District General Hospital of Førde, Førde, Norway.
District General Hospital of Førde & Department of Health and Caring Science, Western Norway University of Applied Science, Førde, Norway.
Qual Life Res. 2021 Nov;30(11):3117-3125. doi: 10.1007/s11136-020-02550-1. Epub 2020 Jun 15.
Routine outcome monitoring (ROM) and clinical feedback systems (CFS) are becoming increasingly prevalent in mental health services. Their overall efficacy is unclear, but quantitative evidence suggests they can be useful tools for preventing treatment failure and enhancing therapeutic outcomes, especially for patients who are not progressing in therapy. The body of qualitative material, however, is smaller and less refined. We need to know more about how ROM/CFS is used in psychotherapy, and why it is helpful for some patients, but not others.
We recorded therapy sessions of 12 patients who were using a CFS as part of their therapies at an outpatient clinic in Norway. We then conducted video-assisted interviews and follow-up interviews with patients. Data were analyzed with systematic text condensation.
Analysis revealed three themes: (1) triggering reflections, emotions, and self-awareness, (2) Ambivalent and ambiguous self-presentation, and (3) potential for feeling understood and talking about what matters.
Answering questions in a CFS is an interpretative and intentional process of self-presentation and the results from ROM/CFS must be interpreted and explored in conversation to be clinically useful. When they are, they have potential for enhancing the therapeutic process by stimulating self-awareness, reflexivity, and allowing access to new therapeutic topics. Further research should explore this how-to aspect of ROM/CFS with different CFS and different types of patients. Integrating clinical feedback in therapeutic practice can be conceptualized as a clinical skill, which should be a part of training programs for therapists.
常规结果监测（ROM）和临床反馈系统（CFS）在精神卫生服务中越来越普遍。它们的整体效果尚不清楚，但定量证据表明，它们对于预防治疗失败和改善治疗效果非常有用，尤其是对于那些在治疗中没有进展的患者。然而，定性材料的数量较少且不够完善。我们需要更多地了解 ROM/CFS 在心理治疗中的使用方式，以及为什么它对某些患者有帮助，而对其他患者则没有帮助。
我们记录了在挪威一家门诊诊所接受 CFS 治疗的 12 名患者的治疗过程。然后，我们对患者进行了视频辅助访谈和随访访谈。使用系统文本浓缩法对数据进行了分析。
分析揭示了三个主题：（1）触发反思、情绪和自我意识，（2）矛盾和模糊的自我呈现，（3）被理解和谈论重要事情的潜力。
在 CFS 中回答问题是一个解释性和有意的自我呈现过程，ROM/CFS 的结果必须在对话中进行解释和探讨才能具有临床意义。当它们具有这种作用时，它们有可能通过刺激自我意识、反思性和允许讨论新的治疗话题来增强治疗过程。应该进一步研究不同的 CFS 和不同类型的患者如何使用 ROM/CFS 来探索这一方面。将临床反馈纳入治疗实践可以被概念化为一种临床技能，应该成为治疗师培训计划的一部分。
