Premium
Measuring Outcomes in Adult Outpatient Psychiatry
Author(s) -
Blais Mark A.,
Sinclair Samuel J.,
Baity Matthew R.,
Worth Jonathan,
Weiss Anthony P.,
Ball Laurie Ansorge,
Herman John
Publication year - 2011
Publication title -
clinical psychology and psychotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.315
H-Index - 76
eISSN - 1099-0879
pISSN - 1063-3995
DOI - 10.1002/cpp.749
Subject(s) - anxiety , mood , randomized controlled trial , psychology , depression (economics) , psychiatry , mental health , substance abuse , clinical psychology , mood disorders , medicine , surgery , economics , macroeconomics
Despite growing pressure for accountability, mental health professionals continue to debate the value of routinely measuring treatment outcomes. This paper sought to move the outcomes measurement debate forward by reviewing some of the current limitations in outcomes methodology and by providing initial strategies to address them. Using these strategies, we evaluated outcomes for a large diagnostically diverse group of adult outpatients receiving treatment as usual (TAU) within an academic medical centre. Initial self‐report and clinician‐rated assessments were obtained from 5546 patients, and follow‐up data were obtained from 1572 (28%) patients. Using the subset of patients with the follow‐up data, we determined treatment effect sizes, rates of reliable improvement (and deterioration) and rates of clinically significant improvement for all patients and for specific diagnostic groups (depression, anxiety, substance abuse, mood disorders not otherwise specified, bipolar and psychotic conditions). TAU outcomes for depression and anxiety were also compared with benchmarks derived from the randomized controlled trial literature. Lastly, the impact of patient or sample characteristics on outcome was explored. Overall, these findings generally support the benefit of TAU over no treatment while also highlighting both the utility and limitations inherent in the current approaches to evaluating treatment outcomes. Suggestions for improving outcomes measurement are provided. Copyright © 2011 John Wiley & Sons, Ltd. Key Practitioner Message Routine outcomes measurement of real world treatment is valuable.