Collecting and delivering progress feedback: A meta-analysis of routine outcome monitoring.

This systematic review and meta-analysis examines the impact of measuring, monitoring, and feeding back information on client progress to clinicians while they deliver psychotherapy. It considers the effects of the 2 most frequently studied routine outcome monitoring (ROM) practices: The Partners for Change Outcome Management System and the Outcome Questionnaire System. Like other ROM practices, they typify attempts to enhance routine care by assisting psychotherapists in recognizing problematic treatment response and increasing collaboration between therapist and client to overcome poor treatment response.

The relationship between clients' depression etiological beliefs and psychotherapy orientation preferences, expectations, and credibility beliefs.

The purpose of this study was to examine the relationship between clients' etiological beliefs for depression and treatment preferences, credibility beliefs, and outcome expectations for five different depression treatments-behavioral activation, cognitive therapy, interpersonal psychotherapy, pharmacotherapy, and psychodynamic psychotherapy. Adult psychotherapy clients (N = 98) were asked to complete an online survey that included the Reasons for Depression Questionnaire, a brief description of each of the five treatment options, and credibility, expectancy, and preference questions for each option. On average, the participating clients rated pharmacotherapy as significantly less credible, having a lower likelihood of success, and being less preferred than the four types of psychotherapy.

Creating a climate for therapist improvement: A case study of an agency focused on outcomes and deliberate practice.

Recent evidence suggests that psychotherapists may not increase in effectiveness over accrued experience in naturalistic settings, even settings that provide access to patients' outcomes. The current study examined changes in psychotherapists' effectiveness within an agency making a concerted effort to improve outcomes through the use of routine outcome monitoring coupled with ongoing consultation and the planful application of feedback including the use of deliberate practice. Data were available for 7 years of implementation from 5,128 patients seen by 153 psychotherapists.

Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting.

Objective: Psychotherapy researchers have long questioned whether increased therapist experience is linked to improved outcomes. Despite numerous cross-sectional studies examining this question, no large-scale longitudinal study has assessed within-therapist changes in outcomes over time.

Method: The present study examined changes in psychotherapists' outcomes over time using a large, longitudinal, naturalistic psychotherapy data set.

Using client outcome monitoring as a tool for supervision.

A large body of research has supported the use of client outcome monitoring and client feedback in psychotherapy. However, discussions between supervisors and trainee clinicians in supervision are still largely based on subjective appraisals made by the trainees. In this article, we discuss 3 strategies for integrating client outcome data and feedback into the supervisory process: training students to obtain and use objective client feedback, using specific client data to inform discussions of clients, and identifying patterns of outcomes across clients to facilitate supervisee growth and development.

Supervisor variance in psychotherapy outcome in routine practice.

Objective: Although supervision has long been considered as a means for helping trainees develop competencies in their clinical work, little empirical research has been conducted examining the influence of supervision on client treatment outcomes. Specifically, one might ask whether differences in supervisors can predict/explain whether clients will make a positive or negative change through psychotherapy.

Method: In this naturalistic study, we used a large (6521 clients seen by 175 trainee therapists who were supervised by 23 supervisors) 5-year archival data-set of psychotherapy outcomes from a private nonprofit mental health center to test whether client treatment outcomes (as measured by the OQ-45.

Preferences for mental health treatment options among Alaska Native college students.

In this study we investigated the mental health treatment preferences held by Alaska Native (AN) college students regarding treatment type, treatment provider, and therapy roles. Preferences were compared between AN and Caucasian participants and also between ANs with high and low identification with their Indigenous culture. While there were many similarities between groups, some important differences were found.

A prediction of initial appointment attendance and initial outcome expectations.

Clients' outcome expectations have been found to play an important role in psychotherapy. Although expectations likely exist before the start of treatment, little is known about how early expectations are developed and the role they play in initial appointment attendance. Adult clients (n = 57) from two psychology department training clinics completed measures of outcome expectations, generalized hope, and distress at the time of referral (after the initial phone conversation).

Providers' voices on telebehavioral health: survey of an outpatient counseling agency in Alaska.

Hope Counseling Center sought to expand behavioral health services to underserved populations in Alaska by offering telebehavioral health services. Providers completed a questionnaire addressing their experiences, opinions, and training needs as they relate to telebehavioral health. Open conversations about the training needs, limitations, and benefits of telebehavioral health supported program development and led to training on new equipment, rapport building, and telebehavioral health outcome studies.

Outcome measures for practice.

The current review targets efforts to use outcome measures in routine care for the purpose of enhancing psychotherapy outcome, particularly for patients who are predicted to have a negative treatment outcome. The place of outcome measures in solving the negative effects problem is emphasized, with a narrow focus on one set of measures that is relatively well advanced in its clinical utility. This clinical innovation relies on research-based clinical decision tools that provide psychotherapists with timely warnings and problem-solving strategies when a patient deviates from an expected treatment response.

Providing feedback to psychotherapists on their patients' progress: clinical results and practice suggestions.

We describe and illustrate our system to measure, monitor, and feed back information about patient treatment. This clinical innovation relies on research-based clinical decision tools that provide psychotherapists with timely warnings when a patient's deviation from an expected treatment response foretells possible treatment failure. We summarize the results of four controlled studies using this methodology; the collective results suggest that measuring, monitoring, and predicting treatment failure (feedback) enhance treatment outcomes for patients who have a negative response.

Improving outcomes for poorly responding clients: the use of clinical support tools and feedback to clients.

We present two methods of enhancing outcome and preventing treatment failure in psychotherapy. The first involves providing therapists with a decision tree and several assessment measures for clients who are not having a positive response to psychotherapy. The organization of the decision tree and the selection of measures were based on results from psychotherapy outcome studies.