Skip to main content

Quality Improvement and Clinical Psychological Science

  • Chapter
  • First Online:
Quality Improvement in Behavioral Health

Abstract

Clinical psychological science (CPS) faces significant challenges including low uptake of empirically supported treatment, slow progress in improving efficacy, and low treatment seeking. Quality improvement (QI) offers a number of promising insights that may help address these challenges. This chapter discusses how key QI themes are exemplified in promising research directions within CPS and how these efforts can be further clarified and enhanced. Themes that are explored include: examining quality as a multifaceted construct, focusing on systems for improvement, identifying and targeting sources of variability in quality, focusing on consumers, reducing costs while improving quality, and using iterative improvement cycles and continuous evaluation. This chapter explores each of these QI themes within the context of promising and innovative CPS research examples. In doing so, the chapter seeks to highlight how QI principles might help guide a more progressive approach to CPS research that addresses current challenges.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Aarons, G. A. (2004). Mental health provider attitudes toward adoption of evidence-based practice: The Evidence-Based Practice Attitude Scale (EBPAS). Mental Health Services Research, 6, 61–74.

    Article  PubMed  PubMed Central  Google Scholar 

  • Arch, J., Deacon, B., Twohig, M. P., Bluett, E., & Landy, L. (2013). Impact of ACT vs CBT rationale for exposure therapy. Paper presented at the annual meeting of the Association for Behavioral and Cognitive Therapies in Knoxville, TN.

    Google Scholar 

  • Baardseth, T. P., Goldberg, S. B., Pace, B. T., Wislocki, A. P., Frost, N. D., Siddiqui, J. R., … Wampold, B. (2013). Cognitive-behavioral therapy versus other therapies: Redux. Clinical Psychology Review, 33, 395–405.

    Google Scholar 

  • Beidas, R. S., & Kendall, P. C. (2010). Training therapists in evidence-based practice: A critical review of studies from a systems-contextual perspective. Clinical Psychology: Science and Practice, 17, 1–30.

    Google Scholar 

  • Berwick, D., & Nolan, T. (1998). Physicians as leaders in improving health care: A new series. Annals of Internal Medicine, 128(4), 289–292.

    Article  PubMed  Google Scholar 

  • Carper, M. M., McHugh, R. K., & Barlow, D. H. (2013). The dissemination of computer-based psychological treatment: A preliminary analysis of patient and clinician perceptions. Administration and Policy in Mental Health and Mental Health Services Research, 40(2), 87–95.

    Article  PubMed  Google Scholar 

  • Castonguay, L. G., Locke, B. D., & Hayes, J. A. (2011). The center for collegiate mental health: An example of a practice-research network in university counseling centers. Journal of College Student Psychotherapy, 25, 105–119.

    Article  Google Scholar 

  • Chaudoir, S. R., Dugan, A. G., & Barr, C. H. (2013). Measuring factors affecting implementation of health innovations: A systematic review of structural, organizational, provider, patient, and innovation level measures. Implementation Science, 8, 22.

    Article  PubMed  PubMed Central  Google Scholar 

  • Collins, L. M., Murphy, S. A., & Strecher, V. (2007). The Multiphase Optimization Strategy (MOST) and the Sequential Multiple Assignment Randomized Trial (SMART): New methods for more potent ehealth interventions. American Journal of Preventive Medicine, 32, S112–S118.

    Article  PubMed  PubMed Central  Google Scholar 

  • Craske, M. G., Rose, R. D., Lang, A., Welch, S. S., Campbell‐Sills, L., Sullivan, G., … Roy‐Byrne, P. P. (2009). Computer‐assisted delivery of cognitive behavioral therapy for anxiety disorders in primary‐care settings. Depression and anxiety, 26(3), 235–242.

    Google Scholar 

  • Cuijpers, P., Donker, T., van Straten, A., Li, J., & Andersson, G. (2010). Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and metaanalysis of comparative outcome studies. Psychological Medicine, 40(12), 1943–1957.

    Article  PubMed  Google Scholar 

  • Danaher, B. G., Milgrom, J., Seeley, J. R., Stuart, S., Schembri, C., Tyler, M. S., … Lewinsohn, P. M. (2012). MomMoodBooster web-based intervention for postpartum depression: Feasibility trial results. Journal of Medical Internet Protocols, 15 e242l.

