Effects of Routine Feedback to Clinicians on Youth Mental Health Outcomes: A Randomized Cluster Design

Vanderbilt University

Status: Completed

Conditions: Psychosocial Problem; Mental Health Wellness 1

Treatments: Behavioral: Contextualized Feedback Systems (CFS)tm

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01308879

070342

R01MH068589 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

The purpose of this clinical trial was to test the hypothesis that clients of clinicians who were scheduled to receive weekly feedback on their clients' progress would improve faster than clients of clinicians who were not scheduled to receive weekly feedback.

Full description

The primary approach to improving psychosocial treatment for youths has been to implement evidence-supported treatments (ESTs) in community services. However, this approach has not produced clear cut results of effectiveness. A recently developed alternative is to improve outcomes through routine measurement and feedback to clinicians and supervisors. The investigators used a cluster randomized experiment with 28 sites affiliated with a national behavioral health organization to assess whether clients of clinicians who were scheduled to receive weekly feedback on their clients' progress would improve faster than clients of clinicians who were not scheduled to receive weekly feedback.

Enrollment: 356 patients

Sex: All

Ages: 11 to 18 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

• all youths 11-18 years old, entering treatment as usual, home-based services through the service provider. Youths' primary caregiver and clinician also participate.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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356 participants in 2 patient groups

Weekly feedback

Experimental group

Description:

After clinical questionnaires are entered into the system (CFStm), an automated online report is available weekly to clinicians in the experimental group that shows current mental health status of youths, alerts, and trends over time based on youth, caregiver, and clinician responses. Reports also show some clinical data on caregivers.

Treatment:

Behavioral: Contextualized Feedback Systems (CFS)tm

No feedback

Other group

Description:

Clinicians in the control group do not have access to weekly feedback. Instead, they receive reports every 90 days after the youth is enrolled in CFStm. Because the average duration of CFS enrollment was 3.8 months, many youths would have been discharged before the first 90-day report became available three months after treatment start. Thus, we considered the 90-day feedback group to be essentially a no-feedback group.

Treatment:

Behavioral: Contextualized Feedback Systems (CFS)tm