{"id":38477,"date":"2026-10-20T09:50:11","date_gmt":"2026-10-20T13:50:11","guid":{"rendered":"https:\/\/greenspacehealth.com\/en-us\/?p=38477"},"modified":"2026-10-20T09:50:11","modified_gmt":"2026-10-20T13:50:11","slug":"qa-from-beyond-outcomes-the-roi-of-mbc","status":"publish","type":"post","link":"https:\/\/greenspacehealth.com\/en-us\/qa-from-beyond-outcomes-the-roi-of-mbc\/","title":{"rendered":"Q&#038;A from Beyond Outcomes: The ROI of MBC"},"content":{"rendered":"<p>We had an incredible turnout for <strong>Beyond Outcomes: The ROI of Measurement-Based Care<\/strong>. Hosted by Simon Weisz, Co-Founder and President of Greenspace, the session brought together three exceptional voices from across the behavioral health sector:<\/p>\n<ul>\n<li>Denise Dickerson, LCADC, LCPC, Director of Behavioral Health at Calvert County Behavioral Health, who shared how MBC data has directly strengthened the organization&#8217;s grant strategy and community impact;<\/li>\n<li>Andy Kelly, Chief Commercial Officer at Boulder Care, who offered a rare and candid payor-side perspective on value-based contracting in substance use;<\/li>\n<li>Nick Forand, PhD, ABPP, Principal Clinical Research Scientist at Two Chairs, whose work on MBC and early dropout has produced some of the most compelling research in the field.<\/li>\n<\/ul>\n<p style=\"margin-top: 25px;\">The discussion covered a lot of ground, and there were more thoughtful questions to explore than time allowed. Attendees flooded the Q&amp;A with thoughtful, specific, and genuinely challenging inquiries about implementation, measurement design, culture change, payer dynamics, and more. We wanted to make sure those questions didn&#8217;t go unanswered, so we&#8217;ve gathered them below, along with responses informed by our panelist and the session itself, organized by theme.<\/p>\n<p>Need a refresher on the session? <a href=\"https:\/\/greenspacehealth.com\/beyond-outcomes-the-roi-of-measurement-based-care\/\">Watch the full recording here<\/a> before coming back to the questions and answers below.<\/p>\n<h2><a id=\"section_1\"><\/a>Assessment Tools and Measurement Approach<\/h2>\n<p><strong>MBC often focuses narrowly on validated group-level tools like the PHQ-9 and GAD-7. Have you incorporated more individually tailored approaches such as goal attainment scaling?<\/strong><\/p>\n<p>This is an important distinction. Standardized, validated tools like the PHQ-9 and GAD-7 are foundational for population-level comparison, benchmarking, and reporting, but they are not the whole picture. Individually tailored approaches, including goal attainment scaling (GAS) and measures specific to a client\u2019s unique experiences, add meaningful clinical value by capturing what matters most to each individual client.<\/p>\n<p>We often see a combination of both approaches. Organizations can configure a standardized core battery for consistency across programs while giving clinicians the flexibility to assign additional client-specific measures. Goal attainment scaling in particular is well-suited to complex populations where standardized symptom measures may not capture the full scope of progress. If your organization uses or wants to use GAS, our team can work with you on how to incorporate it effectively within your MBC program.<\/p>\n<p><strong>Is there a specific tool recommended to measure therapeutic alliance?<\/strong><\/p>\n<p>Therapeutic alliance is a core component of MBC and is measured through validated self-report tools rather than qualitative data alone. The most widely used is the Working Alliance Inventory (WAI), with a brief revised version (<a href=\"https:\/\/greenspacehealth.com\/br-wai\/\">BR-WAI<\/a>) available for routine administration. When therapeutic alliance measures are included as part of a standard assessment battery, Greenspace can surfaces alliance scores alongside symptom data in the clinical dashboard, so clinicians can see both dimensions of the therapeutic relationship in one view.<\/p>\n<p><strong>How do you collect valid and reliable information on a continuing basis without adding to the workload of already stretched clinical staff?<\/strong><\/p>\n<p>This is one of the most common concerns we hear, and it is the right question to ask before implementing MBC. The answer lies in automating MBC in a way that fits into clinicians\u2019 existing workflows. When assessments are delivered directly to clients via email or SMS on a set schedule, scored automatically upon submission, and returned to the clinical record without manual steps, the burden on clinicians is minimal. The clinician&#8217;s role shifts from administering and scoring measures to reviewing results and using them in session, which ultimately adds clinical value rather than administrative load.<\/p>\n<p>That said, it takes intentional workflow design to get there. Greenspace&#8217;s implementation team works with each organization to configure assessment schedules, delivery methods, and EHR integration in a way that fits existing clinical routines. The goal is for MBC to feel like a natural extension of how care is already delivered, not an additional task.<\/p>\n<h2><a id=\"section_2\"><\/a>Clinician Buy-In and Culture Change<\/h2>\n<p><strong><s>H<\/s>ow do you change the culture to get buy-in for MBC from providers?<\/strong><\/p>\n<p>Implementing MBC in a way that encourages buy-in from providers comes down to making it easy to embed into their workflow, and ensuring providers understand the meaningful impact MBC can have on their clients\u2019 outcomes. When they can see that outcome data helps them understand their clients better, identify who is drifting, and have more productive conversations in session, they start to see MBC as a clinical asset rather than a compliance requirement.