Using outcomes measures with young people
Top tips when using outcome measures:
- Transparency: explain why you are using measures, what they can tell you and what they can’t, and what decisions the measures help to inform. Young people tell us that they are more likely to be honest in their responses if they understand why they are completing them.
- Options: where possible, offer choice over which measures young people complete and how they fill them in (e.g. with you, on their own).
- Process: take children and young people with you on the journey of outcomes measures, explaining every step along the way. Start by explaining what measures are and why you use them, then give young people space to talk through their answers and discuss the decisions you are making in response to what they have shared.
- Trust: young people tell us they are more likely to be honest in their responses if they trust the person asking them to complete outcome measures. Take time to get to know them first.
- Interpret together: allow young people to explain or justify their responses, including if they feel a question doesn’t capture their experiences.
- Piece of the puzzle: be clear that outcomes measures are an important piece of the puzzle when, but they are not the only factor which determines treatment or support.
- Save for later: come back to their responses in later sessions, to show them progress or to facilitate reviewing their support. Young people have told us that can feel confusing or pointless when they complete outcomes measures and then never see their responses again.
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Explaining outcomes measures to young people
Outcome measures are ways for measuring or recording the change of children and young people’s mental health and wellbeing and are used to try and understand the impact of the treatment or intervention that they are receiving. They are usually in the form of a questionnaire and can be filled in by either young people, parents or carers, practitioners or your teachers.
Feedback measures, on the other hand, are usually questionnaires which record children and young people’s experience of the service or session they are attending.
The short animation below explains what an outcome measure is and how it might be used in children and young people’s mental health services.
In a nutshell, outcome measures:
- Help children and their therapist to better understand their situation.
- Allow them to share their experience during treatment.
- Communicate how helpful the support they are receiving is.
- Enable changes to support and treatment.
- Help improve services for others.
Our 'I am a Young Person' page has lots of information for young people about what outcomes measures are and how they can be used.
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Why use outcome and feedback measures?
Young people often tell us that outcome and feedback measurement can open up conversations, as it may be easier to say something on a questionnaire than it is in real life by oneself. We also hear that being able to look back and compare how you’re doing now to how you were doing 6 months ago is a helpful to identify progress, especially as improvement can be hard to notice by oneself.
For practitioners, outcome and feedback measurement provide another piece of information that can help to build a picture of what’s going on for a young person. Looking at outcomes across your service is also helpful in identifying areas that are going well and ones that may need more attention. Of course, being able to back up arguments for funding with data is a really important reason for collecting data, especially in times when funding is limited.
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Young people's experience of using outcome measures
Outcome and feedback measures can be really helpful for young people to see their progress and identify where change could be made. Communication, transparency and feedback are key to young people feeling comfortable and confident in completing measures.
In this video two of the Anna Freud Champions, Juliette and Jummy, tell us about their experience of what makes a good outcome and how they would measure it.
In this video project some of the mental health practitioners in CORC member services and Young Champions from the Anna Freud Centre have shared their views.
- 02:02 How is the service user involved, and how does this become helpful to the young people and a meaningful part of their support
- 06:01 Not every young person feels comfortable or safe when filling out mental health outcome questionnaires. What can practitioners do to support the young person?
- 07:39 Some young people do say that they experience outcome questionnaires as tick-box exercise. What can practitioners do to avoid that?
- 09:07 Acknowledge that the outcome measures are impacted by the service user and practitioner relationship
- 10:26 Don’t assume what a young person will feel or think about outcome measures
We encourage you to share this video with your colleagues and use it in your training programmes. The messages from young people in this video can be really useful if routine outcome monitoring is being introduced in your programme or service for the first time or if you are reviewing practice.
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Communicating with young people about measures
In terms of honest feedback from questionnaires, it’s really about transparency – making sure people know why they’re being asked these questions, who will see their responses, and what will be done with the data. Even if the feedback won’t be used in sessions and will only be used for service improvement, we find that young people are really happy to give honest feedback to try and help the service for other young people like them in the future, but this needs to be transparent.
How people are asked to give feedback, and having a trusting relationship with the person asking, are absolutely crucial. They need to be the right questions, asked in the right way, by the right person, at the right time.
How to use them well:
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Giving young people a voice in choosing and using measures
Giving young people a choice between types of measures, which means practitioners and services need the training and flexibility to do this, can be really important in building trust and giving young people control over the outcomes they are interested in.
However, we also must recognise and be explicit that sometimes completing measures can feel like a tick box exercise – some questions may not feel like a good fit for everyone. But, if we explain why this information is useful (so we can look at similarities and differences in experiences across different young people) then at least we are being transparent about this.
Bringing together different types of measures may go some way to help with this. For example, you could use a more general measure of depression and anxiety that is complemented with a more tailored and individual measure such as the Goal Based Outcome Tool.
Having a space to discuss measures, including which questions feel less relevant or too simplified, shows young people that you are interested in their individual experiences, not just a number on a page.
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Young people's rights
Children and young people have a right to have a say in all decisions which affect them (Article 12, UNCRC). They have the right to express their views and for their views to be given due weight. This includes having a voice in how services are designed and delivered, and how outcomes measures are used.
At CORC and Anna Freud, we use the Lundy model to help us uphold this right.
Visit this section for information on children's rights and the Lundy model of participation.
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CORC Training opportunities
There are lots of opportunities with CORC to learn more about involving young people in service and measure design and delivery.
Our Best Practice Framework is a set of tools and guidance that supports services using outcome and feedback measures. One of the themes of the framework is ‘service user engagement’. Services that can show best practice against this area of the framework can be awarded a CORC Badge of Recognition.
Service User Participation is one of the four pillars of our Best Practice Framework. CORC lead Kate Dalzell explains the framework in this video:
You can learn more about our Best Practice Framework here:
CORC provide training to services to help them improve their use of outcome measures. As part of our regular training programme, our participation in research officer, Rachael Stemp, delivers a 90 minute training on 'Engaging Young People in routine outcome monitoring'.
Click here for more details on the next available online session:
We can also provide tailored training so do get in touch if you’d like to discuss this.