A History of Routine Outcome Measurement in Clinical Practice: A Review of Evidence and Issues
Over the last several decades, psychologists have come under increasing pressure to empirically demonstrate the efficacy of the clinical interventions they implement. Towards this end, Routine Outcome Monitoring (ROM) has been repeatedly shown to utilize feedback to enhance treatment outcomes by way of capturing negative changes that may otherwise lead to treatment failures. Despite the documented benefits of incorporating ROM into clinical practice, research suggests that the majority of clinicians in the United States have not done so and instead continue to base treatment planning decisions and assessments of client progress through the more subjective clinical interpretation. The reasons that practicing clinicians choose not to utilize ROM appear to be both practical and philosophical in nature. In order to better understand factors that affect ROM use among clinicians, this paper summarizes the origins of ROM and the contexts in which it currently exists, as well as research documenting the potential benefits of ROM and the ways in which it enhances treatment outcomes. Frequently endorsed reasons that practicing clinicians do not collect outcome data include the cost and time needed for regularly administering and interpreting measures, and concerns about the usefulness of this information in treatment. These challenges are discussed and considered alongside findings from the ROM literature. The limitations of ROM are also discussed, such as disorders and populations in which publicly available ROMs are needed, the lack of investigation into how clinicians’ therapeutic orientations affect implementing ROM in practice, and the immutable need to interpret data using clinical judgement. Future directions for research and practice using ROM are reviewed as well.
Keywords: Routine outcomes measurement (ROM), feedback-informed treatment, assessment, patient reported outcomes
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