Skip to main content
Top
Published in: Child and Adolescent Psychiatry and Mental Health 1/2015

Open Access 01-12-2015 | Research article

The use of routine outcome monitoring in child semi-residential psychiatry: predicting parents’ completion rates

Authors: Audri Lamers, Chijs van Nieuwenhuizen, Bart Siebelink, Thijs Blaauw, Robert Vermeiren

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2015

Login to get access

Abstract

Background

Parents’ perspectives on their children’s treatment process and outcomes are valuable to treatment development and improvement. Participants’ engagement in Routine Outcome Monitoring (ROM) has, however, been difficult and may particularly be so in specialized settings, such as semi-residential psychiatry. In this paper, the use of a web-based ROM system implemented in a child semi-residential psychiatric setting is described and predictors associated with low completion rates of questionnaires by parents are identified.

Methods

Parents and the multidisciplinary team of 46 children admitted to semi-residential psychiatric treatment participated in this study and completed a battery of questionnaires in three month intervals.

Results

The overall completion rate of both parents during ROM assessment was 77 % compared to 83 % of all clinicians involved. Completion of questionnaires by parents was higher around first assessments and declined after a year treatment. For eight clients at least one of the parents stopped filling out questionnaires during ROM measuring. Logistic multilevel analyses revealed initial treatment factors associated with a low completion of questionnaires by parents during ROM: high comorbidity of the child on DSM Axis I, single parenthood, a higher parental educational level and having a weaker therapeutic alliance regarding goal setting.

