This study analyzed data from 374 projects in the MHRN portfolio database to examine trends in service user involvement and its association with study success. The results showed that service user involvement has increased slightly over time. Higher levels of involvement were predicted by certain funders and clinical study groups. Studies with jointly or service user-initiated collaboration were more likely to successfully recruit over 90% of their target sample size. However, the study noted limitations and more research is needed to fully understand the relationship between involvement and recruitment success.
The first quasiexperiemental study of the ORS/SRS in a telephonic EAP company. Doubled outcomes and improved retension. Set the stage for the RCTs that followed
The Partners for Change Outcome Management System: Duncan & Reese, 2015Barry Duncan
Despite overall psychotherapy efficacy (Lambert, 2013), many clients do not benefit (Reese, Duncan, Bohanske, Owen, & Minami, 2014), dropouts are a problem (Swift & Greenberg, 2012), and therapists vary significantly in success rates (Baldwin & Imel, 2013), are poor judges of negative outcomes (Chapman et al., 2012), and grossly overestimate their effectiveness (Walfish, McAlister, O'Donnell, & Lambert, 2012). Systematic client feedback offers one solution (Duncan, 2014). Several feedback systems have emerged (Castonguay, Barkham, Lutz, & McAleavey, 2013), but only two have randomized clinical trial support and are included in the Substance Abuse and Mental Health Administration’s National Registry of Evidence based Programs and Practices: The Outcome Questionnaire-45.2 System (Lambert, 2010) and the Partners for Change Outcome Management System (PCOMS; Duncan, 2012). This article presents the current status of the Partners for Change Outcome Management System, the psychometrics of the PCOMS measures, its empirical support, and its clinical and training applications. Future directions and implications of PCOMS research, training, and practice are detailed. Finally, we propose that systematic feedback offers a way, via large scale data collection, to re-prioritize what matters to psychotherapy outcome, reclaim our empirically validated core values and identity, and change the conversation from a medical model dominated discourse to a more scientific, relational perspective.
A figure illustrating what meta-analytic research suggests about the factors running across all therapies that account for change in psychotherapy. From On Becoming a Better Therapist, 2nd Edition by Barry Duncan published by APA (2014).
Slone, N. C., Reese, R. J., Mathews-Duvall, S., & Kodet, J. (2015). Evaluating the Efficacy of client feedback in group psychotherapy. Group Dynamics: Theory, Research, and Practice, 19, 122-136. doi:10.1037/gdn0000026
The original validation of the CORS for kids and the ORS for adolescents. Allowed the benefits of client based outcome feedback to expand to youth and family and paved the way to the current RCT with kids in the schools.
The first quasiexperiemental study of the ORS/SRS in a telephonic EAP company. Doubled outcomes and improved retension. Set the stage for the RCTs that followed
The Partners for Change Outcome Management System: Duncan & Reese, 2015Barry Duncan
Despite overall psychotherapy efficacy (Lambert, 2013), many clients do not benefit (Reese, Duncan, Bohanske, Owen, & Minami, 2014), dropouts are a problem (Swift & Greenberg, 2012), and therapists vary significantly in success rates (Baldwin & Imel, 2013), are poor judges of negative outcomes (Chapman et al., 2012), and grossly overestimate their effectiveness (Walfish, McAlister, O'Donnell, & Lambert, 2012). Systematic client feedback offers one solution (Duncan, 2014). Several feedback systems have emerged (Castonguay, Barkham, Lutz, & McAleavey, 2013), but only two have randomized clinical trial support and are included in the Substance Abuse and Mental Health Administration’s National Registry of Evidence based Programs and Practices: The Outcome Questionnaire-45.2 System (Lambert, 2010) and the Partners for Change Outcome Management System (PCOMS; Duncan, 2012). This article presents the current status of the Partners for Change Outcome Management System, the psychometrics of the PCOMS measures, its empirical support, and its clinical and training applications. Future directions and implications of PCOMS research, training, and practice are detailed. Finally, we propose that systematic feedback offers a way, via large scale data collection, to re-prioritize what matters to psychotherapy outcome, reclaim our empirically validated core values and identity, and change the conversation from a medical model dominated discourse to a more scientific, relational perspective.
