To investigate the effects of measurement feedback systems (MFSs) in therapy on mental health outcomes through a literature review and meta-analysis. Using a three-level modeling approach, we conducted a meta-analysis of all effect sizes from randomized controlled studies of MFSs used in the treatment of common mental health disorders. Eighty-two effect sizes were extracted from the thirty-one included studies. Analyses were performed to consider the post-treatment effects of the MFS-assisted treatment compared to treatment as usual. A separate analysis was done for the subgroup "not-on-track" patients as it is theorized that MFSs will be clinically useful because they make therapists aware of patients who fail to progress. MFSs had a significant effect on mental health outcomes (d = 0.14, 95% CI [0.082-0.206], p < .001). Further analysis found a larger effect in patients identified as less respondent to therapy, the "not-on-track" group (d = 0.29, 95% CI [0.114, 0.464], p = .003). Moderation analyses indicated that the type of outcome measurement and type of feedback system used, and whether it was used for a child and youth or adult population, influenced effect sizes. MFSs seem to have a small positive effect on treatment outcomes. The effects seem to be larger for "not-on-track" patients, the group of patients that would usually not benefit much from treatment.
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