Modum Bad research Institute 2010

The Implementation of the OQ45 at Modum Bad and Psychiatric Center:

Ingunn Amble, M.D. With Sven Stubdal, Tore Gude, Leigh McCullough Drammen: Anne Marie Skjørten

INTRODUCTION: Problem: More than 50% of psychotherapy Randomizing cases do not improve; about 10% actually get worse. Until recently there have ”double- usually been no standardized measures for patients to evaluate the quality of their therapy. blind”

The OQ-45 System provides therapists and their patients online-feedback prior to each therapy session. Both therapist & patient read the feedback reports before the sessions, thus enabling them to discuss progress, deterioration, proposed therapy changes or other OQ-comments. This has been shown to improve treatment outcomes, identify patient deterioration before it goes to far, and shorten the length of treatment (Lambert, 2006).

The project aims to adapt the OQ-45 System to a Norwegian Goals: Receiving population distributing it to regular psychiatric outpatient populations. the laptop from Proposed study: The patients at Modum Bad Outpatient secretary Clinic and Drammen Psychiatric Center are randomized to Feedback and No- feedback condition. All patients fill in OQ-45(Outcome Questionnaire with 45 items is an outcome and screening instrument with three subscales: Symptom Distress, Interpersonal Relations and Social Role Performance, sensitive to change.) Online prior to each therapy session. The System provides the Feedback condition with a report each to therapist and patient. The No-feedback condition scores are not opened until the end of the study.

Sponsors: Filling The Norwegian Health Departement in OQ-45 online Rådet for psykisk helse Helse og Rehabilitering Modum Bad

Figure1. OQ-45 Research Design To test the effects of feedback on psychotherapy effectiveness in a Norwegian sample Getting n=400 feedback JUST KIDDING! Patients ALL normally PARTICIPANTS like getting feedback

RANDOM ASSIGNMENT - ALL PATIENTS TAKE THE OQ 45

THERAPIST + CLIENT NO FEEDBACK FEEDBACK

OQ -45 ADMINISTRATION REPEATED WEEKLY

ON NOT ON NOT TRACK ON TRACK TRACK ON TRACK

The OQ-45 scales Tot: Total Distress Score SD: Symptom Distress IR: Interpersonal Relations SR: Social Role Functioning The lower score, the better!

Table 1: Average Intake Scores

Tot. SD IR SR WHAT WE HAVE DONE SO FAR: 1. Translated the OQ-45 Form and Feedback System Norw. Outpatient Pilot (N=15) 85 55 15 15 into Norwegian

US Outpatient norm 83 49 20 14 2. Installed the System at the Modum Bad Outpatient Clinic 3. 15 Patients, Pilot Project, tested the System. Us norm Community Sample 45 25 10 10 Intake score: 85,3(Table 1) 4. Started recruiting, including and randomizing patients into the study If You Want To Contribute To Our Research: 5. Instructed the therapists and staff Put Your Scored Test In The ‘Research ‘ Box, below. 6. Started collecting data TAKE the OQ-45 YOURSELF AND CHECK YOUR SCORE! (Tests are in the box below. Sum the items for the score.) 7. Started test-retest reliability survey

Ingunn Amble MD is Clinical Sven Stubdal is a Clinical Director at The Modum Bad Social Worker and Family Outpatient Clinic, Psychiatrist Therapist at The Modum and Doctoral Candidate Bad Outpatient Clinic and at Modum Bad Research Institute, Research assistant. , and the University of .