MONITORING PSYCHOTHERAPY THROUGH FEEDBACK ASSISTED CLINICAL EXCHANGE (F.A.C.E.): EMPIRICAL EVIDENCE AND FUTURE DIRECTIONS IN THE ITALIAN CLINICAL CONTEXT

This doctoral dissertation investigates the role and applications of Routine Outcome Monitoring (ROM) in psychotherapy, with a specific focus on the Italian public health context. The thesis adopts a multi-perspective approach, integrating clinical, empirical, educational, and technological dimensions across four complementary studies.The first study qualitatively explored Italian psychotherapists’ experiences with ROM implementation in public health services, highlighting both its perceived clinical utility and barriers related to its systematic use. The second study assessed the effectiveness of Dynamic Interpersonal Therapy (DIT) delivered in-person and via videoconferencing to patients with depression and anxiety. Concerning the use of ROM in psychotherapy, these findings highlight its empirical value, as repeated session-by-session measurement captures therapeutic change over time and offers a more nuanced understanding of the treatment process. The third study presented a scoping review of empirical evidence on the use of ROM in clinical supervision, revealing encouraging but methodologically heterogeneous findings and underscoring the need for structured supervisor training. Finally, the fourth study introduced the F.A.C.E. platform, a digital tool for dyadic ROM data collection, demonstrating preliminary evidence of reciprocal influences between therapist and patient perspectives on symptoms and therapeutic alliance.Taken together, the findings support the potential of ROM to improve clinical practice, foster patient engagement, and strengthen training and supervision. However, successful implementation requires adequate training, contextual adaptation, and technological support. This dissertation contributes to bridging the gap between research and practice, emphasizing the value of ROM as a multipurpose tool to enhance psychotherapy outcomes and service delivery within Italian mental health care.