Session Rating Scale (SRS)

Evidence-based practices are being effective in consistently producing positive outcomes in psychotherapy (APA Task Force on Evidence-Based Practice, 2006; Norcross & Wampold, 2011). Being included on SAMHSA’s National Registry of Evidence-based Programs and Practices, means that the Session Rating Scale (SRS) should be a valuable tool for any evidence-based practice that wishes to improve the likelihood of clients achieving their therapeutic goals.

The therapist-client bond, known as the therapeutic alliance, has long been seen to be a good predictor of successful outcomes. Evidence supporting the efficacy of this relationship continues to accumulate (Baldwin, Wampold, & Imel, 2007). Along with its companion measure, the Outcome Rating Scale (ORS), the SRS was developed by Scott D. Miller and Barry L. Duncan over a decade ago. It was quickly demonstrated to be a valid and reliable measure of the therapeutic alliance (Duncan, Miller, Sparks et al., 2003).

MyOutcomes® SRS is a four-item scale that enables the therapist to get a quantitative measure of the client’s assessment of the therapist-client relationship. Specifically, the SRS asks the client to use a sliding scale to assess their relationship with the therapist, whether the goals and topics cover what the client feels they need, how well the therapist’s approach fits the client’s needs, and an overall general assessment of the most recent session. Based upon the composite score of these measures, the therapist can determine whether the alliance is threatened. If so, the therapist is able to devote time to explore issues that will strengthen the relationship e.g. shifting goals, changing approach, etc.

Evidence suggests (e.g. Campbell & Hemsley, 2009) even those therapists who express a desire to solicit feedback from their clients are unlikely to do so if the process is burdensome and time-consuming. In other words, a tool like MyOutcomes® SRS, which takes less than a minute to administer and obtain a score, will be seen as being extremely feasible to incorporate into each therapeutic session. Consistent monitoring of therapy via solicited feedback has been shown (Reese, Norsworthy, & Rowlands, 2009) to play an important role in achieving successful outcomes.


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

Baldwin, S., Wampold, B., & Imel, Z. (2007). Untangling the alliance Outcome correlation: Exploring the relative importance of therapist and patient variability in the alliance. Journal of Consulting and Clinical Psychology, 75, 842–852.

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.

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.

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.