Implementing Standardized Assessments in Clinical Care: Now's the Time

Valenstein, Marcia; Adler, David A.; Berlant, Jeffrey; Dixon, Lisa B.; Dulit, Rebecca A.; Goldman, Beth; Hackman, Ann; Oslin, David W.; Siris, Samuel G.; Sonis, William A.

doi:10.1176/ps.2009.60.10.1372

Cited by 64 publications

(39 citation statements)

References 7 publications

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“…Measurement based care involves the use of clinician administered and self report scales for disease assessment, tracking, and treatment to achieve optimal outcomes.33 Although measurement based care already forms the bedrock of the management of chronic medical conditions such as diabetes and hypertension, it is infrequently used for assessment and monitoring of psychiatric conditions,34 despite calls for its widespread adoption by psychiatric clinicians. 33,35 Primary care physicians routinely assess basic health measurements such as pulse, blood pressure, and weight and regularly conduct a so-called review of systems to enquire about the most common problems that can affect various body systems. Psychiatry would benefit from a standardised toolkit of ps hiat i easu es that ould oth p o ide a pi tu e of the i di idual s e tal health status and facilitate monitoring of specific conditions.…”

Section: Diagnostic Assessmentmentioning

confidence: 99%

The WPA- Lancet Psychiatry Commission on the Future of Psychiatry

Bhugra

Tasman

Pathare

et al. 2017

The Lancet Psychiatry

345

187

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Executive Summary BackgroundThis Commission addresses several priority areas for psychiatry over the next decade, and into the 21st century. These represent challenges and opportunities for the profession to sustain and develop itself to secure the best possible future for the millions of people worldwide who will face life with mental illness. Part 1: The patient and treatmentWho will psychiatrists help? The patient population of the future will reflect general demographic shifts towards older, more urban, and migrant populations. While technical advances such as the development of biomarkers will potentially alter diagnosis and treatment, and digital tech-nology will facilitate assessment of remote populations, the human elements of practice such as cultural sensitivity and the ability to form a strong therapeutic alliance with the patient will remain central. Part 2: Psychiatry and health-care systemsDelivering mental health services to those who need them will require reform of the traditional structure of services. Few existing models have evidence of clinical effectiveness and acceptability to service users. Services of the future should consider stepped care, increased use of multidisciplinary teamwork, more of a public health approach, and the integration of mental and physical health care. These services will need to fit into the cultural and economic framework of a diverse range of settings in high-income, low-income, and middle-income countries. Part 3: Psychiatry and societyIncreased emphasis on social interventions and engagement with societal expectations might be an important a ea fo ps hiat s de elop e t. This ould e o pass ad o a fo the ights of individuals living with mental illnesses, political involvement concerning the social risk factors for mental illness, and, on a smaller scale, work with families and local social networks and communities. Psychiatrists should therefore possess communication skills and knowledge of the social sciences as well as the basic biological sciences. Part 4: The future of mental health lawMental health law worldwide tends to be based on concerns about risk rather than the protection of the rights of individuals experiencing mental illness. The United Nations Convention on the Rights of Persons with Disabilities, which states that compulsion based in whole or in part on mental disability is discriminatory, is a landmark document that should inform the future formulation and reform of mental health laws. An evidence-based approach needs to be taken: mental health legislation should mandate mental health training for all health professionals; ensure access to good-quality care; and cover wider societal issues, particularly access to housing, resources, and employment. All governments should include a mental health impact assessment when drafting relevant legislation. Part 5: Digital psychiatry-enhancing the future of mental healthDigital technology might offer psychiatry the potential for radical change in terms of service delivery and the development of new treatm...

