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Outcome Rating Scale
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About Outcome Rating Scale
Scale Name
Outcome Rating Scale
Author Details
Scott D. Miller, Barry L. Duncan, Jeb Brown, Jacqueline A. Sparks, and David A. Claud
Translation Availability
English
Background/Description
The Outcome Rating Scale (ORS), developed by Miller et al. (2003), is a 4-item self-report visual analog scale designed to monitor global functioning and therapy outcomes in adults and adolescents (13+ years). Published in the Journal of Brief Therapy, the ORS assesses four domains: Individual Well-Being (personal functioning), Interpersonal Relationships (family/close relationships), Social Role (work/school), and General Sense of Well-Being (overall functioning). Each item is rated by placing a mark on a 10-cm line (0 = low functioning, 10 = high functioning), making it a brief, user-friendly tool for tracking progress in psychotherapy across various theoretical orientations.
Scores are measured with a ruler (in millimeters, converted to a 0–10 scale per item), summed for a total score ranging from 0–40, with higher scores indicating better functioning. The ORS was validated with 435 clinical clients (mean age ≈ 30–50 years, mixed gender, U.S.-based) and 89 non-clinical participants. Normative data show non-clinical samples average 28.0, clinical samples 19.6, with a reliable clinical cutoff of 25 (scores ≤25 indicate distress). The reliable change index is 4.3 (rounded to 5), indicating meaningful change. The ORS correlates with the Outcome Questionnaire-45 (OQ-45; r ≈ 0.58) and measures of psychological distress (r ≈ 0.40–0.60). It is used in clinical psychology, counseling, and research to monitor therapy progress, assess client outcomes, and inform treatment adjustments.
Administration, Scoring and Interpretation
- Obtain the scale from Miller et al. (2003) or authorized sources (e.g., Journal of Brief Therapy, International Center for Clinical Excellence), ensuring ethical permissions.
- Explain to participants (adults or adolescents 13+ in therapy) that the scale assesses general functioning to support treatment, emphasizing confidentiality and voluntary participation.
- Administer the 4-item scale before each therapy session, using paper or digital formats, with instructions to mark a 10-cm line for each domain based on current functioning.
- Score by measuring each mark in millimeters (0–10 cm = 0–10 points), summing for a total score (0–40).
- Estimated completion time is 1–2 minutes.
- Ensure a private, supportive environment; provide mental health resources (e.g., crisis hotlines) and adapt for accessibility (e.g., oral administration) if needed.
Reliability and Validity
The ORS demonstrates strong psychometric properties for a brief scale (Miller et al., 2003; Campbell & Hemsley, 2009). Internal consistency is high (Cronbach’s alpha = 0.79–0.93) across clinical (N = 435) and non-clinical (N = 89) samples. Test-retest reliability is not explicitly reported but inferred as moderate (r ≈ 0.60–0.80 over 1 week) from similar visual analog scales. Convergent validity is supported by correlations with the OQ-45 (r ≈ 0.58), Symptom Checklist-90-Revised (r ≈ 0.50–0.70), and measures of well-being (r ≈ 0.40–0.60).
Criterion validity is evidenced by its ability to differentiate clinical (mean = 19.6) from non-clinical (mean = 28.0) samples and sensitivity to therapy-related changes (reliable change index = 4.3). Discriminant validity is shown by weak correlations with unrelated constructs (e.g., general intelligence, r < 0.20). The scale’s unidimensional focus on global functioning supports its construct validity. Pairing with measures like the Schwartz Outcome Scale (SOS-10) or Session Rating Scale enhances comprehensive assessment.
Available Versions
04-Items
Reference
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.
Miller, S. D., & Duncan, B. L. (2000). The outcome rating scale. Chicago, IL: authors.
Important Link
Scale File:
Frequently Asked Questions
What does the Outcome Rating Scale measure?
It measures global functioning across individual, interpersonal, social, and overall well-being domains.
Who is the target population?
Adults and adolescents (13+) in psychotherapy.
How long does it take to administer?
Approximately 1–2 minutes.
Can it inform interventions?
Yes, it monitors therapy progress with a reliable change index of 5 points.
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