Routine Outcome Monitoring in Mental Health Care and Particularly in Addiction Treatment: Evidence-Based Clinical and Research Recommendations

Abstract

Routine Outcome Monitoring (ROM) concerns the repeated measurement of the progress of a patient's treatment during the course of therapy. ROM is receiving mounting attention as an important quality tool, and because of increased emphasis on health care accountability and cost containment. ROM seems especially relevant for complicated chronic patients that require a long-term treatment. Although addictive patients often have these clinical characteristics, ROM is relatively less investigated within addiction treatment. The present article summarizes recent state-of-the-art information concerning the use of ROM in mental health care and particularly in addiction treatment. First, some basics about ROM in general are described. Next, evidence for the effectiveness of ROM in mental health care and addiction treatment is reviewed. Finally, some clinical & research recommendations are suggested for the use of ROM in addiction treatment.

The Assessment and Impact of Careless Responding in Routine Outcome Monitoring within Mental Health Care

“…From the many ROM self-report instruments used in the assessment, we selected the BSI and the MASQ because they were completed by a large part of the sample and because they are often used in ROM procedures (Carlier & van Eeden, 2017). The BSI is a shortened version of the Symptom Checklist (SCL-90) and consists of 53 items.…”

“…There is growing interest in routinely monitoring clients' progress during psychiatric or psychological treatment, termed routine outcome monitoring (ROM; de Beurs et al, 2011). ROM has been implemented in many countries and in many different mental health care settings (Carlier & van Eeden, 2017;Trauer, 2010). It can provide feedback to clinicians and to clients themselves on how clients fare during treatment.…”

Feasibility of a Mobile Health App for Routine Outcome Monitoring and Feedback in Mutual Support Groups Coordinated by SMART Recovery Australia: Protocol for a Pilot Study

“…This may be of particular importance when a client is not on track (ie, not improving in line with clinical norms [ 4 ]). ROM has been specifically recommended for use in AOD treatment settings as the provision of tailored feedback to clients has been found to improve treatment outcomes across a range of AOD treatment settings (eg, acute, community, veterans) [ 3 , 5 , 6 ]. Evidence also supports clinician use of ROM and tailored feedback to enhance outcomes and/or prevent further deterioration for those clients identified as not on track early in addiction and/or mental health treatment [ 7 , 8 ].…”

“…Despite the importance of ROM and tailored feedback, ongoing variability in the implementation, sustainability, and use of ROM data has been noted [ 9 ]. The time associated with the completion, scoring, interpretation, and feedback of outcome assessments represents a key barrier to systematic implementation [ 6 , 9 ]. Using a digital platform to administer ROM and feedback may help address these concerns.…”

“…Evidence from related approaches (eg, therapeutic assessment [ 20 ]) has also shown that providing clients with assessment feedback during psychotherapy promotes client self-verification, self-discovery, and self-enhancement [ 18 ]. Moreover, delivering feedback directly to the client seems to further enhance the positive impact of ROM on treatment outcome(s), particularly among group-based treatment settings [ 6 ]. Therefore, to meet this important need of putting the client at the center of the ROM and feedback process, during the first phase of this study, we developed a purpose-built mHealth app.…”