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Workforce Development / Training / Supervision

Content and strategies used during consultation aimed to increase use of measurement-based care in community mental health settings

(PS7-C70) Content and Strategies Used During Consultation Aimed to Increase Use of Measurement-based Care in Community Mental Health Settings

Saturday, November 19, 2022

10:30 AM – 11:30 AM EST

Location: Westside Ballroom, 5th Floor

Author(s)

Grace S. Woodard, B.S.

Doctoral Student
University of Miami
Coral Gables, Florida

Co-Author(s)

EC

Elizabeth P. Casline, M.S.

Doctoral Candidate
University of Miami
Coral Gables, Florida
SP

Scott T. Pollowitz, B.S.

Student
University of Miami
Aventura, Florida
Jill Ehrenreich-May, Ph.D.

Professor
University of Miami
Coral Gables, Florida
GG

Golda S. Ginsburg, Ph.D.

Professor
University of Connecticut School of Medicine
Farmington, Connecticut
AJ

Amanda Jensen-Doss, Ph.D.

Professor
University of Miami
Miami, Florida

Training and consultation are widely used implementation strategies to increase the use of evidence-based practices (EBP). Training alone is not enough to change clinical practice; however, the optimal content or dose of post-training consultation is unknown. Measurement-based care (MBC), defined as regularly administering outcome measures to clients to inform clinical decision making, has initial evidence of effectiveness in youth. MBC has the potential to improve treatment broadly due to its applicability across diagnoses and theoretical orientations, but only ~20% of clinicians use MBC. Little research has studied consultation focused on MBC or on assessing the content of and techniques used during consultation. The current study assesses the content of and techniques used by consultants during consultation calls focused on MBC. Clinicians (N = 55) were participants in a randomized controlled trial treating teens with anxiety or depression, who were assigned to use MBC with their usual care treatment. MBC was used every session with clients and their parents using the Youth Outcome Questionnaire through the online OQ Analyst measurement feedback system. Ongoing consultation was provided weekly following an initial workshop training in MBC. Notes were taken during consultation calls, 58.4% of which were transcript-style minutes. The codebook was developed by adapting previous codebooks for supervision (Dorsey et al., 2018) and consultation (Edmunds et al., 2013). The final codebook included 12 content and 10 consultant technique codes. Consultation call minutes were coded by case discussion with a total of 301 case discussions during the consultation period. Cases were coded to consensus by two coders, one of which was a graduate student. Frequencies of content and technique codes were calculated. The most common content discussed was client symptoms based on the report (88.4% of cases), therapy alliance based on the report (55.8%), YOQ measure administration (51.5%), planning future report feedback discussions with the client (45.2%), OQ system logistics (42.5%), and past discussion of feedback reports with the client (30.6%). The most common techniques used by consultants were modeling feedback report viewing and interpretation (76.1%), eliciting feedback report viewing and interpretation (54.2%), making a clinical suggestion (48.5%), didactics about clinical issues (38.9%), and didactics about technical issues (36.5%). Behavioral rehearsal was used 0 times. Our results mirror previous findings that passive consultation techniques, such as modeling, making suggestions, and didactics, are more commonly used than active techniques, such as behavioral rehearsal. This may have occurred due to the novelty of MBC and the online measurement feedback system used to deliver it, which may have meant that consultants had to spend more time teaching rather than discussing. However, much of the common content of the calls seem specific to MBC implementation, including when to administer measures and how to use the OQ system. This suggests that a major unanticipated role of consultation for MBC is focused on technical aspects of the measurement feedback system rather than clinical aspects of MBC.