Evidence-based assessment/Prescription phase
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| EBA Implementation |
|---|
| Assessment phases |
| Steps 1-2: Preparation phase |
| Steps 3-5: Prediction phase |
| Steps 6-9: Prescription phase |
| Steps 10-12: Process/progress/outcome phase |
Prescription Phase
[edit | edit source]Overview
[edit | edit source]The prescription phase is the second phase of the Evidence-Based Assessment Approach. This phase begins at the intake interview building off of the prediction phase.[1] This phase is about figuring out what is the best direction to go in next by using gathered information so far for case conceptualization. Case conceptualization is a provisional map of a person’s presenting problems that describes the territory of the problems and explains the processes that likely caused and are maintaining the problems.[2] A good case conceptualization describes problems and processes in ways that are verifiable.” Good case conceptualization will provide a roadmap for intervention but it is always open for revisions or changes in directions.
Rationale
[edit | edit source]The big differences in treatment prescription are between externalizing and internalizing disorders[3], or perhaps between subtypes of conduct disorder versus other disruptive behavior disorders[4], or unipolar versus bipolar mood disorders[5][6]. The distinction between oppositional defiant disorder or disruptive behavior disorder not otherwise specified does not change the choice of treatment, so we do not lose predictive or prescriptive information by lumping them together[7]. If there is no electronic medical record, then some sort of random sampling of charts or cases can provide a good snapshot of services – perhaps drawing 5 or 10 percent of cases at a clinic from each month to get a picture of services throughout the year including the variation in referral patterns between the school year and summer.
Steps to put into practice
[edit | edit source]Tables and figures
[edit | edit source]Coverage of common diagnostic interviews
[edit | edit source]| Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) | Mini-International Neuropsychiatric Interview (M.I.N.I.) | Schedule for Affective Disorders and Schizophrenia (SADS) | Diagnostic Interview Schedule for Children (DISC) | World Health Organization Composite International Diagnostic Interview (WHO-CIDI) | Diagnostic Interview for Children and Adolescents (DICA) | Child and Adolescent Psychiatric Assessment (CAPA) | |
|---|---|---|---|---|---|---|---|
| Anorexia Nervosa | Yes | Yes (also bulimia, binge eating) | |||||
| Antisocial Personality | Yes | ||||||
| Attention Deficit Hyperactivity Disorder | Yes | Yes | |||||
| Autism Spectrum Disorder | Yes | ||||||
| Bipolar (adults) | Yes | ||||||
| Bipolar (child) | Yes | Yes | |||||
| Conduct disorder | Yes | ||||||
| Depression (youth) | Yes | Yes | |||||
| Generalized anxiety disorder | Yes | Yes | |||||
| Self harm | (in depression module) | Yes | |||||
| Obsessive-compulsive disorder | Yes | Yes | |||||
| Oppositional defiant disorder | Yes | ||||||
| Posttraumatic stress disorder | Yes | Yes | |||||
| Schizophrenia | Yes | Yes (psychotic disorders) | |||||
| Simple phobia | Yes | ||||||
| Social anxiety disorder | Yes | Yes | |||||
| Substance use disorder | Yes | Yes (separate modules for alcohol and non-alcohol) | |||||
| Traumatic brain injury |
Performance of common diagnostic interviews
[edit | edit source]| Measure | Format (Reporter) | Age Range | Administration/
Completion Time |
Interrater Reliability | Test-Retest Reliability | Construct Validity | Content Validity | Highly Recommended | Free and Accessible Measures |
|---|---|---|---|---|---|---|---|---|---|
| Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS PL) | Semi-structured Interview[8] | 6-18 | 45-75 minutes | G | A | E | G | X | Homepage |
| Diagnostic Interview for Children and Adolescents (DICA)
*not free |
Structured Interview[9] | Parent of 6-17 year old
Youth 9-17 |
70-120 minutes | A | A | A | G | Homepage | |
| Child and Adolescent Psychiatric Assessment (CAPA)
*not free |
Structured diagnostic interview[10] | 9-18 | 1.5 hours | G | A | G | G | X | Homepage |
| Structured Clinical Interview for DSM-V (SCID) | Semi-structured interview to be administered by a clinician or an experienced rater[11] | Adults
(Ages 18+) |
1-2 hours | G | G | G | G | 
|
-Available for purchase from APA Publishing (Note: Not free)
-Modified PDF Version (not most recent version, SCID-I) -Located on Penn Lab, See Appendix 1 for schizophrenia modules |
| SADS (Schedule for Affective Disorders and Schizophrenia) | Interview (Patient) | Adult | 1-2 hours | G | G | G | G |
|
|
| Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)[12] | Interview | Children | 34 minutes[13] | G-E[13] | G-E[13] |
Note: L = Less than adequate; A = Adequate; G = Good; E = Excellent; U = Unavailable; NA = Not applicable
See also the "Interviews are not Perfect" page if you are interested in this in more detail.
