There are so many reasons why establishing a robust PROMs pipeline would be beneficial for your practice.

Here are the top ten:

1. Clients leaving therapy prematurely

Clients drop out of therapy for a variety of reasons, but the most common is lack of progress. They don’t feel better and lose confidence in their therapist as a result. Why spend hard-earned-money on something that isn’t providing any relief, right?

The problem is that many therapists DON’T KNOW that this is the case—until clients leave. That’s because clients don’t know how to tell them. They may like the therapist and not want to hurt their feelings. They may struggle with confrontation or be high on trait agreeableness. It’s common for a client who smiles and nods in session to disappear overnight without a word of warning.

You avoid this pitfall when you administer outcome measures on a routine basis. This bypasses the issue of clients needing to “find the right words”, because lack of symptom relief will be reflected in persistently high scores and severity ranges.

Therapists can simply raise this fact with clients in an easygoing manner, so that both can pivot—and begin making real inroads. At Measurely, every outcome measure assessment is accompanied by a prompt asking clients for written feedback—providing an additional check on progress.

Overlooking risk markers

In the same way that clients often avoid telling therapists about a lack of improvement—they often avoid disclosing thoughts, feelings and behaviours that place them at risk. It can be awkward to bring up suicidal ideation with your therapist—especially if you don’t yet know them well. There remains considerable stigma around this topic.

If clients are vulnerable, are socially anxious, or high on effacing personality traits—it is unlikely that they will proactively discuss their suicidal thoughts. Rather, they’ll wait for the therapist to ask the right question…which often never comes. There is an entire literature devoted to the topic of how risk markers get overlooked in clinical settings.

Don’t become a part of these statistics. Many PROMs contain items that ask patients specific questions about their risk of self-harm or harm to others. At Measurely, endorsement of a red-flag item will lead to immediate notification of the treating clinician.

This isn’t to say that PROMs represent a complete risk-assessment strategy—they certainly don’t. But they can cover a lot of bases, and become a screening entry-point into more comprehensive risk assessment.

Missing the presence of a diagnosis

Therapists differ in terms of their views on diagnosis. Some view it as essential—others, as a stigmatising form of labelling that is best avoided. Whatever your opinion happens to be, it’s best to cover yourself by recording diagnostic information about a client based on objective criteria, whenever such information arises.

Many PROMs have empirically validated cutoff-scores for the full-scale or subscales—which reliably indicate the likely presence of a diagnosis. For example, research examining the PCL-5 has shown that scores between 31-33 are optimal for diagnosing Post-traumatic Stress Disorder (PTSD; Bovin et al., 2016).

Underestimating symptom severity

Similarly, due to a range of biases, clinicians often underestimate the severity of their clients’ symptoms. They neither record this information in an objective way, or use it to adjust the therapeutic approach. Many PROMs have well-established symptom severity ranges for obtained scores. At Measurely, where such ranges are missing—we use clinical and normative means and standard deviations to describe symptom severity.

Poor team morale

Feedback is a precondition for motivation and confidence. People feel good about their fitness and health progress when they are able to visually monitor outcomes like their levels of stress, sleep, activity and calorie intake. Treatment outcomes—when skilfully used—can facilitate a team culture that is transparent, caring, close-knit and strong in motivation.

Losing team members

Therapists leave when they don’t enjoy their work. Non-enjoyment of work can be the result of many factors—but is often related to therapeutic burnout, imposter syndrome and perceived ineffectiveness. PROMs and treatment outcomes are an important key to the solution here.

Administrative overwhelm

When administrative tasks get missed and their is a backlog, both practitioners and clients are at risk. Negative outcomes emerging from the audit of a practitioner (e.g. by AHPRA or Medicare)—usually result from that individual being experiencing administrative overwhelm.

They have had too much on their plate, and have failed to maintain the necessary practice standards. Missed follow-up assessments are a common source of stress for practitioners, and increase the probability of complications later on.

Referrer disillusionment

Referrers are busy, but they do pay attention to outcomes. When referrers receive no objective indication that patients are benefiting from therapy, they stop referring to the treating practitioner.

By contrast, positive outcomes can result in an expanding volume of new patients sent to that practitioner. Impress referrers and grow your practice by providing concrete, visually-appealing evidence of treatment success.