Implementing Feedback Interventions to Improve Outcomes

实施反馈干预措施以改善结果

• 批准号: 7222803
• 负责人: Leonard Bickman
• 金额: $ 59.02万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-10 至 2009-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7222803
• 关键词: Address; Adolescent; Adopted; Affect; Affective; Applied Research; Attention; Back; Basic Science; Behavior; Behavior Therapy; Behavioral; Cells; Client; Clinical; Cognition; Cognitive; Condition; Data; Discipline; Effectiveness; Employee; Feedback; Fibrinogen; Finches; Future; Goals; Health Personnel; Health Status; Heterogeneity; Home environment; Intervention; Investigation; Knowledge; Manuals; Measures; Mediating; Mental Health; Mental Health Services; Modality; Modeling; Outcome; Performance; Persons; Process; Professional counselor; Provider; Psychology; Randomized; Range; Rate; Relative (related person); Research; Research Personnel; Role; Self Efficacy; Services; Severities; Site; Symptoms; Testing; Theoretical model; Therapeutic; Therapeutic Effect; Training; Translations; Treatment Factor; Treatment outcome; Work; Youth; base; design; feeding; image processing; improved; innovation; interest; size; social; theories; therapeutic target

DESCRIPTION (provided by applicant): We propose to study the effects of a theory-driven and empirically-based feedback intervention to influence the cognition and behavior of counselors who provide in-home mental health services to adolescents. The feedback to counselors will be based on client ratings of therapeutic alliance. An improved therapeutic relationship is predicted to have a positive effect on the youth's mental health. The predominant approach to improving mental health outcomes is to disseminate and implement efficacious treatments into the "real world". This proposal offers an approach to improving outcomes of services that is sensitive to the organizational context. Feedback on performance has been shown to improve performance in thousands of studies across many disciplines. However, in a trial of the studies feedback resulted in a decrease in performance. A theoretical understanding of feedback is required to understand the heterogeneity of the effect of feedback. Through a review of basic and applied research in cognitive, social, organizational psychology, and management we have developed a theoretical model that aims to elucidate and optimize the effects of feedback on the performance of mental health service providers. We propose to target therapeutic alliance (TA), as it is the most agreed upon common treatment factor associated with positive clinical outcomes. We will conduct a 2x2 randomized factorial study of the effects of feeding back the youth's TA ratings to the counselor. In Study 1, counselors will be randomly assigned by site to either a "feedback" or a "no feedback" condition. Sites will also be randomly assigned to a "high involvement" or "low involvement" condition in which their supervisor does or does not receive the client-generated feedback. Our model predicts an interaction effect between these two factors that should produce the largest change in counselor cognitions and behavior and the greatest improvement in symptoms and functioning. Study 2 will utilize the same design to test whether an educational component (TA counselor's manual) in addition to feedback will have an even greater positive effect on client ratings of TA and subsequent treatment outcomes. We believe that this research is both theory-based and highly relevant to mental health providers. It offers an innovative approach to improving mental health services.

描述（由申请人提供）：我们建议研究以理论驱动和经验的反馈干预的影响，以影响为青少年提供家庭心理健康服务的辅导员的认知和行为。 对辅导员的反馈将基于客户的治疗联盟评级。 预计改善的治疗关系将对年轻人的心理健康产生积极影响。 改善心理健康成果的主要方法是将有效的治疗传播到“现实世界”中。 该建议提供了一种改善对组织环境敏感的服务结果的方法。 已经证明，对绩效的反馈可以提高许多学科研究的成千上万的研究。但是，在研究反馈的试验中导致了性能下降。 需要对反馈的理论理解来了解反馈效果的异质性。 通过对认知，社会，组织心理学和管理领域的基本和应用研究的回顾，我们开发了一个理论模型，旨在阐明和优化反馈对精神卫生服务提供者绩效的影响。 我们建议针对治疗联盟（TA），因为它是与阳性临床结果相关的最常见的治疗因素。 我们将进行2x2随机阶乘研究，以将年轻人的TA收视率喂入辅导员的效果。 在研究1中，辅导员将被站点随机分配给“反馈”或“无反馈”条件。 网站还将随机分配给主管或未接收客户生成的反馈的“高参与”或“低参与”条件。 我们的模型预测了这两个因素之间的相互作用效果，这些因素应产生辅导员认知和行为的最大变化，以及症状和功能的最大改善。 研究2将利用相同的设计来测试除反馈外的教育部分（TA辅导员手册）是否会对TA的客户评级和随后的治疗结果产生更大的积极影响。 我们认为，这项研究既基于理论，又与心理健康提供者高度相关。 它为改善心理健康服务提供了创新的方法。