A figure illustrating what meta-analytic research suggests about the factors running across all therapies that account for change in psychotherapy. From On Becoming a Better Therapist, 2nd Edition by Barry Duncan published by APA (2014).
Slone, N. C., Reese, R. J., Mathews-Duvall, S., & Kodet, J. (2015). Evaluating the Efficacy of client feedback in group psychotherapy. Group Dynamics: Theory, Research, and Practice, 19, 122-136. doi:10.1037/gdn0000026
The original validation of the CORS for kids and the ORS for adolescents. Allowed the benefits of client based outcome feedback to expand to youth and family and paved the way to the current RCT with kids in the schools.
Feedback condition achieved nearly four times the amount of clients reaching reliable or clinically significant change. Nearly a 50% less separation/divorce at rate at follow up.
This is the 6 month follow up study of the Norway Feedback Trial of couple's impressions of couple therapy. Found that feedback couples had less complaints about service delivery (a component of the alliance) and most clients found feedback helpful.
Duncan & Sparks Ch 5 of Cooper & DrydenBarry Duncan
THIS CHAPTER DISCUSSES
•
Systematic feedback and the Partners for Change Outcome Management System (PCOMS)
•
PCOMS as a way to truly privilege clients, include them as full partners in decision-making and operationalize social justice and a pluralistic approach
PCOMS: A Viable Quality Improvement Strategy for Public Behavioral HealthBarry Duncan
This is the latest from the research team of the Heart and Soul of Change Project, published in the Journal of Consulting and Clinical Psychology. This study demonstrated that PCOMS is not only a viable quality improvement strategy but also that services to the poor and disenfranchised provided in a public behavioral setting, contrary to earlier research, can be as effective as those delivered in randomized clinical trials.
The Norway Couple Project: Lessons LearnedBarry Duncan
Couple therapists in routine practice may find it difficult to apply findings from an increasingly expanding and complex body of couple therapy research. Meanwhile, concerns have been raised that competency in evidence-based treatments is insufficient to inform many practice decisions or ensure positive treatment outcomes (American Psychological Association
Presidential Task Force on Evidence-Based Practice, American Psychologist, 2006, 271). This article aims to narrow the research/practice gap in couple therapy. Results from a large, randomized naturalistic couple trial (Anker, Duncan, & Sparks, 2009) and four companion studies are translated into specific guidelines for routine, eclectic practice. Client feedback, the therapeutic alliance, couple goals assessment, and therapist experience in couple therapy provide a research-informed template for improving couple therapy outcomes.
PCOMS as an Alternative to Psychiatric Diagnosis (Duncan, Sparks, & Timimi, 2...Barry Duncan
Part of an incredible series about diagnostic alternatives by the Journal of Humanistic Psychology edited by Sarah Kamens, Brent Dean Robbins, & Elizabeth Flanagan
Article by Dr Mary Haynes about her agency's journey to a recovery orientation via CDOI and PCOMS published in the SAMHSA Recovery to Practice Newsletter.
This article, "Casting a Wider Net in Behavioral Health Screening in Primary Care" found that the ORS identified more clients for behavioral healthcare consultation than the PHQ-9. A first step toward the upcoming RCT with PCOMS in an integrated setting.
This is the validation study of the Group Session Rating Scale (GSRS). In a nutshell, this study found more than acceptable reliability and validity with not only an alliance measure but also with group climate and cohesiveness scales. The GSRS was also predictive of last session outcomes. An RCT comparing PCOMS to TAU in group therapy has been submitted.
This 2 page article, which appeared in The Iowa Psychologist, provides an ultra brief summary of what makes therapy effective (the common factors) and how we can get better at what do: namely, add PCOMS, harvest client existing resources, and rely on that neglected old friend, the therapeutic alliance.
Summary of SAMHSA's review of and listing of feedback Informed Treatment as an evidence-based practice. The International Center for Clinical Excellence received perfect scores for readiness for dissemination materials
PCOMS works with kids too!
Cooper, M., Stewart, D., Sparks, J., Bunting, L. (2013). School-based counseling using systematic feedback: A cohort study evaluating outcomes and predictors of change. Psychotherapy Research, 23, 474-488.
