The Institute for the Study of Therapeutic Change (ISTC) was founded by Scott Miller, Barry Duncan, and Mark Hubble after a serendipitous meeting and discussion (over great Irish beer) revealed them to be kindred spirits in their beliefs about the search for the Holy Grail (the perfect model) and the empirical support for the common factors—those factors accounting for change found in all approaches. Building upon the translation of common factors research into a “client directed” perspective described in Changing the Rules, the ISTC began as a medium to disseminate information from research about what works in therapy to mental heath and substance abuse professionals all over the world. Barry, Scott, and Mark’s common passions resulted in several books and dozens of articles, and culminated in the APA best selling, The Heart and Soul of Change. As detailed in that book, the things that make therapy work are largely about the client—the true hero of therapeutic change—and the quality of the relationship formed with the therapist, far more important than model or technique. Soon after work on The Heart and Soul was finished, Mark Hubble stepped back from active involvement and a new era of the ISTC began as Scott introduced Barry to what they would later come to see as the most revolutionary idea to hit psychotherapy in decades—namely, the use of client-based feedback to tailor services and improve effectiveness. After a trial and error struggle with existing measures and reaching the conclusion that any method must be feasible as well as reliable and valid, Scott and Barry developed the Outcome Rating Scale (ORS) and Session Rating Scale (SRS) (building on the work of Lynn Johnson) as clinical tools to encourage therapists to openly discuss the benefit and fit of services with clients. During that time, Jacqueline Sparks (now an associate of ISTC) became involved and ultimately collaborated on Heroic Clients, Heroic Agencies, as well as many other projects (e.g., the dangers of psychiatric drugs for children) including the development and validation of the child measures and The Heroic Client revised edition. .

The ISTC, continuing a devotion to empirically-derived clinical practices, evolved as it embraced the paradigm shift represented in client-based feedback to an organization dedicated to the creation of outcome management systems that truly partner with clients while honoring the daily pressures of front-line clinicians. Incorporating the most robust predictors of therapeutic success and after 7 years of development, research, and publication in peer reviewed journals, Scott and Barry launched the Partners for Change Outcome Management System (PCOMS). PCOMS, now in a web-based application (MyOutcomes.com), is a reliable, valid, and feasible feedback process that has been shown to significantly improve effectiveness and efficiency in real clinical settings. Unlike other methods of measuring outcome, this system truly gives clients the voice they deserve and assigns consumers key roles in determining how services are both delivered and funded.

Mark Hubble has recently rejoined our efforts as an editor, along with associate Bruce Wampold, on the second edition of The Heart and Soul of Change: Delivering What Works, due out in early 2009.

The ISTC continues to grow and is supported by the efforts of many including Associates, Certified Trainers, the Heroic Agency Network, and the Heroic Agencies list, Jacqueline’s brainchild of now over 500 international professionals dedicated to delivering CDOI services.