Implementing Measurement-Based Care in Behavioral Health

Lewis, Cara C.; Boyd, Meredith; Puspitasari, Ajeng J.; Navarro, Elena; Howard, Jacqueline; Kassab, Hannah; Hoffman, Mira; Scott, Kelli; Lyon, Aaron R.; Douglas, Susan; Simon, Greg; Kroenke, Kurt

doi:10.1001/jamapsychiatry.2018.3329

Cited by 437 publications

(385 citation statements)

References 91 publications

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“…Moreover, given the relatively low correlations with clinician ratings, individuals providing treatment may be unaware of these patient's feelings. Incorporating such data could become a useful component of measurement-based care for pediatric anxiety (Lewis et al, 2019). One might integrate this methodology into cognitive behavioral therapy (CBT) for treatmentseeking anxious youth in ways that would allow therapists to capitalize on more accurate, in-vivo assessments of symptoms and treatment adherence (e.g., Pramana, Parmanto, Kendall, & Silk, 2014).…”

Section: Discussionmentioning

confidence: 99%

Advancing clinical neuroscience through enhanced tools: Pediatric social anxiety as an example

et al. 2019

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Background: Clinical researchers face challenges when trying to quantify diverse processes engaged during social interactions. We report results from two studies, each demonstrating the potential utility of tools for examining processes engaged during social interactions.Method: In the first study, youth (n = 57) used a smartphone-based tool to rate mood and responses to social events. A subset (n = 20) completed the second, functional magnetic resonance imaging study. This second study related anxiety to error-evoked brain responses in two social conditions-while being observed and when alone.We also combined these tools to bridge clinical, social-contextual, and neural levels of measurement.Results: Results from the first study showed an association between negativelyperceived social experiences and a range of negative emotions. In the second study there was a positive correlation during error monitoring between social-anxiety severity and context-specific activation of the pregenual anterior cingulate cortex.Finally, during imaging, the perceived quality of peer interactions as assessed using the smartphone-based tool, interacted with social context to predict levels of activation in the hippocampus and superior frontal gyrus.Conclusions: By improving measurement, enhanced tools may provide new means for studying relationships among anxiety, brain function, and social interactions.

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Section: Discussionmentioning

confidence: 99%

Advancing clinical neuroscience through enhanced tools: Pediatric social anxiety as an example

et al. 2019

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“…34 Despite this movement, the uptake of measurement-based care by behavioral health providers, including those in cardiology, is lagging. 35 A recent study highlighted the importance of patient-reported outcomes for heart failure patients; they listed criteria for a valuable, reliable cardiac patient-reported outcomes measure based on Food and Drug Administration guidelines, which included establishment of content validity, construct validity, reliability, responsiveness to change, performance diversity, feasibility, interpretability, and prognostic value. 36 Based on our literature review, the FSAS meets most of these criteria; however, future research is needed to confirm the interpretability and prognostic value for risk stratification and appropriate treatment provision.…”

Section: Future Directionsmentioning

confidence: 99%

Measuring ICD shock anxiety: Status update on the Florida Shock Anxiety Scale after over a decade of use

Tripp

Huber

Kuhl³

et al. 2019

Pacing Clinical Electrophis

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Introduction Approximately 44% of patients with implantable cardioverter defibrillators (ICDs) experience some form of shock anxiety, associated with cardiac fear, physical inactivity, and increased morbidity and mortality. The Florida Shock Anxiety Scale (FSAS) was created to measure ICD‐specific fears for a more precise target of patient psychologic distress and potential need for intervention. The current paper describes results from a focused literature review of studies using FSAS over the past 15 years, with the aim of summarizing its current reliability and validity, associated outcomes, and potential future directions for its clinical and research implementation. Methods In this review, 26 peer‐reviewed articles were analyzed and selected from an in‐depth literature search of two electronic databases. Results The reliability and validity of FSAS has been upheld since its initial validation and remain positive. The majority of studies used FSAS as an assessment tool to evaluate a clinical need for psychologic support or psychoeducation. The most frequently reported predictors of FSAS shock anxiety include experience of shock, appropriate and inappropriate, and number of shocks experienced. Common correlates of higher FSAS scores include lower device‐related knowledge, lower perceived support from healthcare providers, greater posttraumatic stress disorder symptoms, and negative attitudes about device dependency. Younger age and female gender are also associated with increased shock anxiety. Conclusions Since 2006, FSAS has been widely represented as a valid and reliable assessment tool for quantifying device‐related anxiety in ICD recipients in diverse populations. Future directions for FSAS should explore its potential role in support of measurement‐based care.

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“…Despite the fact that providing continuous feedback has been viewed as part of good practice and feedback studies in adult mental health care are abundant, the implementation of ROM is often problematic and the take-up by clinicians is low (Patterson et al 2006). Surveys spanning different countries indicate that fewer than 20% of practitioners (17.9% of psychiatrists, 11.1% of psychologists, and 13.9% of masters-level practitioners) engage in ROM, and as few as 5% use it during every session (Lewis et al 2019). Jensen-Doss et al (2018) showed that only 13.9% of clinicians reported using standardized progress measures at least monthly and 61.5% never used them.…”

Section: Introductionmentioning

confidence: 99%

Challenges in Investigating the Effective Components of Feedback from Routine Outcome Monitoring (ROM) in Youth Mental Health Care

Sonsbeek

Hutschemaekers

Veerman

et al. 2020

Child Youth Care Forum

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BackGround Studies on feedback in youth mental health care are scarce and implementation of feedback into clinical practice is problematic. Objective To investigate potentially effective components of feedback from Routine Outcome Monitoring (ROM) in youth mental health care in the Netherlands through a three-arm, parallel-group, randomized controlled trial in which a literature-based, multi-faceted implementation strategy was used. Method Participants were randomly allocated to three conditions (basic feedback about symptoms and quality of life; basic feedback supplemented with clinical support tools; discussion of the feedback of the second condition with a colleague while following a standardized format for case consultation) using a block randomization procedure, stratified by location and participants’ age. The youth sample consisted of 225 participants (mean age = 15.08 years; 61.8% female) and the parent sample of 234 mothers and 54 fathers (mean age of children = 12.50 years; 47.2% female). Primary outcome was symptom severity. Secondary outcomes were quality of life and end-of-treatment variables. Additionally, we evaluated whether being Not On Track (NOT) moderated the association between condition and changes in symptom severity. Results No significant differences between conditions and no moderating effect of being NOT were found. This outcome can probably be attributed to limited power and implementation difficulties, such as infrequent ROM, unknown levels of viewing and sharing of feedback, and clinicians’ poor adherence to feedback conditions. Conclusions The study contributes to our limited knowledge about feedback from ROM and underscores the complexity of research on and implementation of ROM within youth mental health care. Trial registration Dutch Trial Register NTR4234 .

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Implementing Measurement-Based Care in Behavioral Health

Cited by 437 publications

References 91 publications

Advancing clinical neuroscience through enhanced tools: Pediatric social anxiety as an example

Advancing clinical neuroscience through enhanced tools: Pediatric social anxiety as an example

Measuring ICD shock anxiety: Status update on the Florida Shock Anxiety Scale after over a decade of use

Challenges in Investigating the Effective Components of Feedback from Routine Outcome Monitoring (ROM) in Youth Mental Health Care

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