I was trained heavily on the importance of monitoring client outcome and assessing feedback. I'm a huge proponent of the work by Scott Miller, Michael Lambert, and the like. I think it's so important for therapists to objectively track treatment outcomes and intervene if clients deteriorate or stagnate. If you haven't looked into this, i'd highly encourage you to. There are eye-opening studies showing how god awful clinicians are at subjectively assessing the how therapy is going. Anyway, that's all to say that during my training I have been fortunate that these measures were typically included in the organizations (e.g. OQ-45, CAPPS, etc). However, now that I have my private practice, I feel that I am essentially flying blind by not having these measures. I'm trying to use free, symptom focused measures (e.g. DASS-21), but they don't come close to the utility of real, standardized, ROM and FIT measures (e.g. Scott Miller's SRS/ORS, OQ-45). It's tough because as a small, growing practice, I don't know if I can yet justify spending hundreds of dollars every year on purchasing a license for these measures (when my practice is BARELY paying for itself right now). Anyways, I just thought I would share my frustration and wonder if others have run into similar difficulties or have any guidance in the matter.