Abstract:
Problem: In recent decades there has been growing concern about the ability of mental
healthcare services to demonstrate their value. The primary purpose of this quantitative
study is to advance the client-focused research paradigm for improving quality and
efficiency in the provision of psychotherapy services by investigating the use of
outcomes measures by Licensed Marriage and Family Therapists (LMFTs) in Iowa.
Secondary purposes of the study are to collect basic demographic and practice data on
LMFTs in Iowa and to examine the relationships between LMFTs' use of outcome
measures and demographic and practice variables.
Procedures: Paper surveys were mailed to all 174 LMFTs in the state ofIowa. Addresses
were obtained from the Iowa Department of Public Health's Bureau of Professional
Licensure. A self-report survey instrument, LMFT Outcomes Survey, was created for
this study. An initial mailing with cover letter and survey was followed up with a
reminder postcard sent two weeks later. A 52.3% response rate was achieved.
Findings: Sixty-four percent of the active therapists in the sample reported utilizing 80
different outcome measures with 70% of their clients to assist in assessing client
outcomes. Five percent of active therapists report continuous use of outcome measures in
routine practice, with Partners for Change Outcome Management System's Outcome
Rating Scale and Session Rating Scale outcome measures being utilized the most. No
significant relationships were found among demographic and practice variables and
LMFTs' use of outcomes measures.
Future Research: While therapists are using outcome measures consistently, they are not
using them with every client over the course of treatment. Future research questions
could include: (a) What is occurring with the clients/cases for whom outcome measures
are not utilized? and (b) more clinically focused questions, such as, How is the use of
outcome measures aiding the client? Additionally, exploring therapist training received in
master's degree programs or in on-going supervision settings and examining workplace
requirements could yield useful information, illuminate current practice, and perhaps
accelerate the adoption of a scientific-practitioner mindset with regard to measuring
outcomes.
