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임상심리학/상담 및 심리치료

The Partners for Change Outcome Management System (PCOMS)

by 오송인 2018. 7. 6.
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PCOMS는 상담에서 활용 가능한 증거기반 평가 체계임. 주요 저널에 에비던스가 꽤 누적돼 있음.


ORS: 일주일 간의 내담자 생활에서 어떤 변화가 있었는지 쉽게 파악 가능.

SRS: 상담 세션 평가


이하 컷오프 관련 내용임.


ORS


The clinical cutoff for the adult ORS is 25 (for adolescents, 28, and for children, 32). Recall that the ORS is really a measure of distress, so the number 25 out of 40 generally means that those under 25 are reporting the level of distress typically associated with being a client, and those over 25 are reporting a level of distress generally associated with not being a client. It’s not magic. It is just the number that reliably distinguishes the two populations. The average intake score of an outpatient psychotherapy setting is from 18 to 20, but anywhere between one fourth and one third of your clients will come in over the clinical cutoff. People who score under the cutoff are typically looking for change, something different in their lives, while those who score higher or over the cutoff tend to be folks who are more satisfied with the status quo and therefore may require a bit more context to understand what they are looking for from therapy. p. 53


SRS


The cutoff of 36 may be a bit of overkill, given that more recent data indicate that the average first-session SRS scores range from 33.5 to 33.9 and increase from there. But the importance of the alliance warrants erring on the side of caution. Moreover, exploration of the alliance in and of itself helps build the alliance. So if a client scores less than a total of 36, or less than 9 cm on any dimension on the SRS, there is a potential problem that should be discussed, as well as an opportunity to enhance your relationship. Given these parameters, you can do a very quick visual check and then integrate the results into the conversation. p. 64


Only through knowing where we are, can we change where we are going. p. 68


출처: Barry L. Duncan - On Becoming a Better Therapist_ Evidence-Based Practice One Client at a Time (2014, American Psychological Association.


ORS 및 SRS 양식 다운로드 주소: https://betteroutcomesnow.com/about-pcoms/ 

(메일 주소만 입력하면 무료 다운로드 가능. 한국어 버전이 있는데 조금 수정이 필요해 보임.)


상담 결과에 영향을 미칠 수 있는 요인에 여러가지가 있는데 특히 내담자의 일상에 영향을 주고 있는 주요 요인들에 대한 탐색이 중요하다고 봄. 상담이 잘 진행되고 있는지 매 회기마다 평가하는 것도 중요함. PCOMS는 이 두 가지를 매우 직관적인 방식으로 가능하게 함. 


SRS 같은 경우 라포가 형성된 뒤에 사용하는 것이 좋을 것 같은데, 라포가 형성됐다 한들 서양보다 자기표현을 꺼리는 동양문화권에서 SRS를 사용하는 것이 상담에 도움이 될지는 사용해 봐야 알 것 같음. 상담자나 상담 과정 등에 대한 직접적 평가를 하고 있기 때문임. 척도 개발 배경과 사용법은 위 출처에 언급한 책을 보는 것이 좋음.  

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