{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:28:29Z","timestamp":1791581309675,"version":"4.3.4"},"reference-count":48,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Direcci\u00f3n de Investigaci\u00f3n y Vinculaci\u00f3n, Universidad de Las Am\u00e9ricas, Ecuador","award":["PGR.PSI.23. 14.01"],"award-info":[{"award-number":["PGR.PSI.23. 14.01"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,4,17]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Practice-oriented research uses scientific methods to generate practice-based evidence on psychotherapy processes and outcomes. The Consorcio Latinoamericano de Investigaci\u00f3n en Psicoterapia (CLIP) unifies data collection across multiple sites to enhance the value of routine outcome monitoring. This project aims to generate practice-based evidence on the implementation, progress and predictors of change in psychological interventions within Ecuador\u2019s routine mental health settings, using CLIP\u2019s unified data forms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analyses<\/jats:title>\n                    <jats:p>This is a protocol for an observational, naturalistic, longitudinal study. From February 2025 to February 2028, we will describe implementation processes and examine intervention progress and outcomes across 11 Ecuadorian mental health services. Participants will include adolescents (11\u201317 years) and adults (\u226518 years) seeking psychological intervention along with their therapists and trainees. Clients\u2019 change will be monitored through psychological distress measures. Socio-demographic and intervention satisfaction data will be collected alongside information on therapists and services. Analyses will include initial contact characterisation, reliable change, outcome predictors and the examination of how time, therapist and service characteristics each contribute to clients\u2019 change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The protocol for this study was approved by the Human Research Ethics Committee of the Universidad de Las Am\u00e9ricas, Ecuador (ID: 2024-OBS-033). The results will be disseminated within the services for service improvement, in peer-reviewed scientific articles and at conferences and workshops.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT07257848\">NCT07257848<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-115254","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T14:50:30Z","timestamp":1779115830000},"page":"e115254","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Generating practice-based evidence for common mental health problems using routine outcome monitoring: a protocol for a longitudinal naturalistic study in Ecuadorian mental health services"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct07257848","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1106-9567","authenticated-orcid":false,"given":"Clara","family":"Paz","sequence":"first","affiliation":[{"name":"Grupo de Investigaci\u00f3n Bienestar, Salud y Sociedad, Escuela de Psicolog\u00eda y Educaci\u00f3n, Universidad de Las Am\u00e9ricas, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9849-257X","authenticated-orcid":false,"given":"Itaty","family":"Benalc\u00e1zar-Betancourt","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Bienestar, Salud y Sociedad, Escuela de Psicolog\u00eda y Educaci\u00f3n, Universidad de Las Am\u00e9ricas, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9382-0512","authenticated-orcid":false,"given":"Jorge","family":"Valdiviezo-O\u00f1a","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Bienestar, Salud y Sociedad, Escuela de Psicolog\u00eda y Educaci\u00f3n, Universidad de Las Am\u00e9ricas, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Evans","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n Bienestar, Salud y Sociedad, Escuela de Psicolog\u00eda y Educaci\u00f3n, Universidad de Las Am\u00e9ricas, Quito, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"2026060801251146000_16.5.e115254.1","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.jad.2015.08.072","article-title":"Clinical effectiveness of cognitive behavioral therapy for depression in routine care: A propensity score based comparison between randomized controlled trials and clinical practice","volume":"189","author":"Lutz","year":"2016","journal-title":"J Affect Disord"},{"key":"2026060801251146000_16.5.e115254.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10567-023-00433-8"},{"key":"2026060801251146000_16.5.e115254.3","doi-asserted-by":"crossref","DOI":"10.1007\/s11920-017-0780-z","article-title":"Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective","volume":"19","author":"Wainberg","year":"2017","journal-title":"Curr Psychiatry Rep"},{"key":"2026060801251146000_16.5.e115254.4","doi-asserted-by":"crossref","unstructured":"Evans C , Carlyle J . 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