Rohaan Mehta, Rachel L. Grover, Ph.D.
Routine Outcome Monitoring in Psychotherapy
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.