Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
International Journal of Mental Health Systems
Published in: International Journal of Mental Health Systems 1/2017

Open Access 01-12-2017 | Research

What are “good outcomes” in public mental health settings? A qualitative exploration of clients’ and therapists’ experiences

Authors: Christian Moltu, Jon Stefansen, Jan Christian Nøtnes, Åse Skjølberg, Marius Veseth

Published in: International Journal of Mental Health Systems | Issue 1/2017

Login to get access

Abstract

Background

The mental health field sees a surge of interest in Routine Outcome Monitoring, mandated by a wish to help better those not-on-track to recovery. What constitutes positive outcomes for these patients is not fully understood.

Aims

To contribute knowledge into what constitutes meaningful outcome concepts in the experiences of patients with long and complex mental health suffering and treatment, and the clinicians who work to help them.

Methods

A qualitative in-depth study of 50 participants’ experiences. Data are collected through focus groups and individual interviews, and analyzed using a team based structured thematic analytic approach.

Results

We found an overarching theme of outcome as an ongoing process of recovery, with the four constituent themes: (1) strengthening approach patterns for new coping; (2) embodying change reflected by others; (3) using new understandings developed in dialogue; and (4) integrating collaborative acceptance.

Conclusions

We discuss our findings in light of existing empirical studies and different recovery concepts, and suggest that if outcomes monitoring is to become an integral part of routine practice, it might be beneficial to integrate an understanding of outcomes as ongoing processes of recovery within mental health suffering into these systems.
Appendix
Available only for authorised users
Literature
1.
Bowens M, Cooper M. Development of a client feedback tool: a qualitative study of therapists’ experiences of using the Therapy Personalisation Forms. Eur J Psychother Couns. 2012;14(1):47–62.CrossRef
2.
Carlier IVE, Meuldijk D, Van Vliet IM, Van Fenema E, Van der Wee NJA, Zitman FG. Routine outcome monitoring and feedback on physical or mental health status: evidence and theory. J Eval Clin Pract. 2012;18:104–10.CrossRefPubMed
3.
de Jong K, van Sluis P, Nugter MA, Heiser WJ, Spinhoven P. Understanding the differential impact of outcome monitoring: therapist variables that moderate feedback effects in a randomized clinical trial. Psychother Res. 2012;22(4):464–74.CrossRefPubMed
4.
Boswell JF, Kraus DR, Miller SD, Lambert MJ. Implementing routine outcome monitoring in clinical practice: benefits, challenges, and solutions. Psychother Res. 2015;25(1):6–19.CrossRefPubMed
5.
Lambert MJ, Cattani K. Practice-friendly research review: collaboration in routine care. J Clin Psychol. 2012;68(2):209–20.CrossRefPubMed
6.
Lambert MJ. Prevention of treatment failure. The use of measuring, monitoring, and feedback in clinical practice. Washington: American Psychological Association; 2010.CrossRef
7.
8.
Evans C, Connell J, Barkham M, Margison F, McGrath G, Mellor-Clark J, Audin K. Towards a standardised brief outcome measure: psychometric properties and utility of the CORE—OM. Br J Psychiatry. 2002;180(1):51–60.CrossRefPubMed
9.
Green D, Latchford G. Maximising the benefits of psychotherapy. A practice-based evidence approach. Oxford: Wiley; 2012.CrossRef
10.
Harmon SC, Lambert MJ, Smart DM, Hawkins E, Nielsen SL, Slade K, Lutz W. Enhancing outcome for potential treatment failures: therapist-client feedback and clinical support tools. Psychotherapy Research. 2007;17(4):379–92.CrossRef
11.
Connolly MB, Strupp HH. Cluster analysis of patient reported outcomes. Psychother Res. 1996;6(1):30–42.CrossRef
12.
Strupp HH. The vanderbilt psychotherapy research project: past, present, and future. In: Simek-Downing L, editor. International psychotherapy: theories, research, cross-cultural implications. New York: Praeger Publishers; 1989. p. 191–209.
13.
Klein MJ, Elliott R. Client accounts of personal change in process–experiential psychotherapy: a methodologically pluralistic approach. Psychother Res. 2006;16(1):91–105.CrossRef
14.
Binder PE, Holgersen H, Nielsen GH. What is a “good outcome” in psychotherapy? a qualitative exploration of former patients’ point of view. Psychother Res. 2010;20:285–94.CrossRefPubMed
15.
Solstad SM, Castonguay LG, Moltu C. Patients’ experiences with routine outcome monitoring (ROM) and clinical feedback systems (CFS): a systematic review and synthesis of qualitative empirical literature. Psychotherapy Research submitted.
16.
Friedlander ML, Austin CL, Cabrera P. When psychotherapy is indefinite and there is no final outcome: case study of a community mental health clinic. Psychotherapy. 2014;51(4):580–94.CrossRefPubMed
17.
18.
Van Manen M. Phenomenology of practice. Meaning-giving methods in phenomenological research and writing. Walnut Creek: Left Coast Press; 2014.
