Treatment success or failure? Using a narrative interview to supplement ROM

Although routine outcome monitoring (ROM) has been demonstrated to improve therapy efficiency and effectiveness, categorizations of improvement or deterioration using ROM measures (typically global symptoms) may not always be consistent with the lived experience of the client. A recent line of investigation examines these discrepancies and recommends supplementing ROM with additional measures or narrative interviews. In this case study, we use qualitative analysis of a posttreatment interview to specifically examine the client's perspective of discordant outcome when ROM indicated that the client deteriorated during treatment and the client reported retrospective improvement. We find that the interview provides a unique and helpful narrative perspective that supplements ROM. Findings suggest it may be useful to supplement ROM with approaches that extend beyond global symptom measurement and that outcomes from aggregated patient-focused research may be more complex than anticipated.