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Effects Of Routine Feedback To Clinicians On Youth Mental Health Outcomes:A Randomized Cluster Design
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| Presenter(s):
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| Leonard Bickman, Vanderbilt University, leonard.bickman@vanderbilt.edu
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| Susan D Kelley, Vanderbilt university, susan.d.kelley@vanderbilt.edu
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| Carolyn Breda, Vanderbilt University, carolyn.s.breda@vanderbilt.edu
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| Ana Regina Andrade, Vanderbilt University, ana.regina.andrade@vanderbilt.edu
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| Manuel Riemer, Wilfrid Laurier University, manuel.riemer@gmail.com
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| Abstract:
We tested the hypothesis that youths receiving treatment as usual in a community setting would improve faster when clinicians received frequent feedback on their clients' progress. A cluster randomized experiment was conducted with 28 sites delivering home-based treatment in 10 U.S. states. Data were collected at the end of each session from the youths, caregivers and clinicians. A total of 356 youths, 432 caregivers and 167 clinicians participated. Intent to treat analyses using hierarchical linear modeling of data provided by clinicians, caregivers, and youths all showed that clients of clinicians in the sites that could receive feedback improved faster than those in sites that could not receive such feedback. A dose-response analysis showed that those clinicians who viewed more feedback reports showed even stronger effects. Routine measurement and feedback can be used to improve outcomes for youths who receive TAU.
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Evaluation of an Organizational Innovation: Use Of A Clinical Quality Tool To Improve Substance Abuse Treatment
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| Presenter(s):
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| Kakoli Banerjee, Santa Clara County Alcohol & Drug Services, kakoli.banerjee@hhs.sccgov.org
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| Laurie Drabble, San Jose State University, laurie.drabble@sjsu.edu
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| Michael Hutchinson, Santa Clara County, michael.hutchinson@hhs.sccgov.org
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| Abstract:
In health care organizations, innovation is driven by a need to improve service delivery, service quality or client outcome. Because pragmatic considerations drive the adoption of innovative practices, they frequently occur in circumstances where traditional program evaluation models cannot be readily used. In this paper, we use an approach based on theory of change to evaluate an innovative clinical quality tool in a large county substance abuse treatment system. The county implemented a patient reported outcome measurement system based on Miller and Duncan's model as a clinical tool. In this study, we propose to link client derived measures (clinical measures gathered during treatment) with organizational measures (treatment context) and substance abuse treatment outcomes at discharge. This study affords an opportunity to examine the interaction between an intervention and different contexts to see how the client impact may differ across individual treatment providers, using data gathered for program monitoring purposes.
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Evaluating Metal Health Providers' Perceptions of Using Routine Outcome Surveys to Measure Clients' Progress in Therapy: A Mixed Method's Approach using Ajzen's Theory of Planned Behavior
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| Presenter(s):
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| Jennifer D Lockman, Centerstone Research Institute, jennifer.lockman@centerstone.org
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| Randall S Reiserer, Centerstone Research Institute, randall.reiserer@centerstone.org
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| Casey C Bennett, Centerstone Research Institute, casey.bennett@centerstone.org
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| Christina Van Regenmorter, Centerstone Research Institute, christina.vanregenmorter@centerstone.org
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| April Bragg, Centerstone Research Institute, april.bragg@centerstone.org
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| Rebecca Selove, Centerstone Research Institute, rebecca.selove@centerstone.org
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| Kathryn Bowen, Centerstone Research Institute, kathryn.bowen@centerstone.org
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| Tom Doub, Centerstone Research Institute, tom.doub@centerstone.org
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| Abstract:
Behavioral health policy makers and insurance providers have emphasized using standardized outcome assessments to track clients' progress in therapy. However, behavioral health providers rarely measure patient reported outcomes (PROs). Here we discuss a mixed methods evaluation of a large-scale pilot study that addressed clinician perceptions of the Client Directed Outcomes Informed (CDOI) instrument in a real-world community behavioral health setting. The purpose of this study was: 1) to use Ajzen's Theory of Planned Behavior (TPB) to identify effective factors for implementation and 2) to examine the degree to which collecting routine outcomes using CDOI impacts client-reported therapeutic outcomes. Our results suggest that the CDOI instrument has the capacity to predict client progress in therapy. Therapeutic progress varied with respect to different domains of Ajzen's TPB, clinician age, and years of clinical experience. We discuss values-bases implications for creating an organizational climate conducive to using outcomes measures to track therapeutic progress.
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