Using routine outcome measures as clinical process tools: Maximising the therapeutic yield in the IAPT programme when working remotely

TY - JOUR

T1 - Using routine outcome measures as clinical process tools

T2 - Maximising the therapeutic yield in the IAPT programme when working remotely

AU - Faija, Cintia L

AU - Bee, Penny

AU - Lovell, Karina

AU - Lidbetter, Nicky

AU - Gellatly, Judith

AU - Ardern, Kerry

AU - Rushton, Kelly

AU - Brooks, Helen

AU - McMillan, Dean

AU - Armitage, Christopher J

AU - Woodhouse, Rebecca

AU - Barkham, Michael

N1 - © 2022 The Authors.

PY - 2022/5/16

Y1 - 2022/5/16

N2 - OBJECTIVES: The objective of the study was to investigate the administration and use of routine outcome monitoring session by session in the context of improving guided-self-help interventions when delivered remotely at Step 2 care in the English Improving Access to Psychological Therapies (IAPT) services.DESIGN: Qualitative research using recordings of telephone-treatment sessions.METHOD: Participants (11 patients and 11 practitioners) were recruited from four nationally funded IAPT services and one-third sector organisation commissioned to deliver Step 2 IAPT services, in England. Data collection took place prior to the COVID-19 pandemic. Transcripts of telephone-treatment sessions were analysed using thematic analysis.RESULTS: Four themes were identified: (1) lack of consistency in the administration of outcome measures (e.g. inconsistent wording); (2) outcome measures administered as a stand-alone inflexible task (e.g. mechanical administration); (3) outcome measures as impersonal numbers (e.g. summarising, categorising and comparing total scores); and (4) missed opportunities to use outcome measures therapeutically (e.g. lack of therapeutic use of item and total scores).CONCLUSIONS: The administration of outcome measures needs to ensure validity and reliability. Therapeutic yield from session-by-session outcome measures could be enhanced by focusing on three main areas: (1) adopting a collaborative conversational approach, (2) maximising the use of total and items scores and (3) integrating outcome measures with in-session treatment decisions. Shifting the perception of outcome measures as impersonal numbers to being process clinical tools ensures a personalised delivery of psychological interventions and has the potential to enhance engagement from practitioners and patients what may reduce drop-out rates and improve clinical outcomes.

AB - OBJECTIVES: The objective of the study was to investigate the administration and use of routine outcome monitoring session by session in the context of improving guided-self-help interventions when delivered remotely at Step 2 care in the English Improving Access to Psychological Therapies (IAPT) services.DESIGN: Qualitative research using recordings of telephone-treatment sessions.METHOD: Participants (11 patients and 11 practitioners) were recruited from four nationally funded IAPT services and one-third sector organisation commissioned to deliver Step 2 IAPT services, in England. Data collection took place prior to the COVID-19 pandemic. Transcripts of telephone-treatment sessions were analysed using thematic analysis.RESULTS: Four themes were identified: (1) lack of consistency in the administration of outcome measures (e.g. inconsistent wording); (2) outcome measures administered as a stand-alone inflexible task (e.g. mechanical administration); (3) outcome measures as impersonal numbers (e.g. summarising, categorising and comparing total scores); and (4) missed opportunities to use outcome measures therapeutically (e.g. lack of therapeutic use of item and total scores).CONCLUSIONS: The administration of outcome measures needs to ensure validity and reliability. Therapeutic yield from session-by-session outcome measures could be enhanced by focusing on three main areas: (1) adopting a collaborative conversational approach, (2) maximising the use of total and items scores and (3) integrating outcome measures with in-session treatment decisions. Shifting the perception of outcome measures as impersonal numbers to being process clinical tools ensures a personalised delivery of psychological interventions and has the potential to enhance engagement from practitioners and patients what may reduce drop-out rates and improve clinical outcomes.

U2 - 10.1111/papt.12400

DO - 10.1111/papt.12400

M3 - Article

C2 - 35570708

SN - 1476-0835

JO - Psychology and psychotherapy

JF - Psychology and psychotherapy

ER -