Improving Outcomes in Social Services Through Routine Outcome Monitoring and Systematic Client Feedback

Official title

Empowering Clients, Preventing Dropout and Improving Outcomes Through Routine Outcome Monitoring and Systematic Client Feedback in Social Services

Overview

In this project the investigators want to test whether a new method FIT (Feedback informed treatment) can improve the interventions people receive through social services. The FIT method involves regularly providing information about how the client think things are going and what the client thinks about the help and care they receive.

Detailed description

A randomized controlled trial conducted in social services' outpatient care, addiction care and in residential treatment. In addition to direct effects of using FIT (Feedback informed treatment), cost-effectiveness, instrument psychometrics and predictive value will be examined. The project include outcome measures for quality of life, behavior and symptoms which have been selected in collaboration with representatives of the users (social workers and clients). The project will also examine both clients' and social workers' experiences of giving and receiving feedback using FIT, as well as examine factors that influence implementation within social services.

Social services have an ambition to use evidence based practice, but there is a lack of methods that can help social workers and the social service to systematically follow and adapt the interventions based on the clients' situation, context and preferences. FIT is an internationally proven system for doing this. If findings of the current project are positive, it can be spread within social services through an existing network of practitioners and with existing digital tools.

Participating units with experience and interest in FIT will be recruited in collaboration with the Swedish FIT network and with already engaged municipalities and treatment units. The project will ensure that participating social workers have sufficient skills and that their workplace is ready to work with FIT. Clients who are granted treatment at the unit will be asked if they want to be included in a study where they can give feedback on the interventions they receive and help to follow their progress. After baseline, they will be randomized to treatment as usual or treatment with the addition of FIT. To support implementation, the therapists in the FIT group will be offered regular supervision.

Interventions

• Behavioral Feedback informed treatment (FIT)
  Consists of digital or paper tools that systematically collect feedback from the client and presents this to counselor or therapist. However, FIT is more than a collection of measures: an approach, both on the part of the social worker and on the part of the organization, where feedback from the client is actively sought and welcomed, and support of flexibility that interventions can be changed during the treatment period to prevent a negative outcome.
• Behavioral Treatment as usual (TAU)
  Psychosocial support and treatment interventions to help clients in social services with various problems. This can be in the form of individual counselling, social casework, family and network interventions, and similar. These interventions include a variation of cognitive, behavioral, family therapeutic and psychodynamic therapeutic techniques as well as methods for supporting and caring for the client rather than treating specific conditions. The task of social services in Sweden borders to t

Primary outcome measures

• Main problem level [Time frame: Baseline, three months, six months and one year]

Secondary outcome measures (5)

• Days of problem in main area [Time frame: Baseline, three months, six months and one year]
• Secondary problem level [Time frame: Baseline, three months, six months and one year]
• Days of problem in secondary area [Time frame: Baseline, three months, six months and one year]
• Clinical outcomes in routine evaluation outcome measure (CORE-OM-8) [Time frame: Baseline, three months, six months and one year]
• EuroQol Five Dimensions (EQ-5D) [Time frame: Baseline, three months, six months and one year]

Eligibility criteria

Inclusion criteria

People who have been granted assistance under the Social Services Act at includes centers.

Exclusion criteria

• People who do not have sufficient knowledge of Swedish or have impaired cognitive functions that prevent them from using FIT in Swedish, as they cannot benefit from the intervention that the study intends to evaluate the effects of. This is assessed by the respective social service.
• People who receive support and treatment interventions that are not voluntary, i.e. interventions according to the Act on the Compulsory Care of Young People (LVU) or the Act on the Compulsory Care of Drug Abusers (LVM)

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Treatment

Study locations

Sweden · 1 center

• Linköpings kommun — Linköping

Identifiers

NCT: NCT07303608 · 2025-00833-01 · 2023-01738

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