Our training provides us with signs that clients are improving. Some of us also rely on our experience, having seen similar cases in the past, to gauge improvement. And, as scientists, we know that behavioral or mental health outcomes measurement is an integral part of evaluating clients' perceptions of the effectiveness of psychotherapy. But what about our own effectiveness – is there a good way to assess both clients and ourselves as therapists?
The Partners for Change Outcome Management System (PCOMS) shifts the conversation in the clinical supervision process away from our love affair with models and preoccupation with psychopathology. Based on outcome data – instead of theoretical explanations or pontifications about why clients are not changing – supervision is aimed at identifying clients who are not benefiting so that services can be modified in the very next session.
Placing clients' perceptions of the effectiveness of psychotherapy center stage is a departure from tradition, because rather than the therapist choosing which clients will be discussed, the clients choose themselves by virtue of their scores and lack of change —and therefore bring their voices into the clinical supervision process. The data also provide an objective way to determine whether or not development is actually happening and become the impetus for therapists to take charge of the improvement.
When implemented using the Better Outcome Now (BON) web application, PCOMS allows the clinical supervisor quick and easy access to harvest what information has been gleaned from successful and unsuccessful clients, identify anything that was new or different, and inquire more deeply into the therapist’s impressions of various client sessions.
However, the primary purpose of PCOMS is to improve therapy outcomes by identifying at-risk clients. Only then does the focus shift to the supervisee and professional development using data as an objective standard of effectiveness over time. Thus, PCOMS privileges the client in therapy as well as carries a client-first priority into the clinical supervision process.