Clinical practitioner’s attitudes towards the use of Routine Outcome Monitoring within Child and Adolescent Mental Health Services: A qualitative study of two Child and Adolescent Mental Health Services

Norman, Shelley; Dean, Sarah; Hansford, Lorraine; Ford, Tamsin

doi:10.1177/1359104513492348

Cited by 42 publications

(54 citation statements)

References 25 publications

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“…This supported previous findings [4], [11,29] where these generic measures were not considered specific enough to detect changes related to a given disorder. Recently, Wolpert et al [30] have also acknowledged the challenge for ROM in choosing measures specific enough to be clinically useful but general enough to allow comparisons across services.…”

Section: Resultssupporting

confidence: 91%

A qualitative process evaluation of electronic session-by-session outcome measurement in child and adolescent mental health services

et al. 2014

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BackgroundRegular monitoring of patient progress is important to assess the clinical effectiveness of an intervention. Recently, initiatives within UK child and adolescent mental health services (CAMHS) have advocated the use of session-by-session monitoring to continually evaluate the patient’s outcome throughout the course of the intervention. However, the feasibility and acceptability of such regular monitoring is unknown.MethodSemi-structured qualitative interviews were conducted with clinicians (n = 10), administrative staff (n = 8) and families (n = 15) who participated in a feasibility study of an electronic session-by-session outcome monitoring tool, (SxS), which is based on the Strengths and Difficulties Questionnaire (SDQ). This study took place in three CAMHS clinics in Nottinghamshire. The interview transcripts were thematically analysed.ResultsWe found clinicians accepted the need to complete outcome measures, particularly valuing those completed by the patient. However, there were some difficulties with engaging clinicians in this practice and in the training offered. Generally, patients were supportive of completing SxS in the waiting room prior to the clinic session and assistance with the process from administrative staff was seen to be a key factor. Clinicians and families found the feedback reports created from SxS to be helpful for tracking progress, facilitating communication and engagement, and as a point of reflection. The use of technology was considered positively, although some technological difficulties hindered the completion of SxS. Clinicians and families appreciated the brevity of SxS, but some were concerned that a short questionnaire could not adequately encapsulate the complexity of the patient’s issues.ConclusionsThe findings show the need for appropriate infrastructure, mandatory training, and support to enable an effective system of session-by-session monitoring. Our findings indicate that clinicians, administrative staff and young people and their parents/carers would support regular monitoring if the system is easy to implement, with a standard ‘clinic-wide’ adoption of the procedure, and the resulting data are clinically useful.

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Section: Resultssupporting

confidence: 91%

A qualitative process evaluation of electronic session-by-session outcome measurement in child and adolescent mental health services

et al. 2014

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“…A certain backlog concerning scoring and interpretation of instrument was stated as well by many participants. These results match those of a qualitative study with British therapists (Norman et al, 2014) that also identified main themes like "Implementation issues", which included increased time and effort for already overscheduled practitioners as well as a lack of understanding of monitoring systems. Also, a main theme of "depersonalising" was identified, including objections to an overly strong focus on "numbers" to describe subjective experiences in psychotherapy.…”

Section: Clinicians Expressed Various Practical Advantages Of Monitorsupporting

confidence: 77%

Attitudes of Austrian psychotherapists towards process and outcome monitoring

Kaiser¹,

Schmutzhart²,

Laireiter³

2017

Preprint

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While monitoring systems in psychotherapy have become more common, little is known about the attitudes that mental health practitioners have towards these systems. In an online survey among 111 Austrian psychotherapists and trainees, attitudes towards therapy monitoring were measured. A well-validated questionnaire measuring attitudes towards outcome monitoring, the outcome measurement questionnaire (OMQ), was used. Clinicians' theoretical orientations as well as previous knowledge and experience with monitoring systems were associated with positive attitudes towards monitoring. Possible factors that may have led to these findings, like the views of different theoretical orientations or obstacles in Austrian public health care, are discussed.

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“…As a therapist put it, “each patient is individual. Have to look individually” (Norman et al., , p. 586). By including items indicated by patients themselves, PQ and other outcome PGM allow monitoring progress on case‐specific issues that are not captured by their nomothetic counterparts they introduce novelty (Ashworth et al., ; Sales, Neves, Alves, & Ashworth, ) that is valued and used by therapists (Antunes et al., ; Barkham, ), while also perceived by patients as useful for promoting self‐reflection (Alves, Sales, & Ashworth, ; Guerra, Sales, & Pereira, ).…”

Section: Discussionmentioning

confidence: 99%

How Routine Patient‐Centered Monitoring Relates to Therapeutic Gains in Family Therapy: A Single‐Case Study

Sales

Ferreira²,

Matos

2018

J Marital Family Therapy

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As routine outcome monitoring systems develop, questions emerge about how therapists incorporate feedback into their practice, and how this relates to therapeutic gains. A case of covert grief was monitored in each session with the Personal Questionnaire and the Helpful Aspects of Therapy instruments. At 4 months follow‐up, the Change Interview was administered. Individualized items facilitated access to the private views and needs of each member, which was useful for case formulation and ongoing personalization of the intervention. Qualitative feedback of treatment experiences helped therapists confirm the impacts of interventions, monitor therapeutic alliance, reformulate clinical hypothesis, and plan sessions. Therapists followed a critical triangulation process to decide the clinical meaning of feedback, according to his/her intervention model, expertise, and case‐specific context.

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Clinical practitioner’s attitudes towards the use of Routine Outcome Monitoring within Child and Adolescent Mental Health Services: A qualitative study of two Child and Adolescent Mental Health Services

Cited by 42 publications

References 25 publications

A qualitative process evaluation of electronic session-by-session outcome measurement in child and adolescent mental health services

A qualitative process evaluation of electronic session-by-session outcome measurement in child and adolescent mental health services

Attitudes of Austrian psychotherapists towards process and outcome monitoring

How Routine Patient‐Centered Monitoring Relates to Therapeutic Gains in Family Therapy: A Single‐Case Study

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