Tracking Mental Health Outcomes

At this point in the history of psychotherapy, one of the most needed and yet most overlooked areas in outpatient mental health treatment is the measurement and documentation of treatment effectiveness and efficacy. By extension, such research would allow the identification of proven and reliable therapeutic approaches for various psychological problems and complaints. However, psychotherapists - - whether in private practice, group practice, on managed care provider panels, or on staff at community mental health centers - - are invariably overwhelmed with the business of actually providing mental health services; there is little time or energy left over to use standardized treatment planning approaches or to evaluate the results of the treatments we provide.

From its opening chapters this book takes a refreshingly direct and pragmatic approach. The first issue tackled is how to meaningfully define successful outcome in psychotherapy. The authors provide a succinct and useful discussion of these issues, contrasting efficacy and effectiveness research and providing a brief history of psychotherapy outcome research efforts going back as far as Eysenck's classic studies in the early 1950s.

Treatment success may be (and most often is) defined differently by clients, therapists, and third-party payers such as insurers and managed care operations. For example, a client may experience significant relief of troubling psychological symptoms but show no outward, measurable changes in daily functioning; in such cases, client self-reports and satisfaction surveys may be the only proof of successful therapy outcome. For third-party payers and managed case companies, this may not be sufficient evidence of the value of psychotherapy, however. For example, cost-containment (e.g., no further need or demand for costly inpatient or outpatient services) may be a more relevant measure for these companies.

The practical nature of the book is evident throughout. For example, in Chapter Three the authors point out that for the clinician, large-scale empirical studies are unfeasible. Thus, questions about the effectiveness and/or efficacy of interventions cannot usually be answered at the clinic or individual clinician level. Fortunately, it's usually enough to simply show that ones' clients benefit by making progress toward acceptable treatment goals. To assist with this, the authors provide a number of sample forms, including assessment and history forms, individualized treatment plan formats, progress note forms, behavioral observation forms and objectives charts, treatment outcome summary formats, and even a suggested narrative report format. The various chapters sequentially walk the reader through this individualized approach to treatment planning and the measurement of "clinically significant change".

This book is quite readable and is highly recommended for those clinicians and administrators who want or need a practical and time-effective way to approach assessment, treatment planning and outcome measurement.

© 2002 Keith Harris
 

Keith Harris, Ph.D.  is a clinical psychologist and supervisor of Victor Valley Behavioral Health Center in San Bernardino county, California. His interests include clinical supervision, the empirical basis for psychotherapy research (and its design), human decision-making processes, and the shaping of human nature by evolutionary forces.

Also available from Barnes & Noble.com:

Tracking Mental Health Outcomes: A Therapist's Guide to Measuring Client Progress, Analyzing Data, and Improving Your Practice