Background: Patient Reported Outcome Measures (PROMs) are increasingly being used in Child and Adolescent Mental Health Services (CAMHS). The aim of this research was to explore change in standardized and idiographic outcome measures in CAMHS using naturalistic, routinely collected data. Method: We explored change in psychosocial difficulties and impact on daily life as evaluated by a broad standardized measure, the Strengths and Difficulties Questionnaire (SDQ) (Goodman, 1997, J. Child Psychol. Psychiatry, 38, 581) and progress toward goals as evaluated by a personalized idiographic measure, the Goal Based Outcomes tool (GBO) (Law, 2011, Goals and Goal Based Outcomes (GBOs): some useful information. London: CAMHS Press) in a sample of N = 137 CAMHS attenders. Results: Psychosocial difficulties and impact on daily life showed less change over the course of treatment than progress toward goals in this study. Change in psychosocial difficulties and impact on daily life were also less strongly associated with change in clinician-reported functioning and satisfaction with care at time two than change in progress toward goals. Conclusions: Findings of the present research may support previous studies in which service users and clinicians report that idiographic measures are more capable than standardized measures of capturing relevant change for individuals. Key Practitioner Message• For normative comparison and clinical purposes, it is important to know how to interpret change in standardized and idiographic measures in CAMHS.• Past research suggests that standardized measures (e.g. the Strengths and Difficulties Questionnaire or SDQ) may be less clinically useful than idiographic measures (e.g. the Goal Based Outcome tool or GBO), but more amenable for aggregation and therefore comparing groups of patients.• The SDQ showed less change than the GBO in this study in terms of mean score change and reliable change.• Change captured by the SDQ was less strongly associated with change in clinician-reported functioning and satisfaction with care at time two than change captured by the GBO, and only change in the GBO was uniquely associated with change in clinician-reported functioning over treatment.• Findings of this study suggest that change greater than 2.45 points in the GBO represents reliable change.

The results suggest that goals may capture areas not captured by other normed outcome measures. In particular, goals may capture higher order, underlying factors, such as confidence, resilience, coping, and parenting factors that may not be explored by other measures. The differences across perspectives also link to existing literature suggesting a different focus on treatment based on perspectives and highlights the potential importance when jointly agreeing goals of ensuring the voice of the child/young person is heard and included in goal setting.

In CAMHS, involving both children and parents in decision making may contribute to enhanced treatment outcomes.

Idiographic patient‐reported outcome measures (I‐PROMs) are a growing set of individualized tools for use in routine outcome monitoring (ROM) in psychological therapies. This paper presents a position statement on their conceptualization, use, and analysis, based on contemporary evidence and clinical practice. Four problem‐based, and seven goal‐based, I‐PROMs, with some evidence of psychometric evaluation and use in psychotherapy, were identified. I‐PROMs may be particularly valuable to the evaluation of psychological therapies because of their clinical utility and their alignment with a patient‐centered approach. However, there are several challenges for I‐PROMs: how to generate items in a robust manner, their measurement model, methods for establishing their reliability and validity, and the meaning of an aggregated I‐PROM score. Based on the current state of the literature, we recommend that I‐PROMs are used to complement nomothetic measures. Research recommendations are also made regarding the most appropriate methods for analyzing I‐PROM data.