Overview of using the Partners for Change Outcome Management System (PCOMS) with mandated substance users in Recovery Action and Progress (RAP) Groups.

1. Brauchtworks Consulting
www.brauchtworks.com Applying Science to Practice
2014 International Heart and Soul of Change Conference
June 5 & 6 at the Sheraton Cavalier in Saskatoon, Saskatchewan
Using the Partners for Change Management System
(PCOMS) with Substance Abuse:
Mandated Clients and Group Work Challenges
with
George S. Braucht, LPC
Brauchtworks Consulting &
The Georgia State Board of Pardons and Paroles
Email: george@brauchtworks.com
*Certified Trainer in Partners for Change Outcome Management System (PCOMS)
services with the Heart and Soul of Change Project: www.heartandsoulofchange.org
*Co-Founder of the Certified Addiction Recovery Empowerment Specialist
(CARES) Academy: www.gasubstanceabuse.org
The Endless Vine: An ancient symbol
of life, infinity or the interweaving wisdom of the
flow of time and movement on the path with That Which Is Eternal

2. Using the Partners for Change Management System (PCOMS) with
Substance Abuse: Mandated Clients and Group Work Challenges
with
George S. Braucht, LPC
Brauchtworks Consulting & The Georgia State Board of Pardons and Paroles
Table of Contents
Page
Session Description ......................................................................................................................... 3
Learning Objectives ........................................................................................................................ 3
Recovery-Oriented Systems of Care Principles and Practices ....................................................... 4
Faces and Voices of Recovery Bill of Rights ................................................................................. 6
Three Skills of PCOMS-Informed Services ................................................................................... 7
Top 10 Practical Considerations for Conducting PCOMS-Informed Recovery Groups ............... 8
Materials Needed for PCOMS-Informed Recovery Action and Progress Groups ......................... 9
Recovery Action and Progress Group Handout ............................................................................ 10
Self-Completed Overview of Recovery Experience Board (SCORE Board) ............................... 11
Downloading Instructions for PCOMS and Brauchtworks Consulting Materials ......................... 12
References and Resources ............................................................................................................. 13
Using PCOMS with Substance Abuse www.brauchtworks.com Page 2 of 13

3. Using the Partners for Change Management System (PCOMS) with
Substance Abuse: Mandated Clients and Group Work Challenges
with
George S. Braucht, LPC
Brauchtworks Consulting & The Georgia State Board of Pardons and Paroles
Session Description
This 3-hour session covers the fundamentals of using the Partners for Change Outcome
Management System’s (PCOMS) tools with groups of clients who have substance use recovery
issues, many who are on criminal justice supervision. Following an overview of research-based
recovery-oriented, client-directed and outcome-informed principles, participants will experience
using the PCOMS tools during a Recovery Action and Progress Group.
Learning Objectives. Upon completion of this session participants will be able to:
1. Summarize eight recovery-oriented systems of care principles.
2. Identify three skills for facilitating PCOMS-informed services.
3. Administer and interpret the Outcome Rating Scale (ORS), the Group Session Rating
Scale (GSRS) and the Self-Completed Overview of Recovery Experience Board (SCORE
Board).
4. List the five steps in a Recovery Action and Progress Group session.
Notes, Doodles and My Top Three Takeaways:
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Using PCOMS with Substance Abuse www.brauchtworks.com Page 3 of 13

4. Recovery-Oriented Systems of Care Principles and Practices
1. Empower people to pursue multiple pathways to recovery: plan, design, deliver, and evaluate
services while advocating for pro-recovery policies and programs in the wider
community that target five zones of personal experience: 1) physical, 2) psychological, 3)
relational, 4) lifestyle, and 5) spiritual.
2. Conduct strength-based assessments: identify and build on the strengths – called recovery
capital - of individuals, families and communities while emphasizing the first-person
voices of persons seeking or in recovery and their family members. Ask, “What’s right
with you?”
3. Develop culturally-congruent recovery resources: guide individuals and family members into
relationships with indigenous recovery communities; create physical, psychological and
social space within the community in which recovery can occur; link personal,
professional and community resources into recovery management teams.
4. Deliver recovery education and training: enhance the recovery-based knowledge and skills of
individuals, family members, allies, service providers, and the larger community with
The Science of Addiction & Recovery, Recovery Messaging, and other
trainings/presentations
5. Monitor and support interaction continuity: sustain contact and support across three recovery
phases: a) engagement and recovery priming (pre-recovery/treatment or no treatment), b)
recovery initiation and stabilization (recovery activities and treatment), and c) recovery
maintenance (post or no-treatment). Conduct Recovery Check-Ins.
6. Collect practice-based evidence of service effectiveness: while implementing evidence-based
practices, eliminating barriers to recovery and delivering community in-reach services.
7. Advocate for recovery: promote institutional and social policies that counter stigma and
replace discrimination with resources for building recovery capital and strengthening the
individual person in recovery’s voice.
8. Model hope: display the research-grounded hope for recovery based on millions of people
who have achieved full and partial recoveries from severe behavioral health problems.
Using PCOMS with Substance Abuse www.brauchtworks.com Page 4 of 13

