Article by Dr Mary Haynes about her agency's journey to a recovery orientation via CDOI and PCOMS published in the SAMHSA Recovery to Practice Newsletter.
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
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
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.
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.
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
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.
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.
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.
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
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
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.
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.
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
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.
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.
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 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 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.
Overview of PCOMS and couple and family therapy.
Duncan, B., & Sparks, J. (2017). The Partners for Change Outcome Management System. In J. L. Lebow, A. L. Chambers, & D. C. Breunlin (Eds.), Encyclopedia of Couple and Family Therapy (pp. 1-10). New York: Springer.
The Partners for Change Outcome Management System (PCOMS) uses brief scales completed by clients at each session to provide feedback on client progress and the therapeutic alliance. This allows clinicians to identify clients at risk for negative outcomes early. Five randomized clinical trials have shown that PCOMS significantly improves treatment outcomes and reduces costs by shortening treatment length and increasing provider productivity. Hundreds of organizations in the U.S. and other countries have implemented PCOMS, which involves clients in their care while respecting clinicians' time.
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.
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.
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
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.
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.
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.
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.
What Is Client Directed Outcome InformedScott Miller
Client Directed Outcome Informed (CDOI) clinical work privileges the client's perspective and uses their feedback to guide treatment in a partnership between client and provider. Several mental health and substance abuse treatment organizations that have implemented CDOI report improved outcomes like higher retention rates and lower costs from reduced sessions and cancellations. Research shows involving clients in decisions about their treatment and focusing on whether treatment is working improves success rates by an average of 65%.
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.
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.
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.
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.
Practical hints and tips for assessing readiness to change - Dr Bronwen BonfieldMS Trust
Aims:
To have increased awareness of the factors that affect an individuals readiness to change.
To explore the theoretical models that underpin change behaviour
To develop awareness of skills and strategies to support individuals and their families.
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 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.
Overview of PCOMS and couple and family therapy.
Duncan, B., & Sparks, J. (2017). The Partners for Change Outcome Management System. In J. L. Lebow, A. L. Chambers, & D. C. Breunlin (Eds.), Encyclopedia of Couple and Family Therapy (pp. 1-10). New York: Springer.
The Partners for Change Outcome Management System (PCOMS) uses brief scales completed by clients at each session to provide feedback on client progress and the therapeutic alliance. This allows clinicians to identify clients at risk for negative outcomes early. Five randomized clinical trials have shown that PCOMS significantly improves treatment outcomes and reduces costs by shortening treatment length and increasing provider productivity. Hundreds of organizations in the U.S. and other countries have implemented PCOMS, which involves clients in their care while respecting clinicians' time.
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.
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.
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
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.
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.
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.
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.
What Is Client Directed Outcome InformedScott Miller
Client Directed Outcome Informed (CDOI) clinical work privileges the client's perspective and uses their feedback to guide treatment in a partnership between client and provider. Several mental health and substance abuse treatment organizations that have implemented CDOI report improved outcomes like higher retention rates and lower costs from reduced sessions and cancellations. Research shows involving clients in decisions about their treatment and focusing on whether treatment is working improves success rates by an average of 65%.
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.
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.
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.
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.
Practical hints and tips for assessing readiness to change - Dr Bronwen BonfieldMS Trust
Aims:
To have increased awareness of the factors that affect an individuals readiness to change.
To explore the theoretical models that underpin change behaviour
To develop awareness of skills and strategies to support individuals and their families.
This document outlines Advantage Behavioral Health Systems' Recovery Initiative. It provides details about Advantage, including its mission, services, finances, and accreditation. It then discusses what is currently working well and their ideals for the future. Specific change projects are proposed to help achieve this ideal, like redesigning clinic lobbies to feel more welcoming, improving referrals, and increasing customer service. The document emphasizes the importance of collaboration, a recovery culture, and sharing stories of recovery. It concludes by discussing lessons learned and next steps to continue implementing the initiative.
