Idiographic patient reported outcome measures (I‐PROMs) for routine outcome monitoring in psychological therapies: Position paper

Abstract

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.

Working with Goals and Trauma in Youth Mental Health

“…Seeking to uncover and understand a young person’s wishes, desires, hopes, and intentions—or in short, their goals—are fundamental to both mentalization and SDM. The GBO tool, is a client-defined feedback tool [ 34 ] or ideographic patient-reported outcome measure (I-PROM) [ 35 ] developed to help facilitate collaborative goal-oriented conversations, set goals with the client, and to help track progress towards goals. In turn, this can facilitate further collaborative goal-oriented conversations [ 34 ].…”

“…Using tools such as the GBO is a signal of interest in the client’s intentional states, where the client has an experience of being mentalized by the therapist, which opens a possibility of building trust, breaking down the wall of mistrust, and allowing a space where adaptation and learning can begin. I would argue strongly that this process of goal-oriented practice is the primary purpose that underpins the value of all client-defined feedback tools and I-PROMs [ 35 ] such as the GBO. The aim of the GBO tool is to remind the practitioner of the fundamental need to seek to understand the client’s hopes and wishes, and to remind them to show interest in the client’s intentional mind [ 34 ].…”

Goals Form: Reliability, validity, and clinical utility of an idiographic goal‐focused measure for routine outcome monitoring in psychotherapy

“…Given this specification-that items on the Goals Form may be formative as well as reflective-we believe, as with Sales et al (2022), that only tests appropriate to both models should be used for validating I-PROMs. While our analysis of the Goals Form, therefore, is based on Elliott et al's (2016) framework for examining the psychometric properties of an I-PROM (the Personal Questionnaire), we do not present data on internal consistency and dimensionality (Edwards & Bagozzi, 2000).…”

Test–retest stability, convergent validity, and sensitivity to change for the Goal‐Based Outcome tool for adolescents: Analysis of data from a randomized controlled trial

“…Conversely, the strength of idiographic measures lies in their ability to provide clinicians and researchers with the capacity to focus on the individual and their needs, wants, and aspirations. In this respect, I-PROMs are more consistent with a constructivist epistemology, whereby an individual's goals or problems are understood in terms of their own lived experiences (Sales et al, 2022). However, idiographic measures have been criticized for not being able to operate as population-level indicators of outcomes due to the individualized nature of the indicators set.…”