A Systematic Review and Meta-Analysis of Measurement Feedback Systems in Treatment for Common Mental Health Disorders

Adm Policy Ment Health. 2023 Mar;50(2):269-282. doi: 10.1007/s10488-022-01236-9. Epub 2022 Nov 25.

Abstract

To investigate the effects of measurement feedback systems (MFSs) in therapy on mental health outcomes through a literature review and meta-analysis. Using a three-level modeling approach, we conducted a meta-analysis of all effect sizes from randomized controlled studies of MFSs used in the treatment of common mental health disorders. Eighty-two effect sizes were extracted from the thirty-one included studies. Analyses were performed to consider the post-treatment effects of the MFS-assisted treatment compared to treatment as usual. A separate analysis was done for the subgroup "not-on-track" patients as it is theorized that MFSs will be clinically useful because they make therapists aware of patients who fail to progress. MFSs had a significant effect on mental health outcomes (d = 0.14, 95% CI [0.082-0.206], p < .001). Further analysis found a larger effect in patients identified as less respondent to therapy, the "not-on-track" group (d = 0.29, 95% CI [0.114, 0.464], p = .003). Moderation analyses indicated that the type of outcome measurement and type of feedback system used, and whether it was used for a child and youth or adult population, influenced effect sizes. MFSs seem to have a small positive effect on treatment outcomes. The effects seem to be larger for "not-on-track" patients, the group of patients that would usually not benefit much from treatment.

Keywords: Measurement feedback systems; Meta-analysis; Outcome monitoring; Psychotherapy; Three-level analysis.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Feedback
  • Humans
  • Mental Disorders* / psychology
  • Mental Disorders* / therapy
  • Mental Health*
  • Treatment Outcome