Related Experiment Video
Updated: May 25, 2026

Multimodal Protocol for Assessing Metacognition and Self-Regulation in Adults with Learning Difficulties
Published on: September 27, 2020
[Routine monitoring: the interpretation of graphical feedback inevitably involves subjectivity]
1Sinai Centrum, Joodse Geestelijke Gezondheidszong, Amersfoort. a.hafkenscheid@sinaicentrum.nl
Background:
Most systems for routine monitoring provide therapists with graphical feedback. Many therapists, however, find it extremely difficult to interpret graphs.
Aim:
To increase therapists' awareness that the interpretation of graphical feedback is inevitably a subjective process.
Method:
A single case was analysed in which the objective graphical scores for successive patient-therapist sessions were shown on two monitor instruments. The scores were then compared with the patient's verbal reactions to the scores and score differences.
Results:
The clinical example demonstrates that the interpretation of 'objective' graphical feedback depends on the commentary given by the patient.
Conclusion:
Routine monitoring is a subjective process which does not simply reveal the secrets of treatment processes and outcomes; what it does is to raise the lid of 'the black box' very slightly.
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