How can we assess the implementation of standardized therapy?
Sep 15, 2019 · Effective needs assessment methods help narrow SUD treatment capacity gaps. In 2017, 7.6% of the population age 12 or older had a need for substance use treatment in the past year (as defined by the National Survey on Drug Use and Health, or NSDUH); however, only 1.5% of the population received any substance use treatment in the past year ...
Which research methodologies should you choose for your study?
Assessment of treatment receipt involves verifying the participants’ understanding of the information provided in the treatment and verifying that they can use the skills and recommendations discussed (Appendix 1). This could include written verification (pre-post tests), using audiovisuals (repeat information orally and visually), and behavioral strategies (role plays …
Why do we need to assess the quality of treatment?
Clinical diagnosis is the process of using assessment data to determine if the pattern of symptoms the person presents with is consistent with the diagnostic criteria for a specific mental disorder outlined in an established classification system such as the DSM-5 or ICD-10 (both will be described shortly). Any diagnosis should have clinical utility, meaning it aids the mental …
What are appropriate methodologies for the evaluation of clinical interventions?
Dec 01, 2002 · Methods. Ideally, outcomes should be assessed using converging methods of measurement and sources of information. Treatment goals. The outcomes selected should be consistent with the goals and orientation of the treatment. Summary comments and cautionary notes on treatment efficacy
Which methodology should I use?
A thumb rule for deciding whether to use qualitative or quantitative data is: Using quantitative analysis works better if you want to confirm or test something (a theory or hypothesis) Using qualitative research works better if you wish to understand something (concepts, thoughts, experiences)Feb 17, 2020
What are the 3 methodology?
Researchers use three primary methodology types: qualitative, quantitative and mixed methods.
Which type of study is best at determining whether a treatment is effective?
Clinical trial A study to determine whether a treatment is safe and effective.
What is appropriate methodology in research?
Appropriate selection of your research methodology also involves scrutinizing and considering the approaches used by other researchers in the discipline or studies with similar aims and objectives. Researchers from same disciplines often follow a common methodological approach or set of approaches.
What are the 4 types of research methodology?
Data may be grouped into four main types based on methods for collection: observational, experimental, simulation, and derived.Mar 9, 2021
What are the different types of methodology?
List of Types in Research MethodologyQuantitative Research. ... Qualitative Research. ... Descriptive Research. ... Analytical Research. ... Applied Research. ... Fundamental Research. ... Exploratory Research. ... Conclusive Research.More items...
How do you know if a treatment is effective?
Evidence of efficacy is provided if the benefit is consistently seen when treatment is given and the benefit disappears when treatment is not given. This is a specific example of a before-after study design without controls.
What is the best type of clinical trial?
A randomized, controlled trial (RCT) provides the most compelling medical evidence and is considered to be the most reliable way to learn whether a certain test or treatment works.
What type of study provides best evidence?
Systematic Reviews and Meta Analyses Well done systematic reviews, with or without an included meta-analysis, are generally considered to provide the best evidence for all question types as they are based on the findings of multiple studies that were identified in comprehensive, systematic literature searches.Mar 22, 2022
What is qualitative methodology?
Qualitative method is used to understand people's beliefs, experiences, attitudes, behavior, and interactions. It generates non-numerical data. The integration of qualitative research into intervention studies is a research strategy that is gaining increased attention across disciplines.
What kind of research methods were utilized?
Most frequently used methods include: Observation / Participant Observation. Surveys. Interviews.Sep 21, 2018
Breadcrumb
Needs Assessment Methodologies in Determining Treatment Capacity for Substance Use Disorders: Final Report
ABSTRACT
This project evaluated needs assessment methodologies for substance use disorder (SUD) treatment capacity, highlighting best practices and identifying gaps and opportunities for improvement.
ACRONYMS
The following acronyms are mentioned in this report and/or appendices.
EXECUTIVE SUMMARY
In September 2017, the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation contracted with the Human Services Research Institute to evaluate needs assessment methodologies for substance use disorder (SUD) treatment capacity.
INTRODUCTION AND BACKGROUND
In September 2017, the U.S.
