Routine Outcome Monitoring and Clinical Feedback in Psychotherapy: Recent Advances and Future Directions

Abstract

In the past decade, there has been an increase in research related to the routine collection and active use of standardized patient data in psychotherapy. Research has increasingly focused on personalization of care to patients, clinical skills and interventions that modulate treatment outcomes, and implementation strategies, all of which appear to enhance the beneficial effects of ROM and feedback. In this article, we summarize trends and recent advances in the research on this topic and identify several essential directions for the field in the short to medium term. We anticipate a broadening of research from the focus on average effects to greater specificity around what kinds of feedback, provided at what time, to which individuals, in what settings, are most beneficial. We also propose that the field needs to focus on issues of health equity, ensuring that ROM can be a vehicle for increased wellbeing for those who need it most. The complexity of mental healthcare systems means that there may be multiple viable measurement solutions with varying costs and benefits to diverse stakeholders in different treatment contexts, and research is needed to identify the most influential components in each of these contexts.

Psychotherapists’ outcome expectations: How are they established?

“…It is reasonable to expect that therapists’ OEs affect their actions during treatment and that patient changes during treatment similarly affect therapists’ expectations continuously throughout the treatment process. Some of the best evidence for this comes from measurement-based care, in which patients’ symptoms are tracked during routine practice (McAleavey et al, 2024). Tracking outcomes allows therapists’ OEs to be updated during treatment, and when the data show that patients are not improving at an appropriate rate, many therapists seem able to adjust treatment to reduce negative outcomes (Lambert et al, 2018).…”