Supplemental Learning
Next Training Module
Transcript
0:00 Hello and welcome to our self-serve training modules. If you don't know me already from the previous trainings, I'm Mona Barman, the licensed clinical psychologist and clinical implementation lead here at Blueprint.
0:12 In our prior training modules, we focused on what measurement based, care is, and steps one and two of implementing measurement based care, which involved collecting the assessment data and sharing those results with our clients.
0:26 In this training module, we're going to focus on acting on those assessment results. Now here, I've depicted the collect, share, and act model of implementing measurement based care.
0:41 And as I mentioned, we're going to focus on the act portion. This is going to focus on how to utilize the assessment results to, inform our treatment.
0:54 Now measurement based care is not necessarily going to tell you what to do in treatment as much as it's going to tell you when it's time to do something different.
1:03 Let's take a look at this example. Here where I've depicted two clients, PHQ nine scores over time in session. So you can see here on the vertical axis I have PHQ nine score on the horizontal axis is the session number and for each client the dots represent their PHQ nine score at that session.
1:26 What we see here for client one depicted in purple is that the assessment score for the PHQ nine fluctuates up and down yet the overall.
1:37 Trend is going downwards indicating that PHQ nine scores are getting lower and their symptoms are reducing. This would be an indication that treatment appears to be effective and working and to continue on the This would be an indication that treatment appears to be effective and to continue on the
1:53 Now, if we look at client two depicted in the green, we do see some fluctuation in the PHQ nine score over each session.
2:02 However, if we look at that green line to look at the trend over time, we see that it's relatively stable and there's really no change.
2:09 From baseline to session six, this would be the indication that perhaps it's time to do something different in treatment. I want to normalize and validate for all the clinicians out there that as clinicians, we've all had clients.
2:26 Whose assessment scores didn't change or perhaps got worse over time. And this is not a reflection of you as a therapist per se, but rather an indication that there could be something else going on and it's time to see what that is.
2:42 So the first step when you notice that it's time to change is to be willing to have an open and honest conversation with your client about their lack of progress or and barriers to progress.
2:57 Right? And so. Things that I think about when I'm talking to my client and I'm seeing that their assessment scores aren't changing, things that are going on in the back of my mind are, am I assessing for the right thing?
3:09 You know, are we measuring the right symptoms? And if not, do we need to change the assessment measure? We're using to accurately reflect our patient's experiences.
3:18 I might also consider if there's any kind of psychosocial barriers outside that are going on and preventing this client's progress in therapy.
3:28 I might also consider changing my treatment strategy or approach, right? So if I'm seeing a client for anxiety and I'm doing CBT for anxiety and that's just not clicking with the client, I might take a step back and choose maybe an acceptance-based method.
3:44 Talking more about mindfulness and acceptance-based approaches to anxiety. I might also want to look at the therapeutic alliance and take a moment to assess what the client-clinician relationship is like, how connected we are, what the trust level is like between the two.
4:03 And ensuring that we're on the same page and thinking about if there's been a rupture in that therapeutic alliance, can we repair it?
4:13 You may also want to consider your client's readiness for change or their motivation level. I think I'm, You might also want to consider practice, Great..as far as what you want to have rights in the Most employers are thinking about addressing our evidence-based practices in a more flexible way to
4:38 make sure that you're connecting with your clients and really addressing their symptoms and individualizing treatment for them. Lastly, you also may want to consider based on what they told you if this client is appropriate for a medication evaluation or reevaluation and or a higher level of care.
4:59 Again, these are just some options and some responses to consider depending on the discussion that you have with your client as to the lack of their progress and barriers to progress.
5:13 So just to review implementing measurement-based care, we talked about step one which was collecting the assessment data, making sure you're selecting brief and personal assessment measures that are relevant to your client.
5:27 Then we talked about sharing those assessment results, right, by reviewing them and then discussing it with your client. And then lastly we discussed today was acting on those assessment results.
5:40 And changing the treatment strategy and approach as necessary. I've listed out here some additional resources for implementing measurement-based care and that includes our Blueprint Clinical Webinar series.
5:53 I host those every Tuesday from, 9am to about 945am Pacific time or that would be noon Eastern time. These,this 4 session recurring clinical webinar series goes over an introduction to measurement-based care.
6:12 We also review how to use blueprint to implement measurement-based care effectively and the 4th session includes an open office hours where you can come in and ask any questions about measurement-based care and blueprint.
6:27 This is recurring every month. We will send out monthly reminders. The other place that you can check out for resources is the Yale Measurement-Based Collaborative.
6:37 This is from the Yale Department of Psychiatry. They have collected a wonderful set of resources and handouts on _____. _____.