Assessing Patient Progress in Psychological Therapy Through Feedback in Supervision: the MeMOS* Randomized Controlled Trial (*Measuring and Monitoring clinical Outcomes in Supervision: MeMOS).
BACKGROUND
Psychological therapy services are often required to demonstrate their effectiveness and are implementing systematic monitoring of patient progress. A system for measuring patient progress might usefully 'inform supervision' and help patients who are not progressing in therapy.


OBJECTIVE
To examine if continuous monitoring of patient progress through the supervision process was more effective in improving patient outcomes compared with giving feedback to therapists alone in routine NHS psychological therapy.


METHODS
Using a stepped wedge randomized controlled design, continuous feedback on patient progress during therapy was given either to the therapist and supervisor to be discussed in clinical supervison (MeMOS condition) or only given to the therapist (S-Sup condition). If a patient failed to progress in the MeMOS condition, an alert was triggered and sent to both the therapist and supervisor. Outcome measures were completed at beginning of therapy, end of therapy and at 6-month follow-up and session-by-session ratings.


RESULTS
No differences in clinical outcomes of patients were found between MeMOS and S-Sup conditions. Patients in the MeMOS condition were rated as improving less, and more ill. They received fewer therapy sessions.


CONCLUSIONS
Most patients failed to improve in therapy at some point. Patients' recovery was not affected by feeding back outcomes into the supervision process. Therapists rated patients in the S-Sup condition as improving more and being less ill than patients in MeMOS. Those patients in MeMOS had more complex problems.
Institute of Health and Wellbeing,University of Glasgow.
Kate M
KM
Davidson
Institute of Health and Wellbeing,University of Glasgow.
Michelle L
ML
Rankin
Institute of Health and Wellbeing,University of Glasgow.
Amelie
A
Begley
Robertson Centre for Biostatistics,Institute of Health and Wellbeing,University of Glasgow.
Suzanne
S
Lloyd
Robertson Centre for Biostatistics,Institute of Health and Wellbeing,University of Glasgow.
Sarah J E
SJ
Barry
Robertson Centre for Biostatistics,Institute of Health and Wellbeing,University of Glasgow.
Paula
P
McSkimming
Institute of Health and Wellbeing,University of Glasgow.
Lisa
L
Bell
NHS Greater Glasgow and Clyde.
Carole
C
Allan
NHS Greater Glasgow and Clyde.
Morag
M
Osborne
NHS Greater Glasgow and Clyde.
George
G
Ralston
NHS Education for Scotland.
Geraldine
G
Bienkowski
Centre for Community Mental Health,Birmingham City University.
John
J
Mellor-Clark
Robertson Centre for Biostatistics,Institute of Health and Wellbeing,University of Glasgow.
Andrew
A
Walker
D000328:Adult; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome
CORE; Clinical supervision; patient progress; psychotherapy outcome research; randomized controlled trial