Towards an evidence informed adventure therapy implementing feedback informed...Will Dobud
ABSTRACT
As an intervention for adolescents, adventure therapy has evolved considerably over the last three decades with support from multiple meta- analyses and research input from both residential and outpatient services. Tainted by a history of unethical practice and issues of accountability, this article explores the question of how adventure therapy can meet a standard of evidence preferred by policymakers and funding bodies on the international stage. In this case, feedback-informed treatment (FIT) is presented as a means for routine outcome management, creating a framework for adventure therapy which aims to improve the quality of participant engagement while maintaining and operationalizing today’s definitions for evidence-based practice. A case vignette illustrates the use of FIT with an adolescent participant engaged on a 14-day adventure therapy program.
Feedback condition achieved nearly four times the amount of clients reaching reliable or clinically significant change. Nearly a 50% less separation/divorce at rate at follow up.
This is the 6 month follow up study of the Norway Feedback Trial of couple's impressions of couple therapy. Found that feedback couples had less complaints about service delivery (a component of the alliance) and most clients found feedback helpful.
Duncan & Sparks Ch 5 of Cooper & DrydenBarry Duncan
THIS CHAPTER DISCUSSES
•
Systematic feedback and the Partners for Change Outcome Management System (PCOMS)
•
PCOMS as a way to truly privilege clients, include them as full partners in decision-making and operationalize social justice and a pluralistic approach
PCOMS: A Viable Quality Improvement Strategy for Public Behavioral HealthBarry Duncan
This is the latest from the research team of the Heart and Soul of Change Project, published in the Journal of Consulting and Clinical Psychology. This study demonstrated that PCOMS is not only a viable quality improvement strategy but also that services to the poor and disenfranchised provided in a public behavioral setting, contrary to earlier research, can be as effective as those delivered in randomized clinical trials.
The Norway Couple Project: Lessons LearnedBarry Duncan
Couple therapists in routine practice may find it difficult to apply findings from an increasingly expanding and complex body of couple therapy research. Meanwhile, concerns have been raised that competency in evidence-based treatments is insufficient to inform many practice decisions or ensure positive treatment outcomes (American Psychological Association
Presidential Task Force on Evidence-Based Practice, American Psychologist, 2006, 271). This article aims to narrow the research/practice gap in couple therapy. Results from a large, randomized naturalistic couple trial (Anker, Duncan, & Sparks, 2009) and four companion studies are translated into specific guidelines for routine, eclectic practice. Client feedback, the therapeutic alliance, couple goals assessment, and therapist experience in couple therapy provide a research-informed template for improving couple therapy outcomes.
PCOMS as an Alternative to Psychiatric Diagnosis (Duncan, Sparks, & Timimi, 2...Barry Duncan
Part of an incredible series about diagnostic alternatives by the Journal of Humanistic Psychology edited by Sarah Kamens, Brent Dean Robbins, & Elizabeth Flanagan
Article by Dr Mary Haynes about her agency's journey to a recovery orientation via CDOI and PCOMS published in the SAMHSA Recovery to Practice Newsletter.
This article, "Casting a Wider Net in Behavioral Health Screening in Primary Care" found that the ORS identified more clients for behavioral healthcare consultation than the PHQ-9. A first step toward the upcoming RCT with PCOMS in an integrated setting.
This is the validation study of the Group Session Rating Scale (GSRS). In a nutshell, this study found more than acceptable reliability and validity with not only an alliance measure but also with group climate and cohesiveness scales. The GSRS was also predictive of last session outcomes. An RCT comparing PCOMS to TAU in group therapy has been submitted.
This 2 page article, which appeared in The Iowa Psychologist, provides an ultra brief summary of what makes therapy effective (the common factors) and how we can get better at what do: namely, add PCOMS, harvest client existing resources, and rely on that neglected old friend, the therapeutic alliance.
Summary of SAMHSA's review of and listing of feedback Informed Treatment as an evidence-based practice. The International Center for Clinical Excellence received perfect scores for readiness for dissemination materials
PCOMS works with kids too!
