Six randomized clinical trials demonstrating that PCOMS dramatically improves outcomes are now in print. The sixth trial appears in the prestigious Journal of Counseling Psychology! A special thanks to our Chinese colleague, Zhuang She. Following is the abstract.
Although client feedback has been demonstrated to improve psychotherapy outcomes in over a dozen randomized clinical trials, no studies to date have investigated the feedback effect outside of the United States or Europe. This study examined the impact of a client feedback intervention, the Partners for Change Outcome Management System, in a college counseling center in Wuhan, China (N = 186). Using a randomized design within routine care, treatment as usual (TAU; n = 85) was compared with a feedback condition (n = 101) in which therapists had access to client-generated outcome and alliance information at each session. Clients in the feedback condition demonstrated significantly greater improvement than those in the TAU condition at posttreatment. Not-on-track (n = 60) clients also demonstrated significantly more improvement at six times the rate of reliable change compared to the TAU condition. Survival analysis revealed that 66.7% of the clients in the feedback condition achieved reliable and clinically significant change after a median of 4 sessions whereas 57.0% of the clients in the TAU condition achieved reliable and clinically significant change after a median of 6 sessions. Alliance scores improved significantly more across treatment and were higher at posttreatment in the feedback condition. Although preliminary, this study suggests that the positive effects of improved outcomes and increased efficiency associated with systematic client feedback can also occur in a college counseling setting in China.
Public Significance Statement: Previous randomized clinical trials and studies about the effects of client feedback, an intervention designed to identify clients not responding to psychotherapy to enable psychotherapists to restore treatment to a positive trajectory, have only been conducted in the United States or Europe. This study is the first to demonstrate the effects of improved outcomes and efficiency associated with a client feedback intervention in a Chinese setting.
Besides the strong findings for PCOMS, the article also addresses the non-findings of PCOMS trials done in Europe. Plagued by non-adherence, it is no wonder that a feedback effect wasn’t demonstrated when a substantial number of therapists didn’t administer the measures and/or said they never discussed the results with clients. Without ongoing follow up to ensure adherence and use of the data to demonstrate to therapists that PCOMS can improve their work, implementation will likely fail and the extensive benefits of PCOMS will not be realized.