Category: Dissemination / Implementation
Routine Outcome Monitoring (ROM) is the practice of using brief assessment measures to monitor treatment progress, provide feedback to clinicians and clients, and empirically inform treatment. Regular use of ROM has been found to speed symptom recovery, alert clinicians to client deterioration, reduce early termination, and improve outcomes (Lambert, 2007; Shimokawa, Lambert, & Smart, 2010; Whipple et al., 2013). Additionally, clinicians report that ROM has many advantages including monitoring clients' progress, setting and tracking therapeutic goals, and assessing the effectiveness of treatment approaches (Norman et al., 2014). Despite the objective and perceived values of ROM, less than 14% of clinicians utilize ROM regularly with their clients (Jensen-Doss et al., 2016). Reported barriers to ROM implementation include philosophical, organizational, and practical barriers (Levine et al., 2016). Thus, ROM implementation has emerged as a critical science-practice gap issue within evidence-based practices across diverse settings. This study seeks to address this issue via implementation data from a training clinic.
Training clinics are the ideal setting to study and reduce the ROM implementation gap because they allow for a controlled setting to examine implementation barriers and study treatment outcomes, while also systemically disseminating ROM theory and practices to the next generation of clinical scientists. This study examines a three-year systematic implementation of an advanced routine outcome monitoring project in a psychology training clinic. The project, called SCORE (Standardized Clinical Outcome Research & Evaluation Project) includes many novel features designed to improve ROM implementation including : weekly online administration of broad-spectrum (e.g., BASE-6) and symptom specific measures (e.g., PHQ-9, GAD-7, OASIS, CMFQ) for children, adults, and parents; bi-weekly administration of therapeutic alliance measures (WAI-S, TASC-R); auto-scoring; and auto-graphing. To date we have enrolled 100 clients in this ongoing study and 100% of practicum students have used ROM with their clients. Eighty-five percent of clients surveyed reported completing measures on a session-by-session or every other session basis. Additionally, 74% reported that the measures accurately assessed their symptoms while 64% noted that ROM was helping them to better understand their symptoms and treatment progress. Further data and ideas informing the ROM implementation gap including utilization rates, clinician training, client and clinician attitudes toward ROM, barriers, and therapist compliance will be presented.