Cooper, M., Stewart, D., Sparks, J., Bunting, L. (2013). School-based counseling using systematic feedback: A cohort study evaluating outcomes and predictors of change. Psychotherapy Research, 23, 474-488.
Towards an evidence informed adventure therapy implementing feedback informed...Will Dobud
ABSTRACT
As an intervention for adolescents, adventure therapy has evolved considerably over the last three decades with support from multiple meta- analyses and research input from both residential and outpatient services. Tainted by a history of unethical practice and issues of accountability, this article explores the question of how adventure therapy can meet a standard of evidence preferred by policymakers and funding bodies on the international stage. In this case, feedback-informed treatment (FIT) is presented as a means for routine outcome management, creating a framework for adventure therapy which aims to improve the quality of participant engagement while maintaining and operationalizing today’s definitions for evidence-based practice. A case vignette illustrates the use of FIT with an adolescent participant engaged on a 14-day adventure therapy program.
A project by a group of students of Augmented Reality & Mobile Experience (Politecnico di Milano).
We want to create an experience that is about re-discovering place in Milan, and about connecting stories to these places.
Nuevos paquetes de baterías psicométricas y de competencias para selección y desarrollo de capital humano.
www.monroyasesores.com.mx
contactanos@monroyasesores.com.mx
Skype: amonroyacosta
The Edelman Cloverleaf forecast reflects our latest thinking on the digital information ecosystem and the convergence of content publishers and technology platforms.
The research is based on dozens of interviews conducted across six parts of the Edelman Cloverleaf™.
Marco Lombardi: Promoting Social Inclusion: the Perception of Priorities in A...Beitissie1
The lecture describes a study centering on the level of importance given by therapists treating people with intellectual disabilities, to activity geared towards social inclusion.
Stakeholder Engagement in a Patient-Reported Outcomes Implementation by a Pra...Marion Sills
Kwan BM, Sills MR, Graham D, Hamer MK, Fairclough DL, Hammermeister KE, Kaiser A, Diaz-Perez MJ, Schilling LM. Stakeholder Engagement in a Patient-Reported Outcomes Implementation by a Practice-Based Research Network. JABFM. In Press.
1
5
Nursing Research Utilization Project Proposal: Monitoring
The delivery of individualized care is important in ensuring receipt of optimal benefits of care rendered to patients. Discharged patients should be released to community agencies that provide in-home assistive services. The transition plan must consider the patient's home environment as well as the risks for injury and find ways of mitigating them as soon as possible. Service providers should take advantage of family conferences to advise the patients’ family of how to care for the patient after they have been discharged from the hospital. Hence, there is a need for post-discharge follow-up especially for high-risk patients, to deter readmission rates (Potera, 2009).
This paper aims to discuss methods of monitoring solution implementation; evaluate the solution; and lastly, tackle outcome measures and data collection evaluation.
Monitoring
Monitoring is a scheduled collection and analysis of data so as to track the progress of the implemented solution and ensure that the solution is in compliance with the set health standard regarding patient discharge (Popejoy, L.L., et al., 2015). Monitoring is a critical aspect of any implementation process since it helps in establishing patterns and coming up with strategies for proper management and quality improvement. Monitoring and evaluation in the health care sector are paramount in ensuring quality services. It is critical to monitor the implemented solutions for the issues affecting patient-centered care and discharge planning(Potera, 2009).
The Stetler Model assists in the monitoring of the solution using its steps. “The monitoring consists of preparation, validation, decision-making, application and finally evaluation according to the steps of the Stetler Model (Stetler, 2001).” The preparation formonitoring begins with the purpose; sources of the evidence of the research; and then the context of health care. The identification of purpose depends on the solution proposed. Therefore, the contextual factors must be examined to determine the appropriate monitoring strategy.
The second phase is the validation of the monitoring process. The solution identified was for the IDT to ensure that patients receive individualized care, which are carried out post hospitalization and prevent patients returning to the hospital. Therefore, the patient-centered care and reduction of readmission would be the ultimate goal of monitoring. The monitoring process starts with the formulation of healthcare providers with unified policy-driven structure ensuring that there are proper communication and coordination and culminates with patient being released in the community.
