(PS9-A11) Evaluating Attendance and Adherence to Routine Outcome Monitoring (ROM) in Anxiety and Non-anxiety Clients in a Community Mental Health Clinic

Routine outcome monitoring (ROM) utilizes standardized, continuous measurement to aid the therapeutic process (Cooper et., 2021, Scott & Lewis, 2015). ROM has been shown to decrease dropout and improve treatment outcomes (Lambert, et al., 2018). A majority of clients seen for outpatient mental health treatment have an anxiety disorder; However, anxiety clients are the least likely to regularly attend  sessions after their initial intake  (Satana & Fontenelle, 2011). ROM utilization and compliance for anxiety clients has yet to be examined and may be a useful practice in facilitating treatment attendance and adherence. 

Participants were from a community-based psychology training clinic which utilizes ROM. They were divided into anxiety clients (n = 40) and non-anxiety clients (n = 40) based on DSM-5 criteria and a semi–structured interview (e.g, ADIS). Non-anxiety clients were matched based on age and gender. Clients in the anxiety group varied in age from 19-58 (M = 28.85; SD = 11.5), a majority were female (n = 22, 55%) and were primarily white (n = 31, 77.5%). Clients in the non-anxiety group varied in age from 18-59 (M = 28.8; SD = 10.56), a minority were female (n = 18, 45%) and were primarily white (n = 34, 85%). Attendance was calculated by dividing total session number by weeks in therapy. ROM compliance was calculated by dividing the number of times clients completed measures by the total number of sessions. 

Completion rate for ROM was significantly higher in the anxiety group (M =.903, SD =.136) compared to the non-anxiety group (M =.801, SD =.234), t(78) =2.32, p = .003. Interestingly, attendance rate was not significantly different between the anxiety group (M =.722, SD =.191) and the non-anxiety group (M =.685, SD =.193), t(78) =.863, p = .939. Total session number was not significantly different between the anxiety group (M =25.1, SD =.18.59) and the non-anxiety group (M =22.85, SD =17.64), t(78) =.555, p = .677. 

Findings indicate that anxious clients adhered better to outcome measure completion relative to non-anxious clients, and there was no difference in attendance rate or total session number. Hence, ROM measures may be useful in treating anxiety clients with poor attendance rates by filling in gaps from missed sessions, offering additional insight, and tracking themes to identify potential triggers impacting attendance. Future research should seek to replicate these findings in a larger, more diverse, sample and explore influences of the therapeutic relationship on ROM adherence and session attendance.