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Connors EH, Childs AW, Douglas S, Jensen-Doss A. Data-Informed Communication: How Measurement-Based Care Can Optimize Child Psychotherapy. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01372-4. [PMID: 38662178 DOI: 10.1007/s10488-024-01372-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2024] [Indexed: 04/26/2024]
Abstract
Measurement-based care (MBC) research and practice, including clinical workflows and systems to support MBC, are grounded in adult-serving mental health systems. MBC research evidence is building in child and adolescent services, but MBC practice is inherently more complex due to identified client age, the family system and the need to involve multiple reporters. This paper seeks to address a gap in the literature by providing practical guidance for youth-serving clinicians implementing MBC with children and their families. We focus on MBC as a data-informed, client-centered communication process, and present three key strategies to enhance usual care child and adolescent psychotherapy via developmentally-appropriate MBC. These strategies include (1) go beyond standardized measures; (2) lean into discrepancies; and (3) get curious together. Case-based examples drawn from various child-serving settings illustrate these key strategies of MBC in child psychotherapy.
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Affiliation(s)
| | - Amber W Childs
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Susan Douglas
- Department of Leadership, Policy, and Organizations, Vanderbilt University, Peabody College, Nashville, TN, USA
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Lavik KO, Veseth M, Frøysa H, Stefansen J, Nøtnes JC, Moltu C. This is what I need a clinical feedback system to do for me: A qualitative inquiry into perspectives of adolescents and their therapists. J Clin Psychol 2023; 79:729-747. [PMID: 33320330 DOI: 10.1002/jclp.23100] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 10/13/2020] [Accepted: 11/29/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Routine outcome monitoring and clinical feedback systems might be beneficial for adolescent psychotherapy processes. METHODS Clinicians (n = 34) and adolescent clients (n = 22) aged 14-19 from seven different outpatient clinics located in Norway participated in the study. Adolescents were interviewed in individual in-depth interviews (n = 7) or in four adolescent-only focus groups (n = 15), clinicians participated in seven clinician-only focus groups. RESULTS We report two core domains, (1) feedback about the therapeutic relationship and (2) feedback about the therapeutic work. Seven subthemes specify the functionality that participants need in a feedback system. CONCLUSION Adolescents and therapists requested a feedback system that was relationally oriented, supported collaborative action, and was personalized to the needs of the individual adolescent. The research indicates that a clinical feedback system should have idiographic, as well as nomothetic, components. A clinical feedback system for adolescents should monitor experiences of personal autonomy and the quality of the therapeutic relationship.
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Affiliation(s)
- Kristina O Lavik
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Science, Førde, Norway
| | - Marius Veseth
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Helga Frøysa
- Department of Psychology Services, Askøy Commune, Bergen, Norway
| | - Jon Stefansen
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Jan C Nøtnes
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway.,Department of Health and Caring Sciences, Western Norway University of Applied Science, Førde, Norway
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Sales CMD, Ashworth M, Ayis S, Barkham M, Edbrooke-Childs J, Faísca L, Jacob J, Xu D, Cooper M. Idiographic patient reported outcome measures (I-PROMs) for routine outcome monitoring in psychological therapies: Position paper. J Clin Psychol 2023; 79:596-621. [PMID: 35194799 DOI: 10.1002/jclp.23319] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 11/26/2021] [Accepted: 01/09/2022] [Indexed: 11/07/2022]
Abstract
Idiographic patient-reported outcome measures (I-PROMs) are a growing set of individualized tools for use in routine outcome monitoring (ROM) in psychological therapies. This paper presents a position statement on their conceptualization, use, and analysis, based on contemporary evidence and clinical practice. Four problem-based, and seven goal-based, I-PROMs, with some evidence of psychometric evaluation and use in psychotherapy, were identified. I-PROMs may be particularly valuable to the evaluation of psychological therapies because of their clinical utility and their alignment with a patient-centered approach. However, there are several challenges for I-PROMs: how to generate items in a robust manner, their measurement model, methods for establishing their reliability and validity, and the meaning of an aggregated I-PROM score. Based on the current state of the literature, we recommend that I-PROMs are used to complement nomothetic measures. Research recommendations are also made regarding the most appropriate methods for analyzing I-PROM data.
