Exploring an implicit test to measure affective outcomes in routine psychotherapy evaluations

Objective: Current routine outcome monitoring in psychotherapy relies heavily on self-reports. In the present study, we developed and evaluated a brief implicit measure based on the Affect Misattribution Procedure (AMP) designed to complement the CORE-OM or other ROM measures. Method: Individuals seeking psychotherapy at a university-based service (n = 109) and non-clinical undergraduate controls (n = 46) completed a self-referential Affect Misattribution Procedure and the CORE-OM. We examined group differences, associations between implicit and explicit distress, split-half reliability, and exploratory longitudinal change. Results: Implicit scores were significantly higher in the clinical than in the control group, with a small to medium effect size (g = 0.41), whereas the CORE-OM difference was large (g = 1.07). Implicit and explicit distress showed moderate convergence, and CORE-OM scores accounted for approximately 12% of the variance in AMP scores. The AMP also showed high split-half reliability (rsβ = .92) and preliminary sensitivity to therapeutic change over 12 sessions (dz = 0.54). Conclusion: These findings support the feasibility of a brief implicit task that yields a reliable and partially distinct index of self-identification related to distress, supporting its use as a complementary component for triangulation between implicit measures and explicit self-report measures within routine outcome monitoring.