Therapists’ and patients’ experiences of using patients’ self-reported data in ongoing psychotherapy processes—A systematic review and meta-analysis of qualitative studies

Abstract

Objective: Using patient-generated quantitative data in psychotherapy (feedback) appears to enhance treatment outcome, but there is variability in its effect. Different ways and reasons to implement routine outcome measurement might explain such variability. The goal of this review is to address the insufficient knowledge on how these data are used by therapists and patients. Methods: The present study is a systematic review and meta-analysis of qualitative reports of therapists’ and patients’ experiences using patient-generated quantitative data during ongoing psychotherapy. Results: Four main categories of use were identified: (1) uses of patients’ self-reported data as nomothetic/objective markers for assessment, process monitoring, and treatment planning; (2) intrapersonal uses that enhance self-awareness, initiate reflection, and influence patients’ mood or responses; (3) uses that prompt interactional processes by facilitating communication, supporting exploration, creating ownership in patients, changing treatment focus, enhancing therapeutic alliance, or disturbing the psychotherapy process; and (4) patients responding for specific purposes due to uncertainty and interpersonal motives, or strategic responding to achieve a desired result. Conclusion: These results demonstrate that patient-reported data, when used in active psychotherapy, is very clearly not just an objective measurement of client functioning: the inclusion of patient-data has the potential to influence psychotherapy in numerous ways.