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Session-by-session outcome monitoring in CAMHS: clinicians’ beliefs

Published online by Cambridge University Press:  04 November 2015

Kirsty James*
Affiliation:
Department of Clinical Psychology, University of Bath, Bath, UK
Sarah Elgie
Affiliation:
South Gloucestershire CAMHS, Kingswood Locality Hub, Kingswood, Bristol, UK
Joanna Adams
Affiliation:
Department of Clinical Psychology, University of Bath, Bath, UK
Tracey Henderson
Affiliation:
South Gloucestershire CAMHS, Kingswood Locality Hub, Kingswood, Bristol, UK
Paul Salkovskis
Affiliation:
Department of Clinical Psychology, University of Bath, Bath, UK
*
*Author for correspondence: Ms. K. James, Department of Clinical Psychology, University of Bath, Bath BA2 7AY, UK (email: kirsty471@yahoo.co.uk).

Abstract

The Children and Young People's Improving Access to Psychological Therapies (CYP IAPT) programme emphasizes the meaningful contribution session-by-session routine outcome monitoring (ROM) can make to clinical practice and its importance in highlighting services’ effectiveness. Two studies on issues related to the implementation of ROM in children's services were conducted. Study 1 was qualitative; 12 Child and Adolescent Mental Health Services (CAMHS) professionals participated in focus groups. Themes identified included the idea that ROM could provide objectivity, could be collaborative and empowering. Concerns included how measures may adversely influence therapeutic sessions and how the information may be used by the service. These themes were used to develop a questionnaire about professionals’ experience of and views on session-by-session ROM. In Study 2, 59 professionals from four CAMHS teams completed the questionnaire. It was found that only 6.8% reported ‘almost always’ utilizing session-by-session ROM. Detailed analysis of questionnaire responses suggested two subscales reflecting the perceived negative and positive impact of session-by-session ROM. It was found that clinicians who currently use session-by-session ROM hold stronger positive and negative beliefs than clinicians who do not. This study suggests that session-by-session ROM is not currently routine practice within CAMHS and highlights the importance of considering how this practice can be best implemented within this setting with reference to clinician attitudes.

Type
Original Research
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2015 

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References

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Bickman, L, Kelley, S, Breda, C, de Andrade, A, Riemer, M (2011). Effects of routine feedback to clinicians on mental health outcomes of youths: results of a randomized trial. Psychiatric Services 62, 14231429.Google Scholar
Johnston, C, Gowers, S (2005). Routine outcome measurement: a survey of UK child and adolescent mental health services. Child and Adolescent Mental Health 10, 133139.Google Scholar
Moran, P, Kelesidi, K, Guglani, S, Davidson, S, Ford, T (2012). What do parents and carers think about routine outcome measures and their use? A focus group study of CAMHS attenders. Clinical Child Psychology and Psychiatry 17, 6579.Google Scholar