The document discusses revising the Core Humanitarian Standard (CHS) to make it more accessible and relevant. It provides background on the CHS, which was established in 2014 to define quality and accountability standards for humanitarian organizations. It notes that a consultation process will gather input from communities, organizations, governments and donors on how to strengthen the CHS to better protect people's rights and deliver effective aid. The consultation will focus on validating the CHS's core commitments, identifying any gaps, and simplifying the language to make it more user-friendly. Any proposed changes will be assessed based on whether they reinforce the standard's people-centered approach and simplify use while maintaining continuity.
This document provides information about an upcoming Healthcare Operational Excellence Executive Sector Meeting taking place October 22-24, 2017 in Dallas, TX. It lists the event participants which include various healthcare executives from hospitals and medical centers. The document discusses why attendees should attend, including maximizing their time, finding proven solutions, accessing reliable information from senior healthcare executives, and networking opportunities. It also outlines the think tank session topics that will be discussed during the event.
Faith based team mentoring training cdDenis Rigdon
The document provides guidance for faith-based team mentoring. It outlines the roles of an administrator, primary mentor, special events coordinator and financial planner on the mentoring team. It discusses preparing for mentoring through prayer, establishing boundaries, and focusing on developing the participant's relationship with God and movement toward self-reliance. The document also covers addressing obstacles, the stages of mentoring, and the importance of focusing on building relationships and moving the participant toward dignity and responsibility.
~Our mission is to eradicate preventable diseases, minimize trial and error, increase patient understanding by supporting a wholistic ecosystem that shifts health management to wellness 2.0; whole-life personalized wellness
The document discusses strategies employed by 10 community behavioral health organizations to improve therapy adherence and continuity of care. The organizations focused on 3 core areas: organizational leadership, data-driven decision making, and sustaining changes. Key strategies included executive leadership participation in process reviews, restructuring management teams, sharing data on positive results, using a rapid cycle change model to make quick decisions, and analyzing scheduling data to reduce no-shows and cancellations. Participating organizations saw improvements such as reduced wait times, increased capacity, lower staff turnover, and engagement of staff in the change process.
The document discusses strategies used by 10 community behavioral health organizations to improve therapy adherence and continuity of care. The CBHOs focused on 3 core areas: organizational leadership, data-driven decision making, and sustaining changes. Some key strategies included executive walkthroughs, restructuring management teams, using data to inform scheduling and identify process improvements, emphasizing a patient-centered approach, and evaluating staff productivity. These initiatives led to benefits like reduced wait times, lower no-show rates, increased client capacity and engagement in services.
Comments by the professorWeek 1 Weekly Summary You have done aLynellBull52
Comments by the professor
Week 1 Weekly Summary
You have done a great job in meeting these outcomes, especially in your discussion of past organizational change projects as connected to your leadership self-awareness. You also opened up a new avenue of self-awareness by complete the Zinger-Folkman Extraordinary Leader Assessment and constructing your strengths-to-strategy plan in the interactive exercise. I encourage you to continue collecting new tools for your leadership toolbox and building leadership capacity throughout this course and afterward. You will find that you will test some of the skills you are discovering (or rediscovering) through this class in your practicum project. Let's keep the dialogue going to foster an understanding of leadership from the evidence that supports guiding change for a compelling practice problem. I enjoyed reading your examples and seeing the insight you were able to have with regard to leading a change in your organization and doing some self-reflection on what you could have done differently. Understanding and explaining the change process as a self-aware leader helps you internalize these ideas for future projects, especially the impending DNP projects. Remember that you can leverage others’ skills and attributes, which also facilitates the team process.
