There has been a long-standing need in the field of psychotherapy to document progress and show effectiveness. The evidence-based practice (EBP) movement has had considerable influence in the field of psychology as evidenced by the APA task force that adopted the stance of evidence-based practice in psychology (EBPP) to ensure quality and accountability for psychological services as well as the integration of science and practice. One of the primary components of EBPP is the use of routine outcome measures (ROMs), which seek to integrate research with practice while simultaneously documenting progress and enhancing treatment. Despite the wave of ROM in the field, implementation rates have remained low. Research has brought forth many practical and philosophical concerns of therapists using these measures in routine practice including time burden and local validity. The Clinically Adaptive Multidimensional Outcome Survey (CAMOS) was created to directly address clinicians' concerns with a specific focus on concerns of local validity. The CAMOS was designed to monitor several dimensions of functions, thus covering a wide range of issues. In this study the item pool proposed for the CAMOS was factor analyzed, and acceptable fit was found for a 6-factor model that contained 42 items. The 6 factors include (a) psychological distress, (b) relationship distress, (c) therapy expectations, (d) spiritual distress, (e) physical health distress, and (f) work/school distress. It is of note that spirituality emerged as a distinct factor with this data set and the implications and applications are discussed. With this multidimensional foundation, clinicians could more flexibly use the CAMOS to increase local validity. Clinical applications and future directions are discussed.



College and Department

David O. McKay School of Education; Counseling Psychology and Special Education



Date Submitted


Document Type





outcome measure, clinically adaptive multidimensional outcome survey, camos, evidence based practice, spirituality, research-practice gap