Conclusions

The findings in this paper demonstrate relatively high completion of questionnaires by clinicians and parents when using ROM in child semi-residential psychiatry. Strong administrative and electronic support undoubtedly contributed to this result. Clinicians are encouraged to motivate parents to mutually invest in ROM, and to take into account factors indicating a possible lower completion of questionnaires by parents.
Literature
1.
go back to reference Batty MJ, Moldavsky M, Foroushani PS, Pass S, Marriott M, Sayal K, et al. Implementing routine outcome measures in child and adolescent mental health services: from present to future practice. Child Adolesc Ment Health. 2013;18(2):82–7.CrossRef Batty MJ, Moldavsky M, Foroushani PS, Pass S, Marriott M, Sayal K, et al. Implementing routine outcome measures in child and adolescent mental health services: from present to future practice. Child Adolesc Ment Health. 2013;18(2):82–7.CrossRef
2.
go back to reference Hall C, Moldavsky M, Taylor J, Sayal K, Marriott M, Batty M, et al. Implementation of routine outcome measurement in child and adolescent mental health services in the United Kingdom: a critical perspective. Eur Child Adolesc Psychiatr. 2014;23:239.CrossRef Hall C, Moldavsky M, Taylor J, Sayal K, Marriott M, Batty M, et al. Implementation of routine outcome measurement in child and adolescent mental health services in the United Kingdom: a critical perspective. Eur Child Adolesc Psychiatr. 2014;23:239.CrossRef
3.
go back to reference Murphy JM, Blais M, Baer L, McCarthy A, Kamin H, Masek B, et al. Measuring outcomes in outpatient child psychiatry: Reliable improvement, deterioration, and clinically significant improvement. Clin Child Psychol Psychiatry. 2013. doi:10.1177/1359104513494872. Murphy JM, Blais M, Baer L, McCarthy A, Kamin H, Masek B, et al. Measuring outcomes in outpatient child psychiatry: Reliable improvement, deterioration, and clinically significant improvement. Clin Child Psychol Psychiatry. 2013. doi:10.​1177/​1359104513494872​.
4.
go back to reference Timimi S, Tetley D, Burgoine W, Walker G. Outcome orientated child and adolescent mental health services (OO-CAMHS): A whole service model. Clin Child Psychol Psychiatr. 2012;18(2):169–84.CrossRef Timimi S, Tetley D, Burgoine W, Walker G. Outcome orientated child and adolescent mental health services (OO-CAMHS): A whole service model. Clin Child Psychol Psychiatr. 2012;18(2):169–84.CrossRef
5.
go back to reference De Beurs E, Den Hollander‐Gijsman M, Van Rood Y, Van der Wee N, Giltay E, Van Noorden M, et al. Routine outcome monitoring in the Netherlands: practical experiences with a web‐based strategy for the assessment of treatment outcome in clinical practice. Clin Psychol Psychother. 2011;18(1):1–12.PubMedCrossRef De Beurs E, Den Hollander‐Gijsman M, Van Rood Y, Van der Wee N, Giltay E, Van Noorden M, et al. Routine outcome monitoring in the Netherlands: practical experiences with a web‐based strategy for the assessment of treatment outcome in clinical practice. Clin Psychol Psychother. 2011;18(1):1–12.PubMedCrossRef
6.
go back to reference de Jong K, van’t Spijker A. Routine Outcome Monitoring:‘love it or leave it’? Tijdschr Psychoanal. 2013;39(3):190–4. de Jong K, van’t Spijker A. Routine Outcome Monitoring:‘love it or leave it’? Tijdschr Psychoanal. 2013;39(3):190–4.
7.
go back to reference Martin A-M, Fishman R, Baxter L, Ford T. Practitioners’ attitudes towards the use of standardized diagnostic assessment in routine practice: a qualitative study in two child and adolescent mental health services. Clin Child Psychol Psychiatr. 2011;16(3):407–20.CrossRef Martin A-M, Fishman R, Baxter L, Ford T. Practitioners’ attitudes towards the use of standardized diagnostic assessment in routine practice: a qualitative study in two child and adolescent mental health services. Clin Child Psychol Psychiatr. 2011;16(3):407–20.CrossRef
8.
go back to reference Norman S, Dean S, Hansford L, Ford T. Clinical practitioner’s attitudes towards the use of Routine Outcome Monitoring within Child and Adolescent Mental Health Services: A qualitative study of two Child and Adolescent Mental Health Services. Clin Child Psychol Psychiatry. 2013. doi:10.1177/1359104513492348.PubMed Norman S, Dean S, Hansford L, Ford T. Clinical practitioner’s attitudes towards the use of Routine Outcome Monitoring within Child and Adolescent Mental Health Services: A qualitative study of two Child and Adolescent Mental Health Services. Clin Child Psychol Psychiatry. 2013. doi:10.​1177/​1359104513492348​.PubMed
9.
