District General Hospital of Førde, Sunnfjord, Norway.
Department of Psychology, The Pennsylvania State University, University Park, PA, USA.
Psychother Res. 2021 Feb;31(2):200-210. doi: 10.1080/10503307.2020.1788741. Epub 2020 Jul 8.
Routine outcome monitoring (ROM) and clinical feedback systems (CFS) are becoming prevalent in mental health services, but there are several challenges to successful implementation. ROM/CFS seem to be helpful for some patients, but not for others. To investigate this, we explored patients' experiences with ROM/CFS as an interpersonal and psychotherapeutic process, in naturalistic settings. We used video-assisted interpersonal process recall interviews to investigate the experiences of 12 patients using ROM/CFS in a Norwegian mental health outpatient clinic. Data were analyzed through systematic text condensation. Our analysis resulted in three pairs of experiences with ROM/CFS: (1) Explicit vs. implicit use of information, (2) Directing focus towards or away from therapeutic topics, and (3) Giving and receiving feedback. These experiences could be helpful or hindering, depending on participants' needs and preferences. All participants needed to know that the CFS was used in a meaningful way. If not, it could be detrimental to the therapeutic process. In order to be helpful for patients, ROM/CFS should be used in a way that is flexible, meaningful to patients, and sensitive to individual needs and preferences. Future research should further explore this how-to aspect of ROM/CFS with different CFS and populations.
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及，但成功实施仍面临一些挑战。ROM/CFS 似乎对某些患者有帮助，但对其他患者则不然。为了研究这一点，我们在自然环境中，以人际和心理治疗过程的角度，探讨了患者对 ROM/CFS 的体验。我们使用视频辅助人际过程回忆访谈，调查了 12 名在挪威精神卫生门诊中使用 ROM/CFS 的患者的体验。通过系统文本浓缩法进行数据分析。我们的分析得出了与 ROM/CFS 相关的三组体验：（1）信息的明确与隐含使用，（2）将焦点引导至或远离治疗主题，以及（3）给予和接收反馈。这些体验可能有帮助，也可能有阻碍，具体取决于参与者的需求和偏好。所有参与者都需要知道 CFS 是有意义地使用的。否则，它可能会对治疗过程产生不利影响。为了对患者有帮助，ROM/CFS 的使用方式应该灵活、对患者有意义，并能敏感地满足个体的需求和偏好。未来的研究应该进一步探讨不同 CFS 和人群中 ROM/CFS 的这一“如何实现”方面。
