The Washington Circle continuity of care performance measure: Predictive validity with adolescents discharged from residential treatment

Garner, Bryan; Godley, Andrew; Funk, Rodney R.; Lee, Margaret T.; Garnick, Deborah W.

doi:10.1016/j.jsat.2009.05.008

Cited by 21 publications

(22 citation statements)

References 51 publications

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“…Families/primary caregivers are an integral part of treatment and their inclusion in the process increases the likelihood of improving adolescents' recovery environment and reducing substance use and related problems. Both A-CRA and ACC, which seek to rearrange environmental contingences to make non-using behaviors more reinforcing than using behaviors, are effective treatments for adolescents with SUDs (e.g., Dennis et al, 2004; Garner et al, 2010; Godley et al, 2007; Godley et al, 2011a; Ruiz et al, 2011). …”

Section: Methodsmentioning

confidence: 99%

“…Adolescents with continuity of care after discharge had increased likelihood of abstinence at their three-month follow-up interview (Garner et al, 2010). Thus far, adults have been the focus of research on the relationship between outcomes and the measure of treatment engagement initially developed by the Washington Circle and used in this study.…”

Section: Introductionmentioning

confidence: 99%

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The Washington circle engagement performance measures’ association with adolescent treatment outcomes

Garnick

Lee

O’Brien

et al. 2012

Drug and Alcohol Dependence

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Background For adolescents, substance use disorder (SUD) treatment outcomes (e.g., abstinence, problematic behaviors) often cannot be measured soon enough to influence treatment trajectory. Although process measures (e.g., treatment engagement) can play an important role, it is essential to demonstrate their association with outcomes. This study explored the extent to which engagement in outpatient treatment was associated with outcomes and whether demographic/clinical characteristics moderated these relationships. Methods This is a prospective study of adolescents (N=1,491) who received outpatient treatment for SUDs at one of 28 treatment sites taking part in a national evidence-based practice implementation initiative. Information from the Global Appraisal of Individual Needs interviews at intake and six-month follow-up, as well as encounter data, were used. Adjusted hierarchical logistic models were used to estimate effects of engagement on six-month outcomes. Results Sixty-one percent of adolescents engaged in outpatient treatment. Adolescents engaging in treatment had significantly lower likelihoods of reporting any substance use (OR 0.60, 95% CI 0.41, 0.87), alcohol use (OR 0.63, 95% CI 0.45, 0.87), heavy alcohol use (OR 0.53, 95% CI 0.33, 0.86), and marijuana use (OR 0.64, 95% CI 0.45, 0.93). This association of engagement with abstinence outcomes was not limited to any particular group. Treatment engagement, however, was not associated with adolescents' self-report of illegal activity or trouble controlling behavior at follow-up. Conclusion At the individual level, the Washington Circle engagement measure was a predictor of some positive outcomes for adolescents in outpatient treatment. Efforts to better engage adolescents in treatment could improve quality of care.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Washington circle engagement performance measures’ association with adolescent treatment outcomes

Garnick

Lee

O’Brien

et al. 2012

Drug and Alcohol Dependence

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“…For example: meeting the initiation and engagement criteria is associated with decreased criminal justice involvement (Garnick et al, 2007); engagement is associated with significant improvements in the alcohol, drug and legal composite scores from the Addiction Severity Index among Veterans Affairs (VA) patients (Harris et al, 2008) and the WC continuity of care after residential treatment for adolescents is associated with recovery status at follow-up (Garner, Godley, Funk, Lee, & Garnick, 2009). Therefore, it is not surprising that as states work on improving their NOMs scores, states that report to providers generally include both the WC measures and NOMs in the reports.…”

Section: Discussionmentioning

confidence: 99%

Lessons from five states: Public sector use of the Washington Circle performance measures

Garnick¹,

Lee²,

Horgan³

et al. 2011

Journal of Substance Abuse Treatment

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Five states (Connecticut, Massachusetts, New York, North Carolina, and Oklahoma) have incorporated Washington Circle (WC) substance abuse performance measures in various ways into their quality improvement strategies. In this paper we focus on what other states and local providers might learn from these states’ experiences as they consider using WC performance measures. Using a case study approach, we report that the use of WC measures differs across these five states, although there are important common themes required for adoption and sustainability of performance measures which include: leadership, evaluation of specification and use of measures over time, state-specific adaptation of the WC measure specifications, collaboration with consultants and partners, inclusion of WC measures in the context of other initiatives, reporting to providers and the public, and data and resource requirements. As additional states adopt some of the WC measures, or adopt other performance measurement approaches, these states’ experiences could help them to develop implementations based on their particular needs.

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“…Experts have recommended “performance measures” (e.g., client engagement) (9–11), “key adolescent substance use treatment elements” (e.g., staff trained in adolescent development and co-occurring mental disorders) (12), and “effective addiction treatment principles” (e.g., “[M]any drug-addicted individuals also have other mental disorders”) (13). Many of these ‘measures’, ‘elements’, and ‘principles’ overlap; studies have examined how clinical practice conforms or adheres to some of these guidelines (12, 14, 15) but only one process measure - client engagement - has yet been associated with positive client outcomes (4, 16, 17). …”

Section: Introductionmentioning

confidence: 99%

Provision of Mental Health Services as a Quality Indicator for Adolescent Substance Abuse Treatment Facilities

Ramchand

Griffin²,

Hunter³

et al. 2015

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Objective We sought to test whether adolescents receiving substance use treatment at facilities offering full (can treat all psychiatric conditions) or partial (do not treat severe/persistent mental illness) mental health services have better 12-month substance use and mental health outcomes. Methods Data was collected from 3,235 adolescents served at one of 50 adolescent treatment facilities who were assessed at baseline and at 12-months. Propensity scores were applied to compare client outcomes from three types of facilities (full, partial, or no mental health services); weighted linear models were estimated to examine outcomes. Results Youths attending facilities offering full or partial mental health services had better substance use outcomes than youths attending facilities offering no such services. There was no evidence of a difference in substance use outcomes between facilities offering full versus partial services, nor evidence of differences on mental health outcomes. Conclusions These preliminary findings suggest that the availability of mental health services may be a useful quality indicator for adolescent substance use treatment facilities. More research is needed to examine specific types of mental health services offered at different facilities.

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The Washington Circle continuity of care performance measure: Predictive validity with adolescents discharged from residential treatment

Cited by 21 publications

References 51 publications

The Washington circle engagement performance measures’ association with adolescent treatment outcomes

The Washington circle engagement performance measures’ association with adolescent treatment outcomes

Lessons from five states: Public sector use of the Washington Circle performance measures

Provision of Mental Health Services as a Quality Indicator for Adolescent Substance Abuse Treatment Facilities

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