Do clinicians really use feedback-monitoring systems? A qualitative analysis of 16 group leaders.

Abstract

The use of feedback based on outcome and process measures to inform treatment is gaining ground as one form of evidence-based treatment. However, little is known regarding how therapists actually use feedback, particularly from process measures, to affect treatment. This two-part qualitative study used session-by-session and treatment-episode narratives from group therapists to define how they acted on process feedback from a member-completed measure of the therapeutic relationship: the Group Questionnaire (GQ). Therapists' responses in the first wave of data were also used to develop a therapist-completed measure to quantify how feedback affected treatment. Sixteen group leaders received weekly session feedback reports on group members' responses to the GQ from the preceding group session. Leaders explained how they used that feedback in two ways: (a) with session-by-session written descriptions of feedback use and (b) with end-of-semester debrief interviews in which leaders described their experience with the feedback over the course of an entire group treatment episode. A content analysis of leader descriptions was undertaken by two independent pairs of raters to determine whether common patterns of use could be uncovered. Thirteen common use categories emerged across the two rater pairs. A 7-item questionnaire reflecting the most frequently used categories of use completed at the end of group treatment was shown to be highly correlated with session-by-session leader narrative. Implications of the common use patterns across therapists, variability between therapists, and the potential of the 7-item questionnaire are discussed. (PsycINFO Database Record

The effects of relationship and progress feedback in group psychotherapy using the Group Questionnaire and Outcome Questionnaire–45: A randomized clinical trial.

“…Leaders compete each item using a 6-point Likert scale to estimate the percentage of sessions each item was used (0 ϭ 0%, 1 ϭ 1%-19%, 2 ϭ 20%-39%, 3 ϭ 40%-59%, 4 ϭ 60%-79%, 5 ϭ 80%-100%). Group leaders were asked to complete a GQUQ at the end of each feedback group to assess overall pattern of use at a group level (see Whitcomb, Woodland, & Burlingame, 2018).…”

Alliance Rupture Detection and Repair in Group Therapy: Using the Group Questionnaire--GQ

“…These trainings revealed group leader preference for therapeutic relationship measures over outcome (Strauss et al, 2008). More recently, Whitcomb et al (2018) conducted a qualitative analysis of the case notes created by 16 group leaders describing how they used MBC systems. Even though group leaders received both outcome and relationship MBC reports, nearly all of their qualitative comments focused on how they used the relationship measures to plan interventions and track how these interventions impacted subsequent sessions.…”

“…Third, there is no single way for a leader to use GQ feedback. Whitcomb et al (2018) studied how 16 group leaders at three outpatient clinics used GQ feedback, and there were considerable differences. Some group leaders preferred the GQ over the OQ and carefully reviewed it before the group.…”

A Primer for the Use of Multilevel Models in Couple and Family Therapy Research

“…Trauma. Individual psychotherapy literature suggests that postsession feedback about progress and alliance is most useful for clients who are at risk for drop-out (Whitcomb, Woodland & Burlingame, 2018). They define risk as severity of symptoms.…”

“…There are several software programs that perform MLM including SPSS, SAS, STATA, HLM, and Mplus. The examples will be analyzed using Mplus 8.2 (Muthen & Muthen, 1998-2018, and HLM 7.03 (Raundenbush, Bryk, Cheong, Congdon, and Toit (2011); the full syntax for the models can be found in the appendices).…”