A chance for change : building an outcome monitoring feedback system for outpatient mental health care

Abstract

The principal aim of this thesis was to develop an outcome monitoring feedback model for Dutch outpatient mental health care in the Netherlands and to test whether providing feedback to therapists and patients can improve treatment outcomes. Data on patient progress collected in outpatient centers in the Netherlands were used to predict the functioning of patients at the end of treatment and the rate of change. In addition, two feedback studies were conducted. In the first study the effect of therapist feedback was compared with no feedback. The results showed no significant effect of feedback for the full group, but did show an effect for therapists that actively used the feedback in therapy. Therapist factors mediated the effectiveness of feedback: in therapists with higher self-efficacy the feedback had a more positive effect. The second study had three treatment conditions, a control group, a group with feedba ck to therapists alone and a group in which both therapists and patients received feedback about the patient’s progress. The results showed that feedback to both therapists and patients was more effective than feedback to therapists alone. The feedback effect was strongest in short-term therapy, for cases that were not progressing well.