Consultation Content and Techniques for measurement-Based Care Implementation in Youth Community Mental Health Settings

Elizabeth Casline; Grace S Woodard; Elizabeth Lane; Scott Pollowitz; Susan Douglas; Jill Ehrenreich-May; Golda S Ginsburg; Amanda Jensen-Doss

doi:10.1007/s10488-024-01417-8

Consultation Content and Techniques for measurement-Based Care Implementation in Youth Community Mental Health Settings

Adm Policy Ment Health. 2024 Oct 13. doi: 10.1007/s10488-024-01417-8. Online ahead of print.

Authors

Elizabeth Casline¹, Grace S Woodard², Elizabeth Lane², Scott Pollowitz², Susan Douglas³, Jill Ehrenreich-May², Golda S Ginsburg⁴, Amanda Jensen-Doss²

Affiliations

¹ Institute for Public Health and Medicine, Center for Dissemination and Implementation Science, Northwestern University Feinberg School of Medicine, 633 N. St Clair, Chicago, IL, 60611, USA. elizabeth.casline@northwestern.edu.
² Department of Psychology, University of Miami, Coral Gables, FL, USA.
³ Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA.
⁴ Department of Psychiatry, University of Connecticut School of Medicine, West Hartford, USA.

PMID: 39397117
DOI: 10.1007/s10488-024-01417-8

Abstract

Measurement-based care (MBC) is an evidence-based practice (EBP) focused on regularly administering outcome measures to clients to inform clinical decision making. While MBC shows promise for improving youth treatment outcomes, therapist adoption remains low. Clinical consultation is one strategy that improves MBC implementation, but our limited understanding of consultation hinders the ability to optimize its impact. This research explored the content of, and techniques used during MBC consultation calls. Therapists (N = 55) in a randomized controlled trial treating adolescents with anxiety and/or depression were trained to utilize MBC with usual treatment using the Youth Outcome Questionnaire (YOQ) through an online measurement feedback system (MFS). Weekly ongoing consultation followed an initial workshop training in MBC. Case discussions (N = 294) during consultation calls were coded using a developed codebook, including 12 content and 10 consultant techniques. Results indicated that content focused predominantly on interpretation of client symptom and alliance report, planning for YOQ administration, and discussion of data with clients in session. Common consultant techniques included modeling and eliciting report viewing and interpretation, making clinical suggestions, and didactics about clinical and technical issues. Notably, role-play/behavioral rehearsal was not used. The prevalence of passive consultation techniques (suggestions, didactics) suggests a focus on teaching rather than active techniques (behavioral rehearsal, modeling), potentially influenced by the novelty of MBC and MFS. Technical aspects of MBC, such as measure administration and system usage, emerged as key consultation content, highlighting an unanticipated emphasis on logistics over clinical implementation. These findings underscore the evolving role of consultation in supporting MBC implementation and suggest that addressing technical challenges early in training might enhance adoption.

Keywords: Anxiety; Community Mental Health; Consultation; Depression; Evidence-based Practice; Implementation Science; Measurement-based care; Youth.

Abstract

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