Measurement-based care (MBC) is an evidence-based practice that has gained significant attention in the field of mental health care for its potential to detect deteriorating mental health status early, enhance treatment outcomes, and improve client satisfaction with treatment (Lewis, 2019). This is done through the regular and systematic collection of patient-reported outcomes, clinical data, and other relevant metrics which inform and guide clinical decision-making (Ridout, 2023). In the literature, MBC can also be referred to as routine outcome monitoring (ROM), feedback-informed therapy, measurement-informed care (MIC) or outcomes based care.
Since the mid-90’s, the body of research demonstrating significant benefits of the use of MBC in mental health care continues to grow (Miller, 2023; Boswell, 2023). For example, Fortney et al. (2017) found that clients whose treatment course involved MBC exhibited significantly greater improvements in depressive symptoms compared to those receiving care without MBC. Additionally, Trivedi et al. (2006) highlighted that MBC can lead to higher response and remission rates in clients with depression by allowing clinicians to adjust treatments more quickly due to the availability of real-time data.
MBC has also been associated with increased client engagement and satisfaction. Clients who participate in regular assessments often feel more involved in their treatment process, leading to better adherence and outcomes (Lewis et al., 2019). By providing objective data, MBC helps bridge the gap between subjective clinical impressions and actual client experiences. To be most effective, evidence indicates that MBC must be implemented and the results reviewed immediately before or during therapeutic sessions, in collaboration with clients (Parikh et al., 2020). The impact of MBC as a tool to guide treatment is the enhancement, not replacement, of clinical expertise and strong therapeutic relationships (Lewis et al., 2019; Parikh et al., 2020; Scott, 2015).
As Miller and Wampold (2023) point out, however, the development of professional practice guidelines for MBC does not on its own enhance the quality or efficacy of mental health treatment. Barriers to effective implementation do indeed exist, including challenges around clinician training, concerns about workload burden, or the perception that MBC represents a “one size fits all” approach to care (Scott, 2015; Miller, 2023). The cumulative result of these and other barriers is that uptake of MBC within clinical practice remains low at 20% (Boswell, 2023; Miller, 2023).
This is why we at Dalton Associates have taken great care to ensure our Measurement-Based Care strategy prioritizes meaningful engagement with staff and clinicians alike, actionable steps supported by a robust coaching infrastructure, and as always, accessibility and client-centred care as our core foundational principles.
Read the Literature
Boswell JF, Hepner KA, Lysell K. et al. (2023). The Need for a Measurement-Based Care Professional Practice Guideline. Psychotherapy, 60(1): 1-16.
For options to access: https://psycnet.apa.org/record/2022-76994-001
*This article is not currently open access. You may be able to access using professional or academic logins, or you may need to pay if you wish to access the full publication.
Fortney JC, Unutzer J, Wrenn G et al. (2017). A Tipping Point for Measurement-Based Care. Psychiatric Services, 68(2), 179-188. https://doi.org/10.1176/appi.ps.201500439
Read here (free): https://psychiatryonline.org/doi/10.1176/appi.ps.201500439?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Lewis CC, Boyd M, Puspitasari A, et al. (2019). Implementing Measurement-Based Care in Behavioral Health: A Review. JAMA Psychiatry, 76(3):324-335. doi:10.1001/jamapsychiatry.2018.3329
Read here (free): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6584602/
Miller SD, Wampold BE. (2023). Measurement-Based Care Professional Practice Guideline: Fine, but Guidelines DO Not Make Good Therapy. Psychotherapy, 60(1): 17-19.
For options to access: https://psycnet.apa.org/record/2023-56666-001
*This article is not currently open access. You may be able to access using professional or academic logins, or you may need to pay if you wish to access the full publication.
Parikh, Amit, et al. “Evidence Base for Measurement-Based Care in Child and Adolescent Psychiatry.” Child and Adolescent Psychiatric Clinics of North America, vol. 29, no. 4, 2020, pp. 587–99, https://doi.org/10.1016/j.chc.2020.06.001.
Read here (free): https://www.sciencedirect.com/science/article/abs/pii/S1056499320300419?via%3Dihub
Ridout K, Vanderlip ER, Alter CL, et al. (2023). Resource Document on Implementation of Measurement- Based Care. American Psychological Association.
Read here (free): https://www.psychiatry.org/getattachment/3d9484a0-4b8e-4234-bd0d-c35843541fce/Resource-Document-on-Implementation-of-Measurement-Based-Care.pdf
Trivedi MH, Rush, AJ, Wisniewski SR, et al. (2006)., Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D: implications for clinical practice. The American journal of psychiatry, 163(1), 28–40. https://doi.org/10.1176/appi.ajp.163.1.28
Read here (free): https://psychiatryonline.org/doi/10.1176/appi.ajp.163.1.28?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Scott K, Lewis CC. (2015) Using Measurement-Based Care to Enhance Any Treatment. Cognitive Behavioural Practice, 22(1):49-59. doi: 10.1016/j.cbpra.2014.01.010. PMID: 27330267; PMCID: PMC4910387.
Read here (free): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910387/pdf/nihms793716.pdf