competence and accountability. The study describes how the program integrated continuous client feedback into coursework, clinical training, and supervision using an Outcome Management system. Research shows that incorporating client feedback improves client outcomes and therapist effectiveness. The program believes this approach will train therapists to be more accountable to clients and enhance services provided at their family therapy clinic.
The Norway Couple Project: Lessons LearnedBarry Duncan
The document discusses lessons learned from studies on using client feedback to improve outcomes in couple therapy. A large randomized clinical trial in Norway found that routinely collecting and discussing client feedback on progress and the therapeutic alliance using brief measures led to better outcomes compared to treatment as usual. Specifically, couples receiving feedback showed greater improvement in their relationships and were less likely to deteriorate over time. The findings suggest incorporating systematic client feedback into routine practice can help therapists improve outcomes for couples across different therapy approaches.
This article, "Casting a Wider Net in Behavioral Health Screening in Primary Care" found that the ORS identified more clients for behavioral healthcare consultation than the PHQ-9. A first step toward the upcoming RCT with PCOMS in an integrated setting.
This 2 page article, which appeared in The Iowa Psychologist, provides an ultra brief summary of what makes therapy effective (the common factors) and how we can get better at what do: namely, add PCOMS, harvest client existing resources, and rely on that neglected old friend, the therapeutic alliance.
When children and teens present with behaviour and emotional problems the lure of a quick fix is
understandable and drugs present a ready-made solution. Therapists are often hesitant to talk about
medication and defer to medical professionals. In this paper DUNCAN, SPARKS, MURPHY and MILLER
highlight the explosion in the use of psychotropic medications for children and teens. This trend flies in the
face of the American Psychological Association’s recommendation of the use of psychosocial interventions
as the first intervention of choice with children and teens. The reliability and validity of psychiatric diagnoses is
questioned, in particular against a background of fluctuations in child development and social adaptations,
and a compelling critique is provided of the current research findings on the effectiveness of psychotropic
medications including antidepressants and ADHD medications. Therapists are urged to shed their timidity
and discuss openly the risks and benefits of medication with the knowledge that there is empirical support
for psychosocial interventions as a first line approach. Recommendations are offered to engage clients as
central partners in developing solutions—medical or non-medical—that fit each child and each situation.
This is the validation study of the Group Session Rating Scale (GSRS). In a nutshell, this study found more than acceptable reliability and validity with not only an alliance measure but also with group climate and cohesiveness scales. The GSRS was also predictive of last session outcomes. An RCT comparing PCOMS to TAU in group therapy has been submitted.
PCOMS as an Alternative to Psychiatric Diagnosis (Duncan, Sparks, & Timimi, 2...Barry Duncan
Part of an incredible series about diagnostic alternatives by the Journal of Humanistic Psychology edited by Sarah Kamens, Brent Dean Robbins, & Elizabeth Flanagan
The article discusses the development and research supporting the Partners for Change Outcome Management System (PCOMS). PCOMS uses two brief measures - the Outcome Rating Scale (ORS) and Session Rating Scale (SRS) - to collect feedback from clients at each session on their progress and the therapeutic alliance. The ORS and SRS were developed to be brief and feasible for routine use. Research shows providing therapists feedback based on these measures improves client outcomes compared to treatment as usual. The article outlines how PCOMS was developed and refined, presents supporting research on the measures' psychometrics and clinical usefulness, and discusses examples of implementing PCOMS in behavioral health settings.
Smith, D., Crocker, L., Staton, C., Gillaspy, A., & Charlton, S. (2010). Psychometric properties of the Outcome Rating Scale in a non-clinical sample. Poster presentation at the Heart and Soul of Change Conference, New Orleans.
Poster: Test-Retest Reliability and Equivalence of PRO MeasuresCRF Health
This literature review examined administration intervals used in test-retest reliability and equivalence studies for patient-reported outcome measures. The review found a large variance in intervals, ranging from immediate to 7 years for test-retest studies and from immediate to 1 month for equivalence studies. The most common intervals were 2 weeks for test-retest studies and 1 hour or less for equivalence studies. Intervals varied depending on the medical condition and type of study, with shorter intervals used for equivalence studies compared to test-retest studies for the same conditions.