    Google Scholar 

  • Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., … Jacobson, N. S. (2006). Treatment of depression and anxiety - randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–670.

    Google Scholar 

  • Ekers, D., Richards, D., McMilan, D., Bland, J. M., & Gilbody, S. (2011). Behavioural activation delivered by the non-specialist: Phase II randomized controlled trial. The British Journal of Psychiatry, 198, 66–72.

    Article  PubMed  Google Scholar 

  • Firth, N., Barkham, M., & Kellett, S. (2015). The clinical effectiveness of stepped care systems for depression in working age adults: A systematic review. Journal of Affective Disorders, 170, 119–130.

    Article  PubMed  Google Scholar 

  • Foa, E., Gillihan, S. J., & Bryant, R. A. (2013). Challenges and successes in dissemination of evidence-based treatments for posttraumatic stress: Lessons learned from prolonged exposure therapy for PTSD. Psychological Science in the Public Interest, 14, 65–111.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gallo, K. P., Comer, J. S., & Barlow, D. H. (2013). Direct-to-consumer marketing of psychological treatments for anxiety disorders. Journal of Anxiety Disorders, 27(8), 793–801.

    Article  PubMed  Google Scholar 

  • Gaudiano, B. A., & Miller, I. W. (2013). The evidence-based practice of psychotherapy: Facing the challenges that lie ahead. Clinical Psychology Review, 33, 813–824.

    Article  PubMed  Google Scholar 

  • Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: A systematic review. BMC Psychiatry, 10, 113.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hayes, S. C., Barlow, D. H., & Nelson-Grey, R. O. (1999). The Scientist-Practitioner: Research and accountability in the age of managed care (2nd ed.). New York, NY: Allyn & Bacon.

    Google Scholar 

  • Hayes, S. C., Long, D. M., Levin, M. E., & Follette, W. C. (2013). Treatment development alternatives: Can we find a better way? Clinical Psychology Review, 33, 870–882.

    Article  PubMed  Google Scholar 

  • Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. (2011). Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7, 141–168.

    Article  PubMed  Google Scholar 

  • Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36, 427–440.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gogtay, N., & Insel, T. (2014). Changing NIMH Clinical Trials: Efficiency, Transparency, and Reporting. National Institute of Mental Health.

    Google Scholar 

  • Ioannidis, J. P. A. (1998). Effect of the statistical significance of results on the time to completion and publication of randomized efficacy trials. JAMA, 279, 281–286.

    Article  PubMed  Google Scholar 

  • James, B. C., & Savitz, L. A. (2011). How Intermountain trimmed health care costs through robust quality improvement efforts. Health Affairs, 30, 1–7.

    Article  Google Scholar 

  • Karlin, B. E., & Cross, G. (2014). From the laboratory to the therapy room: National dissemination and implementation of evidence-based psychotherapies in the US Department of Veterans Affairs Health Care System. American Psychologist, 69, 19–33.

    Article  PubMed  Google Scholar 

  • Kazdin, A. E., & Blase, S. L. (2011). Rebooting psychotherapy research and practice to reduce the burden of mental illness. Perspectives on Psychological Science, 6, 21–37.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Demler, O., Frank, R. G., Olfson, M., Pincus, H. A., Walters, E. E., … Zaslavsky, A. M. (2005). Prevalence and treatment of mental disorders, 1990 to 2003. New England Journal of Medicine, 352(24), 2515–2523.

    Google Scholar 

  • Levin, M. E., Hildebrandt, M., Lillis, J., & Hayes, S. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior Therapy, 43, 741–756.

    Article  PubMed  Google Scholar 

  • Levin, M. E., Pistorello, J., Hayes, S. C., Seeley, J. R., & Levin, C. (2015). Feasibility of an Acceptance and Commitment Therapy adjunctive web-based program for counseling centers. Journal of Counseling Psychology, 62, 529–536.

    Google Scholar 

  • Lewis, C., Pearce, J., & Bisson, J. I. (2012). Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: Systematic review. The British Journal of Psychiatry, 200, 15–21.

    Article  PubMed  Google Scholar 

  • Lilienfield, S. O. (2007). Psychological treatments that cause harm. Perspective on Psychological Science, 2, 53–70.

    Article  Google Scholar 

  • Lilienfield, S. O., Ritschel, L. A., Lynn, S. J., Cautin, R. L., & Latzman, R. D. (2013). Why many clinical psychologists are resistant to evidence-based practice: Root causes and constructive remedies. Clinical Psychology Review, 33, 883–900.

