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Introduction To

The Oregon Change Index©
Seth Bernstein, Ph.D.

ABHA Executive Director

Outcome measurement tools provide a structured and consistent method that invites clients to communicate with their therapist how they are feeling and functioning at the beginning of each therapy session.  Repeated administrations during treatment reveals how clients are responding to treatment, and thus changing, over time. 

 In choosing an outcome measurement tool ABHA looked for a tool that provided: 

•      Sensitive, accurate, real time estimates of meaningful clinical change over time

•      Sensitive and informative characterization of process indicators (therapeutic alliance, treatment modality, readiness to change, etc.)

•      Sensitive, informative, real time feedback to consumers (youth and families) and clinicians

 We searched nationally for an outcome measurement tool that met these criteria and in addition, was short and easy to use.  Our prior experience with using a variant of the 35 question OQ-45 was that it was so long and cumbersome to use, that both clinicians and clients were resistant to using it.  The tool we found that met all of these tests was the ORS, a tool developed by Scott D. Miller, Ph.D. and Barry L. Duncan, Psy.D.

 After piloting the ORS for four months, we made a few changes to it based on our experience and renamed the tool the Oregon Change Index (OCI)ã.  We were assisted in this process, including the testing of the tests reliability and validity by a nationally recognized outcome measurement expert, Jeb Brown.  Jeb runs a company called The Center For Behavioral Informatics (www.clinical-informatics.com). Jeb works closely with Scott Miller and many large national managed care organizations.  Jeb is now the director of ABHA’s outcome measurement program.  He will be providing you with regular reports that we hope you will find valuable.

A copy of the OCI is attached.  There is also a youth version of the OCI that is designed to be filled out by a child’s parent or guardian.  It has the same questions, but they are worded, for example, “How are your child’s relationships with family?” instead of “How are your relationships with family?”

 There are several features of the OCI you should take note of:

  1. In addition to being an outcome measurement tool, the OCI is a clinical intervention.  Asking a client to focus on the progress they are making or not making, as well as their treatment goals, at the beginning of each therapy session has a powerful impact on the nature and course of therapy.  Scott Miller has demonstrated that this intervention improves the effectiveness of treatment.

  2. The client is the author of two out of the seven questions of the OCI.  No other outcome measurement tool is organized around the central premise that the most important measures of treatment success are client-defined.  This focus on individualized treatment goals says to the client: what you want from treatment is important; achieving YOUR goals is the true measure of our success.

  3. Study Codes allow clinicians to investigate how well they are doing with specific treatment approaches or with specific clinical populations.  See How To Use Study Codes for details.

  4. The OCI can be used with groups, couples, or families.  See Instructions To Provider for details

  5. You will receive OCI reports from Jeb Brown monthly and quarterly.

    • The monthly Change Index report provide summary information on all cases seen within the past month. Includes intake scores and most recent scores, change scores, and change index scores.

    • The Closed Case Outcomes Report provides aggregate data for all cases with no activity within the past 90 days. Results include all cases within a designated time window (usually 12-24 months). Information includes mean intake and last scores, mean last session mean change score, and mean outcome index score. Results are broken out by age group (adults, adolescents, children).  Reports based on study codes also follow this format.

Outcome measurement is an exciting and evolving process.  ABHA is committed to becoming an “outcomes driven” managed care organization.  This is a goal that can only be achieved with the active involvement of providers and ABHA clients.  We look forward to developing a partnership with you and the ABHA members you serve to achieve this goal.

 

Last : September 09, 2008

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