5. Recovery-Oriented Systems of Care Principles and Practices (cont.)
Adapted by George S. Braucht, LPC from:
1) Sheedy, C. K., & Whitter, M. (2009). Guiding principles and elements of recovery-oriented
systems of care: What do we know from the research? HHS Publication No. (SMA) 09-
4439. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental
Health Services Administration. Available at
http://partnersforrecovery.samhsa.gov/docs/guiding_principles_Whitepaper.pdf.
2) Stengel, K., Schwartz, E. & Mathai, C. (2012). Operationalizing recovery-oriented systems:
Expert panel meeting report. SAMHSA. Available at
http://www.samhsa.gov/recovery/docs/Expert-Panel-05222012.pdf.
3) White, W. L., Boyle, M. G., Loveland, D. L. & Corrigan, P. W. (2008). What is behavioral
health recovery management? A primer. Available online at
www.williamwhitepapers.com.
Using PCOMS with Substance Abuse www.brauchtworks.com Page 5 of 13

6. We will improve the lives of millions of Americans, their families and communities if we treat addiction to alcohol and other drugs as a public
health crisis. To overcome this crisis, we must accord dignity to people with addiction and recognize that there is no one path to recovery.
Individuals who are striving to be responsible citizens can recover on their own or with the help of others. Effective aid can be rendered by mutual support groups or health care
professionals. Recovery can begin in a doctor’s office, treatment center, church, prison, peer support meeting or in one’s own home. The journey can be guided by religious faith, spiritual
experience or secular teachings. Recovery happens every day across our country and there are effective solutions for people still struggling. Whatever the pathway, the journey will be
far easier to travel if people seeking recovery are afforded respect for their basic rights:
1. We have the right to be viewed as capable of
changing, growing and becoming positively connected to
our community, no matter what we did in the past because of
our addiction.
2. We have the right—as do our families and friends
—to know about the many pathways to recovery,
the nature of addiction and the barriers to long-term
recovery, all conveyed in ways that we can understand.
3. We have the right, whether seeking recovery in
the community, a physician’s office, treatment
center or while incarcerated, to set our own
recovery goals, working with a personalized recovery plan
that we have designed based on accurate and understandable
information about our health status, including a comprehensive,
holistic assessment.
4. We have the right to select services that build on
our strengths, armed with full information about the
experience, and credentials of the people providing services
and the effectiveness of the services and programs from which
we are seeking help.
5. We have the right to be served by organizations
or health care and social service providers that
view recovery positively, meet the highest public health
and safety standards, provide rapid access to services, treat us
respectfully, understand that our motivation is related to
successfully accessing our strengths and will work with us and
our families to find a pathway to recovery.
6. We have the right to be considered as more than
a statistic, stereotype, risk score, diagnosis, label or
pathology unit—free from the social stigma that characterizes us
as weak or morally flawed. If we relapse and begin treatment
again, we should be treated with dignity and respect that
welcomes our continued efforts to achieve long-term recovery.
7. We have the right to a health care and social
services system that recognizes the strengths and
needs of people with addiction and coordinates its
efforts to provide recovery-based care that honors and respects
our cultural beliefs. This support may include introduction to
religious, spiritual and secular communities of recovery, and the
involvement of our families, kinship networks and indigenous
healers as part of our treatment experience.
8. We have the right to be represented by informed
policymakers who remove barriers to educational, housing
and employment opportunities once we are no longer misusing
alcohol or other drugs and are on the road to recovery.
9. We have the right to respectful, nondiscriminatory
care from doctors and other health care providers and to
receive services on the same basis as people do for any other
chronic illness, with the same provisions, copayments, lifetime
benefits and catastrophic coverage in insurance, self-funded/
self-insured health plans, Medicare and HMO plans.
The criteria of “proper” care should be exclusively between our
health care providers and ourselves; it should reflect the severity,
complexity and duration of our illness and provide a reasonable
opportunity for recovery maintenance.
10. We have the right to treatment and recovery
support in the criminal justice system and to regain our
place and rights in society once we have served our sentences.
11. We have the right to speak out publicly about our
recovery to let others know that long-term recovery from
addiction is a reality.
Funding provided through an unrestricted educational grant from
Reckitt Benckiser Pharmaceuticals Inc.
www.facesandvoicesofrecovery.org
info@facesandvoicesofrecovery.org
ENDORSED BY: American Association for the Treatment of Opioid Dependence, Inc.
• American Society of Addiction Medicine • Community Anti-Drug Coalitions of America
• Ensuring Solutions to Alcohol Problems • Entertainment Industries Council • Johnson Institute
• Join Together • Legal Action Center • NAADAC, the Association for Addiction Professionals
• National African American Drug Policy Coalition • National Alliance of Advocates for
Buprenorphine Treatment • National Alliance of Methadone Advocates • National Association
on Alcohol, Drugs and Disability • National Association of Drug Court Professionals • National
Association for Children of Alcoholics • National Association of Addiction Treatment Providers
• National Council on Alcoholism and Drug Dependence • National Council for Community
Behavioral Healthcare • Rebecca Project for Human Rights • State Association of Addiction
Services • TASC, Inc. • Therapeutic Communities of America • White Bison

