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Experiences of outcome monitoring in service users with psychosis: Findings from an Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) demonstration site

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Experiences of outcome monitoring in service users with psychosis : Findings from an Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) demonstration site. / Fornells-Ambrojo, Miriam; Johns, Louise; Onwumere, Juliana; Garety, Philippa; Milosh, Craig; Iredale, Catherine; Peters, Emmanuelle; Webster, Adrian; Jolley, Suzanne.

In: British Journal of Clinical Psychology, Vol. 56, No. 3, 09.2017, p. 253-272.

Research output: Contribution to journalArticle

Harvard

Fornells-Ambrojo, M, Johns, L, Onwumere, J, Garety, P, Milosh, C, Iredale, C, Peters, E, Webster, A & Jolley, S 2017, 'Experiences of outcome monitoring in service users with psychosis: Findings from an Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) demonstration site', British Journal of Clinical Psychology, vol. 56, no. 3, pp. 253-272. https://doi.org/10.1111/bjc.12136

APA

Fornells-Ambrojo, M., Johns, L., Onwumere, J., Garety, P., Milosh, C., Iredale, C., Peters, E., Webster, A., & Jolley, S. (2017). Experiences of outcome monitoring in service users with psychosis: Findings from an Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) demonstration site. British Journal of Clinical Psychology, 56(3), 253-272. https://doi.org/10.1111/bjc.12136

Vancouver

Fornells-Ambrojo M, Johns L, Onwumere J, Garety P, Milosh C, Iredale C et al. Experiences of outcome monitoring in service users with psychosis: Findings from an Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) demonstration site. British Journal of Clinical Psychology. 2017 Sep;56(3):253-272. https://doi.org/10.1111/bjc.12136

Author

Fornells-Ambrojo, Miriam ; Johns, Louise ; Onwumere, Juliana ; Garety, Philippa ; Milosh, Craig ; Iredale, Catherine ; Peters, Emmanuelle ; Webster, Adrian ; Jolley, Suzanne. / Experiences of outcome monitoring in service users with psychosis : Findings from an Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) demonstration site. In: British Journal of Clinical Psychology. 2017 ; Vol. 56, No. 3. pp. 253-272.

Bibtex Download

@article{72fa61a2536d4270a98f8cf994272477,
title = "Experiences of outcome monitoring in service users with psychosis: Findings from an Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) demonstration site",
abstract = "Objectives: Psychological therapy services are increasingly required to instate routine outcome monitoring (ROM), to demonstrate the clinical and economic impact of interventions. Professionals' views of ROM are an acknowledged barrier to implementation. Service user perspectives have rarely been examined, but acceptability and perceptions of ROM are critical to successful implementation. We investigated service users' experiences of ROM in an Improving Access to Psychological Therapies for people with Severe Mental Illness psychosis demonstration site. Design: ROM comprised a periodic assessment battery completed at baseline, mid-therapy, and end-of-therapy and a single measure completed session-by-session. Qualitative and quantitative feedback were sought at each periodic ROM administration, and, for sessional ROM, at mid-therapy and end-of-therapy. Demographic and clinical correlates of satisfaction were examined cross-sectionally at baseline. Consistency of satisfaction over time and associations of satisfaction with engagement were examined longitudinally. Methods: Service users rated baseline (n = 281/289), mid-therapy (n = 114/121), end-of-therapy (n = 124/154), and session-by-session (mid-therapy n = 63/87 and end-of-therapy n = 90/123) ROM from 0 ('extremely unhelpful') to 10 ('extremely helpful') and gave qualitative feedback. Results: Service users predominantly found ROM helpful (score 6-10; 64-72%) or neutral (score 5; 19-29%). Finding ROM less helpful was associated with younger age and poorer general outcomes, but not with psychotic symptoms or therapy dropout. Emerging qualitative themes included feeling understood, valuing opportunities to reflect, expressing feelings, and tracking progress towards goals. Shorter batteries would be preferable, particularly for younger respondents, and those with poorer outcomes. Conclusions: ROM is acceptable for people with psychosis. Tailoring assessments to specific subgroups should be considered. Practitioner points: Routine outcome monitoring for psychological therapy is acceptable to people with psychosis. Most respondents experienced outcome monitoring as an opportunity to feel understood. Younger people and those with poorer functioning and well-being might be at higher risk of dissatisfaction. Short assessment batteries and less frequent outcome monitoring might be preferable for some service users. Limitations of the study: Feedback about session-by-session outcome monitoring was not contemporaneous with completion and may be subject to memory or other biases. Only two-thirds of service users provided feedback about session-by-session ROM (compared to >94% for periodic ROM) so findings may not be fully representative. Feedback about measures was not provided anonymously, and it is possible that service users were reluctant to express criticism about ROM to the assessor.",
keywords = "Cognitive behaviour therapy, Family intervention, Routine outcome monitoring, Schizophrenia, Service user feedback",
author = "Miriam Fornells-Ambrojo and Louise Johns and Juliana Onwumere and Philippa Garety and Craig Milosh and Catherine Iredale and Emmanuelle Peters and Adrian Webster and Suzanne Jolley",
year = "2017",
month = sep,
doi = "10.1111/bjc.12136",
language = "English",
volume = "56",
pages = "253--272",
journal = "British Journal of Clinical Psychology",
issn = "0144-6657",
publisher = "Wiley-Blackwell",
number = "3",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Experiences of outcome monitoring in service users with psychosis

T2 - Findings from an Improving Access to Psychological Therapies for people with Severe Mental Illness (IAPT-SMI) demonstration site