Guide for conducting meta analysis in health researchYogitha P
This document discusses meta-analysis and its role in evidence-based dentistry. It defines meta-analysis as the statistical analysis and synthesis of data from multiple scientific studies. Meta-analysis enhances the reliability of conclusions by increasing statistical power and limiting bias compared to individual studies. It can help resolve scientific controversies by establishing whether findings are consistent across studies. The document reviews the steps in conducting a meta-analysis, including developing a clear question and protocol, performing comprehensive literature searches, assessing study quality, extracting outcome data, conducting statistical analyses, and drawing conclusions. It also discusses potential biases and strengths and limitations of meta-analysis.
This document discusses various topics related to outcomes research, including comparative effectiveness research, multilevel data analysis, investigating change over time, and estimating treatment effects from observational data. Comparative effectiveness research directly compares existing healthcare interventions to determine their benefits and harms. Multilevel analysis is helpful for comparing patient outcomes across hospitals while accounting for risk factors. Propensity score adjustment and other statistical techniques can be used to estimate causal treatment effects from observational data and reduce selection bias. Bayesian statistics are increasingly being used in areas like early-phase cancer trials.
Effective strategies to monitor clinical risks using biostatistics - Pubrica.pdfPubrica
In clinical science, biostatistics services are essential for data collection, analysis, presentation, and interpretation. Epidemiology, clinical trials, population genetics, systems biology, and other disciplines all benefit from it. It aids in the evaluation of a drug's effectiveness and safety in clinical trials.
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Does the perception of trust in the usefulness or ease of use of a HIS (Healt...Monica Barrowman MacFadyen
The document summarizes a study that examined how nurses' perceptions of a health information system's (HIS) usefulness (independent variable 1) and ease of use (independent variable 2) influence their usage of the HIS (dependent variable 1). The study found significant positive correlations between both independent variables and usage. It also found females had higher usage than males and differed significantly on all three variables. The study concludes that perceived ease of use has a greater influence on usage than perceived usefulness, and identifies ease of use as a key factor for developers to consider when designing HIS systems.
ANSWER LAST 10 QUESTION THATEXERCISE 9Measures of DispersionRa.docxmelvinjrobinson2199
The document summarizes a study that examined nurses' perceptions of organizational climate and caring practices. Nurses completed surveys measuring organizational climate and how often they engaged in caring practices. Regarding organizational climate, nurses rated their jobs positively but roles, leadership, and the organization more negatively. For caring practices, clinical and comforting care had higher frequencies than relational care. The researchers concluded that workload and role ambiguity prevented nurses from fully engaging in caring practices and that interventions are needed to improve organizational climate and support nursing care.
David Moher - MedicReS World Congress 2012MedicReS
This document discusses sources of bias in medical research and means to assess bias. It acknowledges the Cochrane Collaboration's Bias Methods Group and provides an overview of the impact of bias. Sources of bias can occur in the production and dissemination of evidence, including reporting biases like publication bias. Meta-epidemiological studies have found empirical evidence of biases in randomized controlled trials. Methods have been developed to assess bias in primary studies. While registration of clinical trials and systematic review protocols are attempts to minimize bias, bias remains an issue and further efforts are still needed.
Advanced Regression Methods For Single-Case Designs Studying Propranolol In ...Stephen Faucher
This document discusses a study that used advanced regression methods to analyze data from a single-case design clinical trial of propranolol for treating agitation in patients with traumatic brain injury. The study was a double-blind, randomized clinical trial of 13 patients (9 men and 4 women) with traumatic brain injury. Logistic regression models found that propranolol was not associated with less agitation for most participants, though 4 participants did show a significant response. The study demonstrates how single-case design data can be analyzed using regression methods to obtain clinically and statistically significant information about psychological and medical treatments.
