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

Cintia L Faija, Penny Bee, Karina Lovell, Nicky Lidbetter, Judith Gellatly, Kerry Ardern, Kelly Rushton, Helen Brooks, Dean McMillan, Christopher J Armitage, Rebecca Woodhouse, Michael Barkham

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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.

Original languageEnglish
Number of pages18
JournalPsychology and psychotherapy
Early online date16 May 2022
Publication statusE-pub ahead of print - 16 May 2022

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