The use of Progress Monitoring (PM) measures has been shown to improve outcomes in therapy for clients who do not follow the normal trajectory of improvement. In addition to improved outcomes, there are several other documented benefits of PM that may motivate clinicians to use PM. Research has examined the broader field of selecting mental health care quality assessment tools and a review of the literature has pointed to the importance of considering motivation for assessment when selecting a measure. However, how motivation influences the selection or maintained usage of PM measures has not been studied. This study examined initial motivation as well as measure selection and continuing use of PM. Consensual Qualitative Research methodology was applied to characterize how clinicians (<i>n</i> = 25) started, selected, and maintained use of PM measures and how initial motivation related to measure selection and continued use. Regardless of initial motivation, convenience and effectiveness emerged as important when selecting and continuing to use a measure. Results are compared to current frameworks for selecting mental health- care quality indicators. Our results suggest that PM measures need to strike a balance, emphasizing convenience as well as efficacy in order to improve clinical uptake and adherence.
KeywordsProgress Monitoring (PM)Outcome MonitoringEvidence-Based PracticeConsensual Qualitative Research (CQR)Measure Selection
Anker, M. G., Duncan, B. L., & Sparks, J. A. (2009). Using Client Feedback to Improve Couple Therapy Outcomes: A Randomized Clinical Trial in a Naturalistic Setting. Journal of Consulting and Clinical Psychology, 77, 693-701. http://dx.doi.org/10.1037/a0016062
Burlingame, G. M., Dunn, T. W., Chen, S., Lehman, A., Axman, R., Earnshaw, D., & Rees, F. M. (2005). Selection of Outcome Assessment Instruments for Inpatients with Severe and Persistent Mental Illness. Psychiatry Services, 56, 444-451. http://dx.doi.org/10.1176/appi.ps.56.4.444
Burlingame, G. M., Lambert, M. J., Reisinger, C. W., Neff, W. M., & Mosier, J. (1995). Pragmatics of Tracking Mental Health Outcomes in a Managed Care Setting. The Journal of Mental Health Administration, 22, 226-236. http://dx.doi.org/10.1007/BF02521118
Duncan, B. L. (2012). The Partners for Change Outcome Management System (PCOMS): The Heart and Soul of Change Project. Canadian Psychology, 53, 93-104. http://dx.doi.org/10.1037/a0027762
Duncan, B. L., Solovey, A. D., & Rusk, G. S. (1992). Changing the Rules: A Client-Directed Approach to Therapy. New York: The Guildford Press.
Erbes, C., Polusny, M. A., Billig, J., Mylan, M., McGuire, K., Isenhart, C., & Olson, D. (2004). Developing and Applying a Systematic Process for Evaluation of Clinical Outcome Assessment Instruments. Psychological Services, 1, 31-39. http://dx.doi.org/10.1037/1541-1559.1.1.31
Froyd, J. E., Lambert, M. J., & Froyd, J. D. (1996). A Review of Practice of Psychotherapy Outcome Measurement. Journal of Mental Health, 5, 11-15. http://dx.doi.org/10.1080/09638239650037144
Green, R. S., & Gracely, E. J. (1987). Selecting a Rating Scale for Evaluating Services to the Chrinically Mentally Ill. Community Mental Health Journal, 23, 91-102. http://dx.doi.org/10.1007/BF00757163
Harmon, C., Lambert, M. J., Smart, D. W., Hawkins, E., Nielsen, S. L., Slade, K., & Lutz, W. (2007). Enhancing Outcome for Potential Treatment Failures: Therapist-Client Feedback and Clinical Support Tools. Psychotherapy Research, 17, 379-392. http://dx.doi.org/10.1080/10503300600702331
Hatfield, D. R., & Ogles, B. M. (2004). The Use of Outcome Measures by Psychologists in Clinical Practice. Professional Psychology: Research and Practice, 35, 485-491. http://dx.doi.org/10.1037/0735-7028.35.5.485
Hatfield, D. R., & Ogles, B. M. (2007). Why Some Clinicians Use Outcome Measures and Others Do Not. Administration and Policy in Mental Health and Mental Health Services Research, 34, 283-291. http://dx.doi.org/10.1007/s10488-006-0110-y
Hermann, R. C., & Palmer, R. H. (2002). Common Ground: A Framework for Selecting Core Quality Measures for Mental Health and Substance Abuse Care. Psychiatry Services, 53, 281-287. http://dx.doi.org/10.1176/appi.ps.53.3.281
Hermann, R. C., Leff, H. S., Palmer, R. H., Yang, D., Teller, T., Provost, S., Jakubiak, C., & Chan, J. (2000). Quality Measures for Mental Health Care: Results from a National Inventory. Medical Care Research and Review, 57, 136-154. http://dx.doi.org/10.1177/1077558700573008
Hermann, R. C., Mattke, S., Somekh, D., Silfverhielm, H., Goldner, E., Glover, G., Pirkis, J., Mainz, J., & Chan, J. A. (2006). Quality Indicators for International Benchmarking of Mental Health Care. International Journal for Quality in Health Care, 18, 31-38. http://dx.doi.org/10.1093/intqhc/mzl025
Hermann, R. C., Palmer, H., Leff, S., Shwartz, M., Provost, S., Chan, J., Chiu, W. T., & Lagodmos, G. (2004). Achieving Consensus across Diverse Stakeholders on Quality Measures for Mental Healthcare. Medical Care, 42, 1246-1253. http://dx.doi.org/10.1097/00005650-200412000-00012
Hill, C. E. (2012). Consensual Qualitative Research: A Practical Resource for Investigating Social Science Phenomena. Washington DC: American Psychological Association.
