Spanish Versions of the Outcome Rating Scale and the Session Rating Scale: Normative Data, Reliability, and Validity

Routine outcome monitoring (ROM) uses standardized measures to both track and inform mental health service delivery. Use of ROM has been shown to improve the outcome of psychotherapy when applied to different types of patients. The present research was designed to determine the reliability and validity of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) in a sample of Spanish patients. After a controlled process of translation into the Spanish that is spoken and written in Spain (i.e., in Europe, as distinct from, e.g., Latin American Spanish), both measures were completed by patients of an outpatient mental health unit during eight sessions of psychotherapy. Sixty mental health patients filled out the ORS and 59 the SRS. In addition, the ORS was completed by 33 people who constituted the non-clinical sample. The cut-off of the ORS was 24.52 points, and the Reliable Change Index (RCI) was 9.15 points. ORS and SRS scores exhibited excellent internal consistency. The temporal stability of the SRS was adequate. The convergent and discriminant validity of the two measures were adequate. Regarding the factorial validity of the ORS and the SRS, in the third psychotherapy session, confirmatory factor analyses evidenced the existence of a unifactorial model. The predictive validity of SRS was acceptable. The ORS was sensitive to changes in patients’ symptoms. In conclusion, compared to the original English versions of the ORS and SRS measures, the Spanish versions of the measures are also reliable and valid.

A retrospective analysis comparing clinical outcome measures pre- and post- the introduction of telehealth in a community-based psychiatry clinic in a tertiary medical centre

AimsThe aim of this retrospective analysis was to look at the effect that telehealth had on patient outcomes and the therapeutic alliance.MethodClinical outcomes measures were collected prospectively as part of routine clinical care. Outcome measures were administered at patients’ initial and final appointment. Information was merged into a single database and imported into IBM SPSS for retrospective analysis. The following measures were administered at the beginning and end of treatment and were used to evaluate patient progress; Health of the Nation Outcome Scale (HoNOS), Life Skills Profile (LSP), Session Rating Scale (SRS), Outcome Rating Scale (ORS).ResultTwo cohorts were derived from the clinic; the first cohort (n = 90; 53 females; 37 males; M = 35.72 years; SD = 12.12 years) comprised of those patients whose care occurred between 23/09/2019 and 22/03/2020 and did not receive telehealth appointments. The second cohort (n = 122; 68 females; 54 males; M = 36.2 years; SD = 12.78 years) were those patients who presented to the clinic and were discharged between 23/03/2020 and 21/09/2020 and received at least one telehealth appointment. In the pre-telehealth cohort, mean HoNOS scores at baseline were 17.87 compared to 13.53 at discharge, mean LSP scores at baseline were 10.76 compared to 9.01 at discharge, mean SRS scores at baseline were 34.17 compared to 36.04 at discharge, and mean ORS scores at baseline were 12.97 compared to 21.28 at discharge. In the post-telehealth cohort, mean HoNOS scores at baseline were 14.45 compared to 10.50 at discharge, mean LSP scores at baseline were 7.85 compared to 7.19 at discharge, mean SRS scores at baseline were 36.04 compared to 35.36 at discharge, and mean ORS scores at baseline were 18.83 compared to 15.85 at discharge.ConclusionResults show that telehealth did not impact negatively on the therapeutic effect of clinical sessions, highlighted by similar reductions in HoNOS and LSP scores. It was seen in the post-telehealth cohort that there was worsening in the subject-rated scales (SRS and ORS) which was not seen in the pre-telehealth face-to-face cohort. Thus, there seems to be a discernible negative difference from the patient's perspective in the clinical sessions. This may be due to the difficulties in therapeutic alliance using the telehealth platform. We appreciate that there are a number of confounding factors, especially the effect of COVID-19 isolation. Telehealth is a useful addition to our assessment and treatment paradigms and its use should continue; however, we should be aware of the potential negative effect on therapeutic alliance.

