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NCT Number: NCT07303608

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

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.

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Key information

Conditions

Substance Use Disorders Behavior Chemically-Induced Disorders Child Behavior Problem Criminal Behavior Domestic Violence Everyday Activities Family Communication Family Conflict Housing Mental Disorders Social Care Substance-Related Disorders

Age range

15 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Linköpings kommun

Linköping, Sweden

Location status: Recruiting

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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)

Treatment and study plan

Feedback informed treatment (FIT)

Behavioral

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.

Other names: Partners for Change Outcome System (PCOMS), Outcome Rating Scale (ORS), System Rating Scale (SRS)

Treatment as Usual (TAU)

Behavioral

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 that of psychiatry, addiction care and the correctional system, which are organized on a regional or national level, as opposed to the municipal grounding of social services. Interventions are carried out in the client's environment, in outpatient care and through residential treatment facilities.

Other names: Social services psychosocial support and treatment

Primary outcomes

  1. Main problem level

    Time frame: Baseline, three months, six months and one year

    The participant choose their main problem area that is addressed in their contact with social servises (Work, employment, finances; School, studies; Alcohol, drugs or gambling; Mental health; Violent behavior or crime; Violence in close relationships; Housing and/or everyday routines; Relationship problems; Other) and rate the problems they have experienced in this area on a visual analog scale (0-100) where a higher number indicate more severe problems.

Secondary outcomes

  1. Days of problem in main area

    Time frame: Baseline, three months, six months and one year

    The participant rate the number of days the last months 0-30 that they have experienced problems in their main problem area.

  2. Secondary problem level

    Time frame: Baseline, three months, six months and one year

    The participant can choose one or two secondary problem areas that is addressed in their contact with social services and rate the problem (0-100) they have experienced in this area. A higher number indicate more severe problems.

  3. Days of problem in secondary area

    Time frame: Baseline, three months, six months and one year

    The participant rate the number of days in the last month (0-30) that they have experienced problems in their secondary problem area.

  4. Clinical outcomes in routine evaluation outcome measure (CORE-OM-8)

    Time frame: Baseline, three months, six months and one year

    Patient reported outcome measures. An 8-item alternative brief measure of psychological distress, based on the shorter CORE-OM-6D for this population. Each item is scored 0-4 (0-26 in total). A higher score indicate more severe problems.

  5. EuroQol Five Dimensions (EQ-5D)

    Time frame: Baseline, three months, six months and one year

    Health questionnaire measuring quality of life in five areas: Mobility, Self-care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. Each area is rated 1-5 to form an index. A higher score indicate more severe problems.

Other outcomes

  1. Outcome rating scale (ORS)

    Time frame: during experimental treatment, up to 55 weeks

    Individual (personal well-being), Close relationships (family and friends), Social (work, school, friends) and General (life in general) which are assessed according to four visual analog scales. The ORS is intended to be used several times during treatment or psychotherapy to provide a measure of psychological well-being and treatment progress. The score is 0-40. A lower score indicate more severe problems.

  2. Session Rating Scale (SRS)

    Time frame: during experimental treatment, up to 55 weeks

    A simple, four-item visual analogue scale designed to assess key dimensions of a good therapeutic relationships. The SRS is administered, scored (0-40) and discussed at the end of each session to get real time alliance feedback. A higher score indicate a better therapeutic relationship.

  3. Satisfaction with contact and therapeutic relationship

    Time frame: three months, six months and one year

    Single visual analog scale rating the contact with social worker (0-100) higher indicate a better therapeutic relationship.

  4. Reason for ending treatment

    Time frame: three months, six months and one year

    Two follow-up question about if and why the contact with social services has ended.

Study contacts

Contact information is provided by the study sponsor or research team.

Magnus Johansson, PhD

CONTACT

[email protected]

+46812345783

Therese Nestor

CONTACT

[email protected]

Sponsors and collaborators

Lead sponsor

Karolinska Institutet

Other

Registry information

Official study title

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

Important dates

Study start
2025
Primary completion
2028
Study completion
2028
First posted
Dec 26, 2025
Registry last updated
Dec 26, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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