Introducing Evidence-Based Practice and Technology in Therapeutic Services

Evidence-based treatment (EBT) has a somewhat tumultuous history within psychotherapy for two reasons. First, it has been criticized for reducing clients to their diagnoses and therapists to their treatment technologies. This doesn’t make much sense given that the client, the therapist, and their relationship account for far more of how change happens than model and technique. Second, no one approach as ever demonstrated reliable superiority over any other. This is of course the famous “Dodo Bird Verdict.” This doesn’t mean that EBTs are not worthwhile to consider.

Thankfully, the American Psychological Association Task Force on evidence-based practice ushered in a consideration of context: “Evidence-based practice is the integration of the best available research with clinical expertise in the context of patient (sic) characteristics, culture, and preferences.” Perhaps most importantly, the Task Force said, “The application of research evidence to a given patient (sic) always involves probabilistic inferences. Therefore, ongoing monitoring of patient progress and adjustment of treatment as needed are essential.”

In addition to being evidence based by virtue of its seven randomized clinical trials and SAMHSA designation, the Partners for Change Outcome Management System (PCOMS) is congruent with the Task Force definition and recommendation. PCOMS enables the identification of clients who are not benefiting from any given treatment so that clinicians may collaboratively design different interventions. The Task Force definition and PCOMS call for a more sophisticated clinician who chooses from a variety of methods to best fit client preferences and cultural values, with client measurable response to therapy guiding the way to positive outcomes.

The evolution and use of technology in counseling has taken PCOMS to new levels of application and benefit. The web application of PCOMS, Better Outcomes Now (BON), provides not only convenience but also critical information at your fingertips to ensure quality improvement as well as unlimited data analyses and reporting possibilities.

4 Secrets to Successful Implementation

When introducing PCOMS and BON technology in therapeutic services, keep these tips in mind:

1. Be in It for the Long Haul – Remember that implementation is not a sprint, it’s a marathon. Your staff needs the appropriate structure and support over time. While getting the brass on board is important, organizational commitment at all levels is necessary for successful implementation. This involves not only consensus among senior managers, but also a financial plan to incorporate PCOMS and BON, along with staff training, a supervisory infrastructure, policies and hiring procedures, and an assessment of any IT hardware needs.
2. Love Your Data – Understanding and using data at all levels is essential to long-term implementation success. Everyone from CEOs to front-line clinicians need to stop thinking about data purely as “numbers” and instead learn how data are vital to quality improvement at both therapist/client and programmatic levels. Here is where BON shines, providing an easy way to collect and analyze data, identify at-risk clients, and report outcomes to funders. BON is a viable quality improvement strategy, a feasible way for therapists, supervisors, and managers to obtain an at-a-glance view of the status of all clients in need of further attention.
3. Inspire the Front-Line Clinician – Longitudinal studies show that therapists do this work because they want to make a difference. Also, most therapists want to improve over time. Being a front-line clinician, however, can be challenging and lead to burnout. Although there are many causes for burnout, it may come at a surprise that the secret to avoid burnout is our own growth as therapists. PCOMS and BON can help avoid burnout in two ways: first, by quantifying and demonstrating how therapy can make a difference in people’s lives over time; and by keeping therapist development on the front burner, documenting growth over time and encouraging new therapeutic strategies.
4. Implement Supervision for a Change – Supervision using PCOMS data is the key to implementation success. Supervisors and clinicians should start by discussing client scores and identifying those clients who are at risk. BON makes this very easy and allows rapid filtering of therapist caseloads for supervisory discussion. Identifying clients who are not benefiting and brainstorming solutions can help turn those clients around during the next session. In essence, the supervisor and clinician act as a team, examining results, determining where there could be improvement, and creating new plans for client success.

Don’t Fear PCOMS and BON Technology in Therapeutic Services

Remember that being afraid is not an uncommon reaction to change. Therefore, it’s important to openly address any concerns your staff may have from the get-go. Being transparent can help build trust and alleviate fear when implementing any new system. Be sure to communicate that PCOMS and BON will never be used in any punitive way whatsoever. There is only one purpose: to improve the quality of care provided to clients.

For additional advice on how to get ready for PCOMS implementation, please see our PCOMS Implementation Readiness Checklist. Read more about the four secrets of implementation in the PCOMS manual, your step-by-step guide to everything PCOMS. And, to explore the use of technology in counseling firsthand, request a free trial of BON today.