go back to reference Wolpert M, Fugard AJ, Deighton J, Görzig A. Routine outcomes monitoring as part of children and young people's Improving Access to Psychological Therapies (CYP IAPT)–improving care or unhelpful burden? Child Adolesc Ment Health. 2012;17(3):129–30.CrossRef Wolpert M, Fugard AJ, Deighton J, Görzig A. Routine outcomes monitoring as part of children and young people's Improving Access to Psychological Therapies (CYP IAPT)–improving care or unhelpful burden? Child Adolesc Ment Health. 2012;17(3):129–30.CrossRef
10.
go back to reference Moran P, Kelesidi K, Guglani S, Davidson S, Ford T. What do parents and carers think about routine outcome measures and their use? A focus group study of CAMHS attenders. Clin Child Psychol Psychiatr. 2011;17(1):65–79.CrossRef Moran P, Kelesidi K, Guglani S, Davidson S, Ford T. What do parents and carers think about routine outcome measures and their use? A focus group study of CAMHS attenders. Clin Child Psychol Psychiatr. 2011;17(1):65–79.CrossRef
11.
go back to reference Hall CL, Moldavsky M, Baldwin L, Marriott M, Newell K, Taylor J, et al. The use of routine outcome measures in two child and adolescent mental health services: a completed audit cycle. BMC Psychiatry. 2013;13(1):270.PubMedCentralPubMedCrossRef Hall CL, Moldavsky M, Baldwin L, Marriott M, Newell K, Taylor J, et al. The use of routine outcome measures in two child and adolescent mental health services: a completed audit cycle. BMC Psychiatry. 2013;13(1):270.PubMedCentralPubMedCrossRef
12.
go back to reference Kelley SD, Bickman L. Beyond outcomes monitoring: Measurement feedback systems (MFS) in child and adolescent clinical practice. Current Opinion Psychiatr. 2009;22(4):363.CrossRef Kelley SD, Bickman L. Beyond outcomes monitoring: Measurement feedback systems (MFS) in child and adolescent clinical practice. Current Opinion Psychiatr. 2009;22(4):363.CrossRef
13.
go back to reference Johnston C, Gowers S. Routine outcome measurement: a survey of UK child and adolescent mental health services. Child Adolesc Ment Health. 2005;10(3):133–9.CrossRef Johnston C, Gowers S. Routine outcome measurement: a survey of UK child and adolescent mental health services. Child Adolesc Ment Health. 2005;10(3):133–9.CrossRef
14.
go back to reference Bickman L, Kelley SD, Breda C, de Andrade AR, Riemer M. Effects of routine feedback to clinicians on mental health outcomes of youths: results of a randomized trial. Psychiatr Serv. 2011;62(12):1423–9.PubMedCrossRef Bickman L, Kelley SD, Breda C, de Andrade AR, Riemer M. Effects of routine feedback to clinicians on mental health outcomes of youths: results of a randomized trial. Psychiatr Serv. 2011;62(12):1423–9.PubMedCrossRef
15.
go back to reference Carlier IV, Meuldijk D, Van Vliet IM, Van Fenema E, Van der Wee NJ, Zitman FG. Routine outcome monitoring and feedback on physical or mental health status: evidence and theory. J Eval Clin Pract. 2012;18(1):104–10.PubMedCrossRef Carlier IV, Meuldijk D, Van Vliet IM, Van Fenema E, Van der Wee NJ, Zitman FG. Routine outcome monitoring and feedback on physical or mental health status: evidence and theory. J Eval Clin Pract. 2012;18(1):104–10.PubMedCrossRef
16.
go back to reference Boer F, Markus MT, Vermeiren R. Zeg niet: 'Sta stil, anders kan ik je niet meten!' ROM in de kinder-en jeugdpsychiatrie. Tijdschr Psychoanal. 2012;54(2):167–71. Boer F, Markus MT, Vermeiren R. Zeg niet: 'Sta stil, anders kan ik je niet meten!' ROM in de kinder-en jeugdpsychiatrie. Tijdschr Psychoanal. 2012;54(2):167–71.
17.
go back to reference Bickman L, Nurcombe B, Townsend C, Belle M, Schut J, Karver M. Consumer measurement systems and child and adolescent mental health. Canberra, Australia: Department of Health and Family Services; 2000. Bickman L, Nurcombe B, Townsend C, Belle M, Schut J, Karver M. Consumer measurement systems and child and adolescent mental health. Canberra, Australia: Department of Health and Family Services; 2000.
18.
go back to reference van Sonsbeek MA, Hutschemaekers GG, Veerman JW, Tiemens BB. Effective components of feedback from Routine Outcome Monitoring (ROM) in youth mental health care: study protocol of a three-arm parallel-group randomized controlled trial. BMC Psychiatr. 2014;14(1):3.CrossRef van Sonsbeek MA, Hutschemaekers GG, Veerman JW, Tiemens BB. Effective components of feedback from Routine Outcome Monitoring (ROM) in youth mental health care: study protocol of a three-arm parallel-group randomized controlled trial. BMC Psychiatr. 2014;14(1):3.CrossRef
19.
