Views:
Change vs. Session Target (Clinician/Provider) 
These statistics look at how the clients in the report are progressing in treatment compared to their session target score. This is the projected target score for clients who enter services with the same intake score. 
 
 
 
 

Session Target (ORS) 

 

 
 

This is the predicted score for the client’s current session based on the Expected Treatment Response (ETR) for that client. This is how well the client should be doing at their current session if they are progressing in treatment as expected.  

The Sessions target is calculated using the ORS predictive algorithms. 

 
 

Clients whose second and subsequent ORS scores are at or above the green Positive Expected Treatment Response line are in the green zone and are at or above the Session target. They are similar to clients in the normative sample that entered treatment with the same intake ORS score AND had a successful treatment outcome.  

 
 
 
 

Reaching session target: Percentage of clients  

 

 
 

The percentage of clients reaching the Session Target are clients whose last ORS scores was at or above the green Positive Expected Treatment Response line i.e.  in the green successful treatment zone 

 
 

Clients whose second and subsequent ORS scores are at or above the green line (positive expected treatment response line) for that session are in the green “successful” treatment zone. While the % of All cases reaching session target will vary from clinician to clinician the % of Closed cases reaching session target should be in the range of 64% to 74% of closed cases. 

 
 
 
 

Dropout Rate: Number and Percentage of clients 

 

 
 

The number and percentage of unplanned closed cases (unilateral termination) where the clients discontinued unilaterally without reaching the green zone.  

 
 

A client unilaterally terminating treatment without hitting the Session Target ORS score. Clinicians should work to decrease this percentage over time. 

 
 
 
 

Change Index (Residual Change) (Session) 

 

 

 
 

This is the difference between the average session target for clients in the report and the average of their most recent ORS scores. This is also known as the average residuals. The residual is the amount of change indicated by the session ORS score that was due to treatment rather than chance or random change. 

 
 

A positive number indicates that the clients in this report are exceeding expectations for treatment while a negative number indicates that the clients are on average below the session target. 

 
 
 
 

ESSA (Session) 

 

 
 

This is the overall Severity Adjusted Effect Size (ESSA) based on the Session Targets for the clients in the report. It is calculated using the Session Change Index score divided by the standard deviation of the overall clients in the ORS normative database. This is added to the Mean Effect Size for the dataset to give the Severity Adjusted Effect Size (ESSA).   

It provides a measurement of the effect of treatment compared to no treatment (when correcting for number of sessions, regression to the mean, severity at intake and bias).  

 
 

ESSA (Session) is based on comparing the session target for clients with their most recent score. It provides a measure of client's progress compares with clients at the same point in treatment who began with the same intake score. 

An ESSA is "corrected" or severity adjusted when it takes into account that clients tend to have different intake scores because they vary in the severity of their problems. 

A Session ESSA for active clients that is higher than the Session ESSA for their inactive (closed) clients indicates that the clinicians in the report are becoming more effective over time. 

 
 
 
 

 

 
 

 

 
 

 

 
 
 
 

Benchmarking ESSA (Session) 

Scores 

 
 

It is helpful for clinicians to know their effectiveness in comparison to a more “absolute” benchmark. While there is no definite way to quantify effectiveness, one method is to compare against the most rigorous criteria that is currently available which is published clinical trials. An ESSA = 0.72 is at par with the treatment effect observed in clinical trials. 

 
 

Effect sizes of 0.8 or larger are considered large and are viewed as “providing highly effective treatment”, while effect sizes of 0.5 to 0.8 can be considered moderately large and viewed as “providing effective treatment”.  Effect sizes less than .5 are considered somewhat effective treatment that is “providing treatment that does not have a statistically meaningful impact with regard to improving outcomes”. Effect sizes of less than 0.3 are small, indicating limited progress in treatment and might well have occurred without any treatment at all. 

 
 
 
 

ESSA Relative (Session) 

For clinicians, ESSA Relative provides information as to where their outcomes stand in relation to all cases in the database. Differences in initial severity, population, etc., are already taken into consideration), and thus, the ESSA Relative provide clinicians with a relative rather than “absolute” benchmark of their caseload. 

 
 

The ESSA Relative is a comparison of the Session ESSA for clients in the report with the mean or average Session ESSA for all clients in the ORS normative database.  

Essentially you are comparing how the clients in the report progress compared to the mean or average improvement of clients in the normative database with the same intake scores. 

 

 
 

A positive number indicates better than average progress, a zero indicates progress the same as average client progress and a negative score indicates the clients in the report are not progressing as well as the clients in the ORS normative database did. 

When calculating the Relative Session Effect Size the ESSA (Session) is a fairer comparison of a therapist’s or agency’s effectiveness as ESSA adjusts the effect size score based on the severity of the intake score. 

Keywords: reports, target, sessions, projections