We propose to study the effects of a theory-driven and empirically-based feedback intervention to influence the cognition and behavior of counselors who provide in-home mental health services to adolescents. The feedback to counselors will be based on client ratings of therapeutic alliance. An improved therapeutic relationship is predicted to have a positive effect on the youth's mental health. The predominant approach to improving mental health outcomes is to disseminate and implement efficacious treatments into the """"""""real world"""""""". This proposal offers an approach to improving outcomes of services that is sensitive to the organizational context. Feedback on performance has been shown to improve performance in thousands of studies across many disciplines. However, in a trial of the studies feedback resulted in a decrease in performance. A theoretical understanding of feedback is required to understand the heterogeneity of the effect of feedback. Through a review of basic and applied research in cognitive, social, organizational psychology, and management we have developed a theoretical model that aims to elucidate and optimize the effects of feedback on the performance of mental health service providers. We propose to target therapeutic alliance (TA), as it is the most agreed upon common treatment factor associated with positive clinical outcomes. We will conduct a 2x2 randomized factorial study of the effects of feeding back the youth's TA ratings to the counselor. In Study 1, counselors will be randomly assigned by site to either a """"""""feedback"""""""" or a """"""""no feedback"""""""" condition. Sites will also be randomly assigned to a """"""""high involvement"""""""" or """"""""low involvement"""""""" condition in which their supervisor does or does not receive the client-generated feedback. Our model predicts an interaction effect between these two factors that should produce the largest change in counselor cognitions and behavior and the greatest improvement in symptoms and functioning. Study 2 will utilize the same design to test whether an educational component (TA counselor's manual) in addition to feedback will have an even greater positive effect on client ratings of TA and subsequent treatment outcomes. We believe that this research is both theory-based and highly relevant to mental health providers. It offers an innovative approach to improving mental health services.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH068589-03
Application #
7060867
Study Section
Services Research Review Committee (SRV)
Program Officer
Chambers, David A
Project Start
2004-08-10
Project End
2009-04-30
Budget Start
2006-05-01
Budget End
2007-04-30
Support Year
3
Fiscal Year
2006
Total Cost
$618,983
Indirect Cost
Name
Vanderbilt University Medical Center
Department
Type
Organized Research Units
DUNS #
004413456
City
Nashville
State
TN
Country
United States
Zip Code
37212
Bickman, Leonard; Douglas, Susan R; De Andrade, Ana Regina Vides et al. (2016) Implementing a Measurement Feedback System: A Tale of Two Sites. Adm Policy Ment Health 43:410-25
Riemer, Manuel; Kelley, Susan Douglas; Casey, Susan et al. (2012) Developing effective research-practice partnerships for creating a culture of evidence-based decision making. Adm Policy Ment Health 39:248-57
Dew-Reeves, Sarah E; Athay, M Michele (2012) Validation and use of the youth and caregiver Treatment Outcome Expectations Scale (TOES) to assess the relationships between expectations, pretreatment characteristics, and outcomes. Adm Policy Ment Health 39:90-103
Athay, M Michele; Kelley, Susan Douglas; Dew-Reeves, Sarah E (2012) Brief Multidimensional Students' Life Satisfaction Scale-PTPB Version (BMSLSS-PTPB): psychometric properties and relationship with mental health symptom severity over time. Adm Policy Ment Health 39:30-40
Kelley, Susan Douglas; de Andrade, Ana Regina Vides; Bickman, Leonard et al. (2012) The Session Report Form (SRF): are clinicians addressing concerns reported by youth and caregivers? Adm Policy Ment Health 39:133-45
Athay, M Michele; Riemer, Manuel; Bickman, Leonard (2012) The symptoms and functioning severity scale (SFSS): psychometric evaluation and discrepancies among youth, caregiver, and clinician ratings over time. Adm Policy Ment Health 39:13-29
Athay, M Michele; Bickman, Leonard (2012) Development and psychometric evaluation of the youth and caregiver Service Satisfaction Scale. Adm Policy Ment Health 39:71-7
Bickman, Leonard; Kelley, Susan Douglas; Athay, Michele (2012) The Technology of Measurement Feedback Systems. Couple Family Psychol 1:274-284
Dew-Reeves, Sarah E; Athay, M Michele; Kelley, Susan Douglas (2012) Validation and use of the Children's Hope Scale-revised PTPB edition (CHS-PTPB): high initial youth hope and elevated baseline symptomatology predict poor treatment outcomes. Adm Policy Ment Health 39:60-70
Breda, Carolyn S; Riemer, Manuel (2012) Motivation for youth's treatment scale (MYTS): a new tool for measuring motivation among youths and their caregivers. Adm Policy Ment Health 39:118-32

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