Patient Generated Goals in Mental Health: Better Outcomes?

Study Overview
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Brief Summary
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Researchers believe that clinical care can be improved by engaging patients and families directly in planning the care process. Engagement efforts have included asking patients/families to provide information about whether they are getting better. But what does getting better mean? The merits of surveys, questionnaires, or rating scales have been widely discussed. Should they be disorder-specific or global? What should the investigators do if patients have difficulty reading or understanding these instruments? Investigators in the United Kingdom have proposed a simple solution: ask the patients and families what their primary goal treatment goal is and track progress together on that goal (Goal-Based Outcomes or GBO). Although there has been some work to suggest that this is helpful, it has never been tested in a controlled way. This study will do a randomized controlled trial to test whether GBO improves clinical care in child and youth mental health. Although the study will use this in child and youth mental health care, if it is successful, it can be tested and applied in any care setting with any type of medical problem. This could change practice at the Children's Hospital of Eastern Ontario (CHEO) and throughout Canada.

Official Title
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Patient Generated Goals in Mental Health: Better Outcomes?

Conditions
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Mental Health

Intervention / Treatment
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* Other: Goal Based Outcomes
* Other: Treatment as Usual


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children and youth Attending outpatient mental health services at CHEO Exclusion Criteria: -Child and youth attending group therapy at CHEO Outpatient Mental Health Services

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Treatment as Usual<br>Patients will receive their standard care at the Outpatient Mental Health Service | Other: Treatment as Usual<br>* Patients will receive their standard care at the Outpatient Mental Health Service<br>|
| Experimental: Goal Based Outcomes<br>Up to three goals can be tracked during treatment, although patients often decide to just focus on one. Progress on the goal is then quantitatively rated by the patient, with the provider, at every appointment. Adjustments in the care are then made in an iterative process to ensure that the goal will be met. | Other: Goal Based Outcomes<br>* Up to three goals can be tracked during treatment, although patients often decide to just focus on one. Progress on the goal is then quantitatively rated by the patient, with the provider, at every appointment. Adjustments in the care are then made in an iterative process to ensure that the goal will be met.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient/Family Satisfaction | Measured using the Experience of Service Questionnaire | Administered at study completion (up to 52 weeks) | 
| Change in Symptoms | Measured using the Strengths and Difficulties Questionnaire (SDQ) | Administered at the first appointment and at study completion (up to 52 weeks) | 
| Change in Function | Measured using the Child Global Assessment of Functioning Scale. The total score (on a scale of 0-100) will be used, with a higher score indicating better function | Administered at the first appointment and at study completion (up to 52 weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Depression, Psychosis, Personality Disorder, Substance Abuse