Outcome Rating Scale Scores and Long-term Follow-up Outcomes

Objective: Routine outcome monitoring (ROM) is a well-evidenced means of improving psychotherapy’s effectiveness. However, it is unclear how meaningful ROM is for problems that span physical and mental health such as severe health anxiety. Physical and mental health comorbidities are common amongst severe health anxiety sufferers and cognitive behavior therapy (CBT) is a recommended treatment. Method: Seventy-eight participants received CBT for severe health anxiety in a clinical trial. The Outcome Rating Scale (ORS: a brief ROM assessment of general wellbeing) was completed at each session. Multilevel modelling assessed whether last session ORS score predicted health anxiety and other outcomes over 12-month follow-up. Sudden gainers on the ORS were compared to the remainder to assess whether they improved more long-term. Results: Last session ORS scores predicted all health outcomes up to 12 months later, irrespective of the number of sessions attended. Sudden gainers on the ORS reported significantly greater improvement in generalized anxiety, somatic symptoms, depression, and functioning, but no difference in health anxiety or other measures. Conclusion: The ORS may be a feasible, overall estimate of health, functioning and quality of life in psychological treatment for severe health anxiety. Sudden gains on the ORS may be clinically meaningful with respect to some long-term outcomes.