Trauma-informed measurement-based care for children: Implementation in diverse treatment settings

Psychol Serv. 2020 Aug;17(3):311-322. doi: 10.1037/ser0000383. Epub 2019 Aug 12.

Abstract

Ongoing and comprehensive assessment is a critical part of the implementation of evidence-based care; yet, most providers fail to routinely incorporate measurement into their clinical practice. Few studies have focused on the complex application of routine assessment or measurement-based care (MBC) with children. This pilot examined the acceptability, appropriateness, adoptability, and feasibility of an MBC effort, the Clinical Improvement through Measurement Initiative (CIMI), across several child-serving settings (e.g., community mental health center, residential treatment facility). CIMI includes a comprehensive mental health assessment protocol and combines a mobile technology platform with implementation support. Survey and focus group information, assessing implementation constructs and outcomes, was collected from 44 clinicians and staff. Overall, participants agreed that the implementation process and technology were acceptable, appropriate, and feasible for use in child mental health and that CIMI can be used to guide case conceptualization, facilitate treatment planning, and monitor outcomes. Strategies that supported the implementation process were identified as were recommendations to enhance adoption. Significant differences were observed by Community versus Specialized settings with respect to feasibility and appropriateness, likely because of factors associated with inner setting (climate, compatibility), outer setting (patient needs), and the phase of implementation achieved by sites. Implications and recommendations for tailoring MBC implementation by characteristics related to setting are discussed. MBC across child service settings are discussed in the context of implementation frameworks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

MeSH terms

  • Attitude of Health Personnel*
  • Child
  • Child Health Services / standards*
  • Community Mental Health Centers
  • Feasibility Studies
  • Humans
  • Implementation Science
  • Mental Health Services / standards*
  • Outcome Assessment, Health Care / standards*
  • Pilot Projects
  • Psychological Trauma / therapy*
  • Psychometrics / standards*
  • Quality Improvement / standards*
  • Residential Treatment