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Section: Diagnostic Assessmentmentioning

confidence: 99%

The WPA- Lancet Psychiatry Commission on the Future of Psychiatry

Bhugra

Tasman

Pathare

et al. 2017

The Lancet Psychiatry

345

187

View full text Add to dashboard Cite

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“…Incorporating systematic measurement of client outcomes into treatment has been referred to in the published literature as progress monitoring, outcome monitoring, measurement-based care, or the use of feedback systems (Bickman, 2008; Lambert, Harmon, Slade, Whipple, & Hawkins, 2005; Saggese, 2005; Trivedi et al, 2006; Valenstein et al, 2009). In many but not all cases, these terms refer to a process in which the clinician obtains client progress and outcome data by administering validated measures across treatment.…”

Section: Measurement-based Carementioning

confidence: 99%

Using Measurement-Based Care to Enhance Any Treatment

Scott

Lewis

2015

Cognitive and Behavioral Practice

385

293

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Measurement-based care (MBC) can be defined as the practice of basing clinical care on client data collected throughout treatment. MBC is considered a core component of numerous evidence-based practices (e.g., Beck & Beck, 2011; Klerman, Weissman, Rounsaville, & Chevron, 1984) and has emerging empirical support as an evidence-based framework that can be added to any treatment (Lambert et al., 2003, Trivedi et al., 2007). The observed benefits of MBC are numerous. MBC provides insight into treatment progress, highlights ongoing treatment targets, reduces symptom deterioration, and improves client outcomes (Lambert et al., 2005). Moreover, as a framework to guide treatment, MBC has transtheoretical and transdiagnostic relevance with broad reach across clinical settings. Although MBC has primarily focused on assessing symptoms (e.g., depression, anxiety), MBC can also be used to assess valuable information about (a) symptoms, (b) functioning and satisfaction with life, (c) putative mechanisms of change (e.g., readiness to change), and (d) the treatment process (e.g., session feedback, working alliance). This paper provides an overview of the benefits and challenges of MBC implementation when conceptualized as a transtheoretical and transdiagnostic framework for evaluating client therapy progress and outcomes across these four domains. The empirical support for MBC use is briefly reviewed, an adult case example is presented to serve as a guide for successful implementation of MBC in clinical practice, and future directions to maximize MBC utility are discussed.

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“…As currently treated it has a high relapse rate and is characterized by periods of problematic use and/or functional impairment alternating with periods of remission or less problematic use (Anglin, Hser, & Grella, 1997; McKay & Weiss, 2001; Vaillant, 2003). Measurement-based care (Valenstein et al, 2009) is an essential component of treatment for many chronic physical and mental health conditions, but it is not typically used in the treatment of substance use disorders (SUDs) (McKay, 2009; Murphy, Lynch, Oslin, McKay, & TenHave, 2007). For example, hypertension, asthma/COPD, and diabetes have standard and objective tests that are routinely administered during clinical visits and used to provide a readily accessible summary of symptom/disease status to help guide treatment (Institute of Medicine, 2006; Valenstein et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Development and initial evaluation of the Brief Addiction Monitor (BAM)

Cacciola

Alterman

DePhilippis

et al. 2013

Journal of Substance Abuse Treatment

167

127

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This project developed and tested a 17-item monitoring instrument covering important substance use related behaviors to support measurement-based care and outcomes assessment. The study consisted of two phases, an instrument development phase and an initial study to examine its psychometric properties. Participants were 175 patients entering VA outpatient substance abuse treatment. The findings revealed that this Brief Addiction Monitor (BAM) exhibited acceptable characteristics. Exploratory factor analysis yielded three summary factors; Recovery Protection, Physical & Psychological Problems, and Substance Use & Risk. The RMSEA estimate was acceptable and the factors had alpha values exceeding or approaching 0.70. All three factors were sensitive to change and had excellent test-retest reliability. Predictive validity was demonstrated for two factors, Recovery Protection and Substance Use & Risk. At the item level, there was little indication of inappropriate response patterns. Change over time was significant for most items, and test-retest reliability was acceptable for nearly all items. Additional research is warranted to further establish the BAM’s reliability, validity and usefulness.

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Implementing Standardized Assessments in Clinical Care: Now's the Time

Cited by 64 publications

References 7 publications

The WPA- Lancet Psychiatry Commission on the Future of Psychiatry

The WPA- Lancet Psychiatry Commission on the Future of Psychiatry

Using Measurement-Based Care to Enhance Any Treatment

Development and initial evaluation of the Brief Addiction Monitor (BAM)

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