Psychotherapy can alleviate mental health symptoms, but it is not effective for all patients, with some experiencing deterioration or being non-responsive to therapy. Measurement feedback systems (MFS) involve a systematic collection of information about the patients and delivery of this information to therapists, patients or others involved in the helping process. This can offer a solution to less successful therapies as providing ongoing patient information may help calibrate and tailor treatment to the individual.
Although MFS initiatives have shown positive effects on clinical outcomes, there is considerable heterogeneity in reported effects. The current thesis explores aspects related to the effects of MFS, including whether MFS improve treatment outcomes, the factors that moderate these effects, and efforts made to promote the adoption of MFS. It also examines the feasibility of measuring clinically relevant dimensions of psychopathology in children and youth using brief questionnaires as low burden, psychometrically sound measurement is an important element in MFS.
Through a systematic review, significant overall effects on clinical outcomes were found favoring conditions where MFS was applied. The effects were larger in a subgroup of patients that were predicted to not have positive outcomes from therapy, so called not-on-track patients. This indicated that MFS increases treatment effects by helping the therapists reach patients who normally would be non-responsive to therapy.
For the feedback cycle to work, data collection should not demand much time to administer and should constitute a low burden for patients. Short surveys that measure clinically relevant constructs can be useful in this regard. Two short surveys of central dimensions of psychopathology in children and youth were evaluated in terms of reliability and validity through data collected at a Norwegian outpatient clinic. Both the Brief Problem Monitor (BPM) and Behavior and Feelings Survey (BFS) were found to be highly reliable, and several indicators of their validity were found.
The effects of interventions are highly affected by how they are performed and the strategies to ensure their delivery. The MFS literature indicates that feedback is underused by therapists, and a mapping of the efforts for therapist adoption of MFS would be useful. The current thesis summarizes the process and implementation elements used in the MFS field. This overview maps a field where many reasonable ideas have been applied, yet most of the studies have devoted limited attention to process and implementation elements.