Performance of common interview-based severity ratings
[edit | edit source]| Measure | Format (Reporter) | Age Range | Administration/
Completion Time |
Interrater Reliability | Test-Retest Reliability | Construct Validity | Content Validity | Highly Recommended | Free and Accessible Measures |
|---|---|---|---|---|---|---|---|---|---|
| Children's Depression Rating Scale - Revised (CDRS-R) | Structured Interview[14] | 6-12 | 15-20 minutes | G | A | G | G | X | |
| KSADS Mania Rating Scale | Semi-structured interview to be administered by a clinician or an experienced rater[11] | 5-18 | 10-30 minutes | G | G | G | G |
|
|
| KSADS Depression Rating Scale | Semi-structured interview to be administered by a clinician or an experienced rater[11] | Adult | 1-2 hours | G | G | G | G |
|
|
| YBOCS | Interview |
Note: L = Less than adequate; A = Adequate; G = Good; E = Excellent; U = Unavailable; NA = Not applicable
See also the "Interviews are not Perfect" page if you are interested in this in more detail.
References
[edit | edit source]- ↑ Youngstrom, Eric A.; Meter, Anna Van; Frazier, Thomas W.; Hunsley, John; Prinstein, Mitchell J.; Ong, Mian-Li; Youngstrom, Jennifer K. (2017). "Evidence-Based Assessment as an Integrative Model for Applying Psychological Science to Guide the Voyage of Treatment". Clinical Psychology: Science and Practice 24 (4): 331–363. doi:10.1111/cpsp.12207. ISSN 1468-2850. https://onlinelibrary.wiley.com/doi/abs/10.1111/cpsp.12207.
- ↑ Bieling, Peter J.; Kuyken, Willem (2003). "Is Cognitive Case Formulation Science or Science Fiction?". Clinical Psychology: Science and Practice 10 (1): 52–69. doi:10.1093/clipsy.10.1.52. ISSN 1468-2850. https://onlinelibrary.wiley.com/doi/abs/10.1093/clipsy.10.1.52.
- ↑ Chorpita, B. F., Rotheram-Borus, M. J., Daleiden, E. L., Bernstein, A., Cromley, T., Swendeman, D., & Regan, J. (2011). The Old Solutions Are the New Problem: How Do We Better Use What We Already Know About Reducing the Burden of Mental Illness? Perspectives on Psychological Science, 6(5), 493-497. doi: 10.1177/1745691611418240
- ↑ Frick, P. J. (2012). Developmental pathways to conduct disorder: implications for future directions in research, assessment, and treatment. Journal of Clinical Child and Adolescent Psychology, 41(3), 378-389. doi: 10.1080/15374416.2012.664815
- ↑ Fristad, M. A., & Macpherson, H. A. (2014). Evidence-based psychosocial treatments for child and adolescent bipolar spectrum disorders. Journal of Clinical Child and Adolescent Psychology, 43(3), 339-355. doi: 10.1080/15374416.2013.822309
- ↑ Stark, K. D., Swearer, S., Delaune, M., Knox, L., & Winter, J. (1995). Depressive Disorders. In R. T. Ammerman & M. Hersen (Eds.), Handbook of child behavior therapy in the psychiatric setting (pp. 269-300). New York: Wiley.
- ↑ Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child and Adolescent Psychology, 37(1), 215-237. doi: 10.1080/15374410701820117
- ↑ "Kiddie Schedule for Affective Disorders and Schizophrenia". Wikipedia. 2017-08-21. https://en.wikipedia.org/w/index.php?title=Kiddie_Schedule_for_Affective_Disorders_and_Schizophrenia&oldid=796460290.
- ↑ "Diagnostic Interview for Children and Adolescents (DICA)". Journal of the American Academy of Child & Adolescent Psychiatry 39 (1): 59–66. 2000-01-01. doi:10.1097/00004583-200001000-00017. ISSN 0890-8567. https://www.sciencedirect.com/science/article/pii/S0890856709661013.
- ↑ System, Duke University Health. "Duke Developmental Epidemiology Program". devepi.duhs.duke.edu. Retrieved 2018-03-01.
- ↑ 11.0 11.1 11.2 "Structured Clinical Interview for DSM-5 (SCID-5)". www.appi.org. Retrieved 2018-03-08.
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedSheehan_et_al-2010 - ↑ 13.0 13.1 13.2 Sheehan, David V.; Sheehan, Kathy H.; Shytle, R. Douglas; Janavs, Juris; Bannon, Yvonne; Rogers, Jamison E.; Milo, Karen M.; Stock, Saundra L. et al. (March 2010). "Reliability and validity of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID)". Journal of Clinical Psychiatry 71 (3): 313-26. doi:10.4088/JCP.09m05305whi. PMID 20331933.
- ↑ Mayes, Taryn L.; Bernstein, Ira H.; Haley, Charlotte L.; Kennard, Betsy D.; Emslie, Graham J. (2010-12). "Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents". Journal of Child and Adolescent Psychopharmacology 20 (6): 513–516. doi:10.1089/cap.2010.0063. ISSN 1044-5463. PMID 21186970. PMC PMC3003451. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/.