CURRENT PRACTICES IN THE FIELD
In the environmental scan, we identified two types of needs assessments related to SUD treatment capacity. The first type, which we call "mandated," consists of needs assessments conducted to fulfill program requirements by federal agencies or national organizations.
OPPORTUNITIES FOR FURTHER RESEARCH AND ENHANCEMENT OF SUBSTANCE USE DISORDER NEEDS ASSESSMENT
Opportunities for improving the methodology and utility of needs assessment are discussed below. Some of these are suggested by best or exemplary practices in the field, many of which are associated with academic research studies supported with grants from federal agencies.
What are the three critical concepts of assessment?
The assessment process involves three critical concepts – reliability, validity, and standardization . Actually, these three are important to science in general. First, we want the assessment to be reliable or consistent. Outside of clinical assessment, when our car has an issue and we take it to the mechanic, we want to make sure that what one mechanic says is wrong with our car is the same as what another says, or even two others. If not, the measurement tools they use to assess cars are flawed. The same is true of a patient who is suffering from a mental disorder. If one mental health professional says the person suffers from major depressive disorder and another says the issue is borderline personality disorder, then there is an issue with the assessment tool being used (in this case, the DSM and more on that in a bit). Ensuring that two different raters are consistent in their assessment of patients is called interrater reliability. Another type of reliability occurs when a person takes a test one day, and then the same test on another day. We would expect the person’s answers to be consistent, which is called test-retest reliability. For example, let’s say the person takes the MMPI on Tuesday and then the same test on Friday. Unless something miraculous or tragic happened over the two days in between tests, the scores on the MMPI should be nearly identical to one another. What does identical mean? The score at test and the score at retest are correlated with one another. If the test is reliable, the correlation should be very high (remember, a correlation goes from -1.00 to +1.00, and positive means as one score goes up, so does the other, so the correlation for the two tests should be high on the positive side).
What is clinical diagnosis?
Clinical diagnosis is the process of using assessment data to determine if the pattern of symptoms the person presents with is consistent with the diagnostic criteria for a specific mental disorder outlined in an established classification system such as the DSM-5 or I CD-10 (both will be described shortly). Any diagnosis should have clinical utility, meaning it aids the mental health professional in determining prognosis, the treatment plan, and possible outcomes of treatment (APA, 2013). Receiving a diagnosis does not necessarily mean the person requires treatment. This decision is made based upon how severe the symptoms are, level of distress caused by the symptoms, symptom salience such as expressing suicidal ideation, risks and benefits of treatment, disability, and other factors (APA, 2013). Likewise, a patient may not meet the full criteria for a diagnosis but require treatment nonetheless.
What is the purpose of a CT scan?
Finally, computed tomography or the CT scan involves taking X-rays of the brain at different angles and is used to diagnose brain damage caused by head injuries or brain tumors. 3.1.3.5. Physical examination.
What is MRI imaging?
Images are produced that yield information about the functioning of the brain. Magnetic Resonance Imaging or MRI provides 3D images of the brain or other body structures using magnetic fields and computers. It can detect brain and spinal cord tumors or nervous system disorders such as multiple sclerosis.
When was the DSM revised?
The Herculean task of revising the DSM began in 1999 when the APA embarked upon an evaluation of the strengths and weaknesses of the DSM in coordination with the World Health Organization (WHO) Division of Mental Health, the World Psychiatric Association, and the National Institute of Mental Health (NIMH).
When was the DSM 5 published?
