Abstract
This study examines the applicability and utility of youth Measurement-Based Care (MBC) in a community-based psychological training clinic. Considering the complexity of youth compared to adult MBC, there is an increasing need to expand the evidence base. This study investigated how doctoral students in clinical psychology managed the selection and usage of Patient Rated Outcome Measures (PROMs) for youth and their parents. Additionally, this study evaluates youth attitudes toward MBC and PROMs and overall appropriateness and completion rates. Youth (N = 79) from 1 to 17-years-old with various mental health disorders (i.e., depression, anxiety, ADHD) completed evidence-based psychotherapy. Clinicians (N = 21) were trained to have therapy clients and their caregivers’ complete weekly measures digitally as an integrated part of standard care. All clinicians, youth clients, and their parents reported attitudes supporting the utility of youth PROMs and MBC. Compared to adult clients (N = 81), youth clients were significantly less adherent in regularly completing their weekly measures. These results demonstrate the usage of MBC and utility of implementing this practice for youth clients in a training clinic. Together, there is a need for improving the specificity of training for clinicians who will administer MBC for youth above and beyond what is indicated for adult clients.
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References
Aboraya, A., Nasrallah, H. A., Elswick, D. E., Elshazly, A., Estephan, N., Aboraya, D., Berzingi, S., Chumbers, J., Berzingi, S., Justice, J., Zafar, J., & Dohar, S. (2018). Measurement-based care in psychiatry: Past, present, and future. Innovations in Clinical Neuroscience, 15(11–12), 13–26.
American Psychological Association. (2021). Professional practice guidelines for evidence-based psychological practice in health care. http://www.apa.org/about/policy/psychological-practice-health-care.pdf. Accessed 23 Jan 2023.
Batty, M. J., Moldavsky, M., Foroushani, P. S., Pass, S., Marriott, M., Sayal, K., & Hollis, C. (2013). Implementing routine outcome measures in child and adolescent mental health services: From present to future practice. Child and Adolescent Mental Health, 18(2), 82–87.
Beidas, R. S., Stewart, R. E., Walsh, L., Lucas, S., Downey, M. M., Jackson, K., Fernandez, T., & Mandell, D. S. (2015). Free, brief, and validated: Standardized instruments for low-resource mental health settings. Cognitive and Behavioral Practice, 22(1), 5–19.
Bickman, L., Athay, M., Riemer, M., Lambert, E. W., Douglas Kelley, S., Breda, C., Tempesti, T., Dew-Reeves, S. E., Brannan, A. M., & Vides de Andrade, A. R. (2010). Manual of the Peabody treatment progress battery (2nd ed.). Vanderbilt University.
Bickman, L., Kelley, S. D., Breda, C., de Andrade, A. R., & Riemer, M. (2011). Effects of routine feedback to clinicians on mental health outcomes of youths: Results of a randomized trial. Psychiatric Services, 62(12), 1423–1429.
Bickman, L., Douglas, S. R., De Andrade, A. R. V., Tomlinson, M., Gleacher, A., Olin, S., & Hoagwood, K. (2016). Implementing a measurement feedback system: A tale of two sites. Administration and Policy in Mental Health and Mental Health Services Research, 43(3), 410–425.
Boswell, J. F., Hepner, K. A., Lysell, K., Rothrock, N. E., Bott, N., Childs, A. W., … Bobbitt, B. L. (2023). The need for a measurement-based care professional practice guideline. Psychotherapy, 60(1), 1–16.
Chiauzzi, E. (2021). Lessons learned in measurement-based care with youth mental health clients. Practice Innovations, 6(1), 30–41.
Connors, E. H., Douglas, S., Jensen-Doss, A., Landes, S. J., Lewis, C. C., McLeod, B. D., Stanick, C., & Lyon, A. R. (2021). What gets measured gets done: How mental health agencies can leverage measurement-based Care for Better Patient Care, clinician supports, and organizational goals. Administration and Policy in Mental Health, 48(2), 250–265.