As a reminder, the following Course Outcomes (COs) guided your learning this week
· CO3. Differentiate attributes of effective leaders and followers in influencing healthcare. (PO 6)
· CO5. Formulate selected strategies for leadership and influence across healthcare systems. (PO 8
This week, we discovered that each practice scholar plays a role in transforming healthcare through self-assessment to identify individual leadership gaps. Evaluating leadership gaps builds tacit knowledge to move us toward professional maturity. You now know that insight into improved systems begins with insight into one's self. Improved systems evolve through the collaboration of individuals who are first committed to improving their own practice. Practice scholars are called to transform the health of our nation. I have no doubt that you'll answer the call by reflecting on your individual and professional commitment to gain insight on needed change within yourself, and your organization. Next week, you'll reflect on emotional intelligence and mindfulness in the workplace. So, let's keep going! Your work is needed to improve patient outcomes!
Week 2
Hello! Last week, we explored how the self-aware practice scholar is influencing the practice of nursing and the health of our nation. The call for transformation to improve patient care delivery requires nurse leaders to reach beyond their intellect to their emotional intelligence. By increasing emotional competence, nurse leaders are raising their awareness to make better choices. Establishing and maintaining relationships are essential to leadership, and all relationships have an emotional component. Emotional ...
This document discusses using workshops to develop a customer-focused culture by translating high-level service standards into specific employee behaviors. It recommends that workshops:
1) Provide context on current customer experiences, standards, and challenges through research findings.
2) Use activities to build employee empathy for customers and motivate them to consistently meet standards.
3) Empower employees to brainstorm solutions to issues through breakout groups and develop personal action plans to enhance the customer experience.
Setting clear expectations and follow up helps employees apply what they learn from the workshops. A case study shows how these workshops helped a healthcare provider reinforce their customer service philosophy and improve specific touchpoint experiences.
This document summarizes a research paper about how two change agents, Blue Jay Consulting and MEDI, assisted a hospital called Health Central Hospital in implementing changes to improve processes and culture. Blue Jay Consulting used a change management approach to improve emergency department processes and flow, while MEDI used an organizational development approach to create a collaborative employee culture and break down silos. Both agents helped the hospital target weaknesses and increase patient satisfaction in order to change its reputation from "Death Central".
Peer coaches can help the people and organizations they work with establish effective goals using the SMART framework:
1) Goals should be specific, measurable, attainable, relevant, and time-bound to assess progress.
2) Coaches can work with their coachees to brainstorm potential goals, determine what is most important to focus on, and ensure the goals meet SMART criteria.
3) Establishing clear goals and expectations up front helps coaches effectively support and measure the progress of the people and teams they are coaching over time.
This summary highlights how peer coaches can use the SMART framework and goal setting
OptumHealth, a business segment of United Health Group, underwent a major change in 2007 by moving segments of their staff from working in offices to working remotely from home. The change aimed to consolidate the workforce and realize bottom line savings in facilities costs. While communication of the change was a recurring challenge, OptumHealth did manage to transition staff to telecommuting. However, leadership could have done more to gain staff buy-in during planning and implementation stages. In the long run, the change helped leadership adapt to a new work environment and become more innovative in dealing with situations.
Reaching the Unreachable: Engaging People with SUDS in Pre-Contemplation Phasecommteam
Learn about Co-Occurring Education Groups, identify strategies to assist mental health and substance use staff, and learn about the qualitative outcomes of a non-judgmental, educational approach.
Plan sponsors of all sizes recognize the need to empower participants with financial education. Participants use it when offered. Your peers anticipate more clients will want it in the future. A tremendous opportunity exists for DC specialist advisors to bring financial wellness to clients.
Whether you’ve thought about financial wellness or not, this guide can help you talk to
plan sponsors and establish processes for success.
The document provides 10 tips for leading organizational transformation. Tip 1 emphasizes digging deep to identify the root cause of issues rather than just solving surface problems. Tip 2 stresses setting a clear scope for the transformation by defining what can and cannot be influenced. Tip 3 advises paying equal attention to organizational performance and health during transformation. The tips provide guidance for navigating the human dynamics and ensuring success of large-scale organizational change initiatives.