AU - Fornells-Ambrojo, Miriam

AU - Johns, Louise

AU - Onwumere, Juliana

AU - Garety, Philippa

AU - Milosh, Craig

AU - Iredale, Catherine

AU - Peters, Emmanuelle

AU - Webster, Adrian

AU - Jolley, Suzanne

PY - 2017/9

Y1 - 2017/9

N2 - Objectives: Psychological therapy services are increasingly required to instate routine outcome monitoring (ROM), to demonstrate the clinical and economic impact of interventions. Professionals' views of ROM are an acknowledged barrier to implementation. Service user perspectives have rarely been examined, but acceptability and perceptions of ROM are critical to successful implementation. We investigated service users' experiences of ROM in an Improving Access to Psychological Therapies for people with Severe Mental Illness psychosis demonstration site. Design: ROM comprised a periodic assessment battery completed at baseline, mid-therapy, and end-of-therapy and a single measure completed session-by-session. Qualitative and quantitative feedback were sought at each periodic ROM administration, and, for sessional ROM, at mid-therapy and end-of-therapy. Demographic and clinical correlates of satisfaction were examined cross-sectionally at baseline. Consistency of satisfaction over time and associations of satisfaction with engagement were examined longitudinally. Methods: Service users rated baseline (n = 281/289), mid-therapy (n = 114/121), end-of-therapy (n = 124/154), and session-by-session (mid-therapy n = 63/87 and end-of-therapy n = 90/123) ROM from 0 ('extremely unhelpful') to 10 ('extremely helpful') and gave qualitative feedback. Results: Service users predominantly found ROM helpful (score 6-10; 64-72%) or neutral (score 5; 19-29%). Finding ROM less helpful was associated with younger age and poorer general outcomes, but not with psychotic symptoms or therapy dropout. Emerging qualitative themes included feeling understood, valuing opportunities to reflect, expressing feelings, and tracking progress towards goals. Shorter batteries would be preferable, particularly for younger respondents, and those with poorer outcomes. Conclusions: ROM is acceptable for people with psychosis. Tailoring assessments to specific subgroups should be considered. Practitioner points: Routine outcome monitoring for psychological therapy is acceptable to people with psychosis. Most respondents experienced outcome monitoring as an opportunity to feel understood. Younger people and those with poorer functioning and well-being might be at higher risk of dissatisfaction. Short assessment batteries and less frequent outcome monitoring might be preferable for some service users. Limitations of the study: Feedback about session-by-session outcome monitoring was not contemporaneous with completion and may be subject to memory or other biases. Only two-thirds of service users provided feedback about session-by-session ROM (compared to >94% for periodic ROM) so findings may not be fully representative. Feedback about measures was not provided anonymously, and it is possible that service users were reluctant to express criticism about ROM to the assessor.

AB - Objectives: Psychological therapy services are increasingly required to instate routine outcome monitoring (ROM), to demonstrate the clinical and economic impact of interventions. Professionals' views of ROM are an acknowledged barrier to implementation. Service user perspectives have rarely been examined, but acceptability and perceptions of ROM are critical to successful implementation. We investigated service users' experiences of ROM in an Improving Access to Psychological Therapies for people with Severe Mental Illness psychosis demonstration site. Design: ROM comprised a periodic assessment battery completed at baseline, mid-therapy, and end-of-therapy and a single measure completed session-by-session. Qualitative and quantitative feedback were sought at each periodic ROM administration, and, for sessional ROM, at mid-therapy and end-of-therapy. Demographic and clinical correlates of satisfaction were examined cross-sectionally at baseline. Consistency of satisfaction over time and associations of satisfaction with engagement were examined longitudinally. Methods: Service users rated baseline (n = 281/289), mid-therapy (n = 114/121), end-of-therapy (n = 124/154), and session-by-session (mid-therapy n = 63/87 and end-of-therapy n = 90/123) ROM from 0 ('extremely unhelpful') to 10 ('extremely helpful') and gave qualitative feedback. Results: Service users predominantly found ROM helpful (score 6-10; 64-72%) or neutral (score 5; 19-29%). Finding ROM less helpful was associated with younger age and poorer general outcomes, but not with psychotic symptoms or therapy dropout. Emerging qualitative themes included feeling understood, valuing opportunities to reflect, expressing feelings, and tracking progress towards goals. Shorter batteries would be preferable, particularly for younger respondents, and those with poorer outcomes. Conclusions: ROM is acceptable for people with psychosis. Tailoring assessments to specific subgroups should be considered. Practitioner points: Routine outcome monitoring for psychological therapy is acceptable to people with psychosis. Most respondents experienced outcome monitoring as an opportunity to feel understood. Younger people and those with poorer functioning and well-being might be at higher risk of dissatisfaction. Short assessment batteries and less frequent outcome monitoring might be preferable for some service users. Limitations of the study: Feedback about session-by-session outcome monitoring was not contemporaneous with completion and may be subject to memory or other biases. Only two-thirds of service users provided feedback about session-by-session ROM (compared to >94% for periodic ROM) so findings may not be fully representative. Feedback about measures was not provided anonymously, and it is possible that service users were reluctant to express criticism about ROM to the assessor.

KW - Cognitive behaviour therapy

KW - Family intervention

KW - Routine outcome monitoring

KW - Schizophrenia

KW - Service user feedback

UR - http://www.scopus.com/inward/record.url?scp=85019070792&partnerID=8YFLogxK

U2 - 10.1111/bjc.12136

DO - 10.1111/bjc.12136

M3 - Article

AN - SCOPUS:85019070792

VL - 56

SP - 253

EP - 272

JO - British Journal of Clinical Psychology

JF - British Journal of Clinical Psychology

SN - 0144-6657

IS - 3

ER -

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