In order to evidence RAQ’s effectiveness, Relationships Australia Queensland (RAQ) will soon be introducing the ORS and SRS scales into our counselling services. When used together these scales are called Feedback Informed Therapy (FIT). The Outcome Rating Scale (ORS; Miller & Duncan, 2001) and Session Rating Scale (SRS; Johnson, Miller, & Duncan, 2000) assess client functioning and therapeutic alliance from the client’s perspective. The client completes the forms at every session and both the client and counsellor track the clients’ progress through counselling to ensure that counselling is helping the client feel less distressed.
To ensure the implementation of FIT is successful across RAQ, the project will be implemented through several stages. As part of stage 1 both the ORS and SRS forms were introduced to the Ipswich and Sunshine Coast venues as a trial (or pilot) to 1) track client changes over time and to evidence the effectiveness of interventions and 2) Gain feedback from participating counsellors in order to improve the implementation of the FIT process.
Project Aims
To evaluate effectiveness and ease of use of Feedback Informed Therapy in improving client outcomes
Project Methodology
Participants: 50 clients
Procedure: The ORS is administered at the beginning of, or just before, every session. Scores indicate whether the client is experiencing significant distress. The SRS is completed at the end of the session (with the counsellor present) and assesses the therapeutic alliance. Scores indicates whether the alliance needs work. Counsellor should explore what the client thinks is not so good about the alliance in that session and the counsellor should work to improve the alliance.
Assessment: Outcome rating scale (ORS) and Sessions Rating Scale.
Project Leads
Dr Jemima Petch
Research Topics
FIT
ORS
SRS
client feedback
alliance
In mid-2009 the Commonwealth Attorney-General’s Department commissioned RAQ to develop, implement and evaluate Online Family Dispute Resolution capabilities. This research program covers a broad range of areas—for example, internal change management, market research, usability evaluation, cultural considerations, and professional judgment and client screening.
Project Aims
To assess the efficacy of OFDR in comparison to existing face-to-face and telephone services.
To support the staff transition into online service delivery.
To gather data to support the development of OFDR best-practice guidelines
Project Methodology
Mixed methods research to evaluate the service experience of clients and staff that are involved in this pilot project. A combination of surveys, interviews and observational data will be collected to evaluate the effectiveness of OFDR in comparison to telephone and face-to-face services.
Project Leads
Elisabeth Wilson-Evered and Mark Thomson
Project Sponsors
Commonwealth Attorney-General’s Department
Research Topics
Readiness for On-Line Services
Staff Clients; Evaluating Process and Outcomes of mediation
Impact of modality
F2F
Telephone and Education
Aboriginal Torres Strait Islander Peoples
Couple therapy is a moderately efficacious treatment for relationship distress, with 70% of couples attending therapy reporting improved relationship satisfaction. However, only about 50% of couples have relationship satisfaction in the non-distressed range after therapy. Despite repeated attempts and testing of various therapeutic interventions, it has proved difficult to enhance therapy efficacy beyond about 50% of couples recovering from relationship distress. A similar case is apparent in individual therapy. Recent attempts to improve individual therapy outcome have led to the development of feedback-informed-therapy (FIT) where clients are assessed regularly across the course of therapy and therapists are alerted when clients are not making good progress in therapy AND the process of therapy is assessed systematically as a type of feedback to the therapist. This routine use of continuous therapy process and outcome assessment enhances individual therapy effectiveness and it seems likely that a system of outcome and process assessment in couple therapy could enhance couple counselling outcome in a similar manner. This pilot research will test the useability of iPad technology to assist couple counsellors assess clients in their couples counselling.
Project Aims
To incorporate regular, very brief measures of couple counselling outcome and process
Project Methodology
Participants: 3 counsellors and 2-3 of their clients
Procedure: Counsellors ask couple clients to enter their pre-session and post-session information at every counselling session and asks client for feedback about the system. Counsellors provide the research team with feedback about the IPADs, the measures and the FIT approach.
Assessment: Couple satisfaction, Client mental health, Therapy process.
Project Leads
Professor Kim Halford (UQ)
Project Sponsors
Professor Kim Halford (UQ) and Shane Klintworth (RAQ CEO
Research Topics
iPad technology
couple therapy
feedback
informed therapy
About 50,000 adults and 60,000 children experience family breakdown each year in Australia, which leads to enormous personal, social, and economic costs. Surprisingly, there is very little robust research investigating the efficacy of mediation. First, there are no randomized controlled trials (RCT) evaluating the efficacy of different approaches to mediation in promoting effective co-parenting or positive child and adult adjustment. Second, there is only one RCT investigating the efficacy of mediation (compared to litigation) on satisfaction with the process and outcome of mediation. Third, a number of studies have noted that low numbers of couples reach agreement with mediation, (e.g., between 25-55% of families fail to reach agreement in mediation). The proposed research tests two important innovations in mediation: incorporating motivational interviewing (MI), which is an evidence-based approach to addressing ambivalence about change; and co-parenting education (CPE) that provides knowledge and skills to promote low conflict, effective co-parenting.
