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A plethora of studies has exhibited the effectiveness of using measurement-based care feedback systems within mental health services to improve treatment outcomes; however, patient gender/race and patient-therapist matching on gender and race remain relatively unexplored as predictors/moderators in feedback studies. We conducted predictor/moderator analyses focusing on the relation of gender, race/ethnicity, and patient-therapist gender and race/ethnicity matching on two outcomes: patient self-reported levels of (1) functioning and (2) trust/respect within the therapeutic relationship. We used data from a randomized controlled trial studying the effectiveness of a feedback system comparing patient-reported levels of trust and respect towards their provider (together with symptom feedback) in comparison to symptom only feedback. We found that men improved in functioning more than women when their therapists received trust/respect feedback compared to symptom only feedback (F[1, 902] = 9.79, p = .002, d = 0.21). We also found that dyads matched on race/ethnicity but not gender, and those matched on gender but not race/ethnicity, improved in functioning over time more than dyads mismatched on both gender and race/ethnicity and those matched on both gender and race/ethnicity (F[1, 897] = 8.63, p = .0034, d = 0.20). On trust/respect outcomes, we found a gender difference over time (F[1, 759] = 6.61, p = .01, d = 0.19), a gender matching difference by feedback condition interaction (F[1, 757] = 5.25, p = .02, d = 0.17), and a racial/ethnic matching difference on trust/respect scores over time (F[1, 785] = 3.89, p = .049, d = 0.14). Male patients showed an initial decrease followed by a steady increase in trust/respect over time while female patients showed an initial increase followed by a steady decrease. Gender-matched therapeutic dyads showed higher levels of trust/respect compared to mismatched dyads when therapists received symptom only feedback, but this difference was not apparent when trust/respect feedback was provided. Dyads mismatched on race/ethnicity improved steadily in trust/respect over time, but matched dyads decreased in trust/respect after an initial increase. Future research should focus on the use of feedback systems to enhance outcomes for patients with specific gender and racial/ethnic identities., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Our goal was to develop brief pragmatic assessments of Behavioral Activation (BA) fidelity to support its dissemination in low-resource settings., Methods: We used qualitative and quantitative methods across three investigations to develop pragmatic assessments rated from the perspective of therapists, patients, and observers: (1) we developed an initial comprehensive pool of 119 items and adapted/refined the item pool to 32 items through stakeholder focus groups and cognitive interviews; (2) independent blind judges rated each of items in the refined item pool on an early session of BA for 64 patients to support the selection of items based on predictive validity; and (3) we conducted a preliminary evaluation of the acceptability and feasibility of the assessments of BA fidelity from the perspective of therapists and patients., Results: The internal consistency reliability for the 10-item total score was .83 rated from the perspective of independent observers. The assessment was completed by patients following 90% of sessions and by clinicians following 93% of sessions. Items were rated high on overall satisfaction by both therapists (M = 4.6, SD = 0.89) and patients (M = 4.8, SD = 0.41)., Conclusion: Our findings suggest that these brief assessments of BA fidelity are reliable, feasible, and acceptable to community stakeholders., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The goal of this investigation was to explore changes in psychotherapy utilization for patients with major depressive disorder (MDD) treated in community mental health agencies across two cohorts. We used a Medicaid claims database including approximately 300,000 public sector clients. Although the use of psychotherapy alone showed a small decrease, there was a large increase in the use of combined medication and psychotherapy as a treatment for MDD. Race was a significant predictor of both treatment type received and length of treatment. African American consumers were more likely to receive psychotherapy alone than combined treatment and attended significantly fewer psychotherapy sessions.

Computerized administration of mental health-related questionnaires has become relatively common, but little research has explored this mode of assessment in "real-world" settings. In the current study, 200 consumers at a community mental health center completed the BASIS-24 via handheld computer as well as paper and pen. Scores on the computerized BASIS-24 were compared with scores on the paper BASIS-24. Consumers also completed a questionnaire which assessed their level of satisfaction with the computerized BASIS-24. Results indicated that the BASIS-24 administered via handheld computer was highly correlated with pen and paper administration of the measure and was generally acceptable to consumers. Administration of the BASIS-24 via handheld computer may allow for efficient and sustainable outcomes assessment, adaptable research infrastructure, and maximization of clinical impact in community mental health agencies.