From expectation to experience: Therapists' and trainees' perspectives on implementing routine outcome monitoring in a training context.

Abstract

Objective: Routine outcome monitoring is intended to support clinical decision-making, professional development, and evidence-informed practice in psychotherapy. However, limited qualitative evidence exists on how perceptions of this monitoring transform during implementation. This study explored expectations before implementing a routine outcome monitoring system and subsequent experiences among twenty therapists and trainees at a university-based psychotherapy training center.

Method: We employed an exploratory qualitative design, conducted semi-structured interviews before and after implementation, and analyzed them using Consensual Qualitative Research.

Results: We organized findings around five analytical axes: (1) participants reported heterogeneous prior knowledge and abstract initial assessments; (2) anticipated responsibilities became hands-on learning experiences that build long-term competence; (3) anticipated benefits showed continuity with post-implementation experiences while also becoming more specific, alongside organizational benefits that emerged after implementation; (4) some abstract concerns shifted into concrete challenges, including administrative demands, technical limitations, and difficulties integrating outcome data into clinical work; (5) initial preferences were refined into more specific, practice-grounded recommendations.

Conclusion: Implementing routine outcome monitoring gradually reshapes clinical practice and professional roles. Operational and technical obstacles appeared more prominent than attitudinal resistance in limiting implementation. When clinicians embed monitoring into practice with ongoing training and institutional support, this integration strengthens clinical decision-making and professional development.