Total Frequency

Exemplar Core Idea

Initial Motivation

Fit with therapist

Typical (n = 19)

Participant’s clinical orientation and training are CBT, and the instruments that participant used are consistent with CBT theory and practice.

Effectiveness and therapist development

Typical (n = 13)

Participant was initially motivated to use the measure because the measures facilitate skill development without needing to rely on supervision.

Enhancing the role of the client

Variant (n = 11)

Participant was drawn to measures because they allow clients to direct their own therapy.

Gaining objectivity or additional data

Variant (n = 8)

Participant believes it is a strength to be able to also understand client’s experience into a number, something more objective.


Variant (n = 7)

Participant was motivated to use the measures to demonstrate effectiveness with concrete outcome data due to the demands of the field.

Selecting Measures


Variant (n = 11)

Participant preferred the PCOMS because it does not require a lot of time or energy and was quick and efficient.


Variant (n = 8)

Participant thought the PCOMS had good face validity.


Variant (n = 8)

Participant found that the SRS scores were useful because they prompted new conversation with patients.

Maintaining Use

Engaging clients

Typical (n = 18)

Participant continues to use the measure with clients because they have found that clients provide open and direct feedback, providing a rich discussion.

Enhancing the role of the client

Typical (n = 18)

The measures provide a voice to clients, showing them that therapy is about them; it is feedback system, not just a measure.

Improving effectiveness

Typical (n = 15)

Participant has continued to use measure because of an improvement in clinical practice in terms of better understanding and listening to clients.


Typical (n = 15)

Participant found that the measures are not costly in terms of time.

Helps identify issues in therapy

Variant (n = 12)

Participant likes being able to find failures and clinical ruptures before the clients leave the office.

Helps in guiding treatment

Variant (n = 11)

Participant used PM to set goals, develop treatment plans, and specify the focus for therapy collaboratively.

Providing information to a third party

Variant (n = 8)

Participant continues to use the measure because funders and government agencies require proof that they are providing effective treatment.

Helps engage the therapist

Variant (n = 6)

Participant maintains use of the PM because it is a clinical tool that makes the participant focus on being present in the session and keeps them from taking it easy due to fatigue or mood.