3.2.2.1. A brief history of the DSM. The DSM-5 was published in 2013 and took the place of the DSM IV-TR (TR means Text Revision; published in 2000), but the history of the DSM goes back to 1944 when the American Psychiatric Association published a predecessor of the DSM which was a “statistical classification of institutionalized mental patients” and “…was designed to improve communication about the types of patients cared for in these hospitals” (APA, 2013, p. 6). The DSM evolved through four major editions after World War II into a diagnostic classification system to be used psychiatrists and physicians, but also other mental health professionals. The Herculean task of revising the DSM began in 1999 when the APA embarked upon an evaluation of the strengths and weaknesses of the DSM in coordination with the World Health Organization (WHO) Division of Mental Health, the World Psychiatric Association, and the National Institute of Mental Health (NIMH). This collaboration resulted in the publication of a monograph in 2002 called A Research Agenda for DSM-V. From 2003 to 2008, the APA, WHO, NIMH, the National Institute on Drug Abuse (NIDA), and the National Institute on Alcoholism and Alcohol Abuse (NIAAA) convened 13 international DSM-5 research planning conferences “to review the world literature in specific diagnostic areas to prepare for revisions in developing both DSM-5 and the International Classification of Disease, 11th Revision (ICD-11)” (APA, 2013).
What is gender dysphoria?
Gender Dysphoria. Characterized by distress associated with the incongruity between one’s experienced or expressed gender and the gender assigned at birth.
Why are guideline panels recommended?
It is recommended that guideline panels make detailed recommendations to facilitate independent evaluation of the reliability of the guidelines they produce. Ascertaining whether the guidelines are interpreted and applied consistently by health care professionals comprises one assessment of reliability.
What is a criterion 7.2?
Criterion 7.2 It is recommended that guidelines take into account the effects on treatment outcome of interactions between the patient's and the health care professional's characteristics , including but not limited to language, ethnicity, background, sex, and gender.
What is the purpose of failure to disclose scientific justification for a guideline?
Moreover, failure to disclose the scientific justification for a guideline violates a basic principle of science, which requires open scrutiny and debate. Without the disclosure of adequate scientific information, guidelines are mere expressions of opinion.
Why are guidelines important for treatment?
Good guidelines allow for flexibility in treatment selection so as to maximize the range of choices among effective treatment alternatives.
Why are guidelines promulgated?
Guidelines are promulgated to encourage high quality care. Ideally, they are not promulgated as a means of establishing the identity of a particular professional group or specialty, nor are they used to exclude certain persons from practicing in a particular area.
What factors affect outcome?
Such factors as the professional's skill, experience, gender, language, and ethnic background can affect outcome in ways that are only partly understood. Criterion 7.1 It is recommended that guidelines take into account the effect of the health care professional's training, skill, and experience on treatment outcome.
What is a treatment with proven effectiveness in one type of setting?
A treatment with proven effectiveness in one type of setting (e.g., the home, the school, day treatment, the clinic, the office, or the institution) may vary in effectiveness when it is offered in other settings. Good guidelines specify the settings in which the treatment has been documented to be effective.
Why is surgery so low?
Firstly, there is a lack of high-level convincing clinical research to confirm the evidence that surgery is a better treatment option for rib fractures. Secondly, the disciplinary boundary for treating rib fractures is unclear.
How long does it take for a pulmonary contusion to heal?
The condition of pulmonary contusion would start to improve after 24 to 48 hours. It would completely improve within 14 days after the injury (19-23). While the remote, paraneoplastic effects of pulmonary contusion often occur 8 hours after the injury.
Is internal fixation good for rib fractures?
On the other hand, clinical observations have found that the internal fixation of rib fractures is a very effective option for relieving pain. Nowadays, we can see that there is an increasing number of clinical studies which have used pain relief as one of the main indicators for the internal fixation on rib fractures.
Is there a treatment for rib fractures?
Although there are a significant amount of cases annually, the rib fractures treatment options are still lacking, and the rate of surgical treatment conversion is still very low. This situation is caused majorly by the lack of attention on chest trauma and the controversies and debates on the treatment options for rib fractures.
Is 20% CTVI pulmonary contusion a contraindication?
On the other hand, it is still worthwhile for further studies to confirm whether the 20% CTVI pulmonary contusion score should be one of the criteria for a surgical treatment. In many studies, severe pulmonary contusion is considered to be a contraindication to surgery.
Is flail chest dangerous?
The dangers of a flail chest on the body are the compounded harm, i.e., the possibility of a combination of the severe pulmonary contusion, pain, and abnormal breathing, etc. Current research suggests that almost all cases of death caused by flail chest are accompanied by a pulmonary contusion.
