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Monthly Treatment and Progress Summary Form Report: Progress Rating Validity

Background. CAMHD's provider network consists of a diverse array of service programs and treatment philosophiesStakeholders work together toward delivering accountable practicesMonthly Treatment

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Monthly Treatment and Progress Summary Form Report: Progress Rating Validity

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    1. Monthly Treatment and Progress Summary Form Report: Progress Rating Validity May 19, 2006 Brad Nakamura, M.A. Eric Daleiden, Ph.D. Charles Mueller, Ph.D.

    2. Background CAMHD’s provider network consists of a diverse array of service programs and treatment philosophies Stakeholders work together toward delivering accountable practices Monthly Treatment & Progress Summary Form (MTPS; Child and Adolescent Mental Health Division; 2003) Service format Service setting Treatment targets Clinical progress Treatment practices

    3. Background

    4. Background Clinical Progress Ratings

    5. Background / Purpose Previous research supports the concurrent validity and reliability of clinician-reported treatment targets Validity of the clinical progress ratings was not examined prior to this study Purpose Examine whether MTPS clinical progress ratings (CAMHD’s idiographic progress measure) are meaningfully related to two standardized measures Child and Adolescent Functional Assessment Scale (CAFAS) Child and Adolescent Level of Care Utilization System (CALOCUS)

    6. Is there a Meaningful Relationship between the MTPS and CAFAS / CALOCUS? Examined the degree of change over the course of treatment as assessed by all three measures MTPS scores versus CAFAS scores MTPS scores versus CALOCUS scores

    7. Key Questions Primary questions Did MTPS, CAFAS, and CALOCUS scores improve throughout treatment? Prediction: all get better Did MTPS scores relate to CAFAS and CALOCUS scores at CAMHD intake? Prediction: not related Did MTPS improvement relate to CAFAS and CALOCUS improvement at treatment follow-up? Prediction: are related

    8. Participants Gender: Males > 50% Average age: 13-14 years Ethnicity: Multiethnic Diagnosis: mood, attentional, disruptive Participants

    9. Measures Idiographic Measure Monthly Treatment and Progress Summary (MTPS; Child and Adolescent Mental Health Division; 2003) Treatment targets Clinical progress ratings Standardized Measures Child and Adolescent Functional Assessment Scale (CAFAS; Hodges, 1998) Child and Adolescent Level of Care Utilization System (CALOCUS; American Academy of Child and Adolescent Psychiatry, 1999)

    10. MTPS Descriptive Results How many treatment targets are typically addressed per MTPS report? 6 to 8 targets typically endorsed per report 4 targets typically remain stable What are the most commonly indicated treatment targets? Anger Positive Family Functioning Oppositional Behavior Academic Achievement Treatment Engagement Depressed Mood

    11. Did MTPS, CAFAS, and CALOCUS Scores Improve Throughout Treatment? Youth improved significantly over the course of treatment on all measures

    12. Did MTPS Progress Ratings Meaningfully Relate to CAFAS and CALOCUS Score Changes?

    13. Did MTPS Progress Ratings Meaningfully Relate to CAFAS and CALOCUS Score Changes?

    14. Did MTPS scores relate to CAFAS and CALOCUS scores at CAMHD intake?

    15. Did MTPS Scores Relate to CAFAS and CALOCUS Scores at CAMHD Intake?

    16. Did MTPS Improvement Relate to CAFAS and CALOCUS Improvement at CAMHD Treatment Follow-Up?

    17. Did MTPS Improvement Relate to CAFAS and CALOCUS Improvement at CAMHD Treatment Follow-Up? Over time… MTPS/CAFAS follow-up correlation increases MTPS/CALOCUS follow-up correlation decreases MTPS/CALOCUS findings could not be explained by Sample differences CALOCUS’ foci on level of care scores versus functional status

    18. Did MTPS Progress Ratings Meaningfully Relate to CAFAS and CALOCUS Score Changes?

    19. Summary Improvement? MTPS, CAFAS, and CALOCUS scores improve throughout treatment Intake relationship? MTPS did not relate to CAFAS or CALOCUS at intake Follow-up relationship? MTPS did relate to CAFAS at all follow-up periods MTPS did relate to CALOCUS only at three month follow-up Conclusion Changes measured by the MTPS and CAFAS are more alike over longer follow-up intervals than changes measured by the CALOCUS MTPS provides useful and nonredundant client specific treatment outcome information While related, the MTPS, CAFAS and CALOCUS each capture unique aspects of client change.

    20. Recommendations Continue and increase MTPS usage Incorporate MTPS into client level decision making Consider MTPS for up-to-date information MTPS as a supplement for program level decisions Continue evaluation of MTPS Increase MTPS accessibility and feedback Conduct ongoing MTPS training and review

    21. Thank you!

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