Trauma-informed measurement-based care for children: Implementation in diverse treatment settings

Area of Science:

• Child and Adolescent Mental Health
• Implementation Science
• Evidence-Based Practice

Background:

• Routine assessment is vital for evidence-based care but often not integrated into clinical practice.
• Few studies have explored the application of measurement-based care (MBC) specifically with children.
• Existing child mental health services face challenges in adopting routine outcome measurement.

Purpose of the Study:

• To examine the acceptability, appropriateness, adoptability, and feasibility of implementing an MBC initiative (CIMI) in child-serving settings.
• To assess the utility of CIMI in guiding clinical decision-making and monitoring treatment progress.
• To identify implementation facilitators and barriers in diverse child mental health contexts.

Main Methods:

• A pilot study was conducted across multiple child-serving settings, including a community mental health center and a residential treatment facility.
• The Clinical Improvement through Measurement Initiative (CIMI) involved a comprehensive mental health assessment protocol and a mobile technology platform.
• Data were collected from 44 clinicians and staff via surveys and focus groups to evaluate implementation constructs and outcomes.

Main Results:

• Participants found the CIMI implementation process and technology acceptable, appropriate, and feasible for child mental health settings.
• Clinicians reported that CIMI could effectively guide case conceptualization, treatment planning, and outcome monitoring.
• Significant differences in feasibility and appropriateness were noted between community and specialized settings, influenced by factors like organizational climate and patient needs.

Conclusions:

• The CIMI initiative demonstrates promise for enhancing the use of measurement-based care in child mental health services.
• Tailoring MBC implementation strategies to specific setting characteristics is recommended for successful adoption.
• Further research should explore optimizing MBC implementation across diverse child-serving environments.