7. Three Skills of PCOMS-Informed Services
1. Introducing the scales and the client’s voice in all services and all decisions
 Two key points to emphasize: 1) collaboratively monitor outcomes and do something
different if this is not work and 2) the client’s voice and perspective is what is needed to
direct what we do
 Put into your own words:
a. I may do things a little differently than you have experienced before because your
ideas, goals and resources are most important for your long-term recovery.
b. I am committed to advocating for your self-directed care and the services that I
provide focus on getting what you need for recovery.
c. To do that, it would be helpful to find out how you are doing and how well I am
providing what you need.
d. Many others I have worked with have found the two scales that I use to be very
helpful in tracking how thing are going for you and whether we are on track.
e. It will really help me learn about you and it takes only a few minutes.
f. Are you willing to do that now?
2. Integrating client feedback into practice
 Provide feedback about the client’s ORS score in reference to the clinical cutoff then
allow the client to make sense of it.
 Connect the client’s described experience with her/his marks on the ORS subscales –
allow revisions
 Relate the client’s reasons for seeking services to marks on the ORS and SRS
 At the end of the interaction, review the SRS scores and solicit feedback on how the next
interaction could be better or more useful to her/him.
3. Informing and tailoring services based on client feedback
 Compare the current and last ORS score and look at the change over time.
 When positive change occurs on the ORS, listen for and empower the client’s self-efficacy.
 If no change or lowered ORS, discuss what needs to happen next. If persists over two
sessions, check SRS scores and discuss alliance issues then engage in an urgent
discussion to brainstorm options and entertain the possibility of a referral or transfer to
another helper.
 If ORS change still does not occur, even if the SRS score(s) is high, fail successfully via
a warm handoff to another service provider or program.
Duncan, B. (2014, 2nd Ed.). On becoming a better therapist: Evidence based practice one client
at a time. Washington, DC: American Psychological Association.
Using PCOMS with Substance Abuse www.brauchtworks.com Page 7 of 13

