Commentary on ‘Using Clinical Outcomes in Routine Evaluation’

Implementing an aim-based outcome measure in a psychoanalytic child psychotherapy service: insights, experiences and evidence

In this paper, we describe the use of an aim-based outcome measure used in routine outcome monitoring of child and adolescent psychotherapy within a child and adolescent mental health service. We aim to explore the clinical feasibility and implications of the routine use of this measure. We argue that use of the measure provides a simple and useful way of clarifying the focus of the clinical work and reflecting its progress, while also having the potential to illuminate the clinical picture by contributing an additional source of clinical information from a collaborative process with the patient, parents or both. We argue that while there are some cases where use of the measure may be impossible, or even perverse, in general it enhances rather than detracts from clinical work.

Introducing the CORE-OM in a South African Context: Validation of the CORE-OM using a South African Student Population Sample

The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) was originally introduced as a standardised, practice-based evidence tool for generating effectiveness data by practitioners within the context of routine clinical practice in the United Kingdom's National Health Service (NHS) settings. Following wide application across UK NHS sites the CORE-OM has proven to be a pragmatic measure of both a) gross psychological distress and b) the effectiveness of psychotherapy interventions across client populations, presenting problems, clinical settings and therapy models. However in order for South Africa to benefit from this tool, the CORE-OM must be applicable within a South African context. This requires its validation within South African populations. The aim of this article is to demonstrate the cross-cultural validity of the CORE-OM, using a South African student population sample and in so doing to provide preliminary referential data for use in interpreting CORE-OM scores within English-medium, South African University student counselling centre contexts.

Therapeutic collaboration and formalized feedback: using perspectives from Vygotsky and Bakhtin to shed light on practices in a family therapy unit

Patient-focused research points to the necessity of continuously monitoring process and outcome in psychotherapy to supply service users and their therapists with feedback as a way of avoiding no change and detrimental development. At the Department of Child and Adolescent Mental Health, therapists implement monitoring in an intensive family therapy unit inspired by postmodern and language-oriented forms of family therapy using the Session Rating Scale and the Outcome Rating Scale. Research generated descriptions of users' experiences of these scales as conversational tools are reflected upon using concepts from the work of Vygotsky and Bakhtin. Mediation, dialogicality, voice, the zone of proximal development and the metaphor of scaffolding are offered as conceptualizations that expand the inspirational sources of the unit by creating and enhancing further possibilities for collaboration between families and their therapists.