Routinely monitoring patient progress during therapy is an important part of evidence-based practice in mental health (APA Presidential Task Force on Evidence-Based Practice, 2006). Results from the meta-analysis summarized above support the use of routinely monitoring the mental health of adult patients as they participate in psychotherapy (e.g. individual, couple, and/or group) using one of the several available programs, such as the OQ-System or the PCOMS. Real-time ROM feedback with alerts that identify at-risk cases assists clinicians in more accurately detecting patients who are worsening or who demonstrate less than expected improvement in psychotherapy.
Despite the demonstrated positive impact of using feedback monitoring tools and clinicians’ generally positive attitudes toward the usefulness of gathering progress data and providing feedback to patients, only a small minority of practitioners are currently using them at least once per month or even on a less regular basis. And many, when given the choice, would prefer not to use them at all. Findings from the qualitative study above help to identify some of the barriers clinicians found in implementing progress monitoring.
Clinicians who are interested in monitoring outcomes but have yet to do so can try several strategies to get started.
First, find tools and systems that work for your practice setting. Some take less than five to 10 minutes to administer. Also, continued advances in technology, including online scoring and feedback systems, have further reduced the amount of time it takes to administer, score, and interpret results.
Becoming comfortable at providing an explanation of the purpose and benefits of the measures may help to engender a positive response from patients. Some of this can be part of a well-implemented informed consent process.
Finally, connecting with experienced colleagues or through state associations and professional listservs could be helpful in allaying feelings of anxiety if you are uncertain regarding gathering progress data. An awareness that feelings of anxiety or discomfort are temporary may help clinicians to proceed.
On a larger scale, cultural changes at the organizational level may be needed for effective adoption. Allow for time, training and education regarding evidence that these systems do indeed add utility above and beyond simply checking in informally with patients every session.
Incorporating progress monitoring measures into training programs will likely lower anxiety or discomfort in using measures, allow practitioners to become familiar with the different characteristics of progress monitoring measures so they can choose ones with the best fit, and receive support and supervision to manage potentially negative responses.
Additionally, as more accountability from payers (e.g., Medicare and commercial insurance) is likely, figuring out progress monitoring that works for one's practice may help keep psychologists ahead of the game.
APA has resources for psychologists who wish to learn more about outcome monitoring programs.