Cooper, L. D., Murphy, H. G., Delk, L. A., Fraire, M. G., Van Kirk, N., Sullivan, C. P., Waldron, J. C., Halliburton, A. E., & Gatto, A. (2021). Implementing routine outcome monitoring in a psychology training clinic: A case study of a process model. Training and Education in Professional Psychology, 15(2), 87–96.
Cuperfain, A. B., Hui, K., Berkhout, S. G., Foussias, G., Gratzer, D., Kidd, S. A., ... & Zaheer, J. (2021). Patient, family and provider views of measurement-based care in an early-psychosis intervention programme. BJPsych Open, 7(5), e171.
de Jong, K., Conijn, J. M., Gallagher, R. A., Reshetnikova, A. S., Heij, M., & Lutz, M. C. (2021). Using progress feedback to improve outcomes and reduce drop-out, treatment duration, and deterioration: A multilevel meta-analysis. Clinical Psychology Review, 85, 102002.
Drechsler, R., Brem, S., Brandeis, D., Grünblatt, E., Berger, G., & Walitza, S. (2020). ADHD: Current concepts and treatments in children and adolescents. Neuropediatrics, 51(05), 315–335.
Fortney, J. C., Unützer, J., Wrenn, G., Pyne, J. M., Smith, G. R., Schoenbaum, M., & Harbin, H. T. (2017). A tipping point for measurement-based care. Psychiatric Services, 68(2), 179–188.
Fristad, M. A., Bell, Z., Dopp, R., Ghaziuddin, N., Leffler, J., Schneck, C. D., Singh, M. K., Weinstein, S., & Miller, L. (2021). Letter to the editor: Measurement-based Care in Youth—Feasibility and Acceptance. Journal of Child and Adolescent Psychopharmacology, 31(3), 233–234.
Gatto, A. J., Miyazaki, Y., & Cooper, L. D. (2022). Help me help myself: Examining an electronic mental health self-monitoring system in college students. Higher Education, 83, 163–182.
Hall, C. L., Moldavsky, M., Baldwin, L., Marriott, M., Newell, K., Taylor, J., Sayal, K., & Hollis, C. (2013). The use of routine outcome measures in two child and adolescent mental health services: A completed audit cycle. BMC Psychiatry, 13(1), 1–8.
Jensen-Doss, A., Haimes, E. M. B., Smith, A. M., Lyon, A. R., Lewis, C. C., Stanick, C. F., & Hawley, K. M. (2018). Monitoring treatment progress and providing feedback is viewed favorably but rarely used in practice. Administration and Policy in Mental Health and Mental Health Services Research, 45(1), 48–61.
Jensen-Doss, A., Douglas, S., Phillips, D. A., Gencdur, O., Zalman, A., & Gomez, N. E. (2020). Measurement-based care as a practice improvement tool: Clinical and organizational applications in youth mental health. Evidence-Based Practice in Child and Adolescent Mental Health, 5(3), 233–250.
Lambert, M. J., Whipple, J. L., & Kleinstäuber, M. (2018). Collecting and delivering progress feedback: A meta-analysis of routine outcome monitoring. Psychotherapy, 55(4), 520–537.
Levine, J. C., Cruz, R. A., Cooper, L. D., Murphy, H. G., Peterson, A. P., Hurd, L. E., & Felder, M. T. (2017). Integrating routine outcome monitoring into graduate training clinics to advance evidence-based practice. The Behavior Therapist, 40(1), 17–22.
Lewis, C. C., Boyd, M., Puspitasari, A., Navarro, E., Howard, J., Kassab, H., Hoffman, M., Scott, K., Lyon, A., Douglas, S., Simon, G., & Kroenke, K. (2019). Implementing measurement-based care in behavioral health: A review. JAMA Psychiatry, 76(3), 324–335.
Martin, A. M., Fishman, R., Baxter, L., & Ford, T. (2011). Practitioners’ attitudes towards the use of standardized diagnostic assessment in routine practice: A qualitative study in two child and adolescent mental health services. Clinical Child Psychology Psychiatry, 16(3), 407–420.
