Best cheap/accessiable ways to track outcome in small private practice?

[FreudianSlippers]

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I was thinking about using the PHQ-9 and GAD...but would love to hear other thoughts!

 

[PhDenial]

I'm not 100% clear on what you're asking for (e.g., what outcomes are you trying to measure, what are the populations you're seeing, etc.), but this article may be a helpful resource. It provides a list of free and easily accessible evidence-based assessment for use in low-resource settings.

 

[erg923]

1. Use your initial treatment plan...hopefully it has SMART goals? Stick to it. Talk to your patients about problems/lack of progress for each goal. Revise as necessary with the patient. Fire/refer patients who are not invested in treatment after reasonable attempts.

2. If this is not adequate for a typical psychologist's outpatient practice, it may be the wrong level of care for the patient? Or maybe not a time for them to be in treatment at all?

3. Outcome Questionnaire--OQ-45 (or something with some ecological validity) seems reasonable as an adjunct to the above.

4. Measuring "progress" by using almost verbatim DSM symptom criteria (e.g., GAD-7, PHQ-9) seems fraught with clinical (and legal) problems to me?

5. The idea of conducting empirically-based treatment (EBT) of psychological disorders is that your treatment is based on a scientifically accepted explanatory model of the disturbance, and that treatment is adjusted to account for progress or lack of progress at appropriate intervals. That is all. If you are conducting a research study, its different. But clinical practice can't run like a research study, and the DSM is a list of problems, not real life progress/gains/victories.

 

[FreudianSlippers]

1. Use your initial treatment plan...hopefully it has SMART goals? Stick to it. Talk to your patients about problems/lack of progress for each goal. Revise as necessary with the patient. Fire/refer patients who are not invested in treatment after reasonable attempts.

2. If this is not adequate for a typical psychologist's outpatient practice, it may be the wrong level of care for the patient? Or maybe not a time for them to be in treatment at all?

3. OQ-45 (or something with some ecological validity) seems reasonable as an adjunct to the above.

4. Measuring "progress" by using strict DSM symptom criteria (e.g., GAD-7, PHQ-9) seems fraught with clinical (and legal) problems to me?

5. The idea of conducting empirically-based treatment of psychological disorders is that your treatment is based on a scientifically accepted explanatory model of the disturbance, and that treatment is adjusted to account for progress or lack of progress at appropriate intervals. That is all. If you are conducting a research study, its different.

Thanks for the response @erg923! Sticking to objective SMART goals is not a bad idea at all. I've been fired up and about to see my first private practice client...wanting to make sure I have all my ducks in a row and that I wasn't missing some gold-standard outcome tracking measure. I also work at a counseling center where we use the CCAPS, and its just nice to have a more visual glance at the different domains. I ultimately would love to use something like the CCAPS or OQ-45, I just need to figure out the best way to implement it electronically. Also, I think my research background is coming out a bit here, just wanting to make sure I don't miss out on important "data." I'll have to work on that

 

[FreudianSlippers]

I'm not 100% clear on what you're asking for (e.g., what outcomes are you trying to measure, what are the populations you're seeing, etc.), but this article may be a helpful resource. It provides a list of free and easily accessible evidence-based assessment for use in low-resource settings.

Thats a great article...thanks for sharing! Yeah, in hindsight my question was pretty vague. Basically tracking client progress in more objective ways than just asking about how they are feeling. I was hoping for something less involved and more accessible than the CCAPS or OQ-45 (i.e. something I can just access online).

 

[PhDenial]

Another resource I've found helpful is from the Unified Protocol- it's a Weekly Top Problems Rating Form. Basically, at the first session, you get a list of a client's top 3 problems, and at each session, you ask them for a rating of their problems from 1-8. You hope to see progress in that the ratings for the top problems decrease with time. This also relates to erg923's recommendation in tying the progress monitoring to the client's SMART goals, which are also related to the client's problems. In this case, the form is in the specific context of a child client and has a list of problems for the parent vs. the child, but obviously you can adapt it to adult clients. A fun way to show progress is also to graph it for the client and show them their progress visually. Hope that helps!