19.
Gadamer HG. Truth and method. London: Continuum; 1960/1975.
20.
Laverty SM. Hermeneutic phenomenology and phenomenology: a comparison of historical and methodological considerations. Int J Qual Methods. 2003;2:21–35.CrossRef
21.
Smith JA. Hermeneutics, human sciences and health: linking theory and practice. Int J Qual Stud Health Wellbeing. 2007;2:3–11.CrossRef
22.
Binder PE, Holgersen H, Moltu C. Staying close and reflexive: an explorative and reflexive approach to qualitative research on psychotherapy. Nord Psychol. 2012;64(2):103–17.CrossRef
23.
24.
Krueger RA, Casey MA. Focus groups. A practical guide for applied research. Thousand Oaks: Sage Publications; 2000.
25.
Wilkinson S. Focus groups. In: Smith JA, editor. Qualitative psychology: a practical guide to research methods. London: Sage Publications; 2008.
26.
27.
Kvale S, Brinkmann S. interviews: learning the craft of qualitative research interviewing. London: Sage; 2009.
28.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
29.
Hill CE, Knox S, Thompson BJ, Williams EN, Hess SA, Ladany N. Consensual qualitative research: an update. J Counsel Psychol. 2005;52:196–205.CrossRef
30.
Moltu C, Veseth M, Stefansen J, Nøtnes JC, Skjølberg Å, Binder P-E, Castonguay LG, Nordberg SS. This is what I need a clinical feedback system to do for me: a qualitative inquiry into therapists’ and patients’ perspectives. Psychother Res. 2016. pp. 1–14. doi:10.​1080/​10503307.​2016.​1189619
31.
Topor A, Borg M, DiGirolamo S, Davidson L. Not just an individual journey. Social aspects of recovery. Int J Soc Psychiatry. 2011;57:90–9.CrossRefPubMed
32.
Topor A, Borg M, Mezzina R, Sells D. Others: the role of family, friends, and professionals in recovery processes. Am J Psychiatr Rehabil. 2006;9:17–37.CrossRef
33.
Borg M, Kristiansen K. Recovery-oriented professionals: helping relationships in mental health services. J Ment Health. 2004;13:493–505.CrossRef
34.
Ramon S, Healy B, Renouf N. Recovery from mental illness as an emergent concept and practice in Australia and the UK. Int J Soc Psychiatry. 2007;53:108–22.CrossRefPubMed
35.
Davidson L. Considering recovery as a process: or, life is not an outcome. In: Rudnick A, editor. Recovery of people with mental illness philsophical and related perspectives. Oxford: University Press; 2012. p. 252–63.CrossRef
36.
Anthony WA. Recovery from mental illness: the guiding vision of the mental health system in the 1990s. Psychosoc Rehabil J. 1993;16:11–23.CrossRef
37.
Leamy M, Bird V, Le Boutillier C, Williams J, Slade M. Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. Br J Psychiatry. 2011;199:445–52.CrossRefPubMed
38.
Shanks V, Williams J, Leamy M, Bird V, Le Boutillier C, Slade M. Measures of personal recovery: a systematic review. Psychiatr Serv. 2013;64(10):974–80.CrossRefPubMed
39.
Borg M, Veseth M, Binder PE, Topor A. The role of work in recovery from bipolar disorders. Qual Soc Work. 2013;12(3):323–39.CrossRef
40.
Veseth M, Binder PE, Borg M, Davidson L. Toward caring for oneself in a life of intense ups and downs: a reflexive-collaborative exploration of recovery in bipolar disorder. Qual Health Res. 2012;22:119–33.CrossRefPubMed
41.
Finlay L, Gough B, editors. Reflexivity. A practical guide for researchers in health and social sciences. Oxford: Blackwell Science Ltd; 2003.
42.
Alvesson M, Sköldberg K. Reflexive methodology. New vistas for qualitative research. Thousand Oaks: Sage; 2000.
43.
Morrow SL. Quality and trustworthiness of qualitative research in counseling psychology. J Couns Psychol. 2005;52:250–60.CrossRef
Metadata
Title
What are “good outcomes” in public mental health settings? A qualitative exploration of clients’ and therapists’ experiences
Authors
Christian Moltu
Jon Stefansen
Jan Christian Nøtnes
Åse Skjølberg
Marius Veseth
Publication date
01-12-2017
Publisher
BioMed Central
Published in
International Journal of Mental Health Systems / Issue 1/2017
Electronic ISSN: 1752-4458
DOI
https://doi.org/10.1186/s13033-017-0119-5

Other articles of this Issue 1/2017

International Journal of Mental Health Systems 1/2017 Go to the issue

Research

Perinatal depression in Nigeria: perspectives of women, family caregivers and health care providers

Research

The impact of organisational change and fiscal restraint on organisational culture

Research

Does child and adolescent mental health in-service training result in equivalent knowledge gain among cadres of non-specialist health workers in Uganda? A pre-test post-test study

Research

An overview of mental health care system in Kilifi, Kenya: results from an initial assessment using the World Health Organization’s Assessment Instrument for Mental Health Systems

Case study

Promoting wellbeing and improving access to mental health care through community champions in rural India: the Atmiyata intervention approach

Research

Reliability and validity of the Japanese version of the Community Integration Measure for community-dwelling people with schizophrenia