Routine Outcome Measure Implementation in Graduate Training Programs for Mental Health Professionals

Abstract

Research supports that brief outcome measures play an important role in ensuring clinical competency and optimal therapeutic outcome. The APA has endorsed “the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences” (APA Task Force on Evidence Based Practice, 2006, p. 273). The literature review herein addresses the most widely-used routine outcome measures (ROM) for adult outpatient clients, briefly exploring measure development and implementation in clinical and training settings. This study examined the current implementation of such measures in graduate mental health professional training programs in order to identify best practices for, obstacles to, and common considerations about ROM implementation. Six Program and Training Directors of graduate mental health professional programs were interviewed about their experience implementing routine outcome measures. Major implementation best practices findings included the establishment of a culture of ROM feedback among faculty, choosing a ROM system that is easy to use, employing ROM data in therapist performance review in a manner that does not augment student therapist anxiety, training students on the introduction of ROM systems to clients, and employing ROM data in treatment planning in order to improve outcomes and reduce client dropout. Major obstacles to implementation identified included the cost of ROM systems, the perception of ROM as extra work for the therapist, and the perception of ROM as deleterious to the therapeutic alliance. Major common considerations identified included referencing published research as validation for ROM, ROM being easier to adopt for new therapists, the importance of mandating ROM to ensure full implementation, seeking full integration of ROM with Electronic Medical Record (EMR) systems, viewing the failure to collect ROM data as unethical, and having a limited awareness of ROM implementation in other settings. The diversity of narrative themes identified in this exploratory study likely reflect the diversity of experience in ROM implementation at graduate mental health professional training programs.