Category: Assessment

PS6- #C70 - Successes and Barriers to Routine Outcome Monitoring in Children and Adolescents

Friday, Nov 17
2:45 PM – 3:45 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Clinical Utility | Evidence-Based Practice | Assessment

It is estimated that 13.4% of children and adolescents worldwide are diagnosed with a mental disorder (Polanczyk, Salum, Sugaya, Caye, & Rohde, 2015). Unfortunately, even clients enrolled in treatment have variable outcomes with an estimated 40 to 60% of children prematurely ending treatment (Kazdin, 1996; Wierzbicki & Pekarik, 1993). Routine outcome monitoring (ROM) systems are used as a supplement to clinical intervention that can effectively assist with preventing premature termination. ROM consists of frequent measurement of symptoms to determine treatment effectiveness and client progress over time (de Beurs, et al., 2011). In general, youth outcomes are better when clinicians receive routine feedback on their client’s progress (Bickman, Kelley, Breda, de Andrade, & Riemer, 2011).


Outside of the laboratory, there are a host of barriers to utilizing ROM in clinical settings including financial burdens, changing staff, and misconceptions of the purpose of ROM (Boswell, Kraus, Miller, & Lambert, 2015). While these barriers hold true across diverse client settings, there are a unique set of barriers to utilization of ROM with children and adolescents.  ROM with child clients is particularly challenging due to the nature of self-report in childhood. Younger children are typically unable to report on symptoms leading parents to be the primary reporter for ROM. Parent opinions of ROM can be variable (Moran, Kelesidi, Guglani, Davidson, & Ford, 2011). Additionally, there are clinician barriers to ROM including a lack of effective training to adequately implement ROM (Martin, Fishman, Baxter, & Ford, 2011).


Parents have expressed a handful of concerns about ROM; chief among them, they expressed a desire to work with the clinicians to create ROM that assess progress and outcomes they value (Moran, et al., 2011). Utilization of ROM was explored in parents of clients being seen in a southeastern university training clinic. The clinic continues to see families, and the number of clients is consistently growing; as such, preliminary analyses are demonstrated with the current parent-child dyads who have been assessed on their opinions of ROM (N = 18). The current sample of clients ranges from 5 to 17 years of age.


Parent opinions of ROM were somewhat varied. In general, parents reported completing measures routinely (e.g., every other session) or weekly (n = 14, 77.7%). Qualitative feedback included concerns of measures being too mundane, too lengthy, or static in the face of changing client presentation. Despite concerns about inaccuracy of measures, 77.8% (n = 14) of parents felt measures were accurately assessing their child’s symptoms. Most parents completely disagreed (n = 10; 55.6%) that measures were a waste of time. Standardized training procedures for ROM have been implemented, which will likely result in changes in client opinions over time. Further data and ideas informing ROM utilization rates, client attitudes and barriers will be presented.


Overall, ROM is a critical part of child therapy, but does not come without barriers. Future research should be directed towards further addressing these barriers to increase utilization of ROM in child and adolescent populations.

Alyssa Gatto

B.A.
Virginia Polytechnic Institute and State University
Blacksburg, Virginia

Katharine Waldron

Virginia Polytechnic Institute and State University

Emily Hill

Virginia Tech

Amanda Halliburton

Graduate Student
Virginia Polytechnic Institute and State University
Blacksburg, Virginia

Haley G. Murphy

Graduate Student
Virginia Tech
Christiansburg, Virginia

Lee D. Cooper

Director of Clinical Training
Virginia Tech