McFayden, T.C., Gatto, A. J., Dahiya, A.V., Antezana, L., Miyazaki, Y., & Cooper, L.D. (2021). Integrating measurement-based care into treatment for autism spectrum disorder: Insights from a community clinic. Journal of Autism and Developmental Disorders, 51(10), 3651–3661.
McLeod, B. D., Jensen-Doss, A., Lyon, A. R., Douglas, S., & Beidas, R. S. (2022). To utility and beyond! Specifying and advancing the utility of measurement-based Care for Youth. Journal of Clinical Child & Adolescent Psychology, 51(4), 375–388.
Myers, S. M., Johnson, C. P., & Council on Children with Disabilities. (2007). Management of children with autism spectrum disorders. Pediatrics, 120(5), 1162–1182.
Parikh, A., Fristad, M. A., Axelson, D., & Krishna, R. (2020). Evidence base for measurement-based care in child and adolescent psychiatry. Child and Adolescent Psychiatric Clinics, 29(4), 587–599.
Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., ... & Kirchner, J. E. (2015). A refined compilation of implementation strategies: Results from the expert recommendations for implementing change (ERIC) project. Implementation Science, 10(1), 1–14.
Sale, R., Bearman, S. K., Woo, R., & Baker, N. (2021). Introducing a measurement feedback system for youth mental health: Predictors and impact of implementation in a community agency. Administration and Policy in Mental Health and Mental Health Services Research, 48, 327–342.
Schwartzman, J. M., Williams, Z. J., Paterson, A. V., Jacobs, A. X., & Corbett, B. A. (2023). Community-guided measurement-based care for autistic youth and adults receiving psychotherapy: A conceptual overview and pilot implementation study of MBC-AUT. Autism : The International Journal of Research and Practice, 27(6), 1658–1675.
Scott, K., & Lewis, C. C. (2015). Using measurement-based care to enhance any treatment. Cognitive and Behavioral Practice, 22(1), 49–59.
Tam, H. E., & Ronan, K. (2017). The application of a feedback-informed approach in psychological service with youth: Systematic review and meta-analysis. Clinical Psychology Review, 55, 41–55.
Trivedi, M. H., Rush, A. J., Wisniewski, S. R., Nierenberg, A. A., Warden, D., Ritz, L., ... & Star* D Study Team. (2006). Evaluation of outcomes with citalopram for depression using measurement-based care in STAR* D: Implications for clinical practice. American Journal of Psychiatry, 163(1), 28–40.
van Sonsbeek, M. A., Hutschemaekers, G. J., Veerman, J. W., Vermulst, A., Kleinjan, M., & Tiemens, B. G. (2020, September). Challenges in investigating the effective components of feedback from Routine Outcome Monitoring (ROM) in Youth Mental Health Care. In Child & Youth Care Forum (pp. 1–26). Springer.
Wolpert, M., Curtis-Tyler, K., & Edbrooke-Childs, J. (2016). A qualitative exploration of patient and clinician views on patient reported outcome measures in child mental health and diabetes services. Administration and Policy in Mental Health and Mental Health Services Research, 43(3), 309–315.
Acknowledgements
We acknowledge the undergraduate research assistants who help us maintain our clinical databases from which these analyses were conducted. Specifically, we recognize Serena Fleming, Harveen Pantleay, Casper Brown, Aadila Lynch, and Faith Schiefelbein. We also acknowledge other graduate student leaders including Haley Murphy and Lauren Delk.
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Gatto, A.J., Ko, H., Keller, D.M. et al. Youth, caregiver, and clinician perspectives of youth Patient-Reported Outcome Measures (PROMs) in a psychological training clinic: lessons from early adopters. Curr Psychol 43, 18431–18443 (2024). https://doi.org/10.1007/s12144-024-05619-z
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DOI: https://doi.org/10.1007/s12144-024-05619-z