ABSTRACT
Introduction
Practitioners implementing Routine Outcome Measures (ROMs) and Clinical Feedback Systems (CFS) in counselling and psychotherapy commonly encounter challenges due to the complex nature of therapeutic practice contexts. Healthcare systems have increasingly adopted ROM driven by policy demands for accountability, quality improvement and evidence-based practice. Studies indicate the need for a comprehensive scoping review to fully elucidate the experiences of effective ROM, thereby bridging the gap between research evidence and the numerous contextual factors influencing real-world adoption.
Objectives
This research aimed to inform guidelines by identifying the evidence for ROM/CFS effectiveness, clarifying key implementation factors, examining lived experiences of clients, practitioners and other stakeholders’ perspectives. The study also aimed to gain insights into how research is conducted across diverse contexts and modalities, and identify gaps in knowledge regarding barriers and facilitators to successful adoption.
Method
A five-stage scoping review protocol was operationalised to explore and analyse the existing literature and associated implementation factors by (a) identifying the research questions using the PICOT framework, (b) identifying the relevant literature through systematic database searches, (c) selecting the studies through four-phase consensus screening, (d) charting the data using structured extraction methods and (e) collating, summarising, and reporting the results through narrative synthesis.
Results
The findings highlight the need for culturally responsive approaches, the development of organisationally informed strategies for ROM adoption and reveal significant gaps in research regarding the optimal integration across diverse therapeutic contexts.
Conclusion
The findings support the proposal of evidence-based ROM frameworks and key themes for future research, including culturally informed approaches, organisational leadership development, digital equity considerations and therapeutic process integration, moving away from purely compliance-based mandates toward contextually responsive, engagement-focused implementation strategies.