How Outcome Measures Could Support Transactional Analysts in Clinical Practice to Improve Treatment Trajectories, Manage Risk, Minimise Client Drop-Out Rates and Support Clinical Supervision.

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Carol Remfrey Foote


This article presents a review of the literature on the use of Outcome Measures (OMs) in counselling and psychotherapy. Recent Transactional Analysis (TA) research and literature has focussed on the theory and practice of using Outcome Measures (OM) with clients who present with depression, anxiety, and other mood disorders which support the evidence base for the effectiveness of TA. The use of OMs amongst counsellors, psychotherapists remains low, with time constraints during sessions, and the perception of an increase in the burden of their workload and paperwork. Counsellors and psychotherapists report that clients dislike completing the OMs, they are uncertain over which OMs to use and when, and they have had insufficient training on how to use and interpret OM data. Some counsellors and psychotherapists fear that OMs will interrupt or damage the therapeutic relationship and working alliance. Recent studies estimate that only between 7% and 37% of counsellors and psychotherapists utilise OMs as part of their clinical practice. Research studies have found that many counsellors and psychotherapists overestimate their clinical effectiveness by up to 65% and clients who plateau, deteriorate, and subsequently drop out of treatment are missed. The current research with counsellors and psychotherapists who use OMs confound these perceptions, and corroborate that OMs are; convenient, improve the treatment process and trajectory, engage clients in being able to express themselves and see their progress, support ethical practice, clarifies the clients' strengths and vulnerabilities, supports interpersonal functioning, identifying areas of difficulty or stress, screen for and manage risk. This article will explore these issues and give more depth and detail into the ‘pros and cons’ of OM use in private practice and suggest some practical ways to implement OM theory into clinical practice. 

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Remfrey Foote, C. (2023). How Outcome Measures Could Support Transactional Analysts in Clinical Practice to Improve Treatment Trajectories, Manage Risk, Minimise Client Drop-Out Rates and Support Clinical Supervision . International Journal of Transactional Analysis Research & Practice, 14(2), 3–16.


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