Routine outcome monitoring and clinical supervision: do therapists really care about their patients?

Abstract

Psychotherapy has repeatedly been shown to be an acceptable form of treatment for a variety of psychiatric conditions. However, despite the success of psychotherapy, not all patients improve during a course of treatment. In fact, research has suggested that some patients actually become worse while engaged in psychotherapy. Thus, it becomes important to identify patient deterioration and provide this information back to therapists. Additionally, the ability to detect patient deterioration cannot be solely the result of clinician judgment. Research has shown that utilizing actuarial methods of identifying patient non-responders is superior to that of clinician judgment alone. In turn, the field has moved toward implementing routine outcome monitoring tools/management systems to assist in the process of identifying patients who are failing to respond to treatment. The present study explored potential relationships between routine outcome monitoring, deliberate practice, and routine clinical supervision. Results suggest that the vast majority of practicing therapists do not utilize routine outcome monitoring tools/management systems as part of their daily practices of psychotherapy, and most do not incorporate feedback results into their personal clinical supervision experiences. Additionally, results suggest that therapists who have received formalized training with routine outcome monitoring tools and/or are required to engage in weekly supervision, are more likely to monitor their patient outcome as part of their daily practices of psychotherapy. Moreover, self-assessment bias seems to be present within the sample in regards to identifying patient improvement, non-response, and deterioration. Implications for clinical practice and research are discussed, along with limitations and future directions.