Enhancing mental health and well‐being outcomes for psychotherapy and counselling through idiographic analysis: A four‐quadrant approach

Abstract

Mental health and well‐being outcomes in psychotherapy and counselling have largely been studied through the use of standardised nomothetic measurement. A key limitation is that nomothetic measurement and current statistical analyses do not necessarily capture the outcomes of the complicated and individual psychotherapy processes. There is an increased interest in the use of idiographic patient‐reported outcome measures (I‐PROMs), which are uniquely useful because they may explore areas of importance that are unexplored by nomothetic outcome measures. We argue that to optimise the value of I‐PROMs, it is necessary to consider their contribution alongside standardised nomothetic measures. However, there are important considerations with respect to whether or not I‐PROMs from different clients, or indeed from the same client, can be meaningfully explored at a team/service level, and alongside standardised nomothetic outcomes. We provide worked examples on real client data to show that delineating four quadrants of analysis is important to explore the breadth of information: (a) individual progress on single items, (b) individual progress by aggregated scores, (c) team/service‐level progress by goal item/theme and (d) team/service‐level progress by aggregated scores.

Exploring goal taxonomies using the goal‐based outcome tool in children and young people's mental health settings

“…Rather, using an overarching goal taxonomy could be useful for practitioner‐level, or service‐level organisation of goal data, for activities such as service planning and delivery. Four types of analysis of personalised outcome data have been suggested as a way forward in recent previous research; this incorporates the consideration of goal taxonomies, ensuring that a breadth of information is considered (Jacob et al, 2023). The present study develops this work further through the synthesis of existing goal taxonomies to support the exploration of goal data in this way.…”

“…Whether or not idiographic outcome data should be analysed by theme is a key question in the outcome measurement field, as discussed by Sales et al (2023). Jacob et al (2023) argue for four quadrants of idiographic data exploration for service improvement and client and practitioner reflection purposes. One of the highlighted types of analysis is by goal (or item) theme at the team or service level.…”

“…This might lead to important discussions about who they are (and are not) supporting, and which areas of identified outcome they seem to be most and least effective in supporting clients. This is a practical way of exploring outcome data that move beyond the exploration of overall change and might be considered similar to the exploration of standardised outcome measure subscales (Jacob et al, 2023).…”