The Heart and Soul of Change Project

Year Founded: 2009

Model of Therapy: Partners for Change Outcome Management System (PCOMS)

The Heart and Soul of Change Project is a practice-driven, training and research initiative that focuses on what works in therapy, and more importantly, how to deliver it on the front lines via client based outcome feedback, or what is called the Partners for Change Outcome Management System (PCOMS). Embracing the values of social justice and an expectation that recovery is possible for everyone, the Project is about helping therapists and agencies answer their calling to make a meaningful difference in as many lives as possible. The strength of what the client brings to the change process and the impact of the alliance inspired Barry Duncan, the director, to name the popular book about the common factors as well as this Project—the client is the Heart and the alliance is the Soul of therapeutic transformation. Systematic feedback allows both to be empowered for maximum client benefit. Researchers at the Project conducted all the RCTs that led to the designation of PCOMS as an evidence based practice by the Substance Abuse and Mental Health Services Administration (SAMHSA). 

Our mission is to disseminate PCOMS to those on the front-lines, and to promote research and education to transform mental health services to include consumers as full partners. 

The Partners for Change Outcome Management System, or PCOMS, boils down to this: partnering with clients to identify those who aren't responding to clinician business as usual and addressing the lack of progress in a proactive way that keeps clients engaged while therapists collaboratively seek new directions. PCOMS, then, is not really a model of psychotherapy but rather is a-theoretical or trans-theoretical and may be added to or integrated with any model of practice. It provides a seemingly contradictory way to become evidence based across all your clients while tailoring services to the individual client’s needs, preferences, and culture— evidence based practice one client at a time.

Devoted to empirically-derived clinical practices, PCOMS incorporates the most robust predictors of therapeutic success into an outcome management system that partners with clients while honoring the daily pressures of front-line clinicians. Unlike other methods of measuring outcome, this system truly gives clients the voice they deserve and assigns consumers key roles in determining how services are delivered.

PCOMS uses two brief scales, the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) to measure the client's perspective of benefit and the alliance, respectively. It is the only system that includes a transparent discussion of the results with clients and the only system to include routine measurement of the therapeutic alliance. PCOMS has been shown in five randomized clinical trials, all conducted by Project folks, to significantly improve effectiveness in real clinical settings. PCOMS is included in SAMHSA’s National Registry of Evidence Based Practices and Programs. PCOMS has been implemented by hundreds of organizations, public and private, by thousands of behavioral healthcare professionals in all 50 states and 23 countries serving over 200,000 clients a year.