Session Rating Scale

Session Rating Scale

The Session Rating Scale, SRS, is a brief, 4-item feedback tool completed by clients at the end of a therapy session. Session Rating Scale SRS was developed by Dr. Scott D. Miller and Barry L. Duncan.

SRS, Session Rating Scale measures the strength of the therapeutic alliance. Therapy alliance is how much you trust and have confidence in your therapist, which is one of the strongest predictors of positive treatment outcomes.

How SRS, Session Rating Scale Works

SRS Session Rating Scale consists of four 10-cm visual analog scales. 

Therapy clients place a hash mark on each line to rate their experience in these key areas:

SRS Session Rating Scale Relationship Measurement

Relationship: Do they feel heard, understood, and respected?

SRS Session Rating Scale Goals and Topic Measurement

Goals and Topics: Did the session focus on what they wanted to work on?

SRS Session Rating Scale Approach or Method Measurement

Approach or Method: Is the therapist's approach a good fit?

SRS Session Rating Scale Overall Measurement

Overall: Was the session right for them today?

Scoring Measurement: The therapist measures the client's mark on each of the four lines using a ruler to assign a score between 0 and 10, resulting in a total possible score of 40.

Scoring SRS
Session Rating Scale Scoring

SRS Session Rating Scale Threshold:

SRS Session Rating Scale total score below 36, or a score of 9 or less on any individual item, flags a potential concern in the therapeutic relationship.

SRS Session Rating Scale Utilization: Rather than using it as a strict performance review, therapists use low scores as clinical data to adjust their approach and address any issues collaboratively.

Resources & ToolsPrintable Form: You can view or download the standard clinical form via the UVM Session Rating Scale PDF.Digital Platforms: Many clinics integrate the SRS into digital tracking systems like Greenspace Health or MyOutcomes for automated scoring and real-time alliance monitoring.

Duncan, B. L., Miller, S. D., Sparks, J. A., Claud, D. A., Reynolds, L. R., Brown, J., & Johnson, L. D. (2003). The Session Rating Scale: Psychometric properties of a "working" measure of the therapeutic alliance. Journal of Brief Therapy, 2(1), 3–12.

Canada Online Therapy acknowledges the developers and original copyright holders Scott D. Miller, Barry L. Duncan, and Lynn Johnson (copyrighted in 2002) and licensing and distribution rights managed through the International Center for Clinical ExcellenceICCE). Canada Online Therapy does not own the copyright and confirms that all rights belong to the respective owners. Canada Online Therapy utilizes this material in compliance with the terms and conditions provided by the copyright holder for clinical and educational purposes. The Session Rating Scale (SRS) is a brief, 4-item visual analog scale used in psychotherapy to measure a client's perception of the therapeutic alliance. Developed by Scott D. Miller, Barry L. Duncan, and Jacqueline A. Sparks in 2002, it is administered at the end of every session to catch alliance ruptures and predict treatment outcomes.

Session Rating Scale