Department of Psychology, Brigham Young University.
College of Family Home and Social Sciences, Brigham Young University.
Psychotherapy (Chic). 2018 Jun;55(2):116-131. doi: 10.1037/pst0000133.
Routine outcome monitoring (ROM) systems that identify clients at-risk for treatment failure using outcome and therapeutic process measures are a recognized evidence-based practice. However, only 3 empirical studies have tested ROMs in group therapy, producing mixed results. This randomized clinical trial tested the Outcome Questionnaire System, the ROM system with the most empirical support for individual therapy patients, with 430 group therapy patients who were randomly assigned to 2 experimental arms (Group Questionnaire [GQ] + Outcome Questionnaire-45 [OQ-45] vs. OQ-45). Given the strong evidence for progress feedback, the primary purpose of this study was to ascertain if therapeutic relationship feedback using the GQ reduced rates of relationship deterioration and failure when progress feedback was held constant. Group leaders simultaneously ran pairs of groups that were randomly assigned to the 2 conditions. Of the 430 patients enrolled in 58 groups, 374 attended more than 4 sessions. Results showed that therapeutic relationship predicted improvement in outcome and that feedback reversed the course of relationship deterioration and reduced rates of relationship failure. Although there were no effects on attendance and dropout for feedback, the 2 experimental arms produced mixed results for the OQ-45 not-on-track cases. The combined relationship and progress feedback (GQ/OQ-45) was associated with fewer outcome deterioration cases, while the progress feedback condition (OQ-45) showed higher outcome improvement cases. Findings are discussed with respect to previous group ROM studies, clinical implications, and future research. (PsycINFO Database Record
常规结果监测（ROM）系统使用结果和治疗过程测量来识别有治疗失败风险的患者，这是一种公认的基于证据的实践。然而，只有 3 项实证研究测试了团体治疗中的 ROM，结果喜忧参半。这项随机临床试验测试了结果问卷系统，这是一种在个体治疗患者中最有实证支持的 ROM 系统，共有 430 名团体治疗患者被随机分配到 2 个实验组（团体问卷[GQ]+结果问卷-45[OQ-45]与 OQ-45）。鉴于进展反馈的强有力证据，本研究的主要目的是确定使用 GQ 进行治疗关系反馈是否可以在保持进展反馈不变的情况下降低关系恶化和失败的发生率。同时，团体领导者运行了随机分配到 2 个条件的两组团体。在参加 58 个小组的 430 名患者中，有 374 名患者参加了超过 4 次治疗。结果表明，治疗关系预测了结果的改善，而反馈则扭转了关系恶化的趋势，并降低了关系失败的发生率。虽然反馈对出勤率和脱落率没有影响，但两个实验组对 OQ-45 未达标案例的结果喜忧参半。综合关系和进展反馈（GQ/OQ-45）与较少的结果恶化病例相关，而进展反馈条件（OQ-45）显示出更高的结果改善病例。研究结果与以往的团体 ROM 研究、临床意义和未来研究进行了讨论。
