The search for a routine outcome measure for multidiscipinary interventions with young people in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Manawatu campus, New Zealand

Abstract

Routine outcome measurement in mental health services is becoming standard practice around the world and has benefits for the public, researchers, funders, managers, and most importantly clinicians and clients. New Zealand's child and adolescent mental health services mandated the use of the Health of the Nation Outcome Scale for Children and Adolescents in 2005. Unfortunately, this decision was not based on a systematic or comprehensive review of available measures, as had been the case overseas. This research aimed to identify and recommend a measure that was psychometrically robust, feasible, and useful to multidisciplinary practitioners in New Zealand. The six studies conducted also contributed to the scarce literature on practitioner's opinions about routine measurement and the suitability of an overseas measure for a New Zealand population. A postal survey and focus groups with practitioners indicated mixed support for outcome measurement, with few measures identified or recommended by participants. Although many barriers were endorsed, the reasons to use measures were generally rated as more important. An extensive search of the international literature provided an up-to-date review of outcome measures for young people. From the initial 1665, six short-listed measures were reviewed by experts and practitioners before the Ohio Youth Problems, Functioning, and Satisfaction Scales was recommended as most suited tor multidisciplinary interventions. Two further studies provided preliminary data about the Ohio Scales' (developed in the USA) suitability for use in New Zealand. Consultation with clinicians, parents, and young people indicated minor wording changes would improve its appropriateness for New Zealand. Then, a New Zealand field-test indicated the psychometric properties of the measure were preserved, but significantly different scale scores were found in comparison to a community sample from Ohio, USA, although this could have been a product of the small sample size. The Ohio Scales offers clinicians the necessary balance between breadth of content, brevity, and psychometric strength for its use to benefit their practice and the organisations they work in.