Feedback Informed Treatment

Transkript

1 Feedback Informed Treatment Talk in your work groups: Discuss how FIT can make sense in your work context. Discuss benefits and challenges of using FIT in your work place. Generate questions for Susanne and Kari 1

2 Feedback Informed Treatment Collateral Ratings If the client scores above the cut-off and is there because other people think they should be there (mandated clients): Get the client to fill out the ORS as they think the referral source would rate them. If the client is in the service because she is concerned for her child: Get the client to fill out the ORS to rate the child s functionning I would like you to fill out the scale as you think your mother would see you Feedback Informed Treatment Talk in groups of 3: How would the use of collateral rating make sense in your context? Who would you need to include as collateral raters in your settings? 2

3 Feedback Informed Treatment Scoring: Lines should be cm in length To score, determine the distance in centimeters to the nearest milimeter between the left pole and the client s hash mark on each item. Add all four numbers together to obtain the total score. 3

4 Outcome Score Putting Data to Work The Clinical Cutoff 3 2 B 0 A 1st 2nd 3rd 4th Session Number Actual Score Line 2 2th % 7th % The dividing line between a clinical and non-clinical population (2; Adol. 28; Kids, 32). Basic Facts: Between 2-33% of clients score in the non-clinical range. Clients scoring in the nonclinical range tend to get worse with treatment. The slope of change decreases as clients approach the cutoff. Exercise Break in groups of three: What hypothesis does the graph give you? What give you cause for concern? 4

5 ORS SRS 3 2 ORS SRS 3 2

6 ORS SRS 3 2 ORS SRS 3 2 6

7 ORS SRS 3 2 ORS SRS 3 2 7

8 ORS SRS 3 2 ORS SRS 3 2 8

9 Putting Data to Work Integrating Outcome into Care Utility: Payer Administrator Program Manager Supervisor Intake Worker Summary Statistics Session-by-Session Line Staff 9

10 Feedback Informed Treatment Farvel til Janteloven

11 Achieving Clinical Excellence Achieving Clinical Excellence 11

12 12

13 Achieving Clinical Excellence You have to seek out situations where you get feedback [about your performance]. It's a myth that you get better when you just do the things you enjoy.. Elite performers engage in 'deliberate practice' - an effortful activity designed to improve target performance. Unlike play, deliberate practice is not inherently motivating; and unlike work, it does not lead to immediate social and monetary rewards. In addition, engaging in [it] generates costs. 13

14 Bevidst, målrebet træning 14

15 Achieving Clinical Excellence Psykolog Daryl Chow Associate ICCE Ph.D. projekt i samarbejde med Sco Miller og William Andrews: Inves@ga@ng the development and prac@ces of highly effec@ve psychotherapists

16 Achieving Clinical Excellence 0 00 Top Third (N=9) Mid Third (N=7) Bottom Third (N=1)* Violinists Achieving Clinical Excellence Solitary Prac-ce dvs. udover almindeligt arbejde Tid væk fra arbejde -l at reflektere over arbejdet. Supervision Læse eller gen-læse basis liberatur om kerne terapi-færdigheder. Læse -dsskrider Sagsgennemgang med mentor eller supervisor. Studere mester-terapeuters færdigheder Gennemgå case-eksempler 16

17 Achieving Clinical Excellence At lade sig overraske af feedback Den øverste 1/3 af terapeuterne beskrev langt oqere at de blev overrasket over den feedback de modtog fra deres klienter. De beskrev en åbenhed overfor feedback og en villighed Sl at korrigere på baggrund af feedback They seek out to be disconfirmed Var ikke sammenhængende med at de var konsistente i deres brug af SRS det kunne også være på baggrund af uformel feedback det væsentligste var deres holdning Sl feedback. 63,8% af variasonen imellem terapeuter ser ud Sl at kunne forklares på baggrund af denne holdning. 17