This is what I need a clinical feedback system to do for me: A qualitative inquiry into therapists' and patients' perspectives

Abstract

Routine outcome monitoring and clinical feedback systems (ROM/CFSs) are promising methods of providing naturalistic research data and enhancing mental health care. However, implementation in routine care is challenging, and we need more knowledge about clinicians' and patients' needs from such systems.

Objective: We aimed to study perspectives of clinicians and patients to explore how ROM/CFS can be helpful and acceptable to them.

Method: We interviewed 55 participants in focus groups and individual interviews and analyzed the data through rigorous team-based qualitative analyses.

Results: We report 3 overarching domains: (a) Shared needs, (b) Specific patient needs, and (c) Specific therapist needs. Shared needs, in which perspectives of different stakeholders converge, was the dominant domain in the material. Under each domain, we report 3 specific themes: (a1) Degree of trust in therapy, (a2) Allowing for openness, (a3) Monitoring joint objectives; (b1) Life functioning, (b2) Canary in the coal mine, (b3) Holistic report; and (c1) Emotional presence and style, (c2) Monitoring risk and symptoms, and (c3) Agency and ownership of process.

Conclusions: In what should increase our confidence toward core aspects of ROM, we suggest that an integration of relational feedback concepts and stringent clinical dimension tracking into the ROM/CFS can be beneficial.

Keywords: clinical feedback systems; practice-oriented research; psychotherapy; qualitative study; routine outcome monitoring.