The document summarizes and critically reviews two research papers on factors influencing patient compliance with cardiac rehabilitation programs. The first paper studied the effectiveness of an intervention based on the Theory of Planned Behavior in improving attendance rates. The second was a qualitative study exploring patients' beliefs about cardiac rehabilitation pre-attendance. Both papers provide guidance for practice, such as improving patient education to address misunderstandings about rehabilitation programs. However, limitations in the studies mean changes should be minor and further research is needed before major practice changes.
Running head DATA ANALYSIS1DATA ANALYSIS 7Dat.docxhealdkathaleen
Running head: DATA ANALYSIS 1
DATA ANALYSIS 7
Data Analysis
Tammie Witcher
Columbia Southern University
Data Analysis: Descriptive Statistics and Assumption Testing
Details of how data is collected and analyzed is presented here. The research that led to the achievement of Sun Coast objectives was done using quantitative research methods since they offer detailed insights pertaining to the study. Research design is the specific type of study that one would conduct and is usually consistent with one’s philosophical worldview and the methodological approach the researcher chooses
Correlation: Descriptive Statistics and Assumption Testing
Frequency distribution table
Histogram.
Descriptive statistics table.
Measurement scale. Causal-comparative research methods which was sometimes combined with the descriptive statistics one (Creswell & Creswell, 2018). The former was used to find the relationship between dependent and independent variables after the occurrence of any action in Sun Coast.
Measure of central tendency. The measure of central tendency majored on the mode even though both mean and median were employed for the frequency table to justify various aspects tested in the research.
Evaluation. Sun Coast’s leadership and other business objectives could render descriptive statistics significant since the researchers could use the past figures to analyze the current ones and make a sound forecast of future organizational performance.
Simple Regression: Descriptive Statistics and Assumption Testing
Frequency distribution table.
Histogram.
Descriptive statistics table.
Measurement scale. Regression analysis procedure would be appropriate for RQ3 since the variable, DB levels of work would be predicted before placing employees on-site for future contracts. There is no independent sample among those provided by this RQ.
Measure of central tendency. The measure of central tendency majored on the mode even though both mean and median were employed for the frequency table to justify various aspects tested in the research.
Evaluation. DB levels of work would be predicted before placing employees on-site for future contracts. There is no independent sample among those provided by this RQ.
Multiple Regression: Descriptive Statistics and Assumption Testing
Frequency distribution table.
Histogram.
Descriptive statistics table.
Measurement scale. The measurement for this case applied the regression procedure to use to test different hypotheses since the interest is whether a relationship exists between an independent variable (IV) and dependent variable (DV). Correlation will indicate if there is a relationship between PM size (IV) and the employee health (DV) and the magnitude of that impact if at all there is one
Measure of central tendency. The measure of central tendency majored on the mode even though both mean and median were also used.
Evaluation. The outcomeinvolved dividing populations in Sun Coa ...
This document provides a critique of 4 recent meta-analyses published in Health Psychology. It finds problems with transparency and completeness in how the meta-analyses were reported. It also notes a dependence on small, underpowered original trials of generally poor quality. The document questions the clinical validity and utility of conclusions drawn from these meta-analyses due to issues like clinical heterogeneity among studies and lack of consideration of methodological quality. Overall, it aims to encourage more rigorous standards for meta-analyses to avoid inaccurate or exaggerated conclusions.
This study examined the effect of complementary music therapy on postoperative patients' anxiety, pain, and noise satisfaction. Researchers recruited 41 postoperative patients from a hospital and assigned them to music therapy or control groups. Patients in the music therapy group listened to 30 minutes of non-lyrical music after analgesia, while controls received usual care. Patients completed questionnaires measuring anxiety, pain, and noise satisfaction at various times. Results showed music therapy increased pain and noise satisfaction but not anxiety. Researchers concluded music therapy may improve some postoperative outcomes but limitations included the small sample size. They recommended replicating the study with a larger, more diverse sample.