Bridgeway Rehabilitation Services provides psychiatric rehabilitation services to help adults with serious mental illnesses live independently. They began implementing motivational interviewing (MI) agency-wide to help staff engage clients and address ambivalence about change. Senior management supported extensive MI training for all staff to learn principles, skills, and use a common language. Regular supervision and practice helped staff integrate MI into services like housing, outreach, and career support. Initial outcomes showed more clients progressing to action stages in recovery planning and completing treatment programs.
The document discusses developing effective programs, campaigns and products to promote behavioural change. It covers understanding behaviour change as a process that occurs in stages, with key factors like environment, social support and access to resources influencing change. Effective behaviour change communication requires understanding an individual's situation and community context, and building local capacity to support positive change through participation and empowerment. The goal of any behaviour change program is to help people develop skills and a supportive environment to progress through the stages of change in their own way and time.
2013 10 utilizing member engagement to improve cahps scoresimagine.GO
The webinar discusses utilizing member engagement to improve scores on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. CAHPS scores are an important factor in reimbursement and ratings for healthcare providers and plans. The webinar outlines how CAHPS scores are calculated and impact reimbursement. It then discusses using the modelH business model canvas to develop strategies for improving member engagement through areas like care management, prevention/wellness programs, and rewards/incentives. Focusing engagement efforts on the most impactful customer segments and issues can help providers maximize their CAHPS scores and reimbursement.
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.
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.
Philippine Edukasyong Pantahanan at Pangkabuhayan (EPP) CurriculumMJDuyan
(𝐓𝐋𝐄 𝟏𝟎𝟎) (𝐋𝐞𝐬𝐬𝐨𝐧 𝟏)-𝐏𝐫𝐞𝐥𝐢𝐦𝐬
𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
- Understand the goals and objectives of the Edukasyong Pantahanan at Pangkabuhayan (EPP) curriculum, recognizing its importance in fostering practical life skills and values among students. Students will also be able to identify the key components and subjects covered, such as agriculture, home economics, industrial arts, and information and communication technology.
𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
-Define entrepreneurship, distinguishing it from general business activities by emphasizing its focus on innovation, risk-taking, and value creation. Students will describe the characteristics and traits of successful entrepreneurs, including their roles and responsibilities, and discuss the broader economic and social impacts of entrepreneurial activities on both local and global scales.
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
In this webinar, participants learned how to utilize Generative AI to streamline operations and elevate member engagement. Amazon Web Service experts provided a customer specific use cases and dived into low/no-code tools that are quick and easy to deploy through Amazon Web Service (AWS.)
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
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.
This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, 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.
1. Recovery To Practice Weekly Highlight
October 4, 2012 Volume 3, Issue 31
Please share the Recovery to Practice (RTP) Weekly Highlights with your
colleagues, clients, friends, and family!
Have you seen our NEW Web site? Visit www.samhsa.gov/recoverytopractice to find archived RTP
publications, including Weekly Highlights, E-Newsletters, and Webinars.
One Agency's Journey to Be Recovery Oriented
by Mary Susan Haynes, Ph.D.
In November 2002, Community Health and Counseling Services began a journey to implement Client-Directed, Outcome-
Informed (CDOI) practice [1] in its social work services. CDOI is a truly collaborative way of providing services that acknowledges
the voice of the client to the greatest degree possible. Not only are clients' goals prioritized above those of providers, but the
methods for reaching these goals also take precedence.
In addition, through the administration of two simple empirically validated scales, which take less than 3 minutes to complete,
score, and discuss, feedback is often collected from clients on their progress toward goals and the status of their alliance with
providers. These measures allow us to make immediate changes when services are not working, and to quickly make repairs to
the alliance.
In CDOI practice, it is not enough to simply measure outcome and alliance. So we ask clients to help us understand the meaning
of their ratings. We have learned to highlight the client's heroism in the face of adversity, and to help clients capitalize on their
strengths, resources, and resiliencies to overcome personal challenges.
We didn't make this change because we wanted to foster client recovery. In fact, we talked little about the potential for recovery
because everything we knew about the Recovery Movement seemed to suggest providers were superfluous at best, and
hindrances or even saboteurs at worst, when it came to people's recovery journeys. We didn't see a place for ourselves in
clients' recovery, but we were proud of our ability to help clients maintain their lives in the community without a high likelihood of
rehospitalization.
