Implementing routine outcome monitoring in a psychodynamic training clinic: it’s complicated

ABSTRACT

The use of routine outcome monitoring (ROM) has been shown to improve treatment outcomes, reduce symptom deterioration and treatment dropout, and is especially relevant for training clinics. However, the use of ROM in a psychodynamic training clinic has remained relatively unexplored. We aimed to instigate an open dialogue about the use and usefulness of ROM within the context of contemporary psychodynamic clinical practice. As a graduate trainee and professor in a psychodynamic training program, we reflect on the seemingly irreconcilable differences between psychoanalytic thinking and ROM, the anxiety around being evaluated as a trainee, whom ROM is for, the pragmatic challenges when trying new tools and technology (especially when not chosen yourself), and the limitations of standardized self-report measures, such as the OQ. Overall, these complexities suggest that although ROM is likely worthwhile for patients, therapists, supervisors, and researchers, it will only come to its fruition if we integrate it into the tri-legged stool of evidence-based practice . We will need to engage in a genuine discussion about the use of ROM and consider the possibility that ROM might even improve our psychodynamic practices. Integrating ROM into psychodynamic didactic courses and supervision in graduate training could be a good starting point.

KEYWORDS:

• Routine outcome measurement
• OQ
• graduate training
• psychodynamic

Acknowledgment

We thank all students and faculty who contributed to the town hall discussion around ROM in our training clinic.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Notably, our university training clinic has not (yet) implemented a post-session alliance measure, which means that we will focus our discussion only on the implementation of session-by-session symptom measures, such as the OQ.

Additional information

Funding

The authors did not receive any external funding of any kind.

Notes on contributors

Katie Aafjes-Van Doorn

Katie: Dr Aafjes-van Doorn is a licensed Clinical Psychologist and psychotherapy researcher, and assistant professor at Ferkauf Graduate School of Psychology, Yeshiva University, New York. She enjoys teaching courses on evidence-based psychodynamic psychotherapy, multi-modal psychotherapy research, and research design. Her research interest is in psychotherapy as well as its potential moderators and mediators of change. She is interested in nnovative methods of process codings of videos and transcripts. She is associate editor of Clincial Psychology: Science and Practice.

Jordan Meisel

Dr Jordan Meisel is a recent graduate from the Ferkauf Graduate School of Psychology, Yeshiva University, New York. Her dissertation research was in perceptions of economic inequality. She completed her pre-doctoral internship at Stony Brook University and is joining a group private private in midtown New York as a post-doctoral fellow. She works with adults, couples and adolescents primarily through a psychodynamic framework.