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New Studies Evaluate Better Outcomes Now’s Systematic Feedback in Child and Adolescent Therapy

A proven therapy method for adults called ‘systematic feedback’, in which client feedback is provided to the counselor at each therapeutic session, has shown indications of benefit in two new studies with children and adolescents.
The first study was a pilot randomized clinical trial (RCT) collaboration between the online feedback service Better Outcomes Now (BON), the Department of Psychology at the University of Roehampton and the children’s charity Place2Be.

They trialed BON’s Partners for Change Outcome Management System (PCOMS) for client feedback intervention in ten UK primary schools, with children aged 7-11 years old. There were 38 children total in the study who had been referred for help. The researchers compared play-based counseling with and without using PCOMS. Children who participated in the PCOMS therapeutic sessions were able to give feedback on how they were doing and on how they found the therapy. This group showed an increase in mental health benefits over those who did not have this opportunity.

University of Roehampton Professor Dr. Mick Cooper said, “There’s strong evidence over the last twenty years that the Partners for Change Outcome Management System improves therapeutic results with adults. This is the first controlled pilot study looking at PCOMS in children, and we have found some indicators that this may be effective in improving children’s mental health too. We need to be cautious as it was a pilot study and the sample size is small, but the magnitude of effect was encouraging.”

The second study took place in the US and was a collaboration between BON, the University of Kentucky and Southwest Behavioral & Health Services.

Using a benchmarking methodology, they evaluated the effectiveness of services provided to impoverished, racially and ethnically diverse children and young people, 199 aged 6-12 years old and 270 aged 13-17, diagnosed with depression at a large public behavioral health agency. The researchers analyzed outcomes of children and adolescents after PCOMS was implemented as a quality improvement strategy. Children and adolescents who participated in the PCOMS therapeutic sessions realized clinically superior outcomes in comparison to a wait list benchmark drawn from youth depression clinical trials.

Said Dr. Barry Duncan, PCOMS developer and BON chief executive officer, “Previous studies have demonstrated that mental health care for youth from economically impoverished backgrounds results in negligible to small treatment effects. Our findings of large effect sizes and overall clinical equivalency with RCT treatment outcomes support the contention that psychotherapy that includes systematic client feedback may be an effective quality improvement strategy in services with youth in public behavioral health.”

About Better Outcomes Now

Better Outcomes Now is the psychotherapy outcome measurement app of the Partners for Change Outcome Management System (PCOMS) for client feedback intervention. PCOMS uses two, four-item measures, called the Outcome Rating Scale and the Session Rating Scale, to solicit client feedback regarding factors proven by eight randomized clinical trials to improve therapy outcomes and efficiency. For more information, visit

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