We made the change because we needed a common approach throughout our services—given our wide variety of programs and
the fact that many clients worked with different staff members. Prior to CDOI practice implementation, we described ourselves as
an agency that used a psychosocial rehabilitation approach. However, we only loosely defined what that was, and had not
determined a way to communicate how to put the philosophy into action. Thus, we believed having CDOI practice as a single
sanctioned way of working (a method in which all staff would be well-trained) would provide a more consistent treatment
experience for clients, and help them better maintain their lives in the community.
This was a laudable goal in itself, but an even more amazing thing happened once we got our footing with CDOI practice.
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2. Recovery To Practice Weekly Highlight
Clients began to feel empowered to take control of their lives and decided maintenance was not enough—they wanted recovery.
They came to see themselves as strong and capable. Although they were surprised when providers asked for ideas about
implementing change, clients were delighted when we modified our approach based on their preferences. Many reported they
had never truly experienced collaboration with providers.
We expected big changes in our agency's culture as a result of implementing CDOI practice, but we didn't expect CDOI practice
would help us become a recovery-oriented organization. Inadvertently, we had found a way to operationalize what had once been
an ill-defined path for helping clients create their recovery journeys. Until that point, we hadn't determined what our role in clients'
recovery might be, but now we had a roadmap to guide us.
We've learned many things in 10 years of CDOI practice and our subsequent shift to becoming a recovery-oriented agency. Here
are just a few:
Being a recovery-oriented system often calls for us to be braver than is comfortable. Clients sometimes take actions that
seem destined to fail, and some stakeholders will criticize us for not preventing the failure. It takes courage to hold to a
client-directed philosophy in these situations.
Many times when we think we are being fully collaborative with clients, we really are not. We have to unflinchingly review
our actions to ensure we don't impose our ideas and opinions on clients, or fall too readily into the role of "societal cop."
If recovery is our mission, it is not enough to only help clients obtain needed resources. We also have to help them
understand they are the ones who will make use of those resources. We need to emphasize that their actions are
responsible for bringing about real change.
The decision to use psychotropic medication needs to be as collaborative a process as other interventions. Clients'
preferences about medication should be privileged, and clients should be fully informed about the potential benefits and
risks.
We need to communicate to clients that recovery is possible and probable. Almost all of our clients have been told by a
helping professional that they have an illness from which they will never recover. This message contradicts research
findings on recovery, and we need to stop contributing to its continuation.
1. CDOI practice has given rise to a system that is undergoing review by SAMHSA for national evidence-based treatment designation. The Partners for
Change Outcome Management System is an intervention that uses the measures of outcome and alliance. For more information, visit
http://heartandsoulofchange.com .
Dr. Haynes is the Clinical Director of Community Health and Counseling Services in Bangor, Maine. Contact her at or
mhaynes@chcs-me.org.
Reference
Barry L. Duncan. (2012). The Partners for Change Outcome Management System (PCOMS): The Heart and Soul of Change
Project. Canadian Psychology, 53, 93–104.
Message from APA Recovery Advisory Committee
Do you think psychologists should receive more training in recovery and recovery-oriented practice? If so, here is your
opportunity to influence this important issue. The American Psychological Association (APA) Recovery Advisory Committee is
urging people to respond to the APA Commission on Accreditation, which is currently soliciting public comments about guidelines
and principles that govern the accreditation process for training psychologists. Read step-by-step instructions for commenting,
as well as a set of sample comments, which may be helpful to you in responding. Even though these instructions are lengthy,
we have tested the Web-based commenting process, and it takes less than 10 minutes to complete from start to finish.
This is a small investment of time for a potentially BIG impact on the training of psychologists to promote recovery! We hope you
will join us in responding and forward this message to others who may be willing to be a voice in this important effort.
Register now to submit your comments.
Substance Use in the Military
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