Let's Talk About Us: Insights Into the Impact of Routine Outcome Monitoring on Therapeutic Dyads

ABSTRACT Objective Routine Outcome Monitoring and Feedback (ROM) systems have been widely implemented to improve outcomes of psychotherapy. While their additive effects are robust, effect sizes remain modest, and research indicates differential effectiveness. This study investigates how therapeutic dyads perceive the influence of ROM systems on both intrapersonal and interactive therapeutic processes to identify potential barriers and opportunities for a personalisation of feedback in therapy. Method Qualitative interviews were conducted with 18 participants (9 outpatients and their therapists) who had used the Greifswald Psychotherapy Navigation System (GPNS) during their treatment. Data were analysed using Kukartz's method of qualitative content analysis. Results Eight main categories emerged: (1) structure and use of feedback discussions, (2) reflection and competence development in patients and therapists, (3) reflection and competence change in patients and therapists, (4) patient empowerment, (5) applicability, satisfaction and perceived usefulness, (6) treatment adjustment and changes, (7) reflection on the psychotherapeutic process and (8) therapeutic alliance. Conclusion Overall, the therapeutic dyads agreed on positive influences of the GPNS on intrapersonal competencies and their therapeutic alliance. However, results indicate a differential effectiveness, and clinicians underestimated the benefits their patients reported. To confirm causal mechanisms and optimise feedback applications, further experimental studies are warranted.