The positive and negative effects of routine outcome monitoring (ROM) for traumatised refugees and asylum seekers

Abstract

Routine outcome monitoring (ROM) is a method to systematically collect data about symptoms and treatment effects with the use of mental health questionnaires. This method is hardly being used with traumatised refugees and asylum seekers out of fear for a possible negative impact. The aim of this study was to examine whether there is an impact of ROM, both negative and positive, for this population. Data from 18 refugees with PTSD, 29 non-refugees with PTSD and 17 mental health patients without PTSD (comparison group) were collected directly before ROM, after ROM and after one week. ROM was implemented for all participants and both qualitative and quantitative methods were used to examine a negative impact (distress, identification with the traumatic experiences and PTSD symptoms) and positive impact (pleasure and positive experiences). The results showed that there was a significant quadratic trend in time in distress which did not differ between the groups. However, the refugees group showed a significant increase in distress over time, while the non-refugees group showed a significant decrease over time. No effect was found for identification and PTSD symptoms. The comparison group scored significantly lower on distress and burden of the ROM, but also scored significantly lower on positive effects at follow-up. According to this study, the ROM has both a negative and positive impact for traumatised refugees and asylum seekers. The negative impact might be restricted to an increase in distress, the positive impact can be attributed to a warm and respectful attitude from the clinician.