Many children and adolescents experience no improvement or even deteriorating during mental health treatment. Research shows that the most important factor for change in therapy is the therapeutic alliance. This involves a safe and collaborative relationship between patient and therapist, with a shared understanding of treatment goals and approach.
Unfortunately, it is difficult for clinicians to predict who is at risk of worsening or dropping out of treatment. To improve communication and collaboration between children, adolescents, and their therapists, Feedback Informed Treatment (FIT) is used as a feedback tool to monitor change and alliance. The intention is to make early adjustments to achieve the best possible treatment for each patient.
The aim of this study is to investigate the utility of using FIT as part of routine care with children and adolescents, regardless of diagnosis or issues.
FIT consists of two simple forms, the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS), which are completed by the patient at each treatment session. ORS measures the patient's well-being, while SRS assesses the therapeutic alliance. Both forms give the young person an opportunity to provide feedback on whether the treatment feels helpful and whether the therapeutic alliance is good enough.
Through qualitative interviews with children and adolescents in Child and Adolescent Mental Health Services (CAMHS), we will explore their experiences of providing feedback to their therapist. We also want to see if there is a correlation between what children and adolescents report on the ORS in the first session and other measures used to assess mental health (the validity of the ORS).
This project is important because it fills a knowledge gap; there is little research on the use of FIT and other feedback tools among children and adolescents. Most of the research has been done on adult populations. We aim to increase understanding of how to create a good feedback culture and alliance between young patients and their therapists. This knowledge can contribute to better treatment outcomes for this group.
Ph.D.-student: Linda Svorken
Ph.D.-project with collaborating partners: Toril Sørheim Nilsem, Geir Lorem, and Børge Mathiassen (UNN)
A collaborative project with the University Hospital of Northern Norway (UNN) HF.
Project period: 2022-2026
This study was supported by "The National Program for Integrated Clinical Specialist and PhD-training for Psychologists" in Norway. This program is a joint cooperation between the Universities of Bergen, Oslo, Tromsø, The Norwegian University of Science and Technology (Trondheim), the Regional Health Authorities, and the Norwegian Psychological Association. The program is funded by The Ministry of Education and Research.