Evaluation
All the IDT will be involved in the designing as well as the implementation of the program. Stakeholders are expected to obtain and report their expertise, perspectives and feedback. The next step will be clarifying the scope of the solution plan. In this case, the sc ...
15Nursing Research Utilization Project ProposaKiyokoSlagleis
1
5
Nursing Research Utilization Project Proposal: Monitoring
The delivery of individualized care is important in ensuring receipt of optimal benefits of care rendered to patients. Discharged patients should be released to community agencies that provide in-home assistive services. The transition plan must consider the patient's home environment as well as the risks for injury and find ways of mitigating them as soon as possible. Service providers should take advantage of family conferences to advise the patients’ family of how to care for the patient after they have been discharged from the hospital. Hence, there is a need for post-discharge follow-up especially for high-risk patients, to deter readmission rates (Potera, 2009).
This paper aims to discuss methods of monitoring solution implementation; evaluate the solution; and lastly, tackle outcome measures and data collection evaluation.
Monitoring
Monitoring is a scheduled collection and analysis of data so as to track the progress of the implemented solution and ensure that the solution is in compliance with the set health standard regarding patient discharge (Popejoy, L.L., et al., 2015). Monitoring is a critical aspect of any implementation process since it helps in establishing patterns and coming up with strategies for proper management and quality improvement. Monitoring and evaluation in the health care sector are paramount in ensuring quality services. It is critical to monitor the implemented solutions for the issues affecting patient-centered care and discharge planning(Potera, 2009).
The Stetler Model assists in the monitoring of the solution using its steps. “The monitoring consists of preparation, validation, decision-making, application and finally evaluation according to the steps of the Stetler Model (Stetler, 2001).” The preparation formonitoring begins with the purpose; sources of the evidence of the research; and then the context of health care. The identification of purpose depends on the solution proposed. Therefore, the contextual factors must be examined to determine the appropriate monitoring strategy.
The second phase is the validation of the monitoring process. The solution identified was for the IDT to ensure that patients receive individualized care, which are carried out post hospitalization and prevent patients returning to the hospital. Therefore, the patient-centered care and reduction of readmission would be the ultimate goal of monitoring. The monitoring process starts with the formulation of healthcare providers with unified policy-driven structure ensuring that there are proper communication and coordination and culminates with patient being released in the community.
Evaluation
All the IDT will be involved in the designing as well as the implementation of the program. Stakeholders are expected to obtain and report their expertise, perspectives and feedback. The next step will be clarifying the scope of the solution plan. In this case, the sc ...
Evaluation of the Integrated Care and Support Pioneers ProgrammeNuffield Trust
Nick Mays of the Policy Innovation Research Unit presents some conclusions from the early evaluation of the Integrated Care and Support Pioneers Programme.
An introduction to the stepped wedge cluster randomised trial, by Dr Karla Hemming for the CLAHRC West Midlands Scientific Advisory Group meeting, 9th June 2015, Birmingham, UK
HIT Use in Primary Care Practices: Understanding and Eliminating Disparity UCLA CTSI
UCLA CTSI and University of Minnesota Cross-Institutional Award Projects
Principal Investigators: Hector Rodriguez (UCLA) and William Riley (University of Minnesota)
Large-scale federal investments in health information technology (HIT) are intended to spur health care providers and organizations to share patient information to better coordinate and improve quality of care. However, the uptake of HIT has lagged in ambulatory care settings that care for high proportions of low-income patients. Our pilot study seeks to generate knowledge about facilitators and barriers to the spread of electronic health information exchange (HIE) for improving quality of care among underserved populations. We have established partnerships with two health care organizations: Citrus Valley Health Partners (CVHP), a provider network serving many underserved patients in the East San Gabriel Valley, Calf., and the Federally Qualified Health Center Urban Health Network (FUHN), a group of ten clinic organizations serving the Minneapolis-St. Paul area. We are conducting key informant interviews of physicians, front office staff, IT personnel, and executives. Through these interviews, we are learning about the barriers to electronic exchange of health information within the clinics and practices, between these sites, and at city-wide or regional levels. This multi-level framework elucidates the opportunities and challenges for ambulatory care practices serving underserved populations in adopting and sustaining HIT.
