Yes, More Evidence: Spanish version of the ORS Validated by Chilean Researchers

June 16, 2011 By scottdm Leave a Comment

Last week, Chile. This week, Perth, Australia. Yesterday, I landed in Sydney following a 30 hour flight from the United States. I managed to catch the last flight out to Perth before all air travel was grounded due to another ash clound–this time coming from Chile! I say “another” as just over a year ago, I was trapped behind the cloud of ash from the Icelandic eruption! So far so good. Today, I’ll spend the day talking about “excellence” in behavioral healthcare.

Before heading out to teach for the day, I wanted to upload a report from a recent research project conducted in Chile investigating the statistical properties of the ORS. I’ve attached the report here so you can read for yourself. That said, let me present the highlights:

The spanish version of the ORS is reliable (alpha coefficients .90-.95).
The spanish version of the ORS shows good construct and convergent validity (correlations with the OQ45 .5, .58).
The spanish version of the ORS is sensitive to change in a treated population.

The authors of the report that was presented at the Society for Psychotherapy Research meeting conclude, “The ORS is a valid instrument to be used with the Chilean population.”

As asked in my blogpost last week, “how much more evidence is needed?” Now, more than ever, clinicians needs simple, valid, reliable, and feasible tools for evaluating the process and outcome of behavioral healthcare. The ORS and SRS FITS the bill!

How Much More Evidence Is Needed? A New Meta-Analysis on Feedback-Informed Treatment

June 9, 2011 By scottdm 1 Comment

Received an email from friend and colleague John Norcross, Ph.D. Attached were the results of a meta-analysis completed by Michael Lambert and Kenichi Shimokawa on Feedback-Informed Treatment (FIT) which will appear in the second edition of his book, Psychotherapy Relationships that Work (Oxford University Press). For those who cannot wait, you can access the same results in the lastest issue of the APA journal Psychotherapy (Volume 48, Number 1, March 2011, pages 72-79).

Briefly, the chapter begins with a review of the literature on feedback–a body of evidence that, by the way, dates back to 1930’s and has always shown small to moderate effects on the outcome of treatment. In reviewing studies specific to the ORS and SRS, the authors conclude, “”>the results indicated that those in the feedback group ha[ve] 3.5 times higher odds of experiencing reliable change while having less than half the odds of experiencing deterioration.” Additionally, Lambert and Shimokawa report few if any meaningful differences between therapies informed by the ORS and SRS and those using the well-established and widely used Outcome Questionnaire (OQ). Finally, and importantly, the authors note that in “busy practices…the brevity of the [ORS and SRS]…expedite and ease practical difficulties” thereby decreasing barriers to implementation.

How much more evidence will it take before feedback informed treatment becomes standard practice? All of the available data is summarized in the materials below.

Measures and Feedback January 2011

View more documents from Scott Miller

Be sure and join other clinicians and researchers who are discussing FIT at the International Center for Clinical Excellence–the largest, free, web-based community dedicated to improving the quality and outcome of behavioral health.

Finally, if you are in thinking about or in the process of becoming FIT in your agency or practice, please join us at the upcoming “Training of Trainers” workshop held the first week of August. Registration is limited to 35 participants and we have only a few spots left! Here’s what attendees from last year had to say about the event…

The World Did Not End: What it a Bad Thing?

May 25, 2011 By scottdm Leave a Comment

May 25th, 2011

Chicago, Illinois

On Saturday the 21st of May, 2011 the world was supposed to come to an end. It did not. My question: was that a bad thing? Would it have been better if, as the now twice wrong Prophet Harold Camping predicted, the world had ended.

In the world of public behavioral health, the answer is perhaps. Since the crash of the United States economy in 2008, funding for public behavioral health has been on the chopping block. It’s not the “end of world in one fell swoop.” Rather, its more like slowly having the life strangled out of you. And unlike teachers and prison guards, public behavioral health doesn’t have a strong and vocal lobby.

“It’s sad,” says the director of one agency in the midwest, “I come to work every day feeling weighed down. We are going to experience very close to another one mission dollar cut, that is, on topic of the same cut last year.”

Agencies are doing everything they can to continue to provide effective treatment in the current environment. Here’s what the staff and management in Marion-Crawford county, Ohio have done:

As Bob and Shirley make clear, routinely monitoring outcome and alliance and using the information to inform service delivery is a key to survival in these challenging economic times.

At ICCE, we are working with hundreds of agencies around the US and abroad to improve quality, effectiveness, and efficiency. Soon, we’ll be gathering in Chicago for our annual “Training of Trainers” event. The hands-on, intensive training is the first step to acquiring the skills necessary for navigatng the troubled waters ahead. Here’s what attendee’s from last year said about the event:

Read more about the event or register online by clicking here.