8. Top 10 Practical Considerations for
Conducting PCOMS-Informed Recovery Groups
1. The PCOMS group facilitator’s job is to model relationship enhancement skills and evoke
participant goals, tasks and plans.
2. Prepare participants for group by teaching the use of the Outcome Rating Scale (ORS),
Session Rating Scale (SRS) and Self-Completed Overview of Recovery Experience
Board (SCORE Board) during an individual session or an orientation group (Motivation,
Assessment and Planning [MAP] Group).
3. Limit group size to 10 for a 1-hour group. Subdivide and separate larger groups within the
group room when you have more than 10 and float between the groups.
4. Name tags or tents help everyone learn each other’s names. Also provides a place for
displaying individual contingency management rewards.
5. Making the ORS/Group Session Rating Scale (GSRS) available before group encourages
participants to complete the scale before the group starts. If these materials are available,
don’t be late for group because it will likely start without you!
6. Bring each individual’s file containing completed ORSs, S/GSRSs and SCORE Boards to
each group.
7. A series of 40s or consistently high scores on the ORS does not necessarily mean that you are
doing something wrong, especially during the first sessions. Assist each participant with
connecting the ORS score with her/his lived experience regarding the issue for which
s/he is seeking services. Encourage ORS sub-scale score revisions when disconnects are
realized between described lived experience and scores.
8. Many clients like jotting down keywords from the past week around the sub-scale areas of
the ORS – provides a written record of events when they look back at their ORSs.
9. Always process GSRS scores and thank participants for their feedback. Ask, “what would
make the next group session better?”
10. If meeting with clients once a week, consider administering the ORS and GSRS at the
beginning of alternate weeks’ sessions: ORS in weeks 1 & 3, GSRS in weeks 2 & 4.
Using PCOMS with Substance Abuse www.brauchtworks.com Page 8 of 13

9. Materials Needed for
PCOMS-Informed Recovery Action and Progress Groups
1. Outcome Rating Scale*
2. Group Session Rating Scale*
3. Self-Completed Overview of Recovery Experience Board (SCORE Board)**
4. Recovery Action and Progress Group handout**
5. Ruler: centimeter side!
6. Optional: Recovery Capital Scale and Plan (WHAM)**
7. Optional: File folder for each participant
8. Optional: Name tags/tents
* = PCOMS scales available at www.heartandsoulofchange.com
** = available at www.brauchtworks.com
Using PCOMS with Substance Abuse www.brauchtworks.com Page 9 of 13

10. Recovery Action and Progress Group
Authorized for Brauchtworks training only. See www.brauchtworks.com for reusable document.
Instructions: Begin group with everyone completing a (1) Outcome Rating Scale and 2)
updating her or his SCORE Board. 3) Review the Group Guidelines. 4) One participant
does a Recovery Check-In with another participant using the Relationship Enhancement
OARS until everyone has checked in. 5) End group by completing then discussing today’s
Group Session Rating Scale scores. Be sure to add the GSRS score to your SCORE Board.
A. Group Guidelines
1. Turn off cell phones, pagers, etc., and notify someone before leaving the room.
2. Vegas Rules: Say “Vegas Rules” before you say something that you do not want repeated
outside of this group.
3. No fixing! Instead, share what recovery activities have worked for you by using “I…”
statements.
4. What other guidelines will help make this a safe and respectful place?
B. Recovery Check-In. Use the Relationship Enhancement OARS (below) to ask…
1. What’s right with you today?
2. Describe your ORS score. What progress did you make since your last group on your
recovery goals? May show your Self-Completed Overview of Recovery Experience
Board (SCORE Board).
3. From 0-10, what is your highest craving level since the last group, with 0 = Never thought
of using alcohol or other drugs; 10 = Used
4. Do you have a safe and sober place to stay?
5. Would you like more group time today?
Relationship Enhancement OARS
Open-Ended Questions: Express concern, interest, puzzlement, etc.; Who, What, How
Affirmation/Validation: Affirm appreciation for the other person and identify his or her
strengths; “You stayed sober last weekend!” instead of, “How did you manage to
avoid drinking?” “You are concerned about…”
 Begin with “You…” not “I”  Describe behaviors
 Attend to solutions instead of problems  Attribute interesting qualities to the person
 Focus on a strength or attribute, not the lack of something or what was not done
Reflective Listening: Make statements about what you heard the other person say instead of
asking questions
 Begin with: “You think (feel)…,” “You’re wondering if…,” “So you feel (think)…,”
Summaries: Short, clear statements that organize what’s been said; Use “and” instead of “but”
Using PCOMS with Substance Abuse www.brauchtworks.com Page 10 of 13

11. Self‐Completed Overview of Recovery Experience Board (SCORE Board) of Name:
Session 1 2 3 4 5 6 7 8 9 10 11 12 13 WHAM #1 Goal:
Date
Risk Score
Outcome Rating
Scale (ORS) Score
Tasks = What:
Craving Rating
(0‐10)
.
How Much:
Group/Session/Relationship
Rating Scale Score
How Often:
When:
Write an “O” in the column below to show your ORS Score.
Adult SRS/GSRS
Clinical Cutoff = 36
WHAM #2 Goal:
Tasks = What:
How Much:
#1 Goal Task # How Often:
#1 Goal Task # When:
#2 Goal Task #
# 2 Goal Task #
Briefly describe your needs/goals and task(s) in the column on the right. Above, enter task # as they are completed and  when goal is accomplished.
Using PCOMS with Substance Abuse www.brauchtworks.com Page 11 of 13
40
35
30
25
20
15
10
5
0
Authorized for Brauchtworks training only. See
www.brauchtworks.com/change_agent_toolkit for reusable document.
Adult ORS
Clinical Cutoff = 25