The State of Clinical Outsourcing: Managing Risk in Outsourced Clinical Trials
Interactive Discussion Based on Data from Avoca’s 2013 Industry Research DIA Forum
June 24, 2013
1. Service user involvement and
study success
An analysis of the MHRN portfolio
database
Liam Ennis and Professor Til Wykes
2. Background
Many funders now require service
user involvement (or justification why
not)
MHRN directive = assisting
involvement
3. Involvement – what
“When we talk about service user
involvement, we mean the active involvement of
service users, not their passive involvement as
recipients of services or information. Involving is
often described as doing
things with or by people, rather
than for or to them.
‘Involvement’ covers a range of activities, from
consulting service users abut their views or
wishes, through to working in partnership with them
to develop projects or services, right up to service
users leading projects, services or organisations”
(Taken from TwoCan Associates)
4. Involvement – why
Ensuring that research questions are
those that are valued by service users
Enhancing translational value of
research
Improving quality and feasibility
5. Involvement – where
e.g.
Setting research priorities (Rose et
al, 2008; Thornicroft et al, 2002)
Choosing/generating outcomes
(Crawford et al, 2011; Evans et al, 2012)
Alternative methodologies (Rose et
al, 2011)
BUT no studies investigate whether
there are benefits to the study itself
6. The present study
Aims to establish whether:
1) Service user involvement has increased
over time
2) Particular factors are associated with
involvement
3) Service user involvement is associated
with recruitment success
7. Data source
MHRN portfolio database
Contains all adopted studies since
2004
N = 374
8. Measures
Level of service user involvement:
1. Consultation
2. Researcher-initiated collaboration
3. Jointly/service-user initiated
collaboration, or user-controlled
studies
9. Measures
Study complexity
Primary CSG
Funding body
◦ NIHR/MRC/Charity/International/Government
Study characteristics
◦ Randomised/Intervention/Follow up
Adoption order
10. Outcomes
Levels of servicer user involvement
Successful recruitment (>90% -
nationally set target by NIHR)
11. Statistical analysis
Change in service user involvement over
time was assessed by correlating adoption
order with level of service user involvement
using Pearson’s product moment
Predictors of levels of service user
involvement were explored using
multinomial logistic regression
Associations with participant recruitment
were explored using binary logistic regression
(N = 135)
12. Results
Service user involvement was
modestly correlated with adoption
order, r = ·12, p <· 05 showing that
involvement has increased over time.
13. Predictor Wald's chi-square p odds ratio
CSG
Psychotic disorders 0·66 ·42 0·68
Mood disorders 1·69 ·19 0·46
Other common mental disorders 3·46 ·06 0·29
Developmental disorders 6·31 ·012* 0·06
Personality disorders 5·82 ·016* 0·17
Social interventions 5·14 ·023* 0·14
Funder
NIHR 5·97 ·015* 4·45
MRC 0·18 ·67 0·72
Government 0·001 ·97 1·03
Charities/not for profit 1·64 ·20 3·03
14. Consultation
Researcher
70 Initiated
60 Jointly/Patient-
initiated/Patient
controlled
50
% 40
30
Mean
20 proportion
in highest
10 category
0
NIHR MRC Government Charities/not International
Funder for profit
15. Predictor Wald’s chi-square p odds ratio
Results
Non-follow up 5·94 ·015* 0·23
Complexity 6·55 ·010* 0·83
Involvement
Researcher initiated 1·41 ·236 1·63
Jointly initiated or higher 4·58 ·032* 4·12
16. Interpretation: context
Important to emphasise associations,
not causality
Therefore only provides directions for
future research
Need more variables to delineate this
relationship
17. Why might the association
exist?
Language in information sheets etc
Least-burdensome design of research
Intrinsic appeal of service user
involvement
18. Limitations
Unmeasured factors, e.g. researcher
commitment
Detail of categories of involvement
Are researchers involving users as
they set out to?
19. Future directions
More research…
MHRN adoption forms could help
delineate the relationship by
requesting more detail & being more
specific about the information required