Studies have shown a concerning and disproportionate amount of treatment failure and premature termination in youth populations. Routine measurement feedback has been proposed as a means to prevent treatment failure and premature termination for adults and may also improve youth mental health services. However, studies examining helpfulness of measurement feedback systems in youth populations have demonstrated a lack of effects more likely due to poor measurement implementation than to the measurement feedback system itself. Because contexts within the service settings are such crucial factors in whether an innovation is successfully implemented, examining barriers and facilitators in said contexts is a necessary step towards improving implementation for the ultimate purpose of improving youth mental health services. The present study explored barriers and facilitators to the implementation of the Youth Outcome Questionnaire (Y-OQ) and Treatment Support Measure (TSM) in youth routine clinical care. Thirteen staff of varying job titles, experiences, education and opinions towards measures were interviewed using consensual qualitative research (CQR) methods. Results were similar to previous studies, indicating multilevel barriers and facilitators to measurement implementation such as at the organization, staff, client and measure level. Using CQR data analysis, domains, categories and subcategories along with level of frequency are displayed and discussed in further detail. In addition to barriers and facilitators, interviewees provided recommendations for how to improve implementation of measures within their organization. Researchers provide recommendations of continued communication, re-assessment of barriers and facilitators over time and shared responsibility between stakeholders and professionals invested in improving youth mental health services.



College and Department

Family, Home, and Social Sciences; Psychology



Date Submitted


Document Type





implementation, youth mental health services outcomes, Youth Outcome Questionnaire, Treatment Support Measure, qualitative methods