The good news is that psychotherapy is effective with many clients. The bad news is that not everyone benefits. We need to accept the fact that some clients may not improve under our care. Identifying these clients early on and providing alternative strategies for care is therefore paramount.
Studies show that treatment failure may be more pervasive than expected. One study involving 6,000 individuals receiving an average of four therapy sessions in a community-based setting found that only approximately 35 percent of clients improved. In addition, about 8 percent experienced worse symptoms or functioning.
Other studies show that 85 to 100 percent of individuals who get worse during treatment can be identified using measurement approaches – a much better strategy than relying only on clinical judgment.
What Are Outcome Measures?
Outcome measures assess whether clients are improving their symptoms and functioning in various life domains such as work, school, relationships, and community engagement. Outcomes can be used for both making clinical decisions and engaging clients in care.
Clinicians and researchers have found that even a slight improvement depicted on outcome measures and shown to clients can encourage them to engage more and enhance the therapeutic alliance. Measurement of outcomes also makes care more consumer-centered by not only enabling clients to report information about their symptoms and functioning but also allowing them to be involved in all decisions that affect their care.
Measuring Mental Health Outcomes
Although there are various methods to measure behavioral health outcomes, an easy, quick, and practical way to do so is by using the web application, Better Outcomes Now (BON). BON is a tool for identifying clients who aren’t responding, allowing providers to address the lack of progress in a proactive way that keeps clients engaged while working together to collaboratively seek new directions.
Using a tablet or computer, clients can report improvement or lack-there-of at the beginning of each therapy session and their experience of the encounter at the end of the meeting. BON can be used across orientations and diagnoses, is evidence-based, and has been shown to improve outcomes and decrease client dropouts, no shows, and length of stay.
BON uses measures developed as part of the Partners for Change Outcome Management System (PCOMS). An independent meta-analysis showed that individuals using these measures had a 3.5 times more chance of achieving reliable change and a 50 percent less likelihood of deterioration. More recently, another independent meta-analysis by routine outcome monitoring (ROM) pioneer, Michael Lambert, reported that “aggregated findings indicate that the PCOMS rests on a growing empirical base that boosts confidence in its use as a ROM system. Practitioners can expect that PCOMS feedback will enhance client outcomes.”
Learn more about the science behind PCOMS and BON.