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Rohaan Mehta, Rachel L. Grover, Ph.D.

Routine Outcome Monitoring in Psychotherapy

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Routine outcome monitoring (ROM) is the practice of assessing psychotherapy clients’ treatment response at regular intervals to enhance their eventual treatment outcome. Clients’ treatment response is measured by administering outcome measures (e.g., Beck Depression Inventory, Outcome Questionnaire–45, Treatment Outcome Package) at regular intervals over the course of therapy (e.g., at the beginning of every session). ROM uses frequent measurements of a single client’s progress to evaluate the effectiveness of treatment for that particular individual, taking into consideration their idiosyncratic history, experiences, and personality. This treatment response data is fed back to the clinician, and sometimes the client, and used to modify treatment plans.

ROM provides many advantages across the field of psychology; in clinical research (de Klerk et al., 2011; Grootenboer et al., 2012; van der Lem et al., 2013; van Noorden et al., 2010; van Noorden et al., 2011; van Noorden et al., 2013), in healthcare institutions (McKay, Coombs, & Duerden, 2014; van Noorden et al., 2013), and even on a national level to determine the quality of mental health treatment in a given country (Delespaul, 2015). Yet, it is on an individual level that ROM can be a most powerful tool.

A plethora of studies (e.g., Ellsworth, Lambert, & Johnson, 2006; Hannan et al., 2005; Harmon et al., 2007; Hawkins, Lambert, Vermeersch, Slade, & Tuttle, 2004; Lambert et al., 2001; Lambert et al., 2002; Lutz et al., 2006; Martin, Hess, Ain, Nelson, & Locke, 2012; Whipple et al., 2003) provide evidence in support of ROM improving client outcomes in psychotherapy. However, despite the power of routine outcome monitoring to improve clients’ well-being, there is a scarcity of clinicians who implement ROM in their practice – it is estimated that only 29-37% (Hatfield and Ogles, 2004; Phelps, Eisman, and Kohout, 1998) of clinicians use any kind of outcome measures in their practice, while there is no research available on how routinely clinicians use outcome measures in practice.

The present study will survey a national sample of licensed psychologists practicing in a variety of settings on their use of ROM. The desired sample size is 200 participants to detect a medium effect size. Participants will be solicited via email, using the membership lists of Division 1 (Society for General Psychology), Division 12 (Society of Clinical Psychology), Division 17 (Society of Counseling Psychology), and Division 42 (Psychologists in Independent Practice) of the American Psychological Association. Participants will be surveyed on their use or disuse of ROM, frequency of use, purpose of use, effectiveness in clinical practice, and potential barriers to implementation.

The information obtained will be used to discover which variables predict the use of ROM in clinical practice, and which variables are considered barriers to its implementation. That data will be valuable in determining how more clinicians can be convinced to implement ROM in their practice so that all clients can achieve better outcomes from psychotherapy.


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