Abstract
Measurement-based care (MBC), the of use routinely-collected assessment to guide clinical decision-making, has great potential to improve mental healthcare. MBC is widely endorsed as a cornerstone of evidence-based practice and is capable of increasing the effectiveness of mental health treatment. Lack of clear consensus on key MBC practices has hindered implementation efforts; less than 20% of mental health providers use MBC and even less implement with high quality. A barrier to improving implementation efforts is the limited operationalization of MBC session practices. This study meets this need by developing and evaluating the psychometric properties of the Measurement Based Care – Session Practices, an observational coding system for practices that occur in sessions with clients. A codebook of practices consistent with MBC was developed; content validity was established through ratings by 22 experts in MBC. Preliminary scoring was piloted using audio recorded sessions from the MBC condition of the Community Study of Outcome Monitoring for Emotional Disorders in Teens randomized control trial. Items were refined through examination of inter-rater reliability and discussion. Independent coders rated 121 sessions from a sample of 51 youth (Mage = 14.8 years) using the MBC-SP. MBC-SP item inter-rater reliability coefficients were all greater than 0.90. MBC-SP item correlations provided preliminary support for creation of a scale score. The MBC-SP score showed evidence of construct validity, demonstrating large correlations with clinician reported practices and small correlations with alliance and MBC administration and viewing practices. Support for the predictive and incremental validity of the MBC-SP score was not found; however, this may be due to a restricted range in MBC-SP extensiveness rating across clients at the lower end of the scale. Overall, psychometric findings provide support for the development of a novel, comprehensive measure of MBC session practices and its application in future research.