Systematic client feedback in therapy for children with psychological difficulties: pilot cluster randomised controlled trial

Abstract

ABSTRACT The use of systematic client feedback tools are known to enhance outcomes in adults psychotherapy clients, but their effects with children have yet to be adequately tested. Hence, we piloted a cluster randomised controlled trial of the Partners for Change Outcome Management System (PCOMS) with children aged 7–11 years old; comparing play-based counselling with, and without, the use of this tool. Ten UK primary schools were randomly allocated to either the intervention or control condition. Data were available for 38 children in total: 20 girls and 18 boys, of predominantly a white ethnic origin (mean age = 8.5 years). Clinical outcomes were the total difficulties scores on the teacher and parent completed Strengths and Difficulties Questionnaire (SDQ). Fifty percent of the schools left the trial between initial recruitment and end of data collection, but participant dropout was low and recruitment rates were satisfactory. Participants in the PCOMS condition showed significantly greater reductions in parent completed total difficulties than those in the control condition, with small to moderate effect sizes on all outcomes in favour of PCOMS. Overall, our design appeared feasible, but needs to ensure adequate school retention and counsellor adherence.