Therapists’ and clients’ perceptions of routine outcome measurement in the NHS: A qualitative study

Abstract

Primary objective: This is the first qualitative study that elicited the perceptions of both psychological therapists and their clients in the use of Clinical Outcomes in Routine Evaluation with computer software (CORE-Net), where instant visual feedback for session tracking was given on a computer screen in the therapy room at each therapy session. The study also examined how therapists viewed its potential value in supervision and provides suggestions for improving training. Research design: The study adopted a convenience sample of four therapists in a primary care counselling setting (PCC – General Practitioner referrals) who were experienced in using CORE-Net, and five therapists in an NHS employee/occupational support counselling service (OH) who had just begun to use CORE-Net for session tracking with 10 of their clients. Method: A qualitative methodology was used and interview data were collected from the therapists via focus groups; the clients were interviewed individually face to face. All data was analysed inductively. Findings: The study identified six overarching themes: (i) therapists were initially anxious and resistant; (ii) therapists adapt ‘creatively’; (iii) outcome measures help the client/therapist relationship; (iv) clients perceive visual measures as helpful; (v) CORE scores inform supervision; and (vi) proper and ongoing training/support of therapists is necessary. The main limitations are comparability of data and the generalisabilty of results. Conclusions: The implementation of routine outcome measurement (ROM) is a challenge but can be made easier with proper training and supervision. Clients appear happier than their therapists when routine outcome measurement is used.

Keywords:

• routine outcome measurement
• CORE-Net
• practice-based evidence
• counselling
• psychotherapy

Acknowledgements

We would like to thank the clients and therapists who participated in this study.

Additional information

Notes on contributors

Gisela Unsworth

Gisela Unsworth is a registered psychotherapist and supervisor managing a comprehensive psychological wellbeing service for employees in a district general hospital in the NHS

Helen Cowie

Helen Cowie is a chartered counselling psychologist and a research professor in the Faculty of Health and Medical Sciences, University of Surrey

Anita Green

Anita Green is a dual diagnosis nurse consultant for Sussex Partnership NHS Foundation Trust and an associate teacher in Mental Health in the Faculty of Health and Medical Sciences, University of Surrey