What Works in Therapy  |  Douglas Behan, DSW, LCSW

Routine Outcome Measurement

Routine outcome measurement (ROM) involves therapists giving their clients self-report scales throughout the course of treatment and using the data to ensure treatment is meeting their clients' needs. Very few therapists have been trained to formally evaluate the response their clients are having to treatment. However, there are now brief (and free) instruments that therapists can easily incorporate into their work that provide useful information on how clients are perceiving therapy. Most importantly, use of these tools has been shown to reduce dropouts and improve outcomes.

What the Research Says...

The research evidence supports using ROM across treatment modalities (i.e. individual, family, group) throughout a course of psychotherapy (Duncan & Reese, 2015; Whipple et al., 2003). Five meta-analytic studies examined the research on ROM approaches and found that therapists using ROM-assisted therapy had superior outcomes compared to their treatment-as-usual outcomes (Lambert, Whipple & Kleinstäuber, 2018).  In other words, therapists were more effective when using ROM instruments- with more treatment gains and fewer client dropouts.

Listen to Barry Duncan discuss the benefits and ease of incorporating client feedback into your practice. Follow the link below, where solo practitioners can obtain the free PCOMS tool.

Using Client Feedback to Improve Outcomes - Barry Duncan, PsyD
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Listen to prominent psychotherapy researcher Michael Lambert discuss the research supporting the need for routine outcome measurement (ROM) with clients in psychotherapy.

Why Feedback is Needed - Michael Lambert
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What it Means for Therapists

Reliable and valid ROM instruments are now available outside the domain of research studies. Free and low-cost instruments are now available for individual clinicians and agencies to use in their practice. The brief instruments are relatively easy to incorporate into a client's treatment and will provide real-time data to the therapist about the client's perception of the treatment, giving the therapist the opportunity to adapt the treatment to the client as needed and to detect ruptures at an early stage when they can be addressed to prevent early termination by the client.

If a formal ROM is not used, therapists should regularly seek their clients' verbal feedback on the alliance, treatment progress, and their clients' reaction to them.