References

Barkham, M, Margison, F, Leach, C, Lucock, M, Mellor-Clark, J, Evans, C, Benson, L, Connell, J, Audin, K, McGrath, G (2001). Service profiling and outcomes benchmarking using the CORE-OM: Toward practice-based evidence in the psychological therapies. Journal of Consulting and Clinical Psychology 69, 184.Google Scholar
Bickman, L, Kelley, S, Breda, C, de Andrade, A, Riemer, M (2011). Effects of routine feedback to clinicians on mental health outcomes of youths: results of a randomized trial. Psychiatric Services 62, 14231429.Google Scholar
Braun, V, Clarke, V (2006). Using thematic analysis in psychology. Qualitative Research in Psychology 3, 77101.Google Scholar
Clark, DM (2011). Implementing NICE guidelines for the psychological treatment of depression and anxiety disorders: The IAPT experience. International Review of Psychiatry 23, 318327.Google Scholar
Clausen, AS (2012). The Individually focused interview: methodological quality without transcription of audio recordings. The Qualitative Report 17, 117.Google Scholar
CORC (2012). Children and young people's tracking outcomes, resource pack version 1.4 (www.corc.uk.net/wp…/12/Child-and-YP-IAPT-Measures1.4_131212.pdf). Accessed August 2013.Google Scholar
Dowrick, C, Leydon, GM, McBride, A, Howe, A, Burgess, H, Clarke, P, Maisey, S, Kendrick, T (2009). Patients’ and doctors’ views on depression severity questionnaires incentivised in UK quality and outcomes framework: qualitative study. British Medical Journal 338, b663.Google Scholar
Evans, C, Connell, J, Barkham, M, Margison, F, McGrath, G, Mellor-Clark, J, Audin, K (2002). Towards a standardised brief outcome measure: psychometric properties and utility of the CORE-OM. British Journal of Psychiatry 180, 5160.CrossRefGoogle ScholarPubMed
Fehm, L, Kazantzis, N (2004). Attitudes and use of homework assignments in therapy: a survey of german psychotherapists. Clinical Psychology & Psychotherapy 11, 332343.Google Scholar
Ford, T, Tingay, K, Wolpert, M (2006). CORC's survey of routine outcome monitoring and national CAMHS dataset developments: a response to Johnston and Gowers. Child and Adolescent Mental Health 11, 5052.CrossRefGoogle Scholar
Gyani, A, Shafran, R, Myles, P, Rose, S (2014). The gap between science and practice: How therapists make their clinical decisions. Behavior Therapy 45, 199211.Google Scholar
Hatfield, DR, Ogles, BM (2006). The influence of outcome measures in assessing client change and treatment decisions. Journal of Clinical Psychology 62, 325337.Google Scholar
Hatfield, DR, Ogles, BM (2007). Why some clinicians use outcome measures and others do not. Administration and Policy in Mental Health and Mental Health Services Research 34, 283291.Google Scholar
Johnston, C, Gowers, S (2005). Routine outcome measurement: a survey of UK child and adolescent mental health services. Child and Adolescent Mental Health 10, 133139.Google Scholar
Kahneman, D (2011). Thinking, Fast and Slow. New York: Macmillan.Google Scholar
Kazantzis, N, Lampropoulos, GK, Deane, FP (2005). A national survey of practicing psychologists’ use and attitudes toward homework in psychotherapy. Journal of Consulting and Clinical Psychology 73, 742748.Google Scholar
Knaup, C, Koesters, M, Schoefer, D, Becker, T, Puschner, B (2009). Effect of feedback of treatment outcome in specialist mental healthcare: meta-analysis. British Journal of Psychiatry 195, 1522.Google Scholar
Lambert, MJ (2007). Presidential address: What we have learned from a decade of research aimed at improving psychotherapy outcome in routine care. Psychotherapy Research 17, 114.Google Scholar
Lambert, MJ, Shimokawa, K (2011). Collecting client feedback. Psychotherapy (Chicago). 48, 7279.Google Scholar
Lambert, MJ, Whipple, JL, Hawkins, EJ, Vermeersch, DA, Nielsen, SL, Smart, DW (2003). Is it time for clinicians to routinely track patient outcome? A meta-analysis. Clinical Psychology: Science and Practice 10, 288301.Google Scholar
Law, D (2012). A practical guide to using service user feedback & outcome tools to inform clinical practice in child & adolescent mental health. Some initial guidance from the children and young peoples’ Improving access to psychological therapies outcomes-oriented practice (CO-OP group) (version 1.3, Feb. 2012). London: IAPT-NHS.Google Scholar
Leydon, GM, Dowrick, CF, McBride, AS, Burgess, HJ, Howe, AC, Clarke, PD, Maisey, SP, Kendrick, T (2011). Questionnaire severity measures for depression: a threat to the doctor–patient relationship? British Journal of General Practice 61, 117123.Google Scholar
Miller, SD, Duncan, BL, Sorrell, R, Brown, GS (2005). The partners for change outcome management system. Journal of Clinical Psychology 61, 199208.Google Scholar
Moran, P, Kelesidi, K, Guglani, S, Davidson, S, Ford, T (2012). What do parents and carers think about routine outcome measures and their use? A focus group study of CAMHS attenders. Clinical Child Psychology and Psychiatry 17, 6579.Google Scholar
Nassar-McMillan, SC, Borders, L (2002). Use of focus groups in survey item development. The Qualitative Report 7, 1–12.Google Scholar
NIMHE (2005). Outcomes measurement implementation best practice guidelines (www.nimhe.org.uk).Google Scholar
Salkovskis, PM (1984). Psychological research by NHS clinical psychologists: an analysis and some suggestions. Bulletin of the British Psychological Society 37, 375377.Google Scholar
Shimokawa, K, Lambert, MJ, Smart, DW (2010). Enhancing treatment outcome of patients at risk of treatment failure: Meta-analytic and mega-analytic review of a psychotherapy quality assurance system. Journal of Consulting and Clinical Psychology 78, 298.Google Scholar
Stein, B, Kogan, J, Hutchison, S, Magee, E, Sorbero, M (2010). Use of outcomes information in child mental health treatment: results from a pilot study. Psychiatric Services 61, 12111216.Google Scholar
Thew, GR, Fountain, L, Salkovskis, PM (2015). Service user and clinician perspectives on the use of outcome measures in psychological therapy. The Cognitive Behaviour Therapist. doi:10.1017/S1754470X15000598.Google Scholar
Twigg, E, Barkham, M, Bewick, BM, Mulhern, B, Connell, J, Cooper, M (2009). The young person's CORE: development of a brief outcome measure for young people. Counselling and Psychotherapy Research 9, 160168.Google Scholar
Westbrook, D, Mueller, M, Kennerley, H, McManus, F (2010). Common problems in therapy. In: Oxford Guide to Surviving as a CBT Therapist (ed. Mueller, M., Kennerley, H., McManus, F. & Westbrook, D.), pp. 140. Oxford: Oxford University Press.Google Scholar
Whipple, JL, Lambert, MJ, Vermeersch, DA, Smart, DW, Nielsen, SL, Hawkins, EJ (2003). Improving the effects of psychotherapy: The use of early identification of treatment and problem-solving strategies in routine practice. Journal of Counseling Psychology 50, 59.Google Scholar
Wolpert, M, Fugard, AJB, Deighton, J, Görzig, A (2012). Routine outcomes monitoring as part of children and young people's Improving Access to Psychological Therapies (CYP IAPT) – improving care or unhelpful burden? Child and Adolescent Mental Health 17, 129130.Google Scholar
Wroe, AL, Salkovskis, PM (1999). Factors influencing anticipated decisions about genetic testing: experimental studies. British Journal of Health Psychology 4, 1940.Google Scholar
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