A critical review of the first six months of operation of a trial Hospital Outreach Post-suicidal Engagement (HOPE) service in Australia

Objective: To review the Hospital Outreach Post-suicidal Engagement (HOPE) service in the first six months of the pilot program in a metropolitan Melbourne setting, including a description of: (a) socio-demographic, health and psychosocial stressors of people referred; (b) method of presentation; (c) interventions provided and (d) outcomes measured. Method: A retrospective case file analysis reviewed the first six months of HOPE service operation. Results: Forty people received HOPE service during the study period, 60% female, mean age 35 years (range 17–58). The majority had previously engaged in self-harm (72.5%) or attempted suicide (67.5%). Stressors included social isolation, relationship breakdown, unemployment, financial stress, medical problems, history of mental illness, exposure to family violence and adverse childhood events. Statistically significant improvements occurred in the Outcome Rating Scale (ORS) and Session Rating Scale (SRS) following intervention. There were no deaths by suicide during the study period. Conclusion: People referred to HOPE had significant health and psychosocial stressors. Engagement significantly improved subjective well-being and connection with supports. Findings highlighted the need for an integrated clinical and psychosocial model to promote hope and connection in life post suicide attempt. It remains unclear which interventions improved well-being and if this contributes to suicide prevention.

Therapeutic Relationship and Dropout in High-Risk Adolescents’ Intensive Group Psychotherapeutic Programme

ObjectiveDropout rates are a prominent problem in youth psychotherapy. An important determinant of dropouts is the quality of the therapeutic relationship. This study aimed to evaluate the association between the therapeutic relationship and dropouts in an intensive mentalization-based treatment (MBT) for adolescents with personality disorders.MethodsPatients (N = 105) included were either dropouts (N = 36) or completers (N = 69) of an intensive MBT. The therapeutic relationship was measured with the child version of the Session Rating Scale (C-SRS), which was completed by the patient after each group therapy session. For each patient, the treatment termination status (dropout or completer) was indicated by the treatment staff. The reliable change index (RCI) was calculated for the C-SRS to determine significant changes in the therapeutic relationship.ResultsWhile both groups started with similar scores on the C-SRS, the scores between dropouts and completers differed significantly at the end of the treatment period. On average, during therapy, an increase was seen in the scores of completers, and a decrease was seen in the scores of dropouts. While dropouts could not be predicted based on the C-SRS scores, a significant decrease (RCI) in C-SRS scores during the last two sessions occurred more often for dropouts than for completers.ConclusionOur findings show that to prevent dropouts, the patient’s judgment of the quality of the therapeutic relationship should be monitored continuously, and decreases discussed with the patient and the group.

IMPLEMENTACIÓN DE RETROALIMENTACIÓN SISTEMÁTICA DE ALIANZA Y RESULTADOS TERAPÉUTICOS EN UN CENTRO DE ENTRENAMIENTO: OPORTUNIDADES Y DESAFÍOS.

The present work describes the experience of implementing feedback measures for outcome and therapeutic alliance in the context of a private psychotherapy training center. A descriptive summary of the results of the cases attended between 2011 and 2017 is presented, providing data for the Chilean population in the application of the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). Finally, the facilitators and difficulties of the experience of implementing systematic feedback, recommendations when conducting this type of applied research, and opportunities for therapists training are discussed.

Validation of the French Versions of Two Brief,Clinician-friendly Outcome Monitoring Tools: The ORS and SRS.

<b>French Validation of two brief Routine Outcome Monitoring (ROM)</b> scales <b>from the PCOMS system</b> : the <b>ORS</b> (Outcome Rating Scale, Miller et al., 2005) <b>designed to assess </b>various dimensions of <b>well-being and progression during care</b>, and the <b>SRS</b> (Session Rating Scale 3.0; Miller et al., 2002) <b>designed to assess dimensions of the therapeutic relationship</b>. <b>The research implied clinical and non clinical populations</b> <b>and brings estimates</b> <b>regarding</b> factorial structure, validity, reliability, preliminary index and norms of <b>the two scales in French.</b>

Validation of the French Versions of Two Brief,Clinician-friendly Outcome Monitoring Tools: The ORS and SRS.

<b>French Validation of two brief Routine Outcome Monitoring (ROM)</b> scales <b>from the PCOMS system</b> : the <b>ORS</b> (Outcome Rating Scale, Miller et al., 2005) <b>designed to assess </b>various dimensions of <b>well-being and progression during care</b>, and the <b>SRS</b> (Session Rating Scale 3.0; Miller et al., 2002) <b>designed to assess dimensions of the therapeutic relationship</b>. <b>The research implied clinical and non clinical populations</b> <b>and brings estimates</b> <b>regarding</b> factorial structure, validity, reliability, preliminary index and norms of <b>the two scales in French.</b>