Continuous feedback system
The Outcome Rating Scale (ORS)
The ORS was developed to track patient progress over the course of treatment. It is known as a "visual analogue" scale.
On such measures, content and complexity is kept to a minimum. Patients simply place a mark on the line nearest to the pole that best describes or "fits" with their experience.
The scale was purposefully designed for use at each session as an aid to assessment of a patient's continual progression, or otherwise, during treatment.
(Duncan, Miller, Sparks , 2004)
Scoring
ORS scores can range from zero (worst) to 40 (best). The clinical cut-off for the ORS is 25.
The Session Rating Scale (SRS)
The therapeutic alliance - that is the relationship between the therapist and patient - is of the utmost importance to a successful outcome. The therapist needs to know when they are off track and this is not always apparent during the session.
The SRS uniquely provides an opportunity for the patient to feedback to the therapist their experience of the session. Even subtle changes in the score can provide a valuable insight that points the way to a more enriching dialogue between practitioner and patient.
Scoring
A score below 35 alerts the practitioner to the need to discuss the patient's concerns which can then be addressed at the next session.
Such feedback is invaluable in improving the effectiveness of each session.
(Duncan, Miller, Sparks , 2004)
Psychological Trauma
Post-traumatic stress disorder (PTSD)
.... Re-experiencing;
....
Hyperarousal;
.... Nightmares/flashbacks;
.... Avoidance of things associated with the event
Depression
Anxiety
Phobias
.....Driver, passenger, pedestrian, social etc
Intrusive negative thoughts
Loss of confidence
Panic attacks
Anger and irritability
Breakdown in partner/family relations
Stress
Sleep difficulties
Adjustment problems - change in lifestyle; loss
Pain management
Obsessive/compulsive thoughts or actions
Misuse of alcohol.
Practice based evidence is central to the hgp approach.
Internationally recognised psychometric tests are introduced at assessment and at each domiciliary therapy session. These reveal the patient's psychological problems at the outset, provide session by session progress and illustrate an end of therapy result.
The results indicate that a clinically reliable change is effected in the majority of patients who access our service.
"The hgp model promotes a climate of positive change, enabling people to return to normal, day to day living, in the shortest possible time.
Our evidence-based treatment is delivered within a framework of sound knowledge, experience and accountability to the patients and referrers."
Wendy Amey
Managing director
CBT Rehabilitation Ltd