In routine outcome monitoring (ROM), the rate and timing of treatment failure alerts has been related to the success of feedback in past randomized clinical trials. In a recent OQ-45 feedback study, Burlingame and colleagues (2018) found that the rates and timing of not-on-track (NOT) progress alerts in group treatment were different than those reported for individual treatment. Using data from 58 different therapy groups and 374 patients, NOT progress alerts occurred at 186% of the rate reported by Shimokawa et al. (2010) when they examined over 6,000 patients receiving individual therapy at the same clinics. Another significant difference was found on the timing of the first NOT progress alerts with group treatment's first alerts occurring two sessions later than individual treatment. The goal of the current study was to use de-identified archival OQ-45 data from patients receiving group and individual treatment at a comparable clinic to determine if these rate and timing differences were replicable. Data from individual therapy (N = 5,493) and group therapy (N = 146) patients' OQ-45 scores show that the present study duplicated the significant difference found in the rate of NOT alerts between these formats. Relative risk of alerting as NOT at least once in group therapy was calculated to be 1.43 compared to individual therapy (group patients are 143% more likely to alert than individual patients). On the other hand, the present study did not find a significant difference in the timing of first alerts between formats. The implication of these results are significant when considering ROM in group therapy. Patients participating in group therapy are much more likely to flag as not-on-track later during the course of treatment when compared to patients in individual therapy.

The last 3 decades have seen a dramatic increase in the creation and effective use of spiritually integrated therapy (SIT) for a wide variety of client populations and clinical issues. The outcome research on SIT has increased and improved dramatically, yet process research on SIT has lagged somewhat. While valuable, prior process-oriented studies on SIT have used retrospective survey methods and asked about generalized usage rates of predetermined spiritual interventions. Rather than relying on retrospective reports of SIT with clients, there is great value and likely greater accuracy in examining session-by-session usage of SIT with clients and identifying correlational patterns between clinical issues and spiritual interventions. The current study used a descriptive, practice-based evidence approach and analyzed session-by-session process data from a private practice explicitly marketed as offering SIT. After every therapy session, eight therapists at this site completed an in-depth process measure, the Clinically Adaptive Therapist Session Checklist, and reported which clinical issues they discussed and which spiritual interventions they used in session. Findings revealed that therapists discussed self-esteem, anxiety, depression, and religious/spiritual concerns in over half of their sessions. Therapists also endorsed affirming clients' divine worth, encouraged trusting God, encouraged clients to listen to their heart, and encouraged accepting God's love in over half of their sessions. The strongest positive correlations between spiritual interventions and clinical issues were between challenging shame and challenging fear, and emotional orientation (r = 0.664 and 0.648, respectively). The clinical patterns found in this analysis illustrate one way of incorporating spirituality into clinical work. This study highlights the importance of routine outcome/process monitoring systems to help illuminate the process of SIT and contribute to deliberate practice efforts in the field. This study also stimulated discussion on the distinction between SIT and being a spiritually centered therapist.

Hispanic youth and families, although they comprise a sizeable portion of the population, are underrepresented in mental health settings within the United States and face significant barriers to receiving adequate treatment. Specifically, the lack of availability of Spanish assessment tools for application in treatment prohibits Hispanic clients from accessing the full extent of available therapeutic resources. The Treatment Support Measure (TSM) is a valid and reliable instrument that allows clinicians and researchers to collect information to better understand change processes and relevant client characteristics in therapy. The present study created a Spanish-translated version of the parent and youth TSM (TSM-SP) and assessed its psychometric properties in a Spanish-speaking community sample of 177 youth and 214 adult caregivers. The internal consistency reliability of all domains of the parent and youth versions of the TSM-SP was good, aside from the Youth Motivation domain. In contrast, the test-retest reliability of all domains of the parent and youth versions of the TSM-SP were generally poor. The construct validity of all domains of the parent and youth versions of the TSM-SP as examined by confirmatory factor analysis was excellent, aside from the Youth Motivation domain. Overall, these results laid the foundation for future research examining the utility and properties of the TSM-SP. The TSM-SP has potential to provide clinicians treating Spanish-speaking youth and families with a useful tool to help better serve these populations in therapy and broaden the scope of research into change processes in youth therapy to involve more diverse populations.

No description available.

In recent years, there has been an ever increasing emphasis placed on the collection and use of patient reported outcome measures (PROM) in mental health services. This emphasis stems from a culture of evidence based practice, wherein PROM are shown to improve therapeutic outcomes at the clinical level, as well as provide information for the appropriate development of services and commissioning at a national level. This study uses an online survey to explore the use of PROM by mental health staff (n=112) in various Child and Adolescent Mental Health Services across England. Attitudes toward routine outcome monitoring practices and perceived competency around PROM use were also measured. Results found that although significant numbers of staff were using PROM, the amount of data being collected falls short of policy targets. Staff’s attitudes towards the practice are shown to be ambivalent, whereas overall perceived levels of competency were reasonably good. The relationships between attitudes, competence and PROM usage are discussed and a prediction model for PROM usage is developed in light of existing psychological theory. Results showed that training played an important role in the uptake of PROM and implications for the dissemination of training programs are emphasised.