in cancellations and no-shows, and the aver- age length of therapy decreased by 59%. A recent meta-analysis of outcome monitoring studies indicated that the effects of provid- ing feedback on deteriorating patients were the greatest across all patient groups; ef- fectively those who were most at-risk were identified most effectively.


Overington and Ionita have provided an overview of PM instruments in areas such as domains assessed, target population, admin- istration, cost, and training. The three main domains generally assessed are: 1) symp- toms, 2) well-being, and 3) functionality. Different instruments have various strengths and features. For example, some instru- ments aid in diagnosis; others are used to fa- cilitate discussion around therapy progress. In terms of administration and scoring, most are available in paper and computer versions and the shortest take as little as 2-minutes for clients to complete. Computer versions can be completed by clients on their own tablets in the waiting room and the results calculated and forwarded automatically to the therapist’s inbox in time for the session.


The data from PM measures can also pro- vide a means for evaluation at various levels including the organization, practitioners, and the clients; a term known as benchmarking. At the organizational level, PM measures can be used to compare the quality of services provided by each organization. They can also provide clinicians a useful comparison with other practitioners to see where their clinical skills excel and where they need im- provement. Clients can also be examined to see how they fare in regards to a benchmark created by the particular measure.


PM Usage in Canada


The McGill Psychotherapy Process Research Group (MPPRG) has been studying the use of PM measures in Canada. In 2012, Ionita con- ducted a nationwide survey of PM measure utilization. Of the 1668 clinician-respon- dents, 1124 had not heard of PM measures, 242 knew of - but had never used - them, 101 clinicians had used them in the past, and only 201 clinicians (12%) were current- ly using a measure to track client progress in therapy. Across the provinces, there was a range of utilization from 4.8% to 24%. In other words, even in the province with the highest utilization rates, only one in four


psychotherapists currently use some form of PM measure to track client change.


Ionita also examined the barriers to PM utili- zation. Canadian practitioners who were not using PM indicated that their top three barri- ers to utilization were: 1) lack of training on the measures, 2) limited access to training on the measures, and 3) limited knowledge about the measures. One clinician who overcame her reluctance to use the mea- sures told us, “I was noticing how the same fears and questions I had were being shared all the time by people using it all over the world. So I started thinking, ‘okay it’s not a problem with me, it’s normal to have those doubts’ and reading through how people dealt with and learned how to overcome the barriers... Like everyone does I suppose, we put up barriers when we are coming against something new but it’s just because it’s new.” We all want to help each client; PM measures can provide an objective measure- ment to help to make this a reality.


Surmounting the Barriers


Since the biggest barriers to using PM mea- sures appear to be lack of knowledge and training, the MPPRG is currently developing an online tool to help clinicians access infor- mation, explore their doubts, and choose a PM measure suitable to their practice. It will include information from journal articles, video interviews with psychologists, testi- monials from fellow clinicians, and interac- tive activities that provide an experiential understanding of what PM measures have to offer. We anticipate bringing you news and links to this tool in 2014. Watch for it in Cognica.


13


I don’t know the key to


success, but the key to failure is to try to please everyone.


- Bill Cosby


WWW.CCPA-ACCP.CA


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