Project Aims
To evaluate the effects of incorporating Motivational Interviewing (MI) and Co-Parenting Education (CPE) into family mediation
Project Methodology
Participants: 180 recently separated couples with at least one child aged between 4 and 16 years accessing RAQ FDR services for each study
Method: clients randomly assigned into 1 of 2 conditions:
A) Family Dispute Resolution as usual (FDR) vs family mediation integrating motivational interviewing (FDR+ MI),
B) Family Dispute Resolution as usual (FDR) vs FDR and Co-Parenting Education (FDR + CPE).
Assessment: Rates of agreements, rates of subsequent litigation, and client satisfaction. Adult and child adjustment before and after mediation, and at 3-, and 12- month follow-up.
Project Leads
Kim Halford
Research Topics
family dispute resolution
co-parenting
motivational interviewing
Cognitive-Behaviour Therapy (CBT) is considered the most effective treatment for problem and pathological gambling with two recent meta-analyses reporting that CBT significantly reduced symptom severity, financial loss from gambling, frequency of gambling, pathological diagnoses, and anxiety and depressions symptoms. For example, CBT produces moderate to large effect size changes in financial loss (0.52), symptom severity (1.82) both in the short-term and up to 1 year post treatment. These results, however, are predominantly from efficacy studies (randomized controlled trails conducted in research settings) and little research is done in community settings where counsellors typically practice a range of therapeutic orientations. This study provides crucial data about the effectiveness of gambling treatments in a real-world setting. The results can inform RAQ of how comparable their GHS is relative to best-practice CBT outcomes.
Project Aims
To assess the effectiveness of community practice of the GHS on a variety of gambler outcomes.
Project Methodology
Participants: 60 gamblers attending RAQ GHS in 2012-13.
Procedure: GHS clients complete three assessments (pre, mid and post-assessment) either over phone, online or mail-out of survey.
Assessment: 3-4 page questionnaire assessing gambling severity, gambling behaviour and thoughts, couple relationship functioning, social and work life functioning, general quality of life, loneliness, impulsivity, psychological distress, and alcohol and drug use
Research Topics
gambling
gambling help
counselling
relationships australia
FOK is a training program under the broader Parenting Orders Program (POP) and provides education services for individuals and groups. The program focuses on developing relationship enhancement skills (such as communication and conflict resolution), parenting skills and rebuilding after separation. The FOK client evaluation involved a series of open-ended questions (qualitative survey) and gathered client perceptions of their key learnings and provided them an opportunity to write feedback on their experience of the program. Only data from the Ipswich venue (2009 –2012) was evaluated.
Project Aims
To evaluate the effectiveness of the FOK training program in addressing the needs of separated parents in raising their children
Project Methodology
Participants: 202 clients from the Ipswich venue completed the survey.
Procedure: FOK facilitators administered the feedback evaluation form to clients on the completion of the program. Due to the nature of the evaluation form all data collected was qualitative.
Assessment: Focus on Kids Evaluation survey
Project Leads
Sue Miller
Research Topics
conflict resolution
communication
emotional regulation
distress tolerance
self-reflection and insight
Completed Projects
The 2012 National Research Network (NRN) client survey gathered data on the current levels of psychological distress, couple relationship distress and mediator impartiality amongst 4544 Relationships Australia (RA) Family Support Program (FSP) clients across Australia. The study highlighted that 6% to 18% of family and relationship counselling and mediation clients scored in the very high psychological distress category (30-50) of the Kessler K10. Clients who score in the very high category of the K10 may be experiencing severe levels of distress consistent with a diagnosis of a severe depression and/or anxiety disorder. These very high distress rates are 2 to 5 times higher than the reported national average.
Moreover, 80% of Relationships Australia clients attending couple counselling or couple education reported couple relationship distress. This high rate is understandable given the focus of Relationships Australia family and relationship counselling and education services.
Finally, The majority of the 659 mediation clients ‘agreed’ that their mediators were impartial and neutral as indicated by the 4 out of 5 (5 = strongly agree) mean rating. Clients’ perceptions of mediator impartiality are important for influencing clients’ satisfaction with the mediation process and outcomes.
Project Aims
To collect national data on the prevalence of psychological distress, couple distress and perceptions of mediator impartiality amongst Relationship Australia Family Support Program (FSP) clients.
Project Methodology
Participants: 4544 Family Support Program (FSP) clients across Australia attending a counselling or mediation session between April-May 2012
Procedure: Research officers mailed all client survey materials to venue. Venue staff implemented survey and returned survey sheets to head office. Research officer entered data and analysed data, prepared reports and presented data at Family Relationships Services (FRSA) Australia conference. Telephone Information Referral Officers (TIRO’s) and research officers conducted some of the surveys over phone in order to reach the 50% return rate.
Assessment: psychological distress measure (K10), couple distress measure (CSI-4), and mediator impartiality measure.
Project Leads
Dr Jemima Petch and Jennifer Murray
Project Sponsors
Andrew Bickerdike (RA CEO Sponsor)
Research Topics
psychological distress
couple distress
relationships counselling
family support program
community services