Ionita, G., & Fitzpatrick, M. (2014). Bringing Science to Clinical Practice: A Canadian Survey of Psychologists Practice and Usage of Progress Monitoring Measures. Canadian Psychology, 55, 187-196. http://dx.doi.org/10.1037/a0037355
Kazdin, A. E. (2008). Evidence-Based Treatment and Practice: New Opportunities to Bridge Clinical Research and Practice, Enhance the Knowledge Base, and Improve Patient Care. American Psychologist, 63, 146-159. http://dx.doi.org/10.1037/0003-066X.63.3.146
Kitson, A., Harvey, G., & McCormack, B. (1998). Enabling the Implementation of Evidence Based Practice: A Conceptual Framework. Quality in Health Care, 7, 149-158. http://dx.doi.org/10.1136/qshc.7.3.149
Lambert, M. J., & Shimokawa, K. (2011). Collecting Client Feedback. Psychotherapy, 48, 72-79. http://dx.doi.org/10.1037/a0022238
Lambert, M. J., Harmon, C., Slade, K., Whipple, J. L., & Hawkins, E. J. (2005). Providing Feedback to Psychotherapists on Their Patients’ Progress Clinical Results and Practice Suggestions. Journal of Clinical Psychology, 61, 165-174. http://dx.doi.org/10.1002/jclp.20113
Lambert, M. J., Ogles, B. M., & Masters, K. S. (1992). Choosing Outcome Assessment Devices: An Organizational and Conceptual Scheme. Journal of Counseling and Development, 70, 527-532. http://dx.doi.org/10.1002/j.1556-6676.1992.tb01653.x
Lambert, M. J., Whipple, J. L., Smart, D. W., Vermeersch, D. A., Nielsen, S. L., & Hawkins, E. J. (2001). The Effects of Providing Therapists with Feedback on Patient Progress during Psychotherapy: Are Outcomes Enhanced? Psychotherapy Research, 11, 153-166. http://dx.doi.org/10.1080/713663852
Miller, S. D., Duncan, B. L., Sorrell, R., & Brown, G. S. (2005). The Partners for Change Outcome Management System. Journal of Clinical Psychology, 61, 199-208. http://dx.doi.org/10.1002/jclp.20111
Overington, L., & Ionita, G. (2012). Progress Monitoring Measures: A Brief Guide. Canadian Psychology, 53, 82-92. http://dx.doi.org/10.1037/a0028017
Reese, R. J., Norsworthy, L. A., & Rowlands, S. R. (2009). Does a Continuous Feedback System Improve Psychotherapy Outcome? Psychotherapy, 46, 418-431. http://dx.doi.org/10.1037/a0017901
Reese, R. J., Toland, M. D., Slone, N. C., & Norsworthy, L. A. (2010). Effect of Client Feedback on Couple Psychotherapy Outcomes. Psychotherapy: Theory, Research, Practice, Training, 47, 616-630. http://dx.doi.org/10.1037/a0021182
Ruhe, M. C., Weyer, S. M., Zronek, S., Wilkinson, A., Wilkinson, P. S., & Stange, K. C. (2005). Facilitating Practice Change: Lessons from the STEP-UP Clinical Trial. Preventive Medicine, 40, 729-734. http://dx.doi.org/10.1016/j.ypmed.2004.09.015
Schuman, D. L., Slone, N. C., Reese, R. J., & Duncan, B. (2015). Efficacy of Client Feedback in Group Psychotherapy with Soldiers Referred for Substance Abuse Treatment. Psychotherapy Research, 25, 396-407. http://dx.doi.org/10.1080/10503307.2014.900875
Slade, M. (2002). What Outcomes to Measure in Routine Mental Health Services, and How to Assess Them: A Systematic Review. Australia and New Zealand Journal of Psychiatry, 36, 743-753. http://dx.doi.org/10.1046/j.1440-1614.2002.01099.x
Slone, N. C., Reese, R. J., Mathews-Duvall, S., & Kodet, J. (2015). Evaluating the Efficacy of Client Feedback in Group Psychotherapy. Group Dynamics: Theory, Research, and Practice, 19, 122-136. http://dx.doi.org/10.1037/gdn0000026
Stewart, R. E., & Chambless, D. L. (2007). Does Psychotherapy Research Inform Treatment Decisions in Private Practice? Journal of Clinical Psychology, 63, 267-281. http://dx.doi.org/10.1002/jclp.20347
Waraich, P., Saklikar, R. S., Aube, D., Jones, W., Haslam, D., & Hamill, K. (2010). Quality Measures for Primary Mental Healthcare: A Multistakeholder, Multijurisdictional Canadian Consensus. Quality and Safety in Health Care, 19, 519-525. http://dx.doi.org/10.1136/qshc.2008.027839