A Novel Evaluation Of Optimality For Randomized Controlled TrialsJeff Nelson
This document discusses using a novel approach called Data Envelopment Analysis (DEA) to evaluate randomized controlled trial designs based on both statistical criteria and community perspectives. It considers using a Bayesian adaptive longitudinal design (BADL) for a smoking cessation trial among American Indians. BADL would allow interim analyses to adapt randomization to treatments and potentially stop the trial early if an intervention is found to be more effective, translating results faster to the research field and community. While two-armed BADs are commonly used, they have slightly less power than fixed designs; the BADL aims to improve power through longitudinal adaptation. DEA will evaluate designs based on multiple criteria like statistical power as well as subject and community benefits to determine the optimal design.
No evidence for demand characteristics or social desirability with the Session Rating Scale.
Reese, R. J., Gillaspy, J. A., Owen, J. J., Flora, K. L., Cunningham, L. E., Archie, D., & Marsden, T. (2013). The influence of demand characteristics and social desirability on clients’ ratings of the therapeutic alliance. Journal of Clinical Psychology, 69, 696-709.
Why do evaluation researchers in crime and justice choosen.docxphilipnelson29183
Why do evaluation researchers in crime and justice choose
non-experimental methods?
1
CYNTHIA LUM*,**
College of Criminal Justice, Northeastern University, Boston, MA 02115, USA
* corresponding author: E-mail: [email protected]
SUE-MING YANG
Department of Criminology, University of Maryland, College Park, MD 20742, USA
Abstract. Despite the general theoretical support for the value and use of randomized controlled
experiments in determining Fwhat works_ in criminal justice interventions, they are infrequently used in
practice. Reasons often given for their rare use include that experiments present practical difficulties and
ethical challenges or tend to over-simplify complex social processes. However, there may be other
reasons why experiments are not chosen when studying criminal justice-related programs. This study
reports the findings of a survey of criminal justice evaluation researchers as to their methodological
choices for research studies they were involved in. The results suggest that traditional objections to
experiments may not be as salient as initially believed and that funding agency pressure as well as
academic mentorship may have important influences on the use of randomized controlled designs.
Key words: criminal justice evaluation, evaluation research, experiments, scientific validity, what works
No question has simultaneously dominated practice and research in criminology
and criminal justice more so than Fwhat works?_ in reducing crime, recidivism, and
crime-related risk factors. Since a number of highly influential reports in the 1970s
and 1980s indicating a grim future for many criminal justice programs and policies
(see Kelling et al. 1974; Lipton et al. 1975; Spelman and Brown 1984), the push
towards evaluating criminal justice interventions to find effective treatments has
defined the role of a number of researchers. This emphasis on program
effectiveness can be seen in systematic reviews of programs (most notably,
Sherman et al.’s 1997 report to congress), the increased use of meta-analyses to
draw more parsimonious conclusions from the plethora of evaluation research (see,
e.g., Andrews et al. 1990; Cox et al. 1995; Dowden et al. 2003; Lipsey and Wilson
1993; Logan and Gaes 1993; Lösel and Koferl 1989; Prendergast et al. 2000;
Wilson 2000, 2001; Wilson et al. 2000, 2001; Whitehead and Lab 1989), and the
establishment of the Campbell Collaboration,
2
an organization which advocates for
higher quality research and evidence-based policy (see Farrington and Petrosino
2001; Petrosino et al. 2001).
**In August 2005, Dr. Lum’s affiliation will change to George Mason University.
Journal of Experimental Criminology (2005) 1: 191–213 # Springer 2005
A natural development from this Fwhat works_ pursuit has become assessing the
quality of these evaluations. The believability of evaluation research depends not
only on the theoretical sense of what is being evaluated but also upon the eval-
ua.
Biostatistics_Unit_II_Research Methodology & Biostatistics_M. Pharm (Pharmace...RAHUL PAL
This document provides an overview of biostatistics topics including parametric and non-parametric statistical tests, sample size calculation, and factors influencing sample size. It discusses commonly used parametric tests like the t-test, ANOVA, correlation coefficient, and regression analysis. Non-parametric tests like the Wilcoxon rank-sum test are also covered. The importance of considering sample size, factors that can impact it, and how dropouts are handled are summarized as well.
