Monitoring and feedback: The next crucial step towards improved therapeutic outcomes?

Aim: This study aims to assess the feasibility and effectiveness of collecting sessional outcome data from clients and providing feedback to therapists about symptoms and alliance. We aim to assess whether the benefits of monitoring and feedback on client outcome observed in the US, translate to routine UK secondary care psychological therapies. Therapists’ use of feedback and issues of acceptability and compliance will be explored. Method: Outcome data was collected from consenting clients across two South West Yorkshire sites. Our feedback system used two brief distress measures, which clients completed before each therapy session, and one post session measure assessing helpfulness, alliance and stage of therapy. This data combined with benchmark data determines clients ‘not on track’. Therapists received feedback after each client’s fourth session. Reflexive dialogue between therapists, service users and researchers was implemented.
Results: To date, we have found that it is feasible to operate a feedback system in standard UK psychological therapies providing that initiatives are introduced to enhance ease and acceptability. This is a work in progress and we anticipate that feedback for clients ‘not on track’ will enhance overall therapeutic outcome whilst rendering no effect on those who are ‘on track’.
Discussion: Monitoring and feedback is a promising development in modern psychotherapy practise. Such systems can provide increased sensitivity to client progress; therapists can use this information to guide their care plan to improve overall outcome. We are uniquely placed to identify barriers to implementation and offer recommendations for future replications.