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To ensure the effectiveness and efficiency of the stepped care model of mental health service delivery (Chapter 1) standardised Routine Outcome Measures (ROMs) are systematically taken at every session, informing the IAPT programme Minimum Data Set (MDS; Table 2.2).

Table 2.2

Whilst initially developed to assess the severity of symptoms associated with Generalised Anxiety Disorder (GAD), the GAD-7 (Spitzer et al., 2006) is adopted as the default measure to address severity across the range of anxiety disorders within the IAPT programme. However, when being used for all anxiety disorders, the measure fails to address the key symptoms to target for specific anxiety disorders. This information can inform clinical decision-making (Chapter 4) to target the most distressing symptoms for the patient. Anxiety-related disorder specific ROMs have therefore been recommended to accompany the MDS within the IAPT programme (Table 2.3; NCCMH, 2018).

Table 2.3

Collecting ROMs enables the LICBT practitioner to monitor treatment progress and inform ongoing treatment decisions, supporting ‘self-correction’ within the stepped care model when necessary (Bower and Gilbody, 2005). Furthermore, their use can be effective in enhancing patient outcomes (Shimokawa, et al., 2010) that can be helpful to highlight to patients when introducing ROMs. Within the IAPT programme, analysis of the ROMs also enables services to be monitored centrally to inform programme and organisational efficiency (Richards, 2010a).