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Description: In my previous post (http://wileypsychologyupdates.ca/general-psychology/abnormal-psychology/should-clinical-psychologists-routinely-assess-client-status-and-outcomes-or-do-they-already/) I discussed and provided an article link to the issue of whether clinical psychologists should (be required to) routinely objectively assess the status (wellbeing) and outcomes of their clinical clients. One of the arguments against having clients complete a status assessment prior to each therapy session is that the questions on such assessments could be perceived as irrelevant by the client or could be upsetting to the client or could be responded to randomly by the client (rendering the responses useless)whereas therapists ought to be able to monitor their client’s status and progress using their clinical insight and observational skills. Think a bit about this position and about how you would respond to it and then go back to the article linked below and (re)read the part of it containing this argument (it appears just below half way down the article page). Think about whether there are things that could be done to address these issues and still use status and outcome measure with clinical therapy clients. Also, have a look at the section entitled “Acceptability” on page 53 of the research article linked below (citation in Further Reading section) to see how this sort of question might be addressed in research.

Source: Rethinking therapy: How 45 questions can revolutionize mental health care in Canada, Erin Anderssen, The Globe and Mail and Towards a standardized brief outcome measure: Psychometric properties and utility of the CORE–OM. The British Journal of Psychiatry, 180(1), 51-60

Date: April 7, 2018

Photo Credit: www.goodtherapy.org

Article Links:  https://www.theglobeandmail.com/canada/article-rethinking-therapy-how-45-questions-can-revolutionize-mental-health/  and https://www.researchgate.net/profile/Frank_Margison/publication/11584772_Towards_a_standardised_brief_outcome_measure_Psychometric_properties_and_utility_of_the_CORE-OM/links/0912f50f084e971a19000000/Towards-a-standardised-brief-outcome-measure-Psychometric-properties-and-utility-of-the-CORE-OM.pdf

All of the concerns about how college/university student clients might react to questions on a status/outcome measure they are asked to complete prior to each therapy session are important and need to be considered. What is not at all clear is whether simply doing away with the assessment tool is the answer to addressing these issues. One possibility would be to ensure that the purpose and usefulness of the measure is properly explained by both the clinic’s reception personnel and that it is also addressed by the therapist in the first session. Perhaps a paragraph at the top of the measure itself could also help to ensure that the purpose of the survey questions is clear to the client. An important discussion to have involves consideration of the criteria being used (or that should be used) to assess the full range of issues facing potential therapy clients and to monitor their status and outcomes during and after treatment.

Questions for Discussion:

  1. How to clinical psychologists know if their clients’ issues and symptoms are improving, staying the same or getting worse?
  2. What are some of the ways in which clients entering therapy might negatively react to a status/outcome baseline assessment prior to their first and subsequent sessions?
  3. What steps might clinical psychologists take to ensure that the use of regular and routine status/outcome assessments are a positive (or at least not a negative) part of clients’ therapeutic experiences?

References (Read Further):

Evans, C., Connell, J., Barkham, M., Margison, F., McGRATH, G. R. A. E. M. E., Mellor-Clark, J., & Audin, K. (2002). Towards a standardized brief outcome measure: Psychometric properties and utility of the CORE–OM. The British Journal of Psychiatry, 180(1), 51-60. https://www.researchgate.net/profile/Frank_Margison/publication/11584772_Towards_a_standardised_brief_outcome_measure_Psychometric_properties_and_utility_of_the_CORE-OM/links/0912f50f084e971a19000000/Towards-a-standardised-brief-outcome-measure-Psychometric-properties-and-utility-of-the-CORE-OM.pdf

Garland, A. F., Kruse, M., & Aarons, G. A. (2003). Clinicians and outcome measurement: What’s the use?. The journal of behavioral health services & research, 30(4), 393-405. http://www.academia.edu/download/30335975/garland-et-al-2003-clinicains-and-outcome-measurement.pdf

Brown, S. D. (2017). Meta-analysis and evidence-based career practice: Current status and future directions. Integrating theory, research, and practice in vocational psychology: Current status and future directions, 82. http://journals.fcla.edu/svp2016/article/viewFile/90521/89211

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