Do people fill out the SRS differently IF the therapist is in the room?Scott Miller
This study examined how demand characteristics and social desirability may influence clients' ratings of the therapeutic alliance. 102 clients from two university counseling centers were randomly assigned to one of three conditions for providing alliance feedback: immediate feedback where ratings were discussed with the therapist, next session feedback where ratings were private and discussed later, and no feedback where ratings were private and not shared. The study found no significant differences in alliance scores across the feedback conditions and scores were not correlated with social desirability but were correlated with an established alliance measure, providing evidence that scores were not inflated due to demand characteristics.
How Barcodes Can Be Leveraged Within Odoo 17Celine George
In this presentation, we will explore how barcodes can be leveraged within Odoo 17 to streamline our manufacturing processes. We will cover the configuration steps, how to utilize barcodes in different manufacturing scenarios, and the overall benefits of implementing this technology.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
A Visual Guide to 1 Samuel | A Tale of Two HeartsSteve Thomason
These slides walk through the story of 1 Samuel. Samuel is the last judge of Israel. The people reject God and want a king. Saul is anointed as the first king, but he is not a good king. David, the shepherd boy is anointed and Saul is envious of him. David shows honor while Saul continues to self destruct.
🔥🔥🔥🔥🔥🔥🔥🔥🔥
إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
🔥🔥🔥🔥🔥🔥🔥🔥🔥
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
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RHEOLOGY Physical pharmaceutics-II notes for B.pharm 4th sem students
ORS Replication
1. Journal of Brief Therapy
Volume 5 • Number 1 • 2006
The Reliability and Validity of the
Outcome Rating Scale: A Replication
Study of a Brief Clinical Measure
Major David L. Bringhurst, MSW, LCSW, BCD
Air Force Institute of Technology/Civilian Institutions Program
University of Utah College of Social Work
Salt Lake City, Utah
Curtis W. Watson, MSW, LCSW
University of Utah College of Social Work
Salt Lake City, Utah
Scott D. Miller, Ph.D.
Barry L. Duncan, Psy.D.
Institute for the Study of Therapeutic Change
Chicago, Illinois
There is an industry-wide trend toward making outcome evaluation a routine part of therapeutic
services, yet most measures are infeasible for everyday clinical use. Consequently, the Outcome
Rating Scale (ORS) was developed and recently validated by its authors (Miller, Duncan, Brown,
Sparks, & Claud, 2003). This article reports the findings of an independent replication study
evaluating the reliability and concurrent validity of the ORS as studied in a non-clinical sample.
Concurrent validity was tested by comparing the ORS with the Outcome Questionnaire 45.2 (OQ)
using correlation statistics. The findings re-confirm that the ORS has high test-retest reliability,
strong internal consistency, and moderate concurrent validity. Implications for clinical practice and
future research are discussed.
M
iller, Duncan, Brown, Sparks, and Claud (2003) point to an industry-wide
trend toward making outcome evaluation a routine part of therapeutic services.
They suggest that while various multi-dimensional assessments of outcome are
valid and reliable, their methodological complexity, length of administration, and cost
often render them infeasible for many service providers and settings. Consequently, the
Outcome Rating Scale (ORS) (Miller & Duncan, 2000) was developed as an ultra-brief
alternative. Miller et al. (2003) examined the instrument’s psychometric properties with
23
2. 24 ORS Replication Study
both clinical and non-clinical samples, as well as the feasibility of the measure at various
clinical sites. Results indicated that the ORS is a reliable and valid outcome measure that
represents a balanced trade-off between the reliability and validity of longer measures, and
the feasibility of this brief scale.
The present article reports the results of an independent investigation of the psychometric
properties of the ORS, specifically test-retest reliability, internal consistency reliability,
and concurrent validity with a non-clinical sample. The study was implemented and the
data gathered and analyzed independently; to facilitate replication, the original authors
were consulted about the design and then participated in the write-up and comparison of
the data between the two studies. As with the original investigation, this replication study
compared the ORS to the Outcome Questionnaire – 45.2 ([OQ] Lambert, Burlingame,
Umphress, Hansen, Vermeersch, Clouse, & Yanchar, 1996). Results and implications for
clinical practice and future research are discussed.
