Year of Award

2017

Document Type

Thesis

Degree Type

Master of Arts (MA)

Degree Name

Clinical Psychology

Department or School/College

Psychology

Committee Chair

Christine Fiore, PhD

Committee Co-chair

Cameo Stanick, PhD

Commitee Members

Duncan Campbell, Rick van den Pol

Keywords

implementation, psychology, children mental health, usual care

Subject Categories

Child Psychology | Clinical Psychology

Abstract

Several decades of research have been spent identifying and testing EBTs, but there is currently very little research that examines the therapeutic practices within usual care. The lack of understanding in this area has been implicated as a factor which hinders the successful implementation of evidence-based therapies (EBTs) into usual mental health care settings. The Monthly Treatment Progress Summary (MTPS) is a measure developed to enable monthly tracking of intervention strategies and content within a statewide system of children’s mental health care. Although a growing body of research exists examining the reliability and validity of the treatment practice and progress sections of the MTPS, less research has been conducted on the treatment target section. Specifically, no information exists on the validity of the treatment target section, which is a significant limitation of the measure and has implications for gaining a full picture of usual care treatment. The current study demonstrated some support for the use of the MTPS as an indirect measure of specific content on which clinicians focus in therapy. Trained coders were able to reliably identify specific treatment targets focused on in treatment sessions for 12 of 13 targets that occurred at a high enough frequency to be analyzed. Overall coder-clinician agreement was low, with four of the 12 targets achieving acceptable levels of reliability (ICC ³ .60). These results suggest there may be a difference between clinician intent and the observable content a clinician engages in. These results may also indicate differential levels of familiarity or understanding between coders and clinicians of what constitutes ‘focus’ in session, as the present study demonstrates that several treatment targets on the MTPS can be reliably coded. Future research should incorporate larger samples of more diverse clients that will include content related to treatment targets that were removed from the present analysis. Lastly, the discrepancies noted between coders and clinicians indicate the need for future research to elucidate clinician intent, clinicians’ accuracy in reporting their session content, and the relationship between clinician intent and observable session content.

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© Copyright 2017 Allison K. Powell