Outcome Rating Scale (ORS)

Outcome Rating Scale (ORS)
What is the Outcome Rating Scale?

For two decades, the Outcome Rating Scale (ORS) has repeatedly been demonstrated to be a reliable and valid therapeutic instrument that can be easily and effectively incorporated into  any therapist-client session. (e.g. Miller, Duncan, Brown, Sparks, & Claud, 2003; Bringhurst, Watson, Miller, & Duncan, 2006; Campbell & Hemsley, 2009). Further evidence has been accumulating demonstrating the generalizability of the ORS to a variety of clinical populations and settings. For example, couples (Anker, Duncan, & Sparks, 2009), addictions, adolescents, group, and much more.

With MyOutcomes®, the ORS takes less than a minute to administer and the results can then be compared to a predicted score derived from calculations based on data from nearly three quarters of a million administrations. The brevity of administering the ORS makes for an extremely feasible tool that can easily be completed by clients at the beginning of each therapeutic session. Although feedback per se leads to improved outcomes, it has been demonstrated (Reese, Norsworthy, & Rowlands, 2009) that regular solicitation of feedback is significantly more effective.

MyOutcomes Outcome Rating Scale

Using four visual analog scales, the ORS is an ultra-brief outcome measure that enables clients to provide feedback on their perceptions of their progress in achieving their therapeutic goals. Specifically, the four scales allow the client to provide a quantifiable measure of how they are functioning on a personal level, in their interpersonal relationships e.g., friends and family, their general social interactions, as well as a more global measure of their overall functioning that captures any critical areas not directly measured on the other scales. MyOutcomes® automatically plots each session’s ORS on a continuous graph so that the therapist can determine if the trajectory of change is on course.

Evidence has been accumulating (e.g., APA Task Force on Evidence-Based Practice, 2006; Norcross & Wampold, 2011) that evidence-based practices (EBP) and practice-based evidence (PBE) promote effective outcomes. Any therapist wishing to improve their client outcomes by adopting an EBP or a PBE would be well-advised to incorporate MyOutcomes®’ ORS, along with the SRS, as these two tools, evidenced by their inclusion on the National Registry of Evidence-based Programs and Practices, have been determined by SAMHSA to conform to the standards of an evidence-based practice.


Duncan, B., Miller, S., Sparks, J., Claud, D., Reynolds, L., Brown, J., & Johnson, L. (2003). The Session Rating Scale: preliminary psychometric properties of a “working” alliance measurement. Journal of Brief Therapy, 3(1), 3-12.

Anker, M. G., Duncan, B. L., & Sparks, J. A. (2009). Using client feedback to improve couple therapy outcomes: A randomized clinical trial in a naturalistic setting. Journal of Consulting & Clinical Psychology, 77, 693–704. doi:10.1037/a0016062

APA Task Force on Evidence-Based Practice (2006). Evidence-based practice in psychology. American Psychologist, 61, 4, 271-285.

Bringhurst, D.L., Watson, C.W., Miller, S.D. & Duncan, B.L. (2006). The reliability and validity of the Outcome Rating Scale: A replication study of a brief clinical measure. Journal of Brief Therapy, 5, 1, 23-30.

Campbell, A & Hemsley, S. (2009). Outcome Rating Scale and Session Rating Scale in psychological practice: Clinical utility of ultra-brief measures. Clinical Psychologist, 13, 1, 1-9.

Miller, S.D., Duncan, B.L., Brown, J., Sparks, J.A. & Claud, D.A. (2003). The Outcome Rating Scale: A preliminary study of the reliability, validity, and feasibility of a brief visual analog measure. Journal of Brief Therapy, 2, 2, 91-100.

Norcross, J.C. & Wampold, B.E. (2011). Evidence-based therapy relationships: Research conclusions and clinical practices. Psychotherapy, 1, 98-102. doi: 10.1037/a0022161.

Reese, R., Norsworthy, L., & Rowlands, S. (2009). Does a Continuous Feedback Model Improve Psychotherapy Outcome?Psychotherapy: Theory, Research, and Practice, 46, 418-431.

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