In routine outcome monitoring (ROM), the rate and timing of treatment failure alerts has been related to the success of feedback in past randomized clinical trials. In a recent OQ-45 feedback study, Burlingame and colleagues (2018) found that the rates and timing of not-on-track (NOT) progress alerts in group treatment were different than those reported for individual treatment. Using data from 58 different therapy groups and 374 patients, NOT progress alerts occurred at 186% of the rate reported by Shimokawa et al. (2010) when they examined over 6,000 patients receiving individual therapy at the same clinics. Another significant difference was found on the timing of the first NOT progress alerts with group treatment's first alerts occurring two sessions later than individual treatment. The goal of the current study was to use de-identified archival OQ-45 data from patients receiving group and individual treatment at a comparable clinic to determine if these rate and timing differences were replicable. Data from individual therapy (N = 5,493) and group therapy (N = 146) patients' OQ-45 scores show that the present study duplicated the significant difference found in the rate of NOT alerts between these formats. Relative risk of alerting as NOT at least once in group therapy was calculated to be 1.43 compared to individual therapy (group patients are 143% more likely to alert than individual patients). On the other hand, the present study did not find a significant difference in the timing of first alerts between formats. The implication of these results are significant when considering ROM in group therapy. Patients participating in group therapy are much more likely to flag as not-on-track later during the course of treatment when compared to patients in individual therapy.



College and Department

Family, Home, and Social Sciences; Psychology



Date Submitted


Document Type





routine outcome monitoring, group therapy, individual therapy, differential efficacy