Do flail chest patients need mechanical ventilation?
The impact and the feelings of pain will be more obvious. As mentioned in the previous section, flail chest patients would be required to use mechanical ventilation when the patients have a poor respiratory function.
What is the DAPTI measure?
Measure: Drug and Alcohol Program Treatment Inventory (DAPTI)#N#Citation: Peterson et al. 1994 a, Swindle et al. 1995#N#Description: The DAPTI assesses the distinctive goals and activities of Alcoholics Anonymous/12–step treatment, the therapeutic community approach, cognitive–behavioral treatment, insight/psychodynamic treatment, rehabilitation, dual diagnosis treatment, medical model treatment, and marital/family systems therapy. The current DAPTI consists of four goal and four activity items to assess each of the eight orientations; the eight subscales had moderate to high internal consistency reliability estimates. Swindle and his colleagues (1995) provided validity data in the form of DAPTI subscale scores for programs with independently established treatment orientations and correlations with treatment services as assessed by the DAPSI (see table 1). The DAPTI also has been used to assess community residential facilities for substance abuse patients (Moos et al. 1995). More generally, treatment providers can use the DAPTI to determine the extent to which the treatment staff of a program have similar views about what the program is trying to accomplish and about the therapeutic activities to be used to accomplish the program’s treatment objectives.
What are the advantages of questionnaires?
The advantages of the questionnaire approach relative to coding tapes or transcripts are that questionnaires (a) are less expensive and time–consuming to administer and score and (b) provide overall assessments of treatment orientation (rather than samples of specific treatment sessions) as perceived by multiple respondents. For example, an expanded version of the DAPTI was included in a survey of program directors and used to classify programs as having a 12–step, cognitive–behavioral, or eclectic treatment orientation in an evaluation of Department of Veterans Affairs (VA) substance abuse treatment (Ouimette et al. 1997). Program orientation was verified by examining staff responses to the DAPTI.
How is quality of alcohol treatment determined?
The quality of alcohol treatment is determined, not only by the therapeutic techniques applied, but also by the characteristics of individual treatment providers (panel III in figure 1). In particular, this domain of variables refers to within–program variation in provider characteristics (aggregate, program–level staff characteristics are considered in panel II). Gerstein (1991) argued that “the competence, quality, and continuity of individual caregivers are likely to be critical elements in explaining the differential effectiveness of [substance abuse] treatment programs” (p. 139). In the alcohol treatment field, the few studies that have been conducted (e.g., W.R. Miller et al. 1980; Valle 1981; McLellan et al. 1988; Sanchez–Craig et al. 1991; Project MATCH Research Group 1998; for reviews, see Najavits and Weiss 1994; Najavits et al. 2000) indicate that therapist characteristics play an important role in determining clients’ treatment retention and outcomes.
What are the five treatment approaches?
2001#N#Description: This multidimensional instrument assesses five treatment approaches: psychodynamic or interpersonal, cognitive–behavioral, family systems or dynamics, 12–step, and case management. For each of the first four modalities, items assess beliefs underlying the approach, practices appropriate in individual therapy, and practices appropriate in group therapy. Case management is an individual approach, so no group practices items were included. In addition, items were developed to tap general “group techniques” (e.g., “encouraging peer social support”) and “practical counseling” (e.g.,“developing rapport and trust”). The instrument consists of 48 items that assess 14 subscales. Construct validity was supported by the results of a confirmatory factor analysis in which subscale items loaded on the factor they were intended to assess, but not on other factors. Corresponding belief and practice subscales correlated highly, except for case management. Cronbach alphas for all subscales except psychodynamic and family systems beliefs were above 0.50 and most were over 0.70 (Kasarabada et al. 2001, p. 287). The fact that some of the subscales consist of only three items contributed to low internal consistency estimates.
What is the SEEQ?
