There is extensive research supporting the effectiveness of Measurement-Based Care (MBC) in mental and behavioral health services, showing improved clinical outcomes, higher treatment engagement, and improved collaboration between clients and providers.
It’s important to recognize that MBC flips the usual process of measurement on its head by placing the importance, first and foremost, on providing clinical value to each individual client and clinician—instead of measurement being only an exercise of data collection. What this means is, in order to maximize the benefits of MBC, you can’t just collect data for its own sake; the data is only clinically valuable if you share and discuss it with your client in session and use it to align on treatment goals and to collaborate on and inform care decisions.
So, how do you implement MBC effectively in order to accomplish all of these things?
Dr. Sandy Resnick and Dr. Jessica Barber, two of the researchers and renowned psychologists that form part of the Yale Measurement-Based Care Collaborative, have tackled this question by working to bridge the gap between Measurement-Based Care knowledge and practical application. They recently published an insightful paper describing the Collect, Share, Act Model of MBC, which serves as a guideline for mental health providers to introduce MBC into their work.
This model is particularly helpful for anyone looking to adopt MBC into practice. Here is a brief outline describing the basics of Collect, Share, Act and the ways it can support a successful MBC implementation.
If you’d like to learn in more, check out the full paper here.
Collect involves three key steps or processes:
- Introduce MBC to the client and explain the rationale for its use;
- Decide which measures make sense for the specific client and ensure the client understands how they relate to their treatment goals;
- Administer measures regularly and repeatedly (most measures have a recommended frequency for assessment completion)
An important part of engaging clients in MBC is to ensure that they understand how it benefits them, how their data will be used to inform the treatment process and how often measures will be administered.
When clients understand why they’re completing these measures, they’re more likely to engage in the process and see improvements. It also helps to establish a shared understanding of treatment goals and progress towards them, which will allow MBC to become a key foundation of the client’s care.
Share means making sure the client understands their assessment results and that both the client and clinician can reflect on them together throughout the care process. It’s important to remember that the outcome measures are more than just numbers or scores; each individual response gives context and insight into how a client is truly doing, which creates an opportunity to collaboratively dig in, identify areas to focus on during sessions, enhance therapeutic alliance and ultimately improve treatment outcomes.
During the Share step, clinicians should emphasize the client’s strengths and improvements, as well as any areas that may need additional focus or treatment. Engaging the client in collaborative dialogue about their PROMs can be deeply empowering, as it offers them an additional way to share how they are doing, discuss changes, and address any progress or setbacks that they experience. It strengthens the therapeutic relationship and allows for a deeper understanding of the client’s mental health and life experiences.
Act is the final stage of the model, comprised of three key steps:
- Assess the data trajectory over time and discuss with the client: have things improved, worsened, or has there been no change at all?
- Collaboratively brainstorm ideas for the next steps in the treatment process;
- Agree on a plan of care and document it in the client’s chart.
In this stage, the client and clinician can reflect on all the available PROM data collected throughout treatment. It’s an excellent opportunity to discuss what is working, what needs improvement, and whether or not the treatment focus needs to shift in any way.
This discussion, in combination with the clinician’s judgement, can help to guide treatment plans, inform goal-setting, and therapeutic interventions. One of the most important aspects of MBC is that the client’s voice is valued and prioritized when making decisions about their treatment. During this stage (and all stages), the client should be encouraged to share their concerns, needs, and preferences with regard to treatment goals and decisions.
Collect, Share, Act is a straightforward and valuable clinical model that can help guide clinicians in effectively using MBC. With MBC implemented as part of their care process, clinicians are more likely to catch treatment inertia, understand changing symptoms, enhance client engagement, and most importantly, see stronger treatment outcomes.
We are honoured and grateful to be able to partner with organizations like the Yale Measurement-Based Care Collaborative, whose dedication to bringing MBC to the forefront of mental & behavioral healthcare is helping to transform the mental health system for the better.