Responsible and Meaningful Measurement in Clinical Psychology

Patient-reported measurement is central to clinical psychology, and is widely used in mental healthcare, research, and policy. A widespread assumption is that patient scores can be interpreted prior to, and independently of, the ways in which scores are used. This assumption is rooted in a ‘knowledge-first’ approach to evaluating measurement quality: first, gain knowledge about patients’ symptoms or functioning, then apply this knowledge for the purpose of a study or an intervention. We show that this approach distorts score interpretation and is harmful to patients. Rather than a passive channel for gathering information, patient-reported measurement in clinical psychology is a social technology, that is, a tool for intervening on individuals and society at large. Score interpretation is an ongoing meaning-making process that unfolds differently depending on the interaction between a patient and a measurement practice. We outline six principles (acronym: M-SPACE) for designing responsible measurement practices, where data interpretation and use are aligned with the attainment of desirable individual and social goods. The quality of patient-reported data depends on their contribution to the attainment of such goods, rather than on their ability to reflect a latent trait or disorder.