Methods
The Instruments: The ORS and the OQ
The ORS (Miller et al., 2003) was developed as a brief alternative to the OQ because
of feasibility complaints by clinicians interfered with implementation of the OQ. The
ORS is a 4-item visual analogue self-report outcome measure designed for tracking client
progress in every session. Each item requires the client to make a mark on a ten centimeter
line where marks to left indicate more difficulties in the particular domain and marks to the
right depict fewer difficulties.
Items on the ORS were tailored from three areas of client functioning assessed by the
OQ; specifically, individual, relational, and social well being and functioning.
The OQ is a widely used and respected 45-item self-report scale designed for repeated
measurement of client functioning through the course of therapy. The measure has high
internal consistency (.93) and test-retest reliability (.84). Moderate to high validity
coefficients have been reported between the scale and other well-established measures
of depression, anxiety, and global adjustment. The instrument has proven particularly
useful in documenting the effect of interventions due to therapy as it has been shown
to be sensitive to change in a treated population while remaining stable in a non-treated
population (Lambert, Burlingame, Umphress, Hansen, Vermeersch, Clouse, Yanchar,
1996). Two studies have further documented the scale’s ability to identify and improve
the chances of success in cases at risk for a negative or null outcome (Lambert, Whipple,
Smart, Vermeersch, Nielsen, Hawkins, 2001; Whipple, Lambert, Vermeersch, Smart,
Nielsen, Hawkins, 2003).
Participants
Participants in this study were recruited from the student population at the University
of Utah, College of Social Work. The non-clinical group consisted of 98 total participants
made up of masters and bachelors level students. There were 67 females and 30 males
(1 individual did not report their gender), ranging in age from 20 to 59. Out of 98
participants 84% (82) completed at least two administrations with 58% (57) completing
For a full description of the ORS, see Miller et al. (2003).
3. Bringhurst, Watson, Miller Duncan 25
all three administrations. A further breakdown of participation rates shows that 22.4%
(22) completed the 1st and 2nd administrations, 14.3% (14) participants completed the 1st
administration only, and the remaining 5% (5) participants only completed the 2nd (1), 3rd
(1), or the 1st and 3rd administrations (3). Attrition at the third administration was likely
because this administration occurred during the week of the Thanksgiving holiday.
Procedure
Participants signed an informed consent form prior to their participation in the study.
Participants received three concurrent administrations of the ORS and OQ. The sample
was tested in classroom settings, with proctors administering the instruments. Retest
administration used the same procedure for the 2nd and 3rd administrations over the following
1 to 3 weeks. Data were collected during the last week of October 2003 through the 3rd week
of November 2003. Participant scores were excluded from overall analysis scores if they
failed to complete all three administrations. A minimum of ten cases per item on the ORS
(the ORS has a total of four items) was desired to ensure sample sufficiency for data testing.
This minimum was met at each administration (n = 94, 79, 60 respectively) and overall
(53). The data met assumptions of normality making it suitable for parametric statistics; the
Pearson product-moment correlation coefficient was used to assess concurrent validity.
Results
Normative Data
The means and standard deviations for the sample are displayed in Table 1. The mean
ORS score was similar to that reported in the preliminary ORS reliability and validity study
(Miller et al, 2003). Likewise the mean OQ score for this non-clinical sample was similar to
the normative sample scores reported for the OQ (Lambert et al, 1996). The comparability
of both the ORS and OQ mean scores provides an initial indication of confidence in the
findings.
Table 1: Sample means and standard deviations for the ORS and OQ
Sample Size Instrument Mean Standard Deviation
98 ORS 29.9 7.5
98 OQ 48.3 18.7
Normative data reported for the OQ (Lambert al., 1996) also suggest that individual
scores do not differ due to age or gender. There were 68 females and 30 males who
participated in the study (a normal ratio of females to males in a social work student
population). Differences in OQ intake scores were not found between men and women
(p.10). Table 2 displays the means and standard deviations of the ORS scores by gender.
