The Values of PCOMS

by Jeff Reese, PhD

As I noted in my last blog post, my passion for PCOMS started from a place of skepticism. As my skepticism faded, my appreciation grew not only because of the research support but that it was also grounded in a set of values.

What are those values? Glad you asked. 😊 Although you may have others to add, below are those that most resonate with me. Please share others with me!  

• Humility – For me it starts here. For a therapist to invite feedback about treatment progress and the therapeutic alliance takes humility. Ego takes a backseat and is an acknowledgment that therapist expertise and clinical judgment has limits. There is some evidence that professional self-doubt can predict better treatment outcomes (although experience may be a factor). But this does not mean clinicians lack self-confidence. The same researchers also found that the interaction between professional self-doubt and feeling positive about one’s self predicted better treatment outcomes.

• Relationship – The clinical process around the outcome and alliance measures promote the working relationship and collaboration between the client and therapist. The relationship is a priority – the therapeutic alliance is not left to chance. That intentionality, for me, transcends the data. The mere act of taking the time to ask is relationship building – it is a clear signal that the relationship matters.

• Privileges the Client Voice – PCOMS invites clients to help shape treatment. This is inherently empowering and ensures the that the therapeutic relationship is not hierarchical and is collaborative. When clients see their feedback directly influencing the work, engagement increases and treatment becomes more personalized, responsive, and meaningful.

• Promotes a Multicultural Orientation – The contextually oriented items of the Outcome Rating Scale and the clinical process of PCOMS can promote a “multicultural orientation.” Barry and I noted recently that PCOMS can foster cultural humility and create cultural opportunities to address sociocultural factors that may be relevant to treatment. When feedback is routinely invited, cultural experiences, identities, and contextual stressors have space to emerge and be addressed.

• Models Accountability – Monitoring outcome is a transparent process that models ethical practice. If a client is not improving, it is addressed openly. If a client has improved and is no longer benefitting, that too is addressed openly. Accountability becomes a shared, collaborative commitment rather than a private, internal judgment.

• Pursuit of Excellence – Using client‑provided data to evaluate one’s performance signals a commitment to professional growth and to providing the best possible service. PCOMS supports clinicians in continually refining their work, learning from their clients, and striving toward excellence.