Article

Driving with Roadmaps and Dashboards: Using Information Resources to Structure the Decision Models in Service Organizations

Department of Psychology, University of Hawaii at Mānoa, 2430 Campus Road, Honolulu, HI 96822, USA.
Administration and Policy in Mental Health and Mental Health Services Research (Impact Factor: 3.44). 04/2008; 35(1-2):114-23. DOI: 10.1007/s10488-007-0151-x
Source: PubMed

ABSTRACT This paper illustrates the application of design principles for tools that structure clinical decision-making. If the effort to implement evidence-based practices in community services organizations is to be effective, attention must be paid to the decision-making context in which such treatments are delivered. Clinical research trials commonly occur in an environment characterized by structured decision making and expert supports. Technology has great potential to serve mental health organizations by supporting these potentially important contextual features of the research environment, through organization and reporting of clinical data into interpretable information to support decisions and anchor decision-making procedures. This article describes one example of a behavioral health reporting system designed to facilitate clinical and administrative use of evidence-based practices. The design processes underlying this system-mapping of decision points and distillation of performance information at the individual, caseload, and organizational levels-can be implemented to support clinical practice in a wide variety of settings.

Download full-text

Full-text

Available from: Adam Bernstein, Jun 07, 2015
2 Followers
 · 
154 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Social work is increasingly embracing evidence-based practice (EBP) as a decision-making process that incorporates the best available evidence about effective treatments given client values and preferences, in addition to social worker expertise. Yet, social work practitioners have typically encountered challenges with the application of manualized evidence-supported treatments. For social work, the path to implementing the delivery of science-informed practice remains at a crossroads. This article describes two emergent strategies that offer a plausible means by which many social workers can integrate an EBP model into their service delivery—common factors and common elements. Each strategy will be presented, and related evidence provided. Tools to implement a common elements approach and to incorporate client feedback consistent with a common factors perspective will also be described. These strategies will be placed in the broader context of the EBP framework to suggest possible advances in social work practice and research.
    Research on Social Work Practice 01/2012; 22(1):108-119. DOI:10.1177/1049731511408440 · 1.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There is a widespread recognition that the mental health system is not effective in meeting the needs of the children, adolescents, and families who seek its services. In response to this recognition, researchers and policy makers are developing and implementing strategies to transform mental health systems. This paper suggests that transformational interventions should not proceed faster than our understanding of the complexities of a mental health system. In a complex system, all component parts are interactive and interdependent. Problems with one component cannot be solved in isolation from other components. The inter-relationships between problems create inter-dependencies; and changes in the balance of these inter-dependencies can cause dramatic shifts in policy priorities, such as when managers of mental health systems respond to budget reductions in a recessionary economy. This paper examines the problem domains in mental health systems that are affected by complexity dynamics, and proposes that a well-built infrastructure is a necessary foundation for structural change in a child-adolescent mental health system. The concept of metastructure is proposed to account for the rule-based processes that govern the actions of agents within a system.
    Administration and Policy in Mental Health and Mental Health Services Research 02/2010; 37(1-2):100-10. DOI:10.1007/s10488-010-0282-3 · 3.44 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Recent data have emerged suggesting the benefits of a modular rather than manualized approach to treating anxiety disorders, particularly in school settings. However, little is known about the use of specific modules or their relation to treatment process or response. Using data from a modular cognitive behavioral treatment for anxiety disorders delivered by school clinicians, this study examined (a) the frequency of module use (e.g., exposure, cognitive restructuring), (b) whether therapy session process variables (e.g., therapeutic relationship) varied by module, and (c) the relation between specific module use and treatment response. Data from 124 therapy sessions were used to address these questions. Therapy sessions were delivered by 11 school-based clinicians to a sample of 16 volunteer youth (mean age 11.1 years; 68.8 % female, 87.5 % African-American) as part of a randomized controlled trial (Ginsburg et al. in Child Youth Care Forum 41:1–19, 2011). After each therapy session, clinicians identified the module used and rated various process variables. Treatment response was assessed by blind evaluators who conducted diagnostic interviews with children and parents post-intervention and at a 1-month follow-up. The most frequently used modules were exposure (47 % of sessions), psychoeducation (20 % of sessions), and cognitive restructuring (18 % of sessions). Session process variables (e.g., child involvement, therapeutic relationship) varied by module. No individual module predicted treatment response. Findings suggest that newly trained clinicians do not use CBT modules with equal frequency and type of module does not appear to affect key treatment variables. Future studies are needed to explore the reasons clinicians select specific modules as well as the quality of implementation.
    School Mental Health 12/2012; 4(4). DOI:10.1007/s12310-012-9080-2