Attitudes of Psychotherapists Toward Outcome Measures and Routine Outcome Monitoring in Child and Youth Psychotherapy

Background: In psychotherapeutic treatment, Outcome (OM) and Routine Outcome Monitoring (ROM) are highly recommended for the data-driven personalization of psychotherapeutic interventions. OM/ROM have proven particularly effective in identifying nonresponders and patients at risk of deterioration. However, OM and ROM remain insufficiently implemented in the field of child and adolescent psychotherapy. Their implementation and effectiveness are affected by the attitudes of psychotherapists toward OM/ROM. While several studies have examined the attitudes of therapists working with adults, little is known about which characteristics of psychotherapists working with children and adolescents influence their attitudes toward OM/ROM. In addition, research on specific facilitators of and barriers to implementation in this field is still limited. Objective: In this observational study, we investigated which therapeutic characteristics affect the attitudes of psychotherapists working with children and adolescents toward OM and ROM and how implementation is affected by previous experience and attitudes toward administering OM/ROM. Methods: Attitudes toward the OM/ROM of licensed German psychotherapists and psychotherapists in training working with children and adolescents were assessed in an online survey conducted between June 2023 and March 2024 (N = 126). Results: Compared with psychoanalytic-oriented therapists, therapists with an orientation in Cognitive Behavioral Therapy (CBT) presented more positive attitudes (d = 1.88), but no significant difference was found between orientations in CBT and Psychodynamic Psychotherapy. Therapists working in institutionalized outpatient settings reported more positive attitudes than those working in private practices did (d = 0.88). No effect of previous experience in administering OM/ROM was found for either implementation barriers or facilitators; however, the results suggest that therapists administering pre-post evaluations expect more support in clarification processes than ROM administration currently provides. In addition, more positive attitudes toward OM/ROM are associated with higher expectations regarding both support in therapeutic processes and support in clarification. Conclusion: OM/ROM systems should consider assessing concepts from different psychotherapeutic orientations. The implementation of OM/ROM could benefit from close monitoring.