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Background. CAMHD's provider network consists of a diverse array of service programs and treatment philosophiesStakeholders work together toward delivering accountable practicesMonthly Treatment
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1. Monthly Treatment and Progress Summary Form Report: Progress Rating Validity May 19, 2006
Brad Nakamura, M.A.
Eric Daleiden, Ph.D.
Charles Mueller, Ph.D.
2. Background CAMHD’s provider network consists of a diverse array of service programs and treatment philosophies
Stakeholders work together toward delivering accountable practices
Monthly Treatment & Progress Summary Form (MTPS; Child and Adolescent Mental Health Division; 2003)
Service format
Service setting
Treatment targets
Clinical progress
Treatment practices
3. Background
4. Background Clinical Progress Ratings
5. Background / Purpose Previous research supports the concurrent validity and reliability of clinician-reported treatment targets
Validity of the clinical progress ratings was not examined prior to this study
Purpose
Examine whether MTPS clinical progress ratings (CAMHD’s idiographic progress measure) are meaningfully related to two standardized measures
Child and Adolescent Functional Assessment Scale (CAFAS)
Child and Adolescent Level of Care Utilization System (CALOCUS)
6. Is there a Meaningful Relationship between the MTPS and CAFAS / CALOCUS? Examined the degree of change over the course of treatment as assessed by all three measures
MTPS scores versus CAFAS scores
MTPS scores versus CALOCUS scores
7. Key Questions Primary questions
Did MTPS, CAFAS, and CALOCUS scores improve throughout treatment?
Prediction: all get better
Did MTPS scores relate to CAFAS and CALOCUS scores at CAMHD intake?
Prediction: not related
Did MTPS improvement relate to CAFAS and CALOCUS improvement at treatment follow-up?
Prediction: are related
8. Participants
Gender: Males > 50%
Average age: 13-14 years
Ethnicity: Multiethnic
Diagnosis: mood, attentional, disruptive
Participants
9. Measures Idiographic Measure
Monthly Treatment and Progress Summary (MTPS; Child and Adolescent Mental Health Division; 2003)
Treatment targets
Clinical progress ratings
Standardized Measures
Child and Adolescent Functional Assessment Scale (CAFAS; Hodges, 1998)
Child and Adolescent Level of Care Utilization System (CALOCUS; American Academy of Child and Adolescent Psychiatry, 1999)
10. MTPS Descriptive Results How many treatment targets are typically addressed per MTPS report?
6 to 8 targets typically endorsed per report
4 targets typically remain stable
What are the most commonly indicated treatment targets?
Anger
Positive Family Functioning
Oppositional Behavior
Academic Achievement
Treatment Engagement
Depressed Mood
11. Did MTPS, CAFAS, and CALOCUS Scores Improve Throughout Treatment? Youth improved significantly over the course of treatment on all measures
12. Did MTPS Progress Ratings Meaningfully Relate to CAFAS and CALOCUS Score Changes?
13. Did MTPS Progress Ratings Meaningfully Relate to CAFAS and CALOCUS Score Changes?
14. Did MTPS scores relate to CAFAS and CALOCUS scores at CAMHD intake?
15. Did MTPS Scores Relate to CAFAS and CALOCUS Scores at CAMHD Intake?
16. Did MTPS Improvement Relate to CAFAS and CALOCUS Improvement at CAMHD Treatment Follow-Up?
17. Did MTPS Improvement Relate to CAFAS and CALOCUS Improvement at CAMHD Treatment Follow-Up? Over time…
MTPS/CAFAS follow-up correlation increases
MTPS/CALOCUS follow-up correlation decreases
MTPS/CALOCUS findings could not be explained by
Sample differences
CALOCUS’ foci on level of care scores versus functional status
18. Did MTPS Progress Ratings Meaningfully Relate to CAFAS and CALOCUS Score Changes?
19. Summary Improvement?
MTPS, CAFAS, and CALOCUS scores improve throughout treatment
Intake relationship?
MTPS did not relate to CAFAS or CALOCUS at intake
Follow-up relationship?
MTPS did relate to CAFAS at all follow-up periods
MTPS did relate to CALOCUS only at three month follow-up
Conclusion
Changes measured by the MTPS and CAFAS are more alike over longer follow-up intervals than changes measured by the CALOCUS
MTPS provides useful and nonredundant client specific treatment outcome information
While related, the MTPS, CAFAS and CALOCUS each capture unique aspects of client change.
20. Recommendations Continue and increase MTPS usage
Incorporate MTPS into client level decision making
Consider MTPS for up-to-date information
MTPS as a supplement for program level decisions
Continue evaluation of MTPS
Increase MTPS accessibility and feedback
Conduct ongoing MTPS training and review
21. Thank you!