go back to reference Hall CL, Moldavsky M, Taylor J, Marriott M, Goodman R, Sayal K, & Hollis C. Piloting electronic session‐by‐session monitoring in Child and Adolescent Mental Health Services: a preliminary study. Child Adolesc Ment Health. 2014. Hall CL, Moldavsky M, Taylor J, Marriott M, Goodman R, Sayal K, & Hollis C. Piloting electronic session‐by‐session monitoring in Child and Adolescent Mental Health Services: a preliminary study. Child Adolesc Ment Health. 2014.
20.
go back to reference Gavidia-Payne S, Hudson A. Behavioural supports for parents of children with an intellectual disability and problem behaviours: an overview of the literature. J Intellect Dev Disabil. 2002;27(1):31–55.CrossRef Gavidia-Payne S, Hudson A. Behavioural supports for parents of children with an intellectual disability and problem behaviours: an overview of the literature. J Intellect Dev Disabil. 2002;27(1):31–55.CrossRef
21.
go back to reference Green J, Jacobs B, Beecham J, Dunn G, Kroll L, Tobias C, et al. Inpatient treatment in child and adolescent psychiatry–a prospective study of health gain and costs. J Child Psychol Psychiatr. 2007;48(12):1259–67.CrossRef Green J, Jacobs B, Beecham J, Dunn G, Kroll L, Tobias C, et al. Inpatient treatment in child and adolescent psychiatry–a prospective study of health gain and costs. J Child Psychol Psychiatr. 2007;48(12):1259–67.CrossRef
22.
go back to reference Blanz B, Schmidt MH. Practitioner review: preconditions and outcome of inpatient treatment in child and adolescent psychiatry. J Child Psychol Psychiatr. 2000;41(6):703–12.CrossRef Blanz B, Schmidt MH. Practitioner review: preconditions and outcome of inpatient treatment in child and adolescent psychiatry. J Child Psychol Psychiatr. 2000;41(6):703–12.CrossRef
23.
go back to reference Gavidia‐Payne S, Littlefield L, Hallgren M, Jenkins P, Coventry N. Outcome evaluation of a statewide child inpatient mental health unit. Aust N Z J Psychiatry. 2003;37(2):204–11.PubMedCrossRef Gavidia‐Payne S, Littlefield L, Hallgren M, Jenkins P, Coventry N. Outcome evaluation of a statewide child inpatient mental health unit. Aust N Z J Psychiatry. 2003;37(2):204–11.PubMedCrossRef
24.
go back to reference Green J, Kroll L, Imrie D, Frances FM, Begum K, Harrison L, et al. Health gain and outcome predictors during inpatient and related day treatment in child and adolescent psychiatry. J Am Acad Child Adolesc Psychiatr. 2001;40(3):325–32.CrossRef Green J, Kroll L, Imrie D, Frances FM, Begum K, Harrison L, et al. Health gain and outcome predictors during inpatient and related day treatment in child and adolescent psychiatry. J Am Acad Child Adolesc Psychiatr. 2001;40(3):325–32.CrossRef
25.
go back to reference Setoya Y, Saito K, Kasahara M, Watanabe K, Kodaira M, Usami M. Evaluating outcomes of the child and adolescent psychiatric unit: a prospective study. Int J Ment Health Syst. 2011;5(1):1–8.CrossRef Setoya Y, Saito K, Kasahara M, Watanabe K, Kodaira M, Usami M. Evaluating outcomes of the child and adolescent psychiatric unit: a prospective study. Int J Ment Health Syst. 2011;5(1):1–8.CrossRef
26.
go back to reference Scharer K. Nurse‐parent relationship building in child psychiatric units. J Child Adolesc Psychiatr Nurs. 1999;12(4):153–67.PubMedCrossRef Scharer K. Nurse‐parent relationship building in child psychiatric units. J Child Adolesc Psychiatr Nurs. 1999;12(4):153–67.PubMedCrossRef
27.
go back to reference Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatr. 2001;40(11):1337–45.CrossRef Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatr. 2001;40(11):1337–45.CrossRef
28.
go back to reference Van Widenfelt BM, Goedhart AW, Treffers PD, Goodman R. Dutch version of the Strengths and Difficulties Questionnaire (SDQ). Eur Child Adolesc Psychiatr. 2003;12(6):281–9.CrossRef Van Widenfelt BM, Goedhart AW, Treffers PD, Goodman R. Dutch version of the Strengths and Difficulties Questionnaire (SDQ). Eur Child Adolesc Psychiatr. 2003;12(6):281–9.CrossRef
29.
go back to reference Gowers S, Harrington R, Whitton A, Lelliott P, Beevor A, Wing J, et al. Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the Nation Outcome Scales for children and Adolescents (HoNOSCA). The. Br J Psychiatr. 1999;174(5):413–6.CrossRef Gowers S, Harrington R, Whitton A, Lelliott P, Beevor A, Wing J, et al. Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the Nation Outcome Scales for children and Adolescents (HoNOSCA). The. Br J Psychiatr. 1999;174(5):413–6.CrossRef
30.