    Article  Google Scholar 

  • Longmore, R. J., & Worrell, M. (2007). Do we need to challenge thoughts in cognitive behavior therapy? Clinical Psychology Review, 27, 173–187.

    Article  PubMed  Google Scholar 

  • Martino, S., Canning-Ball, M., Carroll, K. M., & Rounsaville, B. J. (2011). A criterion-based stepwise approach for training counselors in motivational interviewing. Journal of Substance Abuse Treatment, 40, 357–365.

    Article  PubMed  PubMed Central  Google Scholar 

  • Melas, C. D., Zampetakis, L. A., Dimopoulou, A., & Moustakis, V. (2012). Evaluating the properties of the evidence-based practice attitude scale (EBPAS) in health care. Psychological Assessment, 24, 867–876.

    Article  PubMed  Google Scholar 

  • Mohr, D. C., Cheung, K., Schueller, S. M., Hendricks, B. C., & Duan, N. (2013). Continuous evaluation of evolving behavioral intervention technologies. American Journal of Preventive Medicine, 45, 517–523.

    Article  PubMed  Google Scholar 

  • Novins, D. K., Green, A. E., Legha, R. K., & Aarons, G. A. (2013). Dissemination and implementation of evidence-based practices for child and adolescent mental health: A systematic review. Journal of the American Academy of Child & Adolescent Psychiatry, 52, 1009–1025.

    Article  Google Scholar 

  • O’Donohue, W. T., & Draper, C. (Eds.). (2011). Stepped care and E-health: Practical applications to behavioral disorders. New York, NY: Springer.

    Google Scholar 

  • O’Donohue, W. T., & Engle, J. L. (2013). Errors in psychological practice: Devising a system to improve client safety and well-being. Professional Psychology: Research and Practice, 44, 314–323.

    Article  Google Scholar 

  • O’Donohue, W., Snipes, C., & Maragakis, A. (2014). Increasing the productivity of the clinical psychologist: A neglected Archimedean pivot? Professional Psychology: Research and Practice, 45, 357–367.

    Article  Google Scholar 

  • Olfson, M., & Marcus, S. C. (2010). National trends in outpatient psychotherapy. The American Journal of Psychiatry, 167, 1456–1463.

    Article  PubMed  Google Scholar 

  • Regier, D. A., Narrow, W. E., Clarke, D. E., Kraemer, H. C., Kuramoto, S. J., Kuhl, E.A., … Kupfer, D.J. (2013). DSM-5 field trials in the United States and Canada, part II: Test-retest reliability of selected categorical diagnoses. American Journal of Psychiatry, 170, 59–70.

    Google Scholar 

  • Rosen, C. S., Chow, H. C., Finney, J. F., Greenbaum, M. A., Moos, R. H., Sheikh, J. I., … Yesavage, J. A. (2004). VA practice patterns and practice guidelines for treating posttraumatic stress disorder. Journal of Traumatic Stress, 17, 213–222.

    Google Scholar 

  • Swift, J. K., & Callahan, J. L. (2009). The impact of client treatment preference on outcome: A meta-analysis. Journal of Clinical Psychology, 65, 368–381.

    Article  PubMed  Google Scholar 

  • Weisz, J. R., Ng, M. Y., & Bearman, S. K. (2014). Odd couple? Reenvisioning the relation between science and practice in the dissemination-implementation era. Clinical Psychological Science, 2, 58–74.

    Article  Google Scholar 

  • Whipple, J. L., & Lambert, M. J. (2011). Outcome measures for practice. Annual Review of Clinical Psychology, 7, 87–111.

    Article  PubMed  Google Scholar 

  • Whiteside, U., Lungu, A., Richards, J., Simon, G. E., Clingan, S., … Ludman, E. (2014). Designing messaging to engage patients in an online suicide prevention intervention: Survey results from patients with current suicidal ideation. Journal of Medical Internet Research, 16(2) e42.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael E. Levin .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Levin, M.E., Potts, S.A. (2016). Quality Improvement and Clinical Psychological Science. In: O'Donohue, W., Maragakis, A. (eds) Quality Improvement in Behavioral Health. Springer, Cham. https://doi.org/10.1007/978-3-319-26209-3_5

Download citation

Publish with us

Policies and ethics