"I want to know what it is used for": Clients' perspectives on completing a routine outcome measure (ROM) while undergoing psychotherapy.

Objectives: Within mental health care, the use of routine outcome measure (ROMs) has increased. So far, clients' perspectives on ROMs in the context of long-term psychotherapy remain largely unexplored. The present study aimed to explore clients' perspectives on completing the CORE-OM throughout psychotherapy. Method: Eight clients attending a psychiatric outpatient clinic in Sweden were interviewed and the data were analyzed according to the principles of interpretative phenomenological analysis. Results: The results included three main themes. The clients described an uncertainty of the purpose and usage of the CORE-OM, which gave room for interpretations regarding possible consequences of the results. The theme self-reporting in a relational context describes the clients' reflections about the CORE-OM, both as a measure and as a means for communication requiring continuous feedback. The CORE-OM as part of the treatment indicated that completing the questionnaire was useful for clients by evoking feelings and increasing awareness of inner states. Conclusions: ROMs should be used with great care in the treatment process and openness about the purpose of the instrument might increase the validity of the results. The use of ROMs as both an outcome measure on group level and a therapeutic tool is discussed.