Category: Assessment
Lauren Hoffman, Psy.D.
Columbia University Medical Center
New York, New York
Brian Chu, Ph.D.
Professor
Rutgers University
Piscataway, New Jersey
Angela Chiu, Ph.D.
Assistant Professor
Weill Cornell Medicine / New York Presbyterian Hospital
New York, New York
Daniel Cheron, ABPP, Ph.D.
Judge Baker Children's Center
Boston, Massachusetts
Olivia M Fitzpatrick, M.A.
graduate student
Harvard University
Cambridge, Massachusetts
Clinical intervention research with youth has commonly relied on the use of symptom scales to characterize the presentations of clinical samples and to measure treatment progress and outcomes. While symptom measures have advantages, an important shortcoming is that they ignore the consumer’s perspective regarding their reasons for seeking services, their perspective on target treatment goals, and their priorities in treatment. Moreover, symptom scales lack the capacity to attend to individual and cultural differences. The need for personalized assessment and treatment planning is particularly apparent during public and mental health emergencies, as crises such as suicidality, the COVID-19 pandemic, racial trauma, and climate disasters impact youth and families in uniquely meaningful ways.
The Top Problems Assessment (TP; Weisz et al., 2011) is an idiographic, consumer-driven, psychometrically sound measure of client-identified chief concerns that can complement standardized assessment. In this measure, youth and caregivers nominate up to three problems and rate the severity of each problem on a 0 to 10 scale, with higher ratings indicating greater problem severity.
Incorporating client-centered instruments such as the TP into assessment has many benefits. The measure is free, quick to administer, and offers specificity (e.g., specific worries, situations that prompt anger) beyond what can be captured by standardized symptom questionnaires. This versatile measure can be used with a wide range of diagnostic presentations and concerns. The TP can detect agreement/disagreement among youth and their caregivers on treatment targets, which has been shown to predict engagement, motivation and satisfaction with treatment (Hawley & Weisz, 2003; Hoffman & Chu, 2015; Yeh & Weisz, 2001). Clinically, assessing consumer-nominated treatment targets enhances the ability for personalized treatment. For clinical research, the hybrid qualitative and quantitative features of the TP enables one to aggregate change over time on chief concerns that are tailored to the consumer, even when the group of youth is heterogeneous. As a result, this measure can be applied in specialty clinics that treat narrow symptom presentations, in settings with more diverse clientele or even extended to assess needs during public and mental health emergencies.
This symposium will showcase the versatility and utility of the TP by presenting three studies using this idiographic approach across contexts. One researcher will present data on using self-administered TP to describe chief concerns of adolescents and their caregivers within an acute psychiatric program. Another presenter will present on the use of TP to benchmark the effect of a modular treatment approach for youth receiving services from a community mental health agency against the effect from previous randomized controlled trials of this same intervention. Our final speaker will discuss the use of TP in a non-treatment seeking population to capture caregiver-nominated youth mental health problems during the COVID-19 pandemic. An esteemed clinical researcher focused on improving assessment and treatment for youth will serve as the discussant.
Presenter: Angela Chiu, Ph.D. – Weill Cornell Medicine / New York Presbyterian Hospital
Co-author: Payal Desai, M.P.H. – Columbia University/New York State Psychiatric Institute
Co-author: Laura Skriner, PhD – The Center for Stress, Anxiety, and Mood
Co-author: Corinne Catarozoli, PhD – Weill Cornell Medicine
Co-author: Paul Sullivan, Ph.D. – NYU Langone Medical Center/Bellevue Hospital Center
Co-author: Shannon M. Bennett, Ph.D. – Weill Cornell Medical School
Presenter: Daniel M. Cheron, ABPP, Ph.D. – Judge Baker Children's Center
Co-author: Emily M. Becker-Haimes, Ph.D. – University of Pennsylvania
Co-author: H. Gemma Stern, Psy.M. – Rutgers University
Co-author: Aberdine Dwight, M.S., NCSP – Northeastern University
Co-author: Cameo F. Stanick, Ph.D. – Sycamores
Co-author: Angela Chiu, Ph.D. – Weill Cornell Medicine / New York Presbyterian Hospital
Co-author: Eric Daleiden, Ph.D. – PracticeWise, LLC
Co-author: Bruce F. Chorpita, Ph.D. – University of California Los Angeles
Presenter: Olivia M Fitzpatrick, M.A. – Harvard University
Co-author: Amani Carson, BS – Boston Medical Center
Co-author: John R. Weisz, ABPP – Harvard University