February 2019 News - Dalton Associates

Staff Bio of the Month – Katie Crichton

Katie Crichton has been an employee with Dalton Associates for 10 years, having joined the staff team in 2009. In that time, Katie has established herself as the Coordinator of Client Support and Referral Services, and leads the Client Care Team. In this role, Katie ensures that clients receive information they need about our practice, services, and therapists, as well as registering clients for service, and communicating with therapists, psychologists, and referral sources.

Katie has also taken on many other roles within the organization. She supports the marketing team through organizing, attending and educating potential referral sources about our services at trade shows and conferences (e.g., Pri-Med Conference, Human Resources Professionals Association Conference, etc.), as well as supporting associates getting access to, and troubleshooting issues that arise on, the Intranet. Recently, Katie has taken on a role within the Corporate and Government Services division, coordinating assessment services for clients with one of our government partners.

What to Include & Not Include in Case Notes

Case notes are an essential part of the client’s clinical record. There are several purposes for keeping case notes, including (though not limited to): remaining accountable to our clients, supervisors, and our own clinical practice; tracking and reporting on client progress; reflecting on the session, our interventions, the client’s responses, and our own responses as clinicians; and, promoting informed and ethical decision-making within the therapeutic relationship moving forward.

There are several considerations to make with regards to case notes. The case note should be composed as soon as possible after a session with a client, when your memory of the session’s events are most accurate. The more accurate the case note, the better it will serve the client, your supervisor, and yourself moving forward. When composed well, case notes also reduce ethical and legal risks. In the Dalton Associates practice, specifically, case notes are also a mode of supervision; your supervising psychologist should have access to your case notes at all times.

We are attaching an example of a case note that is considered “good” and one that is considered “inadequate”. We are hoping that by reviewing these examples you can reflect on your own documentation practices and determine if any improvements are required.

Click here to view a Good Case Note Example

Click here to view an Inadequate Case Note Example

CPA Task Force Report: Outcome and Progress Monitoring in Psychotherapy (Shared Article)

“The article below highlights the Canadian Psychological Association’s recent special report on the need for psychotherapy practitioners, policy makers and mental health organizations to measure outcome and client progress. In practice, this is already happening throughout Ontario – where both public initiatives and private organizations are using progress monitoring to improve client outcomes and demonstrate their efficacy to funding sources.” – Ontario Psychological Association

With advancements in technology and science, we can measure almost anything – including daily steps, sleep cycles and quality of sleep, blood sugar levels, heart rate and even our fertility. These advancements give us feedback about what is happening in our bodies so we have better insights into our physical health and the ways we can improve it. But what about mental health?

The Canadian Psychological Association recently released a special task force report (the “Report”) to provide guidance to psychotherapy practitioners regarding the need to measure outcome and patient progress in order to provide evidence-based treatment. The Report summarizes the key research in support of outcome and progress monitoring, and also highlights key considerations for practitioners when implementing progress monitoring into practice.

Key Takeaways

Measuring, monitoring, and providing feedback to therapists enable psychotherapists to be more responsive to patients’ needs on a session-by-session basis. It also contributes to empowering patients and enhancing the role of the patient in therapy.
Research on progress monitoring has demonstrated the clear impact on improving patient outcomes. In a meta-analysis of patient feedback systems, Lambert and Shimokawa (2011) found patient outcome monitoring with feedback to the therapist was moderately and significantly associated with positive patient outcomes. Notably, the number of psychotherapy patients who deteriorated was cut in half by using a progress monitoring system.
Psychologists, and most other professionals who provide psychotherapy services, have an ethical obligation to evaluate the services they provide. The Canadian Code of Ethics for Psychologists states that psychologists are expected to: “monitor and evaluate the effect of their activities, record their findings and communicate new knowledge to relevant others”.
For psychotherapists, collecting valid information about progress and outcomes through psychometric assessment is a key component to providing evidence-based care that is relatively free of bias. Outcome and progress monitoring is also an opportunity for organized networks of clinical practice to engage in enhanced program evaluation and psychotherapy research.

CPA Recommendations
Despite the importance of progress monitoring and it being a necessary component of providing evidence based care, only 12% of Canadian psychologists currently do it. This figure is well behind the United States where 39% reported regularly evaluating patient progress in treatment. In light of these shortcomings, the task force made certain recommendations in regards to implementing outcome and progress monitoring in clinical contexts, including:

Psychologists, whether in a private practice or part of an agency or institution, should routinely obtain outcome data on patients they are treating by using psychometrically sound scales.
At a minimum, psychologists and psychotherapists should assess patient outcomes, preferably from the patient’s perspective and/or from a third-party perspective, before and after providing services. However, it is preferable to assess outcomes at multiple time points during therapy.
As part of continuing education, psychologists and psychotherapists should seek out and receive training on how to implement and use outcome and progress monitoring in their practices.

Greenspace is a platform to help therapists measure and monitor client progress in a simple and efficient way. Automate assessment delivery, visually display results and increase client engagement. Learn more here . Dalton Associates is partnered with Greenspace.

Dalton Associates at Pri-Med 2019

Dalton Associates will be attending Pri-Med Canada 2019 as one of the more than 230 exhibitors. Pri-Med is a 3-day conference that attracts more than 3,800 health care professionals, including family physicians, general practitioners, nurse practitioners, pharmacists, nurses, and specialists. Pri-Med is the largest annual inter-professional conference in Canada that focuses on primary care. The conference will be held at The International Center in Toronto from May 8 – 11, 2019.