Measure: Survey of Essential Elements Questionnaire (SEEQ)#N#Citations: Melnick and De Leon 1999; Melnick et al. 2000#N#Description: The SEEQ, which takes 20–30 minutes to complete, consists of 139 items that tap 27 domains related to therapeutic community (TC) treatment. The domains fall into one of six general dimensions: TC perspective on addiction and recovery (e.g., “Right living, including self–reliance and positive social and work–related attitudes is crucial to recovery from substance abuse”); agency treatment approach and structure (e.g., “The treatment approach centers on members’ participation in the community”); community as therapeutic agent (e.g., “Status and privileges are related to progress in the program”); educational and work activities (e.g., “Work is used as part of the therapeutic program [i.e., to build self–esteem and social responsibility]”); formal therapeutic elements (e.g., “The members are reinforced for acting in a positive manner while negative behavior is met with confrontation”); and process (e.g., “The major goal of the primary treatment stage is the development of a set of values consistent with those of the community”). Respondents rate the items on 5–point Likert–type scales, from “extremely important” to “very little importance.” Based on data from directors of 59 of the 69 member programs in the Therapeutic Communities of America organization, internal consistency reliability estimates (coefficient alphas) for the six general dimensions ranged from 0.76 (TC perspective) to 0.94 (community as therapeutic agent) (Melnick and De Leon 1999). Alphas for the 27 domains generally were acceptable, with the exception of 8 domains that had coefficients below 0.70. A cluster analysis based on the 6 SEEQ dimensions classified 45 programs as either traditional TCs ( n = 37) or modified TCs ( n = 8) (Melnick and De Leon 1999; see also Melnick et al. 2000). Melnick et al. (2000) noted that although the SEEQ assesses important aspects of TC treatment, it does not assess the quality of those components.
What is the National Drug and Alcoholism Treatment Unit Survey?
Measure: National Drug and Alcoholism Treatment Unit Survey (NDATUS)#N#Citation: Office of Applied Studies 1991#N#Description: The NDATUS is a brief questionnaire (five pages) that covers (a) the overall organization and structure of programs (ownership, funding sources and levels, organizational setting, capacity in different treatment settings using different treatment modalities, hours of operation, etc.), (b) staffing and staff characteristics, (c) services (e.g., methadone dosages), (d) policies, and (e) clients and client characteristics. The 1989 NDATUS was augmented in 1990 by the Drug Services Research Survey (DSRS) (Office of Applied Studies 1992 a, 1992 b) to obtain additional data in the areas of facility organization and staff, client data, services, and costs and charges. Using data from the 1991 NDATUS, Rodgers and Barnett (2000) found that private, for–profit substance abuse treatment programs tended to be smaller and more likely to provide treatment in only one setting. Public programs and nonprofit programs generally had more treatment staff; Federal and for–profit programs had more psychologists and physicians. In 1992, the NDATUS evolved into the Uniform Facility Data Set (UFDS), sponsored by the Office of Applied Studies.
What is ultimate outcome?
Ultimate outcomes (panel VIII in figure 1) refer to the end points that the treatment is supposed to effect. All treatment programs for alcohol use disorders attempt to impact drinking behavior, with many seeking to eliminate it entirely and others seeking to limit it to levels that do not cause adverse consequences. Some programs also seek to have a broader impact on patient functioning by effecting improvements in such life areas as employment, social functioning, physical health, and/or psychological functioning (for an in–depth discussion of outcome assessment, see Tonigan’s chapter in this Guide ). Treatment process models may specify different dimensions of treatment that should impact different areas of patients’ functioning.
What is quantitative research?
Quantitative research. In this type of research, the data collected is generally expressed in numbers and graphs to confirm theories and assumptions. The data collected are factual information on the topic. Under the quantitative research method, the factual information can be collected in many ways such as:
What is qualitative analysis?
In qualitative research, the analysis will be based on image, language, and observations (generally involving form of textual-analysis). Specific methods might include: Content-analysis: Discussing and categorizing meaning of sentences, words, and phrases.
Which is better, qualitative or quantitative?
A thumb rule for deciding whether to use qualitative or quantitative data is: Using quantitative analysis works better if you want to confirm or test something (a theory or hypothesis) Using qualitative research works better if you wish to understand something (concepts, thoughts, experiences)