An inspection of the table reveals a significant difference between male and female ORS
intake scores (p .05). This somewhat perplexing finding also occurred in the original
study.
4. 26 ORS Replication Study
Table 2: Gender comparison of ORS means and standard deviations
Sample Size Mean Standard Deviation
Males 30 27.4 9.9
Females 68 31 5.9
P.05; two-tailed t-test comparison of ORS scores by gender
Reliability of the ORS
Internal Consistency. Internal consistency of the ORS was evaluated by using
Cronbach’s alpha coefficient. Cronbach’s alpha was .91 for the first administration, .93 for
the second, and .97 for the third. The overall alpha for all ORS administrations was .97 (n
= 53; the number of participants who completed all three administrations of the ORS) and
for the OQ was .98. The overall alpha for the ORS in the original study was .93.
Table 3: Cronbach’s Alpha assessing internal consistency of the ORS
2nd 3rd
1st administration administration All administrations
administration
(n=94) (n=53)
(n=79) (n=60)
.91 .93 .97 .97
Normally an instrument with fewer than 12 items, like the ORS, would be expected
to have lower internal consistency reliability than a measure with 45 items. Miller et al.
(2003) explain these unusual findings: “This high degree of internal consistency reflects the
fact that the four items correlate quite highly with one another, indicating that the measure
can perhaps best be thought of as a global measure of distress rather than one possessing
subscales for separate dimensions” (p. 95).
Test-retest Reliability. Test-retest reliability estimates were obtained through correlation
testing of each administration with each following administration. These correlations
statistics are found in Table 4. Surprisingly, the ORS test-retest reliability had correlations
similar to those of the OQ at the same administrations. Normally the expected test-retest
reliability of an ultra-brief measure would be significantly lower than that for a measure
with 45 items like the OQ. When compared with Miller et al’s preliminary work (2003), the
ORS test-retest correlations in this sample were markedly higher, .80 compared to .66, and
.81 compared to .58, when 2nd and 3rd administrations are paired from each study. Although
further research is needed to explain this difference, it is likely due to the increased time
between administrations in the original study.
5. Bringhurst, Watson, Miller Duncan 27
Table 4: Test-retest reliability correlations
2nd
3rd administration Coefficient Alpha
administration
ORS 0.80** (n=75) 0.81** (n=55) .97
OQ 0.84** (n=78) 0.83** (n=55) .98
(**significant at the 0.01 level, 2-tailed)
Concurrent Validity of the ORS
Concurrent validity was computed using Pearson product-moment correlations (Cohen
Cohen, 1983 not in the references) between the ORS total score and OQ total score. Table
5 displays the correlation coefficients at each administration. The first two administrations
were similar while the third administration shows a higher correlation (.69). The increased
correlation at the third administration may be due in part to the attrition in participation,
leaving the possibility that the more consistent and reliable students remained in class
(Thanksgiving week) to fill out the survey at the third administration. These correlation
coefficients suggest a moderate level of concurrent validity. Miller et al (2003) showed ORS
and OQ correlation coefficients of .69, .53, .54, and .56 through their four administrations
respectively, suggesting a notable similarity in results. Also of note and a replication of the
original study’s findings in support of construct validity, the pre v. post scores of the current
sample was not significant, indicating that the ORS is stable in non clinical populations.
Table 5: Pearson correlation coefficients between ORS and OQ
1st administration 2nd administration 3rd
(n=94) (n=79) administration (n=60)
-0.57** -0.56** -0.69**
(**significant at the 0.01 level, 2-tailed)
Though modeled on the OQ, it is not reasonable to expect very high coefficients of
correlation between the two measures given the shorter nature of the ORS. Nonetheless,
the correlation is respectable and does provide evidence that the ORS is an ultra brief
alternative for assessing global subjective distress similar to that measured by the full-scale
score on the OQ.
