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Examining Utility of Measurement-Based Care in Coordinated Specialty Care Treatment for Clinical High Risk for Psychosis

Examining Utility of Measurement-Based Care in Coordinated Specialty Care Treatment for Clinical High Risk for Psychosis

Heather Muir (1,2,5), Ashley Buchanan (1,2,5), Amanda Weber (1,5), Stephanie Trilling (3), Emily Gagen (4,5), Jessica Stern (1,5)
1. Center For Early Detection, Assessment & Response to Risk, The Brookline Center for Community Mental Health, Brookline, MA;
2. Massachusetts Department of Mental Health, Boston, MA;
3. The Innovation Institute, The Brookline Center for Community Mental Health, Brookline, MA; 4. Massachusetts Psychosis Access and Triage Hub, Brookline, MA; 5 Harvard Medical School, Department of Psychiatry, Boston, MA

Background: Evidence suggests that mental health providers overestimate the improvement rates of their patients and underestimate the deterioration rates for their caseload. Measurement-based care (MBC), the routine administration and use of outcome measures to inform treatment decisions, has been used to improve clinical decision-making. The benefits of using MBC for the average psychotherapy case have been established by several systematic reviews and well-powered meta-analyses. However, no research has centered on MBC for Clinical High Risk for Psychosis (CHRp). The current proposal aims to fill this gap and elucidate the feasibility of implementing MBC for patients receiving CHRp treatment.

Methods: Participants are patients/caregivers of patients with CHRp receiving naturalistic psychotherapy in a coordinated specialty care clinic as well as their clinicians. Patients will be asked to complete a series of measures throughout treatment. Measures include symptomatology, functioning, treatment satisfaction, therapeutic alliance, outcome expectations, and caregiver strain. Qualitative responses regarding benefits and barriers of MBC from patient, caregiver of patient, and clinician perspectives will also be collected.

Results: Time series depictions of consented patients’ scores on each of the measures over time will be presented as well as qualitative themes regarding implementation from patient, caregiver of patient, and clinician perspectives.

Conclusions: Findings would elucidate the feasibility and impact of implementing MBC in a coordinated specialty care program for CHRp populations and identify potential barriers that exist whilst using MBC with this patient population. The findings from this study could inform future treatment-quality improvement.