Implementing Routine Outcome Monitoring in Statutory Children’s Services

By Thomas Mackrill and Idamarie Leth Svendsen 

Child and Adolescent Social Work Journal, doi: 10.1007/s10560-020-00734-9

Review written by Dr David Wilkins

What question does this study focus on? 

This paper reports on a study from Denmark, in which one service implemented the use of routine outcome measurement. Such measurements are often used in counselling services but are much less common in social work.  

In this case, social workers were asked to gather two types of feedback every time they met with a family member. At the beginning of each session, the worker completed an Outcome Rating Scale, to monitor well-being, and at the end of each session, a Session Rating Scale, to obtain feedback on how the meeting went. You can watch a short 1-minute video of how these scales were used in practice here (the video is in Danish but has English subtitle).   

How did they study it? 

The study ran for two years. The researchers observed training and supervision sessions and helped develop a manual for implementing the new approach. They also interviewed social workers and managers about the perceived benefits and challenges of measuring outcomes in this way.   

What did they find? 

They found that social workers were more used to thinking of themselves as case managers, rather than considering how their interactions with the family could be an important mechanism for facilitating change. By obtaining regular feedback, workers become more aware of their practice, of their strengths and their areas for improvement. Workers also found they were having more conversations with family members about whether things were getting better for the child or not.  

Some workers worried that by asking parents directly and more often about their views, this could undermine their statutory authority. Some were also concerned that if the outcome measures showed things were not getting better for the child, this would reflect poorly on them and on the wider service. Workers also felt that the outcome measures were too simplistic to accurately measure the complexity of family life, and that they could detract from a focus on risk and on structural problems such as poverty.  

What are the implications? 

These findings show the potential benefits of implementing routine outcome monitoring in social work, and some of the challenges. The study also shows how making these kinds of ‘simple’ changes is not always straight-forward and can have unintended consequences too.  


Review written by

Dr David Wilkins