Category: Dissemination / Implementation
Background: Research demonstrates significant differences in treatment outcomes among psychotherapists. With increased attention to measurement-based care, mental health provider performance information (PPI) and its use in routine care decision making has become a critical issue. Research also indicates that mental health consumers (MHCs) have multidimensional preferences when seeking care, but little is known about consumer preferences regarding provider variables and mechanisms of PPI access. Aim: This study addressed this knowledge gap by examining diverse MHCs’ attitudes and preferences about the use of PPI.
Method: N = 403 MHCs (66.5% female; 51.1% Caucasian; Mage = 42.2, SD = 12.58) presenting for routine services in community mental health clinics in Massachusetts and New York completed a survey of demographic information; mental health treatment history; attitudes about PPI and its use in provider selection; and treatment choice items presented in a delay-discounting paradigm to assess comparative valuing. Delay-discounting items asked respondents to rate their preference for working with a therapist with a strong track record of success (80% positive response rate) vs. working with a less effective therapist (varying from 20%-80% response rates) possessing an alternative valued characteristic. Indifference points (IP, first point where the therapist with the alternative characteristic is preferred over the therapist with the best track record) were calculated for each scenario.
Results: Among the results, 69.7% of participants reported difficulty finding a provider they were confident would be helpful; over 65% reported never receiving a recommendation or explanation of pros and cons of working with a specific provider. Over 90% endorsed interest in accessing PPI in different formats. Over 90% endorsed the belief that having access to PPI and being matched with a specific provider based on PPI would increase the odds of experiencing treatment benefit. Delay-discounting analyses indicated that MHCs valued PPI-based matching over demographic match (e.g., working with a therapist of the same gender, MIP = 65). On average, participants were willing to sacrifice the most in expected response with a high performing provider to work with a provider who is less expensive (MIP = 45), has domain-specific rather than general competence (MIP = 45), and is interpersonally “easy to get along with” (MIP = 47). Consumers who endorsed trust in how PPI is collected and used were more likely to be in the group that consistently placed a higher value on PPI track records compared to alternative factors (OR = 4.72, [2.81,7.93]). Conclusion: Overall, MHCs want access to PPI, would use PPI to inform provider selection, and often place relatively higher value on provider performance compared to other treatment selection factors. Future research should address the methods for and outcomes related to disseminating PPI to MHCs.
Jennifer Oswald– Graduate Student, University at Albany, SUNY, Albany, New York
Brien Goodwin– University of Massachusetts Amherst
Matteo Bugatti– Graduate Student, University at Albany, SUNY, Albany, New York
Recai Yucel– University at Albany, SUNY
Michael Constantino– Professor, University of Massachusetts Amherst
James Boswell– Assistant Professor of Psychology, University at Albany, SUNY, Albany, New York