<\/p>\n<p>Practically, the organizations that have done this well tend to share a few approaches:<\/p>\n<ol>\n<li>They start with a clear, shared rationale, explaining not just what MBC is but why it matters for the clients they serve.<\/li>\n<li>They embed MBC into supervision rather than treating it as a separate accountability measure.<\/li>\n<li>They identify clinician champions early who can model the practice and help peers problem-solve.<\/li>\n<li>They use data to celebrate wins, not just flag problems, so clinicians can connect measurement to visible clinical impact.<\/li>\n<\/ol>\n<p><strong>For Dr. Forand: in terms of the change management required, what were the most important implementation lessons for dealing with resistance and buy-in issues?<\/strong><\/p>\n<p>Dr. Forand shared two things that stood out as most important in Two Chairs&#8217; implementation.<\/p>\n<p>The first was leadership alignment. Before rolling out MBC, it was critical to get leadership aligned not just on the goal but on the timeline and the level of investment required. Behavior change takes work and time, and the results of that work won&#8217;t be seen immediately. Getting leaders to genuinely commit to that reality, rather than expecting quick wins, was foundational.<\/p>\n<p>The second was explaining the &#8216;Why?&#8217; to clinicians in a way that built trust. Two Chairs was deliberate about framing MBC as something designed to help clinicians become better at their work and improve clinical outcomes, not something imposed by a payer or used to evaluate performance. That distinction mattered in ensuring clinicians understood the intent and could be more excited about adoption.<\/p>\n<p>Dr. Forand also emphasized that making MBC feel like less of an administrative burden at Two Chairs required automation and genuine clinical integration, so clinicians were not manually collecting or scoring measures and the data was actually being used in session. When clients can see that the measures they&#8217;re completing are being reviewed, discussed, and acted upon, they will engage more deeply with the process.<\/p>\n<p><strong>How do you train a large number of therapists to understand the measures and get on board with MBC?<\/strong><\/p>\n<p>Training at scale requires a combination of structured onboarding, ongoing reinforcement, and peer support. A single training session at go-live is rarely enough. The organizations that sustain high adoption tend to build MBC into supervision, provide training in cohorts so clinicians can learn together, and identify clinical champions who can support colleagues over time.<\/p>\n<p>On the platform side, clinicians need to understand not just how to use the platform but how to interpret what they are seeing. That means training on what scores mean clinically, how to recognize reliable change versus normal fluctuation, and how to bring results into a session in a way that feels natural rather than clinical or procedural.<\/p>\n<p>Greenspace provides implementation support and training resources as part of onboarding, and our partnership with the <a href=\"https:\/\/greenspacehealth.com\/yale-mbcc-hub\/\">Yale MBC Collaborative<\/a> gives organizations access to practical, evidence-based guidance on introducing MBC to both clinicians and clients.<\/p>\n<p><strong>Are there any employee-led projects in Measurement-Based Care worth highlighting?<\/strong><\/p>\n<p>Yes. Some of the most successful MBC implementations we have seen have been driven bottom-up by clinicians and program staff in addition to top-down support from leadership. Clinician-led working groups, peer learning circles, and internal champions who share outcome data wins in team meetings can be powerful drivers of sustained adoption. When clinicians feel ownership over the process, rather than having it imposed on them, engagement tends to be higher and more durable.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>We had an incredible turnout for Beyond Outcomes: The ROI of Measurement-Based Care. Hosted by Simon Weisz, Co-Founder and President of Greenspace, the session brought together three exceptional voices from across the behavioral health sector: Denise Dickerson, LCADC, LCPC, Director of Behavioral Health at Calvert County Behavioral Health, who shared how MBC data has directly [&hellip;]<\/p>\n","protected":false},"author":22,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[3,45],"tags":[],"class_list":["post-38477","post","type-post","status-publish","format-standard","hentry","category-blog","category-mbc-education"],"acf":[],"_links":{"self":[{"href":"https:\/\/greenspacehealth.com\/en-us\/wp-json\/wp\/v2\/posts\/38477","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/greenspacehealth.com\/en-us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/greenspacehealth.com\/en-us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/greenspacehealth.com\/en-us\/wp-json\/wp\/v2\/users\/22"}],"replies":[{"embeddable":true,"href":"https:\/\/greenspacehealth.com\/en-us\/wp-json\/wp\/v2\/comments?post=38477"}],"version-history":[{"count":0,"href":"https:\/\/greenspacehealth.com\/en-us\/wp-json\/wp\/v2\/posts\/38477\/revisions"}],"wp:attachment":[{"href":"https:\/\/greenspacehealth.com\/en-us\/wp-json\/wp\/v2\/media?parent=38477"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/greenspacehealth.com\/en-us\/wp-json\/wp\/v2\/categories?post=38477"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/greenspacehealth.com\/en-us\/wp-json\/wp\/v2\/tags?post=38477"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}