Supplemental Learning
Transcript
0:01 Hello and welcome. My name is Mona Barman and I'm a licensed clinical psychologist and the clinical implementation lead here at Blueprint.
0:09 In our previous training modules, we discussed what measurement-based care is and its benefits. We discussed how to implement, measurement-based care utilizing the Collect, Share, and Act model.
0:21 And then we discussed how to engage our clients in measurement-based care and how to use Blueprint. In this training module, we're going to talk about some common misconceptions about, measurement-based care.
0:35 And to start, I'd like to review the definition of measurement-based care, which we broadly defined as the practice of facing clinical care on client data collected throughout treatment.
0:48 Now some, clinicians out there talk about how this isn't for them, this is not how they practice therapy, that this isn't relevant for them, or this might rupture their therapeutic alliance.
0:59 And so I'd like to spend some time reviewing some common misconceptions. The first one is that you have to practice within a certain theoretical orientation to implement measurement-based care.
1:13 And that is not true. Measurement-based care is trans-theoretical and trans-diagnostic. And what I mean by that is that, We have brief, valid, and reliable assessment measures for a variety of different presenting concerns.
1:28 So it's not just the DSM-V diagnostic categories, but there are assessment measures out there for things like therapeutic alliance, relationship satisfaction, ,exceptance, mindfulness, quality of life.
1:43 And when I say that you don't have to be within a certain theoretical orientation, it's because measurement-based care is an added tool that any clinician can use.
1:53 It's not asking that you change your way of practice or change what treatment approach you're taking, but what it's doing is it's allowing for you and your client to ensure that whatever treatment is being implemented is effective and you're reaching the goals of treatment.
2:13 The other common misconception is that you have to be data or number oriented in order to implement measurement-based care. And this is not true.
2:22 Most measures are easily scored either by a total score of 1.5% or 1.5% of the total score of 1.5% of the total score is 1.5% or 1.5% of the total score is 1.5% or 1.5% or 1.5% of the total score is 1.5% of the total score.
2:26 So adding up all the item responses or an average score. But the best part is that a blueprint will make this easier for you because we score all of the assessments for you and provide an interpretation.
2:39 Another common misconception is that you have to be able to do that. The other misconception is that the measurement based care will negatively impact the therapeutic alliance or the therapeutic relationship with clients.
2:50 And actually the opposite has been shown that measurement based care actually improves the therapeutic alliance. And we discussed. This in a previous training module, but I think the collaborative approach and measurement based care is what really improves that therapeutic alliance.
3:06 The assessments give you and your client a shared language to talk about their symptoms and their experiences. And you're utilizing that to.
3:14 Gather to identify and collaborate on treatment targets and you're both using the same ruler, if you will, to assess and measure for treatment progress.
3:27 Another misconception is that measurement based care is. Sooms or suggests that progress has to be linear and this is not true.
3:35 We expect to see both ups and downs in the scores because we know a life happens, right? So what we want to look for when we're giving these assessment measures over time.
3:46 Time is the overall trend. I sort of compare this to when you're on a weight loss journey, right? Day to day you might see some weight fluctuations, but what you really want to look at is the trend over time.
3:58 And the same goes for measurement-based care. Week to week you may see some ups and time. But over time you want to see what that trend looks like.
4:09 Another common misconception is that the assessment results are a reflection of the therapist. And I cannot highlight this enough that assessment results.
4:19 Are not a therapist report card. It's important to take these results seriously, but not personally. And I say this because we can use again if we reflect back to the medical model, right?
4:31 When you see your doctor and they prescribe you an n- An antibiotic for an infection that you have. And if you have an allergic reaction to that commonly prescribed antibiotic, it doesn't mean that that doctor is a bad doctor.
4:46 It doesn't know what he or she is doing. It just means that we need to change the treatment approach and that's the doctor needs to prescribe you another antibiotic.
4:54 And the same goes with mental health care. All of us experience clients who have scores that may be not changing or getting worse and it doesn't mean that you're necessarily doing something wrong.
5:07 But what it does mean is that something needs to change in treatment. And the only way that we're going to know what needs to change is by being willing to have that open and honest conversation with our clients about their treatment and lack of progress and explain.
5:24 So exploring what are the barriers to progress, right? Does it have to do with psychosocial barriers that are interfering with the treatment process?
5:32 Is it that they need a higher level of care? Or perhaps there is something about the therapeutic relationship which you can explore.
5:40 Or the therapeutic alliance and try and repair that. But there's multiple options here. And again, the most important thing is that these assessment results aren't a reflection, but rather an indication that something needs to change.
5:54 And lastly, this thing. The idea that measurement based care replaces the therapist expertise in clinical judgment. And that is not true.
6:03 Measurement based care is simply an additional tool that can be used to improve the quality of care. But it should not be the only to.
6:12 The tool that's used in providing care measurement based care should be used in conjunction with your clinical education knowledge experience and expertise.
6:24 Just a reminder. That measurement based care is active, right? It's an active process that unfolds during therapy sessions so that you and your clients can stay attuned to the progress that's being made in therapy or the lack thereof.
6:43 Measurement based care is relational, right? When we think about the active ingredients of measurement based care, it really taps into those common relational factors associated with positive treatment outcomes such as being aligned on treatment goals, having the therapeutic alliance.
7:01 And client expectations. And lastly, measurement based care is process oriented. It is a tool that helps you focus on the process of understanding your clients and their experiences.
7:17 Through measurement.