The Partners for Change Outcome Management System (PCOMS) is a well-researched, quality improvement strategy that 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. Five randomized clinical trials (RCT) conducted by the clinical developer, Dr. Barry Duncan, and researchers at the Heart and Soul of Change Project have shown PCOMS to significantly improve effectiveness in real clinical settings as well as substantially reduce costs related to length of treatment and provider productivity. Because of these RCTs, PCOMS is recognized in the Substance Abuse Mental Health Services Administration’s (SAMHSA) National Registry of Evidence-based Programs and Practices. PCOMS has been implemented by hundreds of organizations in all 50 states and in 20 countries.

An independent meta-analysis of the RCTs revealed that individuals using PCOMS had a 3.5 times more chance of achieving reliable change and a 50% less likelihood to deteriorate. Studies have shown that PCOMS reduced: total program cost by 10% to 35%; length of stay by 40% to 50%; and cancellation and no show rates by 40% and 25%, respectively. PCOMS can be integrated into any treatment model and applies to all diagnostic categories. One size does fit all. PCOMS provides a cost effective way to be evidence based across all services and clients.

PCOMS uses two, four item scales to solicit consumer feedback regarding factors proven to predict success regardless of treatment model or presenting problem: client assessment of early progress (using the Outcome Rating Scale) and the quality of the alliance or match with the provider (using the Session Rating Scale).


  • Provides objective, quantifiable data on the effectiveness of providers and systems of care;
  • Uses measures that are valid and reliable, but feasible for each clinical encounter; and
  • Provides a methodology for consumer preferences to guide choice of intervention.

Consequently, unlike other methods of measuring outcome, this system truly assigns consumers key roles in determining how services are delivered while honoring the time demands of front-line clinical work and documenting proof of value.


The Partners for Change Outcome Management System has been shown to be consumer-friendly, highly feasible for clinicians, and importantly, repeatedly demonstrated to dramatically improve the quality and efficiency of services in peer-reviewed, published studies conducted across a range of settings, including public behavioral health.

Better Outcomes Now (BON) is a true application of PCOMS, its clinical process and intent. BON provides real time, single page views for consumers, providers, supervisors, and administrators.