Motives of Therapists for Using Routine Outcome Monitoring (ROM) and How it is Used by Them in Clinical Practice: Two Qualitative Studies

Abstract

Despite its demonstrated value, many mental health institutions struggle to implement progress feedback effectively. There is also insufficient information about how therapists utilize progress feedback. To gain more insight, two qualitative studies were conducted. The first study compared the attitudes and motives of therapists who used and those who did not use progress feedback. The second study examined how psychologists incorporated progress feedback into their practice. In total, 23 therapists were interviewed, and the data were analyzed using thematic analysis. The first study found that almost all the therapists had a positive attitude about progress feedback. Those who did not use it indicated reasons such as a heavy workload and patient-related factors, and they also lacked sufficient information about the potential benefits of progress feedback. The second study revealed four major ways in which the therapists utilized feedback, namely: supporting actions to discuss progress feedback, discussing progress feedback with patients, modifications in the ongoing treatment, and peer consultation. However, discussions during peer consultations about using progress feedback for patients who were not benefitting from treatment and how the treatment might be adjusted accordingly were often lacking. In conclusion, it is crucial that training and education be provided to therapists on how to use progress feedback effectively. Having regular discussions about progress feedback during peer consultations could also facilitate its integration into clinical practice.

Keywords: Implementation; Measurement Based Care; Progress Feedback; Qualitative Analysis; Routine Outcome Monitoring.

Fig. 1

Visual representation of how therapists use progress feedback. Note. MDM = Multidisciplinary (peer consultation) meeting