Measurement based care behavioral health is the use of standardized measures to assess behavioral health patients and inform treatment decisions. This practice can improve patient outcomes, enhance clinical decision making, enrich communication between clinicians and patients, demonstrate the value of treatment, and support collaborative practice.
Despite its vast benefits, only around 18% of psychiatrists and 11% of psychologists are using measurement based care practices today. This is likely due to the additional time and effort required to implement it, challenges with EHRs and patient concerns.
The key to measurement based care is the systematic administration of validated brief, patient self-report questionnaires at regular intervals throughout the treatment process and incorporating these into clinical notes as narrative. This allows for a step-by-step approach to assessment, treatment planning, and outcome monitoring while reducing symptom deterioration and improving patient outcomes.
A therapist can then compare the symptom ratings and changes in symptoms from baseline to the current clinical encounter with each client and make adjustments if necessary. This results in more frequent monitoring of progress and more rapid response to treatment fluctuations.
In addition to this, a therapist can also see if any symptom deterioration is occurring, which can be an early indicator of a problem requiring further diagnostic evaluation and testing or a sign that the client might be at risk for relapse. It is important to be able to detect these early warning signs of deterioration and act quickly to correct the situation.
Research has shown that implementing MBC improves treatment outcomes for behavioral health clients, as well as their treatment response time and relapse rates. In fact, one study found that patients who received MBC were more than 2.5 times more likely to reach remission and had half the treatment response time as those who did not.
MBC is a great tool to use in conjunction with clinical judgment because mental health professionals often struggle to detect when a patient’s symptoms are deteriorating or not improving as expected. Using MBC in this way gives clinicians a lifeline to adjust their clinical judgment and overcome treatment inertia.
It is also essential to keep the focus on client goals and not on what has already occurred. This helps to maintain patient engagement and ensure the best outcomes.
Select brief, validated outcome measures that are aligned with your treatment goals and objectives. These are typically patient-rated scales that can be administered by either the therapist or the client, with each score providing a reliable and objective measure of symptom severity that is comparable across individuals and across settings.
Ideally, these scales are scored at regular intervals and at the beginning or end of each session. These can be gathered between sessions as well if the scales are designed to track progress over time.
Measurement based care is becoming the standard of care in many behavioral health treatment models, including outpatient counseling and medication management. The main reasons for this are threefold: First, it can accelerate outcomes and allow for better, faster treatment; second, it supplies empirical data that payors can leverage to get better payment rates for mental health treatment; and third, it is gaining traction as the logical method to measure and report population-level outcome data.