The Ethical Implications and Utility of Routine Outcome Monitoring in Determining Boundaries of Competence in Practice

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Abstract

Routine outcome monitoring (ROM) involves the implementation of standardized measures, usually on a session-to-session basis to monitor treatment progress and alert clinicians when clients are not responding as expected. A growing body of research suggests that ROM is an effective method for enhancing the effectiveness of treatment (Lambert et al., 2003; Miller, Hubble, Chow, & Seidel, 2015); however, the utility of ROM data as an additional source of information in determining issues of competence have not been fully addressed. Commonly, boundaries of competence are determined based on previous education, training, and supervised experience, however these methods may be limited as experience may not equate to clinical effectiveness and therapists’ self-appraisal of their competence is often biased. In this paper, we provide a brief overview of ROM, and argue for the utility of ROM as an additional method for determining boundaries of competence and enhancing ethical decision-making. We provide a clinical example to illustrate the utility of ROM in ethical decision-making. Limitations and future recommendations for the utility of ROM in ethical decision-making are addressed.

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