go back to reference Stinckens N, Ulburghs A, Claes L. De werkalliantie als sleutelelement in het therapiegebeuren: Meting met behulp van de WAV-12, de Nederlandstalige verkorte versie van de Working Alliance Inventory. Tijdschr Klin Psych. 2009;39(1):44–60. Stinckens N, Ulburghs A, Claes L. De werkalliantie als sleutelelement in het therapiegebeuren: Meting met behulp van de WAV-12, de Nederlandstalige verkorte versie van de Working Alliance Inventory. Tijdschr Klin Psych. 2009;39(1):44–60.
31.
go back to reference Vermulst A, Kroes G, De Meyer R, Nguyen L, Veerman JW. Opvoedingsbelastingvragenlijst (OBVL) Handleiding. Nijmegen: Praktikon; 2012. Vermulst A, Kroes G, De Meyer R, Nguyen L, Veerman JW. Opvoedingsbelastingvragenlijst (OBVL) Handleiding. Nijmegen: Praktikon; 2012.
32.
go back to reference Kroll L, Green J. The therapeutic alliance in child inpatient treatment: development and initial validation of a family engagement questionnaire. Clin Child Psychol Psychiatr. 1997;2(3):431–47.CrossRef Kroll L, Green J. The therapeutic alliance in child inpatient treatment: development and initial validation of a family engagement questionnaire. Clin Child Psychol Psychiatr. 1997;2(3):431–47.CrossRef
33.
go back to reference Lamers A, Vermeiren RR. Assessment of the therapeutic alliance of youth and parents with team members in youth residential psychiatry. Clin Child Psychol Psychiatry. 2014. doi:10.1177/1359104514542304. Lamers A, Vermeiren RR. Assessment of the therapeutic alliance of youth and parents with team members in youth residential psychiatry. Clin Child Psychol Psychiatry. 2014. doi:10.​1177/​1359104514542304​.
34.
go back to reference Goodman R, Ford T, Richards H, Gatward R, Meltzer H. The development and well‐being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatr. 2000;41(5):645–55.CrossRef Goodman R, Ford T, Richards H, Gatward R, Meltzer H. The development and well‐being assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatr. 2000;41(5):645–55.CrossRef
36.
go back to reference Rasbash J, Browne W, Goldstein H, Yang M, Plewis I, Healy M, et al. A user's guide toMLwiN. 2nd ed. London: Institute of Education; 2000. Rasbash J, Browne W, Goldstein H, Yang M, Plewis I, Healy M, et al. A user's guide toMLwiN. 2nd ed. London: Institute of Education; 2000.
37.
go back to reference Hall CL, Taylor J, Moldavsky M, Marriott M, Pass S, Newell K, et al. A qualitative process evaluation of electronic session-by-session outcome measurement in child and adolescent mental health services. BMC Psychiatr. 2014;14(1):113.CrossRef Hall CL, Taylor J, Moldavsky M, Marriott M, Pass S, Newell K, et al. A qualitative process evaluation of electronic session-by-session outcome measurement in child and adolescent mental health services. BMC Psychiatr. 2014;14(1):113.CrossRef
38.
go back to reference Shelef K, Diamond GM, Diamond GS, Liddle HA. Adolescent and parent alliance and treatment outcome in multidimensional family therapy. J Consult Clin Psychol. 2005;73(4):689.PubMedCrossRef Shelef K, Diamond GM, Diamond GS, Liddle HA. Adolescent and parent alliance and treatment outcome in multidimensional family therapy. J Consult Clin Psychol. 2005;73(4):689.PubMedCrossRef
39.
go back to reference Ford T, Tingay K, Wolpert M. CORC's survey of routine outcome monitoring and national CAMHS dataset developments: a response to johnston and gower. Child Adolesc Ment Health. 2006;11(1):50–2.CrossRef Ford T, Tingay K, Wolpert M. CORC's survey of routine outcome monitoring and national CAMHS dataset developments: a response to johnston and gower. Child Adolesc Ment Health. 2006;11(1):50–2.CrossRef
40.
go back to reference Hatfield DR, Ogles BM. The influence of outcome measures in assessing client change and treatment decisions. J Clin Psychol. 2006;62(3):325–37.PubMedCrossRef Hatfield DR, Ogles BM. The influence of outcome measures in assessing client change and treatment decisions. J Clin Psychol. 2006;62(3):325–37.PubMedCrossRef
41.
go back to reference Hawkins EJ, Lambert MJ, Vermeersch DA, Slade KL, Tuttle KC. The therapeutic effects of providing patient progress information to therapists and patients. Psychother Res. 2004;14(3):308–27.CrossRef Hawkins EJ, Lambert MJ, Vermeersch DA, Slade KL, Tuttle KC. The therapeutic effects of providing patient progress information to therapists and patients. Psychother Res. 2004;14(3):308–27.CrossRef
Metadata
Title
The use of routine outcome monitoring in child semi-residential psychiatry: predicting parents’ completion rates
Authors
Audri Lamers
Chijs van Nieuwenhuizen
Bart Siebelink
Thijs Blaauw
Robert Vermeiren
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2015
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-015-0049-4

Other articles of this Issue 1/2015

Child and Adolescent Psychiatry and Mental Health 1/2015 Go to the issue