The outcome measures working group brings together members from multiple disciplines: nurses, psychiatrists, psychologists, and occupational therapists.
Together we aim to identify what changes we can make for our patients in treatment and why, using routinely collected data such as risk assessments and goal setting.
By measuring these we can evaluate how beneficial our current therapies are to patients’ recovery. More importantly, we can identify which treatments work best for specific problems patients face such as paranoia or lack of insight. These measures and the goal of this working group are essential to ensuring patients' care improves.
Internal researchers
- Lead: Simon Draycott
- Jonathan Hafferty
- Rachana Punn
- Jordan Crowe.
External partner researchers
- Professor Ralph Serin, Carleton University, Canada
- Professor Michael Daffern, Swinburne University, Australia
- Professor Mick Cooper, Roehampton University, United Kingdom
- Dr Howard Ryland, Oxford University
- Professor Seena Fazel, Oxford University.
Our current research
The client change scale is a new measure developed by Professor Ralph Serin at Carleton University.
The scale measures different factors which predict a patient’s likelihood of positively changing, such as:
- Antisocial thinking styles
- Engagement
- Identity.
Broadmoor Hospital will be using this scale to see if it is reliable, valid and useful for making clinical decisions.
We will compare how patients score on this scale with existing measures of risk assessment, therapy attendance, progression through high secure services, incidents and other indicators of change.
We will also assess if completing the scale based on information taken from patient files has the same scores as clinicians (who have a good knowledge of the patient) completing the score.
Psychological services will collect routine psychological measures at every 6-month time point, including:
- Measures which assess areas of difficulty that patients specify for themselves - e.g., the PSYCHLops
- Measures which allow generalised comparisons across patients - e.g. the CORE.
For each weekly psychological session, patients will complete brief assessments of their change using the Outcome Rating Scale (ORS) and Session Rating Scale (SRS). This measures both the quality of the therapeutic session and its outcome, so that we identify trends and patterns of change.
All these sources of data will be analysed together to explore if individual therapy is useful in aiding individual recovery.
One of the strongest predictors of a therapeutic intervention being successful is the “working alliance”, or the quality of the relationship between the patient and therapist, such as: How collaborative is the patient with the therapist’s goals?
The Working Alliance Inventory (WAI) will be collected over time to assess the quality of patients’ working alliances with their therapists, and how this relates to patient recovery within a high secure hospital.
Data is being gathered across wards within the hospital using the Dynamic Appraisal of Situational Aggression (DASA), a measure of immediate risk of aggression in inpatient settings.
This data will be analysed to identify patterns of change for individual patients and subgroups of patients.
The measure itself will be subject to analysis to identify which items within the measure are most predictive of aggression, with the aim of potential further development of the DASA over time.