My usual pedantry that we should be very careful about the word “outcome” here and that I’d prefer “assessment” or “change”. However, “outcome” is the dominant term and these are exactly what they say: measures, metrics, based on observation of the client.
Details #
These are particularly important where the client may be unable to speak or have very limited communication perhaps as a result of learning/intellectual difficulties. They’re also important when trying to reach issues of which the client might be unaware or perhaps motivated to give a report may “fake good” or “fake bad”. The literature on those terms comes mainly from the forensic realm where there may be very good reason to believe that clients may want to manage how they are perceived in ways that conceal their internal states.
However, I suspect that even outside the forensic realm and in very routine psychosocial interventions we should probably have much more thoughtfulness about clients having conscious, semi-conscious or frankly psychoanalytically unconscious tendencies to minimise or to exaggerate problems or positives. A client may believe that they may be refused therapy if their initial score on a problem oriented measure is too low and may amplify their problems in their responses. Sadly, in some services the client may be quite correct in suspecting that too “normal” a score may result in no offer of therapy. At the end of therapy a client might also believe that scoring “unwell” might prolong the therapy or may want to reward a pleasant but not terribly effective clinician by reporting that they are in a much better state than they really are.
Whether observer rated, or clinician rated measures can really help manage these possibilities has, as far as I have seen, never been explored and standardising observer rated measures sufficiently to minimise inter-rater disagreement/unreliability is also unclear.
Try also #
- Clinician-reported outcome (ClinRO) measures (ClinROMs, CROMs)
- Inter-rater reliability
- Interview measures
- Patient/client-reported outcome (PRO) measures (PROMs)
- Performance outcome (PerfO) measures (PerfOMs, POMS)
- Reliability
- Self-report measures
Chapters #
Not covered in the OMbook.
Online resources #
None forseeable.
Dates #
First created 4.i.25, links tweaked 5.i.25.
