Why assessment is critical at every stage of treatment

By: Dr. Cheri Shapiro, Director

In an earlier post, I spoke about the role of assessment in treatment.  In delivering evidence-based interventions for social, emotional, or behavioral challenges in youth, most intervention manuals, guidelines, or protocols call for some type of assessment of presenting concerns, usually at the beginning and end of treatment.  One rationale is to have a better understanding of exactly what the challenges are when you begin, and to know if you were successful at the end.

However, there is a lot that happens between the “beginning” and the “ending” of treatment, and there are many ways to find out how treatment is progressing.  One approach is to use a measurement tool at each session, or, every few sessions, in order to understand what gains have been made or what challenges remain, and to track for new problems that could arise.  For example, short instruments designed to assess symptoms of anxiety, stress, or substance use can be given frequently during treatment (such as the Beck Depression Inventory).  Other measures may ask about more generally how a client is feeling (such as the Outcome Rating Scale).  Yet other measures are designed to track the therapist-client relationship (such as the Session Rating Scale).

Importantly, we cannot always rely on our professional opinion to know when or if a client is improving.  Keeping an open mind and inquiring along the way – by collecting data from and with our clients – can help us be more effective in treatment planning and delivery.  The families we serve are our most important collaborators in the process, and their progress is the ultimate driver of our work.

Why communication is key for all providers

By: Dr. Cheri Shapiro, Director

Recently, I have encountered important clinical questions regarding types of treatments.  More specifically, many clients are receiving care by medical professionals as well as mental health or substance use treatment providers.  Medication and psychosocial treatments commonly go hand in hand; in fact, for some conditions, a combined treatment approach (here specifically defined as combining medication and psychosocial interventions) has been found to be most effective for improving overall functioning.  Examples include ADHD and early stage schizophrenia, among others.

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What you need to know about NREPP

By: Dr. Cheri Shapiro, Director

In December 2017, the Substance Abuse and Mental Health Services Administration (SAMHSA) ended its long-standing contract (since 1997) with the National Registry of Evidence-based Programs and Practices (NREPP).  (This resource was mentioned, along with others, in an earlier blog post).  The Assistant Secretary for Mental Health and Substance Use, Elinore, F. McCance-Katz, MD, PhD, issued a statement about this decision that included a number of criticisms of NREPP with direction that “…SAMHSA should not encourage providers to use NREPP to obtain EBP’s, given the flawed nature of this system.”

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Why listening is critical in EBI

By: Dr. Cheri Shapiro

As a provider, when it comes to deciding on a treatment course for children or adolescents, as with treating adults, we need to pay very careful attention to assessing what is actually happening for those seeking our care.  This means listening carefully to what children and adolescents tell us directly, but critically, also listening to those that care for these young people.

Parents and caregivers are in the best position to observe and describe behaviors that they see in youth in their care. Simply put, we cannot adequately understand challenges faced by youth without caregiver input. Educators also play an important role in helping us understand whether a child or adolescent’s behavior is typical or not.  Just think, most second-grade teachers, in just a few years, may interact with nearly 75-100 second grade children! This allows educators to develop a good understanding of what behaviors most second grade children do or do not exhibit.

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Challenges of EBI for foster children

By: Dr. Cheri Shapiro

An important question for behavioral health providers and organizations considering evidence-based approaches for children, youth, and families involves the population being served. One important group of youth that are at high risk for a range of poor outcomes are youth in the foster care system. Importantly, children and adolescents in the foster care system are often burdened by trauma, or unresolved grief and loss (for example, see work by Dr. Monique Mitchell) that cannot be ignored.

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What do power outages and EBI have in common?

By: Dr. Cheri Shapiro

Many of you heard about the debacle in Atlanta at the airport caused by a power outage on December 17, 2017.  I had the unfortunate opportunity of being involved; travel plans took me through Atlanta, landing just as the entire airport operations came to a dead stop.

What does this have to do with evidence-based behavioral health interventions for children, youth, and families?

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