Symposium 2 – October 13, 2011 (MC: Shannon Dorsey)

1. Using Fidelity Assessment to Set Payments for EBPs
Presentation Slides       Video of Presentation

Presenter: Howard H. Goldman, MD, PhD
Authors: Howard H. Goldman, University of Maryland School of Medicine

Abstract:    The Maryland Mental Hygiene Administration, the state mental health authority, instituted a pay-for-performance policy of offering a higher increment of payment for programs that achieved a threshold of fidelity on routine assessments. Programs request training in several evidence-based practices (EBPs), such as ACT or IPS supported employment, offered by the EBP Center in the Department of Psychiatry at the University of Maryland School of Medicine. Fidelity assessment is used in the training and implementation activities to promote quality improvement. State monitors conduct annual fidelity assessments, which are used both for quality improvement and to set payment levels for the EBPs under review.


2. Enhancin Fidelity to Assertive Community Treatment: Introducing the TMACT
Presentation Slides       Video of Presentation

Presenter: Maria Monroe-DeVita, PhD
Authors: Maria Monroe-Devita, University of Washington

Abstract:      This presentation will discuss the development and implementation of the Tool for Measurement of Assertive Community Treatment (TMACT), an enhanced version of the Dartmouth Assertive Community Treatment Scale (DACTS), including: 1) an overview of the TMACT and 2) a description of findings in piloting this tool with ACT teams in Washington State and several comparison states.

3. Automating Assessment of Therapist Fidelity: Attainable Goal or Holy Grail?
Presentation Slides       Video of Presentation

Presenter: David Atkins, PhD
Authors: David Atkins, Sarah “Grin” Geiss Trusz, and Christopher Dunn, University of Washington

Abstract:      As mental health implementation research matures, there is an increased need to assess therapist competence and fidelity to evidence-based intervention guidelines. The ultimate goal of this research is to develop standards of care that retain quality but can also be feasibly and acceptably delivered in real-world settings. Despite high motivation from mental care settings to adopt evidence-based approaches, the issue of behavioral counseling competence and quality remains prominent because the current evaluation methods (i.e., behavioral coding) are labor intensive, slow, and costly. Recent developments in linguistic analysis may enable the automation of assessments of therapist fidelity for training and data-based supervision.  We will present initial findings from an NIAAA-funded study examining the feasibility of computerized coding of motivational interviewing for alcohol and drug behavior change counseling.  The interdisciplinary research team includes colleagues from electrical engineering and computer science, in addition to clinical investigators.  Analyses will examine how text-mining processes can reveal semantic content relevant to coding and how speech signal processing can detect arousal and empathy in clients and therapists during MI sessions.  At the end we’ll discuss how these innovations in linguistic analysis may increase the feasibility of disseminating and evaluating therapist competence and fidelity.


Q And A