12. Downloading Instructions for PCOMS
and Brauchtworks Consulting Materials
George S, Braucht, LPC; Email: george@brauchtworks.com; Phone: 404-310-3941
The Partners for Change Outcome Management System (PCOMS) forms are FREE for individual users
and an inexpensive group license must be purchased for agency or organization use. The forms are
copyrighted and require completing a simple licensing agreement before downloading the scales. Access
the SAMHSA’s National Registry of Evidence-based Programs and Practices’ PCOMS summary at:
http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=250.
Professional versions: Outcome Rating Scale (ORS)
Session Rating Scale (SRS)
Group Session Rating Scale (GSRS)
Peer versions: Outcome Rating Scale (ORS)
Relationship Rating Scale (RRS, the SRS adapted for peers)
Group Session Rating Scale (GSRS)
Child, adolescent and telephone versions of the ORS and SRS/RRS are also available
1. Go to www.heartandsoulofchange.com
2. At the top of the page click on “Measures”
3. Review the licensing agreement
4. Click on “click here” to register your email address
5. Notice the different links for peer and professional versions of the forms and a separate link for the
Group Session Rating Scale
Additional forms for professionals and peers are available at
www.brauchtworks.com/helper_toolkit:
A Comparison of Acute Care Treatment and Recovery-Oriented Systems of Care
Addiction Treatment and Recovery Services Practices Overview
Individual Assessment of this Recovery Environment (ICARE): Outpatient and Residential
Knowing a Recovery Culture When You See One
Monthly Recovery Report: Outpatient and Residential versions completed by the client
Recovery Action and Progress Groups Handout
Recovery Capital Scale and Plan
Recovery Check-Ins Overview
Recovery Check-Ins Telephone Practice Guides: Initial and Ongoing
Recovery Coach Monthly Report Sample
Recovery Coach Supervisor Monthly Report Sample
Relationship Enhancement Skills Overview (OARS)
Self-Completed Overview of Recovery Experience Board (SCOREboard)
Using PCOMS with Substance Abuse www.brauchtworks.com Page 12 of 13

13. Using the Partners for Change Management System (PCOMS) with
Substance Abuse: Mandated Clients and Group Work Challenges
with
George S. Braucht, LPC
Brauchtworks Consulting & The Georgia State Board of Pardons and Paroles
References and Resources
1. Brauchtworks Consulting: www.brauchtworks.com
2. Duncan, B. (2014, 2nd Ed.). On becoming a better therapist: Evidence based practice one
client at a time. Washington, DC: American Psychological Association.
3. Duncan, B. L. (2005). What’s right with you: Debunking dysfunction and changing your life.
Deerfield Beach, FL: Health Communications.
4. Duncan, B. L. Miller, S. & Sparks, J. (2004). The heroic client: A revolutionary way to
improve effectiveness through client-directed, outcome-informed therapy. San Francisco:
Jossey-Bass.
5. Faces and Voices of Recovery: www.facesandvoicesofrecovery.org
6. Heart and Soul of Change Project: www.heartandsoulofchange.com
7. Kelly, J. & White, W. (Eds., 2011). Addiction recovery management: Theory, research and
practice. New York: Springer Science.
8. Sheedy, C. K., & Whitter, M. (2009). Guiding principles and elements of recovery-oriented
systems of care: What do we know from the research? HHS Publication No. (SMA) 09-
4439. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and
Mental Health Services Administration. Available at
http://partnersforrecovery.samhsa.gov/docs/guiding_principles_Whitepaper.pdf.
9. Stengel, K., Schwartz, E. & Mathai, C. (2012). Operationalizing recovery-oriented systems:
Expert panel meeting report. SAMHSA. Available at
http://www.samhsa.gov/recovery/docs/Expert-Panel-05222012.pdf.
Using PCOMS with Substance Abuse www.brauchtworks.com Page 13 of 13