Pilot Study on the Clinical Utility of the Tulsa Life Chart

The proposed study aims to examine the usability, utility, and feasibility of the Tulsa Life Chart (TLC) in a sample of patients seeking mental health treatment and their healthcare providers. The TLC is an interactive, web-based application used to create a graphical interface for visualizing a patient's life history.

Understanding the longitudinal course of mental health is critical for case conceptualization. One approach for capturing the complexity of an individual's illness course is to depict it graphically. The first attempt for this method was the National Institute of Mental Health Life Chart for Bipolar Disorder. Subsequent research indicated Life Charts are useful clinically and time- and cost-effective. Despite clinical utility and time and cost efficiency, this approach has not been widely adopted in the mental health field. Possible explanations are the prior focus on bipolar disorder, time required to collect information, and prior versions have not had automatic translation of the patient information into an image.

The Tulsa Life Chart (TLC) was developed by researchers at the Laureate Institute for Brain Research (LIBR). The TLC was developed to address weaknesses of previous life chart methods and help patients and healthcare professionals (HCPs) quickly identify patterns of mental health symptoms across diagnostic categories. To date only one formal exploration of the TLC has been conducted in a sample of individuals with mood, anxiety, eating disorders, and substance use disorders, which suggested that participants felt the TLC was helpful in understanding their mental health symptoms and was pleasant to complete. Unpublished focus groups with HCPs suggest HCPs believe the TLC could help to improve patient encounters by increasing understanding of patients and facilitating conversations. Based on these findings the goal of the proposed study is to examine clinical usability, utility, and feasibility in a pragmatic pilot trial.

The current trial will recruit individuals seeking treatment within the Laureate Psychiatric Clinic and Hospital and healthcare professionals involved with their care. Treatment-seeking patients who are invited to participate will be asked to complete the TLC soon after establishing care in a health system setting. Subsequently, the patient's HCP will review the chart during the intake process and complete several measures related to the chart and their experience (baseline assessment point). Patients and HCPs will engage in treatment as usual in between the TLC and assessment time points. Prior to or shortly following discharge/termination of treatment (approximately 4 to 12 weeks depending on the clinic), patients and HCPs will be asked to again complete questions to determine the TLC's usefulness during treatment. The overarching aim of the current study is to examine the usefulness of the Tulsa Life Chart for treatment-seeking individuals and healthcare professionals.

Eligibility Criteria:
Inclusion Criteria:

Treatment Seekers Inclusion Criteria:

1. Actively seeking mental health treatment at Laureate Psychiatric Clinic and Hospital
2. Provision of informed consent or if \<18 assent and parental consent
3. Age 15 to 65 years
4. Necessary resources to engage in a technology-based intervention
5. English proficiency
6. Willingness to grant access to medical records

HCPs Inclusion Criteria:

1. Employed at Laureate Psychiatric Clinic and Hospital in a patient care role
2. Informed consent
3. English proficiency
4. Access to resources to engage in technology-based intervention

Exclusion Criteria:

Treatment Seekers Exclusion Criteria:

1. Active suicidal ideation with plan or intent
2. No access to resources to participate in a technology-based intervention
3. Completed more than 2 sessions of therapy with their current provider prior to enrollment in the study
4. Not proficient in English

HCPs Exclusion Criteria:

1. No access to resources to participate in a technology-based intervention
2. Not proficient in English