From PCOMS Skeptic to Enthusiast

by Jeff Reese, PhD

As the incoming CEO of Better Outcomes Now (BON), I’ve been asked about my connection to measurement-based care (a term that has never been my favorite) and, more specifically, to the Partners for Change Management System (PCOMS).

My interest in PCOMS actually began from a place of skepticism. In 2004, I attended a Heart and Soul of Change conference in Austin, TX, sponsored by my former employer, Resources for Living, an Employee Assistance Program. The conference featured several prominent psychotherapy researchers—including Bruce Wampold and John Norcross—who emphasized the power of common factors in therapy. Building on the latest research, Barry Duncan and Scott Miller laid out a compelling rationale for maximizing those common factors by monitoring treatment outcome and the therapeutic alliance—what was then called “client feedback.” PCOMS data suggested that effectiveness doubled overall and that treatment dropout decreased. At the time, I found it hard to believe that a pair of four‑item measures could meaningfully change the trajectory of a client’s outcome. Still, I appreciated the underlying values of the process and the intentionality of seeking client feedback.

So, as a skeptic, I decided to conduct my own randomized clinical trial with the University Counseling Center and Marriage and Family Institute at Abilene Christian University, where I was an assistant professor of psychology. And, lo and behold, the results replicated what I had heard in Austin. The PCOMS groups showed twice the improvement of the Treatment-as-Usual groups. Clinicians received only an hour of training—yet the impact was clear. We later published a second study with couples in treatment, and the findings were the same.

There are more chapters to this story, including how I came to appreciate the value of PCOMS in clinical training and supervision, but I’ll save that for another blog!

After a 26-year career in academia as a professor and administrator, I’m delighted to return to my professional roots. I look forward to helping improve treatment outcomes and expanding access to mental health care.