Pitfalls in the Assessment, Analysis, and Interpretation of Routine Outcome Monitoring (ROM) Data; Results from an Outpatient Clinic for Integrative Mental Health

Purpose: Routine outcome monitoring (ROM) and clinical feedback systems (CFS) are becoming prevalent in mental health services. The field faces several challenges to successful implementation. The purpose of this study is to gain a better understanding of these challenges by exploring the patient perspective. Method: We report the findings from a qualitative, video assisted interview study of 12 patients from a Norwegian mental health outpatient clinic using ROM/CFS. Results: Our analysis resulted in three pairs of opposing experiences with using ROM/CFS: 1) Explicit vs. implicit use of CFS information, 2) CFS directing focus towards- vs. directing focus away from therapeutic topics and 3) Giving vs. receiving feedback. None of these were intrinsically helpful or hindering. Participants had vastly differing preferences for how to use ROM/CFS in clinical encounters, but all needed the information to be used in a meaningful way by their therapists. If not, ROM/CFS was at risk of becoming meaningless and hindering for therapy. Conclusion: These findings confirm and provide further nuance to previous research. We propose to consider ROM/CFS a clinical skill that should be a part of basic training for therapists. How to use and implement ROM/CFS skillfully should also be the focus of future research.

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Evaluation of an Online System for Routine Outcome Monitoring: A Cross-Sectional Survey (Preprint)

10.2196/preprints.29243 ◽

2021 ◽

Author(s):

Deanna Wiebe ◽

Pria Nippak ◽

Julien Meyer ◽

Shannon Remers

Keyword(s):

Mental Health ◽

Outcome Measures ◽

Service Providers ◽

Routine Outcome Monitoring ◽

Completion Rates ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Online System ◽

Health Service Providers ◽

Outcome Monitoring

BACKGROUND The use of Routine Outcome Monitoring (ROM) in the treatment of mental health has emerged as a method of improving psychotherapy treatment outcomes. Despite this, very few clinicians regularly use ROM in clinical practice. Online ROM has been suggested as a solution to increase adoption. OBJECTIVE To identify the influence of moving ROM online on client completion rates of self-reported outcome measures and to identify implementation and utilization barriers to online ROM by assessing clinicians’ views on their experience utilizing the online system over previous paper-based methods. METHODS Client completion rates of self-reported outcome measures were compared pre and post implementation of an online system of ROM. In addition, a survey questionnaire was administered to 340 mental health service providers regarding their perception of benefits with an online system of ROM. RESULTS Client completion rates of self-reported measures increased from 15% to 54% after moving online. Fifty-eight% of service providers found the new system less time consuming than previous paper-based ROM and 64% found that it helped monitor clients. However, the perceived value of the system remains in doubt as only 23% found it helped them identify clients at risk for treatment failure, and only 18% found it strengthened the therapeutic alliance. CONCLUSIONS Although the current study suggests mixed results regarding service providers’ views on their experience using an online system for ROM, it has identified barriers and challenges that are actionable for improvement.

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Routine Outcome Monitoring in Child and Adolescent Mental Health in the United Kingdom at the Individual and Systems Levels

The Cycle of Excellence ◽

10.1002/9781119165590.ch7 ◽

2017 ◽

pp. 145-160 ◽

Cited By ~ 1

Author(s):

Miranda Wolpert ◽

Kate Dalzell ◽

Jenna Jacob ◽

Jenny Bloxham ◽

Matt Barnard ◽

...

Keyword(s):

Mental Health ◽

United Kingdom ◽

Adolescent Mental Health ◽

Child And Adolescent ◽

Routine Outcome Monitoring ◽

The United Kingdom ◽

Outcome Monitoring ◽

The Individual

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Challenges in Investigating the Effective Components of Feedback from Routine Outcome Monitoring (ROM) in Youth Mental Health Care

Child & Youth Care Forum ◽

10.1007/s10566-020-09574-1 ◽

2020 ◽

Author(s):

Maartje A. M. S. van Sonsbeek ◽

Giel J. M. Hutschemaekers ◽

Jan W. Veerman ◽

Ad Vermulst ◽

Marloes Kleinjan ◽

...

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Symptom Severity ◽

Youth Mental Health ◽

Routine Outcome Monitoring ◽

Effective Components ◽

Outcome Monitoring

Abstract BackGround Studies on feedback in youth mental health care are scarce and implementation of feedback into clinical practice is problematic. Objective To investigate potentially effective components of feedback from Routine Outcome Monitoring (ROM) in youth mental health care in the Netherlands through a three-arm, parallel-group, randomized controlled trial in which a literature-based, multi-faceted implementation strategy was used. Method Participants were randomly allocated to three conditions (basic feedback about symptoms and quality of life; basic feedback supplemented with clinical support tools; discussion of the feedback of the second condition with a colleague while following a standardized format for case consultation) using a block randomization procedure, stratified by location and participants’ age. The youth sample consisted of 225 participants (mean age = 15.08 years; 61.8% female) and the parent sample of 234 mothers and 54 fathers (mean age of children = 12.50 years; 47.2% female). Primary outcome was symptom severity. Secondary outcomes were quality of life and end-of-treatment variables. Additionally, we evaluated whether being Not On Track (NOT) moderated the association between condition and changes in symptom severity. Results No significant differences between conditions and no moderating effect of being NOT were found. This outcome can probably be attributed to limited power and implementation difficulties, such as infrequent ROM, unknown levels of viewing and sharing of feedback, and clinicians’ poor adherence to feedback conditions. Conclusions The study contributes to our limited knowledge about feedback from ROM and underscores the complexity of research on and implementation of ROM within youth mental health care. Trial registration Dutch Trial Register NTR4234 .

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The Clinical Outcomes in Routine Evaluation-Outcome Measure: A useful option for routine outcome monitoring in Latin America

Revista Brasileira de Psicodrama ◽

10.15329/2318-0498.20190024 ◽

2019 ◽

Vol 27 (2) ◽

pp. 226-230

Author(s):

Clara Paz ◽

Chris Evans

Keyword(s):

Mental Health ◽

Clinical Outcomes ◽

Latin American ◽

Outcome Measure ◽

Brazilian Portuguese ◽

Routine Outcome Monitoring ◽

Present Communication ◽

Community Based ◽

Outcome Monitoring ◽

Evaluation Outcome

Latin American mental health services are moving from the psychiatric hospital model to a community-based model. The effectiveness of these new services needs to be evaluated and that can be done through routine outcome monitoring. The present communication introduces the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM), a free instrument, supported with rigorous psychometric exploration, and which has been translated to Spanish and Brazilian Portuguese that can be used for monitoring purposes across the region.

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