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Monitoring Treatment Progress and Providing Feedback is Viewed Favorably but Rarely Used in Practice

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Abstract

Numerous trials demonstrate that monitoring client progress and using feedback for clinical decision-making enhances treatment outcomes, but available data suggest these practices are rare in clinical settings and no psychometrically validated measures exist for assessing attitudinal barriers to these practices. This national survey of 504 clinicians collected data on attitudes toward and use of monitoring and feedback. Two new measures were developed and subjected to factor analysis: The monitoring and feedback attitudes scale (MFA), measuring general attitudes toward monitoring and feedback, and the attitudes toward standardized assessment scales-monitoring and feedback (ASA-MF), measuring attitudes toward standardized progress tools. Both measures showed good fit to their final factor solutions, with excellent internal consistency for all subscales. Scores on the MFA subscales (Benefit, Harm) indicated that clinicians hold generally positive attitudes toward monitoring and feedback, but scores on the ASA-MF subscales (Clinical Utility, Treatment Planning, Practicality) were relatively neutral. Providers with cognitive-behavioral theoretical orientations held more positive attitudes. Only 13.9 % of clinicians reported using standardized progress measures at least monthly and 61.5 % never used them. Providers with more positive attitudes reported higher use, providing initial support for the predictive validity of the ASA-MF and MFA. Thus, while clinicians report generally positive attitudes toward monitoring and feedback, routine collection of standardized progress measures remains uncommon. Implications for the dissemination and implementation of monitoring and feedback systems are discussed.

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Notes

  1. Providers could indicate multiple work settings and multiple orientations. Providers who indicated they spent any time working in private practice were included in the Private Practice group, those who listed cognitive or behavioral as part of their orientations were counted in the Cognitive-Behavioral group, and those who listed psychodynamic as part of their orientations were counted in the Psychodynamic group.

  2. These definitions are included in the instructions for the final versions of the measures, which are included as supplemental material to this article.

  3. Degree information was not available for AMHCA members.

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Funding

This research was supported by an award from the University of Miami’s Provost Resaerch Award program to Dr. Jensen-Doss. Dr. Lewis’ work on this project was supported by the National Institute Of Mental Health of the National Institutes of Health (NIH) under Award Number R01MH103310 and Dr. Lyon’s work by NIH award K08MH095939.

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Authors and Affiliations

  1. Child Division, Department of Psychology, University of Miami, P.O. Box 248185, Coral Gables, FL, 33124-0751, USA

    Amanda Jensen-Doss, Emily M. Becker Haimes & Ashley M. Smith

  2. University of Washington, Seattle, USA

    Aaron R. Lyon & Cara C. Lewis

  3. Indiana University, Bloomington, USA

    Cara C. Lewis

  4. University of Montana, Missoula, USA

    Cameo F. Stanick

  5. University of Missouri, Columbia, USA

    Kristin M. Hawley

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  1. Amanda Jensen-Doss
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  2. Emily M. Becker Haimes
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  3. Ashley M. Smith
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  4. Aaron R. Lyon
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Correspondence to Amanda Jensen-Doss.

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All procedures performed in this study were in accordance with the ethical standards of the University of Miami Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This study was approved for a waiver of signed consent; all participants were provided with a consent statement.

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Jensen-Doss, A., Haimes, E.M.B., Smith, A.M. et al. Monitoring Treatment Progress and Providing Feedback is Viewed Favorably but Rarely Used in Practice. Adm Policy Ment Health 45, 48–61 (2018). https://doi.org/10.1007/s10488-016-0763-0

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