A mixed-method investigation of patient monitoring and enhanced feedback in routine practice: Barriers and facilitators

Figures & data

Figure 1. (a) Feedback report: Section reporting ASC and HASQ results. The red portions indicate the areas where your client may benefit from extra support. (b) Feedback report: Section reporting negatively rated ASC items (Red areas in Figure 1a).

Figure 2. Flow diagram of patients within the two services.

Table I. Relationship between early and overall changes on the CORE-10 for study sample (with feedback) and benchmark (no feedback).

		Number (%) of patients meeting reliable change categories on the CORE-10 across therapy episodes
Status at session 4	N (%)	Deteriorated ≥ 6 (Session 1 to last) N (%)	No change N (%)	Improved ≥ 6 (Session 1 to last) N (%)
Current study (N = 202)
Not on track (Red)	26 (13)	9 (35)	12 (46)	5 (19)
No change (Amber)	116 (57)	8 (7)	73 (63)	35 (30)
Early responders (Green)	60 (30)	0 (0)	16 (27)	44 (73)
Totals		17 (8)	101 (50)	84 (42)
Benchmark comparator (N = 136)
Not on track (Red)	12 (9)	3 (25)	7 (58)	2 (17)
No change (Amber)	86 (63)	9 (11)	55 (64)	22 (26)
Early responders (Green)	38 (28)	1 ( 3)	11 (29)	26 (68)
Totals		13 (10)	73 (54)	50 (37)

Table II. Effect sizes at end of therapy for each study by session 4 status.

Session 4 status	Feedback study (n = 202)	Benchmark study (n = 136)	ES(diff)
Green	1.28	1.03	0.25
Amber	0.36	0.24	0.12
Red	− 0.18	− 0.10	0.08
Overall	0.56	0.43	0.13

Table III. Therapists’ ratings on the FSQ (n = 15).

Items	Range	Mode (N)	Mean (SD)
Helpfulness (0 = very unhelpful; 10 = very helpful)
How helpful have you found the feedback reports?	3–10	5 (5)	5.5 (2.0)
How helpful have you found the traffic light system?	2–10	7 (5)	6.1 (2.2)
How helpful were the feedback reports in relation to accessing risk?	0–8	5 (4)	4.7 (2.2)
How helpful was the feedback in relation to assessment and formulation?	2–8	7 (5)	5.4 (1.5)
Impact (0 = not at all; 10 = very much)
How much did recruiting patients to the research interfere with normal therapeutic practice?	0–7	7 (4)	4.2 (2.5)
To what extent do you think the feedback reports reflect your patient's progress?	4–10	5 (4)	5.6 (1.6)
To what extent has the feedback affected treatment goals	0–8	0 (5)	2.1 (2.4)
To what extent has the feedback affected the type of therapy provided?	0–7	0 (9)	1.5 (2.4)
To what extent has the feedback affected the outcome of therapy?	0–5	0 (5)	1.5 (1.8)

Figure 3. Therapists’ responses to feedback reports after session 4 for the three groups (n = 142).

Table IV. Patients’ ratings on the PEQ (n = 56).

Items	Range	Mode (N)	Mean (SD)
Experiences (1 = strongly disagree; 7 = strongly agree)
I understand why I am being asked to fill in the forms	1–7	7 (36)	6.3 (1.3)
I find the forms easy to fill in	1–7	7 (23)	5.8 (1.4)
I am comfortable with the place in which I fill in the forms	1–7	7 (23)	5.9 (1.3)
The time it takes me to fill in the forms is acceptable	3–7	7 (29)	6.2 (1.0)
Filling in the forms has helped my therapy	1–7	6 (16)	5.2 (1.6)
The forms capture everything my therapist needs to know about my problems, progress, and therapy	1–7	7 (14)	5.1 (1.8)
My therapist uses information from my forms in the session	1–7	4 (14)	4.7 (2.0)