Implementing routine outcome monitoring in a psychology training clinic: A case study of a process model.

2019 ◽  
Author(s):  
Lee D. Cooper ◽  
Haley G. Murphy ◽  
Lauren A. Delk ◽  
Maria G. Fraire ◽  
Nathaniel Van Kirk ◽  
...  
Keyword(s):  
Process Model ◽  
Routine Outcome Monitoring ◽  
Psychology Training ◽  
Training Clinic ◽  
Outcome Monitoring

Toward an Evidence-based Standard of Professional Competence

2020 ◽  
Author(s):  
Scott D. Miller ◽  
Joshua W. Madsen ◽  
Mark A. Hubble
Keyword(s):  
Professional Competence ◽  
Deliberate Practice ◽  
Routine Outcome Monitoring ◽  
Science Literature ◽  
Current Standard ◽  
Outcome Monitoring ◽  
Informed Treatment ◽  
Assessment Of Competence ◽  
Mere Measurement

Psychotherapists are ethically bound to provide services within the boundaries of their competence traditionally delimited by their education, training, and supervised experience. Throughout this chapter, two historical examples illustrate the shortcomings of the current standard as well as the promise of an alternative. The guidelines now in place are critiqued in light of the empirical evidence. The authors propose that effectiveness become the foundation of any formulation and assessment of competence. Developments over the last two decades make it possible for clinicians to measure their results and compare them to international norms—a process known as routine outcome monitoring. However, mere measurement and comparison to benchmarks are insufficient. To be ethical, to protect public welfare, practitioners must also act on the data provided by routine outcome monitoring. Using feedback informed treatment and deliberate practice therapists can both enhance their responsiveness to individual clients and continuously improve their outcomes. Challenges of implementation are discussed. A case study of an agency that successfully adopted routine outcome monitoring coupled with deliberate practice using best practices gleaned from the implementation science literature is offered.

A case study of lessons learnt from implementing a routine outcome monitoring system for psychotherapy in a South African community clinic

2017 ◽  
Vol 48 (2) ◽  
pp. 193-205
Author(s):  
Jason Bantjes ◽  
Xanthe Hunt ◽  
Mark Tomlinson ◽  
Anja Smit
Keyword(s):  
Psychological Distress ◽  
South African ◽  
Rating Scale ◽  
Routine Outcome Monitoring ◽  
Outcome Monitoring ◽  
Psychological Distress Scale ◽  
Outcome Rating Scale ◽  
Distress Scale ◽  
Kessler Psychological Distress Scale

Monitoring outcomes in psychotherapy is important for advancing research into empirically supported treatments, collecting data to inform practice-based evidence and for monitoring patient treatment responses during routine care. We implemented two routine outcome monitoring measures in a community psychology clinic in South Africa, namely, the Outcome Rating Scale and Kessler Psychological Distress Scale. In this article, we adopt a case study methodology to describe and critically reflect on the implementation process and evaluate the utility of the outcome data collected during the first year of implementation. Our findings suggest that the measures have some utility but that there were significant problems with implementation. We found that Outcome Rating Scale and Kessler Psychological Distress Scale scores correlated in the expected direction; however, Outcome Rating Scale intake scores for the present population were at odds with the measure’s norms. The findings highlight the care that needs to be taken to change routine clinical practice when outcome measures are implemented in local settings and the need for research to validate the use of these ROM measures in South African clinical settings.

Biorefinery implementation for recovery debottlenecking at existing pulp mills- Part II: Techno-economic evaluation

TAPPI Journal ◽  
2012 ◽  
Vol 11 (8) ◽  
pp. 17-24 ◽  
Author(s):  
HAKIM GHEZZAZ ◽  
LUC PELLETIER ◽  
PAUL R. STUART
Keyword(s):  
Cost Estimation ◽  
Process Model ◽  
Black Liquor ◽  
Pulp Mill ◽  
Value Added ◽  
Economic Assessment ◽  
Extraction Process ◽  
Estimation Methods ◽  
Precipitation Process

The evaluation and process risk assessment of (a) lignin precipitation from black liquor, and (b) the near-neutral hemicellulose pre-extraction for recovery boiler debottlenecking in an existing pulp mill is presented in Part I of this paper, which was published in the July 2012 issue of TAPPI Journal. In Part II, the economic assessment of the two biorefinery process options is presented and interpreted. A mill process model was developed using WinGEMS software and used for calculating the mass and energy balances. Investment costs, operating costs, and profitability of the two biorefinery options have been calculated using standard cost estimation methods. The results show that the two biorefinery options are profitable for the case study mill and effective at process debottlenecking. The after-tax internal rate of return (IRR) of the lignin precipitation process option was estimated to be 95%, while that of the hemicellulose pre-extraction process option was 28%. Sensitivity analysis showed that the after tax-IRR of the lignin precipitation process remains higher than that of the hemicellulose pre-extraction process option, for all changes in the selected sensitivity parameters. If we consider the after-tax IRR, as well as capital cost, as selection criteria, the results show that for the case study mill, the lignin precipitation process is more promising than the near-neutral hemicellulose pre-extraction process. However, the comparison between the two biorefinery options should include long-term evaluation criteria. The potential of high value-added products that could be produced from lignin in the case of the lignin precipitation process, or from ethanol and acetic acid in the case of the hemicellulose pre-extraction process, should also be considered in the selection of the most promising process option.

Clinical dilemmas of routine outcome monitoring and clinical feedback: a qualitative study of patient experiences

2020 ◽  
Author(s):  
Stig Magne Solstad ◽  
Gøril Kleiven Solberg ◽  
Louis George Castonguay ◽  
Christian Moltu
Keyword(s):  
Mental Health ◽  
Clinical Skill ◽  
Routine Outcome Monitoring ◽  
Future Research ◽  
Successful Implementation ◽  
Basic Training ◽  
Feedback Systems ◽  
Clinical Encounters ◽  
Outcome Monitoring ◽  
Clinical Feedback

Purpose: Routine outcome monitoring (ROM) and clinical feedback systems (CFS) are becoming prevalent in mental health services. The field faces several challenges to successful implementation. The purpose of this study is to gain a better understanding of these challenges by exploring the patient perspective. Method: We report the findings from a qualitative, video assisted interview study of 12 patients from a Norwegian mental health outpatient clinic using ROM/CFS. Results: Our analysis resulted in three pairs of opposing experiences with using ROM/CFS: 1) Explicit vs. implicit use of CFS information, 2) CFS directing focus towards- vs. directing focus away from therapeutic topics and 3) Giving vs. receiving feedback. None of these were intrinsically helpful or hindering. Participants had vastly differing preferences for how to use ROM/CFS in clinical encounters, but all needed the information to be used in a meaningful way by their therapists. If not, ROM/CFS was at risk of becoming meaningless and hindering for therapy. Conclusion: These findings confirm and provide further nuance to previous research. We propose to consider ROM/CFS a clinical skill that should be a part of basic training for therapists. How to use and implement ROM/CFS skillfully should also be the focus of future research.

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