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Affiliation(s)
- Célia M D Sales
- Faculty of Psychology and Education Sciences (FPCEUP), Center for Psychology at the Universidade do Porto (CPUP), University of Porto, Porto, Portugal
| | - Mark Ashworth
- School of Life Course and Population Sciences, King's College London, Guy's Campus, London, United Kingdom, SE1 1UL, UK
| | - Salma Ayis
- School of Life Course and Population Sciences, King's College London, Guy's Campus, London, United Kingdom, SE1 1UL, UK
| | - Michael Barkham
- Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Julian Edbrooke-Childs
- Anna Freud Centre, Applied Research and Evaluation, The Kantor Centre of Excellence, 4-8 Rodney Street, London, N1 9JH, UK
| | - Luís Faísca
- FCHS & Center for Research in Health Technologies and Information, Universidade do Algarve, Faro, Portugal
| | - Jenna Jacob
- Anna Freud Centre, Applied Research and Evaluation, The Kantor Centre of Excellence, 4-8 Rodney Street, London, N1 9JH, UK
| | - Dan Xu
- Zhejiang University of Technology, Hangzhou, China
| | - Mick Cooper
- Department of Psychology, University of Roehampton, London, UK
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Monitoring and Measurement in Child and Adolescent Mental Health: It's about More than Just Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084616. [PMID: 35457484 PMCID: PMC9024737 DOI: 10.3390/ijerph19084616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/04/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022]
Abstract
Routine outcome monitoring (ROM) provides information to practitioners and others providing healthcare support to demonstrate the impact of interventions and for service evaluation [...].
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Austin A, Potterton R, Flynn M, Richards K, Allen K, Grant N, Glennon D, Mountford VA, Franklin‐Smith M, Schelhase M, Jones WR, Serpell L, Mahoney K, Brady G, Nunes N, Kali K, Connan F, Schmidt U. Exploring the use of individualised patient‐reported outcome measures in eating disorders: Validation of the Psychological Outcome Profiles. EUROPEAN EATING DISORDERS REVIEW 2021; 29:281-291. [DOI: 10.1002/erv.2819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 11/09/2020] [Accepted: 12/15/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Amelia Austin
- King's College London Institute of Psychiatry, Psychology and Neuroscience London UK
| | - Rachel Potterton
- King's College London Institute of Psychiatry, Psychology and Neuroscience London UK
| | - Michaela Flynn
- King's College London Institute of Psychiatry, Psychology and Neuroscience London UK
| | - Katie Richards
- King's College London Institute of Psychiatry, Psychology and Neuroscience London UK
| | - Karina Allen
- King's College London Institute of Psychiatry, Psychology and Neuroscience London UK
- South London and Maudsley NHS Foundation Trust London UK
- School of Psychological Sciences The University of Western Australia Western Australia Australia
| | - Nina Grant
- South London and Maudsley NHS Foundation Trust London UK
| | | | - Victoria A. Mountford
- King's College London Institute of Psychiatry, Psychology and Neuroscience London UK
- South London and Maudsley NHS Foundation Trust London UK
- Maudsley Health Abu Dhabi United Arab Emirates
| | | | | | | | - Lucy Serpell
- North East London NHS Foundation Trust London UK
- Division of Psychology and Language Sciences University College London London UK
| | - Kate Mahoney
- North East London NHS Foundation Trust London UK
| | - Gaby Brady
- Central and North West London NHS Foundation Trust London UK
| | - Nicole Nunes
- Central and North West London NHS Foundation Trust London UK
| | - Kuda Kali
- Central and North West London NHS Foundation Trust London UK
| | - Frances Connan
- Central and North West London NHS Foundation Trust London UK
| | - Ulrike Schmidt
- King's College London Institute of Psychiatry, Psychology and Neuroscience London UK
- South London and Maudsley NHS Foundation Trust London UK
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Alves P, Faísca L, Sales CMD, Ashworth M. Personalising Outcome Measurement in Substance Misuse Treatment: the Feasibility and Psychometrics of Two Individualised Outcome Measures. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00396-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
AbstractIndividualised information in substance misuse treatment complements standardised outcome measures. However, few studies investigate the use of individualised measures and their robustness in terms of quantifying outcomes. In this study, we analysed the psychometrics and feasibility of two individualised outcome measures (PQ and PSYCHLOPS). We followed a cross-sectional methodology, administering the individualised measures and three additional standardised measures (TOP, a measure of psychological health within addiction services; PHQ-9; CORE-OM) to a sample of 93 patients entering substance misuse treatment in four clinical services. The results showed high levels of patient acceptability of the two individualised measures (response rates > 95%). The internal reliability was good for both PQ and PSYCHLOPS (Cronbach’s alpha, .79 and .72, respectively). Convergent validity of PQ with standardised measures was weak: Pearson’s r values for TOP (psychological health), PHQ-9 and CORE-OM were .21, .22 and .27, respectively. In contrast, convergent validity of PSYCHLOPS was moderate: r = .40, .39 and .50, respectively. Convergence between PQ and PSYCHLOPS was weak (r = .28). Experience of previous treatment episodes was associated with higher PQ and PSYCHLOPS scores; PSYCHLOPS but not PQ scores were higher among those opting to complete the questionnaires in written rather than verbal format. Our findings demonstrated that PQ and PSYCHLOPS are reliable and feasible individualised outcome measures for use in substance misuse treatment units, although the lack of strong convergent validity indicates that they may be measuring different underlying constructs. Optimal outcome measurement may involve combining individualised and standardised measures.
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