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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, M; Johns, L; Onwumere, J; Garety, P; Milosh, C; Iredale, C; Peters, E; ... Jolley, S; + view all (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) pp. 253-272. 10.1111/bjc.12136. Green open access

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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.

Type: Article
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
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/bjc.12136
Publisher version: https://doi.org/10.1111/bjc.12136
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Social Sciences, Psychology, Clinical, Psychology, schizophrenia, routine outcome monitoring, service user feedback, cognitive behaviour therapy, family intervention, Cognitive-behavior Therapy, 1st Episode Psychosis, Health System, Individuals, Schizophrenia, Challenges, Deficits, Risk, Care
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10054282
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