Discussion
Outcome evaluation can be used to enlighten clinical decision-making and improve
treatment effectiveness (Duncan, Miller, Sparks, 2004; Howard, Moras, Martinovich,
Lutz, 1996). Studies of outcome feedback in psychotherapy (Lambert, Whipple, Smart,
6. 28 ORS Replication Study
Vermeersch, Nielsen, Hawkins, 2001; Whipple, Lambert, Vermeersch, Smart, Nielsen,
Hawkins, 2003) have demonstrated a 65% improvement in cases most at risk for negative
outcomes. Furthermore, Miller, Duncan, Brown, Sorrell, Chalk (in press) found that
the ongoing outcome feedback to clinicians doubled overall effectiveness in a sample of
over 6000 clients. These dramatic results point to the importance of the development of an
outcome measure that clinicians view as user-friendly as well as reliable and valid.
This article reported the results of an independent investigation of the reliability and
validity of an ultra-brief outcome measure, the ORS. Although a short measure can’t be
expected to achieve the same specificity or breadth of information as a longer measure
like the OQ, this study replicated the original validation study and found that the ORS has
adequate concurrent validity, and moderate to high reliability.
It is curious that the finding that females scored significantly lower than males in
the Miller et al. study was also replicated. Further research should examine this finding.
Research using assorted clinical and non-clinical samples is also recommended, as well as
a focus on the stability of the ORS with clinical samples prior to treatment, longitudinally,
and with normal controls.
References
Cohen, J., Cohen, P. (1983). Applied multiple regression/correlational analysis for the
behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.
Duncan, B. L., Miller, S. D., Sparks, J.A. (2004). The heroic client: A revolutionary way to
improve effectiveness (Revised). San Francisco: Jossey Bass.
Howard, K., Moras, K., Brill, P., Martinovich, Z., Lutz, W. (1996). Evaluation
of psychotherapy: Efficacy, effectiveness, and patient progress. American
Psychologist, 51(10), 1059-1064.
Lambert, M.J., Burlingame, G.M., Umphress, V., Hansen, N.B., Vermeersch, D.A., Clouse,
G.C., Yanchar, S.C. (1996). The reliability and validity of the Outcome Questionnaire.
Clinical Psychology and Psychotherapy, 3, 249-258
Lambert, M.J., Whipple, J., Smart, D., Vermeersch, D., Nielsen, S., Hawkins, E.
(2001). The effects of providing therapists with feedback on patient progress during
psychotherapy: Are outcomes enhanced? Psychotherapy Research, 11(1) 49-68.
Miller, S. D., Duncan, B. L., Brown, J, Sorrell, R., Chalk, M. (2006). Using formal client
feedback to improve retention and outcome: Making ongoing real-time assessment
feasible. Journal of Brief Therapy, 5(1).
Miller, S.D., Duncan, B.L., Brown, J., Sparks, J., Claud, D. (2003). The outcome rating
scale: A preliminary study of the reliability, validity, and feasibility of a brief visual
analog measure. Journal of Brief Therapy, 2(2), 91-100.
Miller, S. D. Duncan, B. L., (2000). Outcome Rating Scale. Retrieved May 29, 2003,
from www.talkingcure.com; directed on its use by personal email from Scott Miller.
Whipple, J. L., Lambert, M. J. Vermeersch, D.A., Smart, D.W., Nielsen, S.L.; Hawkins, E.
J. (2003). Improving the effects of psychotherapy: The use of early identification of
treatment and problem-solving strategies in routine practice. Journal of Counseling
Psychology, 50(1) 59-68.
7. Bringhurst, Watson, Miller Duncan 29
Major David L. Bringhurst, MSW, LCSW, BCD
Air Force Institute of Technology/Civilian Institutions Program
University of Utah College of Social Work
Salt Lake City, Utah
davidandbelinda@yahoo.com
Curtis W. Watson, MSW, LCSW
University of Utah College of Social Work
Salt Lake City, Utah
Scott D. Miller, Ph.D.
Barry L. Duncan, Psy.D.
Institute for the Study of Therapeutic Change
P.O. Box 578264
Chicago, Illinois
scottdmiller@talkingcure.com