In the last several years, considerable progress has been made in treatment outcome monitoring (TOM) in psychotherapy. Numerous instruments have been developed to assist practicing psychotherapists in assessing the impact of their services, and several clinical tools have been developed to directly improve the quality of services provided. As a field, we have begun to view these outcome monitoring and feedback systems with increasing confidence as evidence accrues to support their efficacy. In this paper we examine the types of errors that may occur in making inferences in TOM, in particular the determination of whether change in psychological symptoms is occurring, has occurred, or not. We examine this as any other empirical question, using the classic hypothesis-testing framework to describe two types of errors in decision-making. In particular, we discuss the strengths and vulnerabilities of two prominent assessment strategies in TOM (general and multidimensional measurement) in order to minimise inferential errors and maximize the effectiveness of outcome monitoring efforts. Finally, we provide a few examples of new developments that make use of multidimensional measurement to minimise Type II errors to improve outcomes.
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