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This approach to therapy can help patients feel better faster

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If you’ve never heard of measurement-based care, you’re in good company. Here’s why it’s worth asking your therapist about. 

Jessica Migala

By Jessica Migala

As you begin therapy, it’s normal to wonder when you’ll start feeling better. When will you be able to control your anxiety or depression or overcome a trauma? As you move along on your journey, you’ll find that healing isn’t always so cut-and-dried.

That’s where measurement-based care (MBC) may help. It’s an approach that allows you and your provider to objectively gauge your progress and treatment decisions. But if you’ve never heard of it, you’d hardly be the first. In fact, not all mental health-care providers are using this effective approach.

“It’s surprising that mental health is the only health care field that’s not routinely practicing in a measurement-based way,” says clinical psychologist Russell DuBois, PhD. He’s the director of clinical operations and customer success at Blueprint, a mental health care technology company.

“Recent research shows that less than 20% of mental health providers use measurement as part of their care,” says DuBois. That’s according to a review published in JAMA Psychiatry. It looked at psychiatrists, psychologists and masters-level practitioners.

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How does measurement-based care work?

Your provider collects objective information about your experiences and progress throughout the course of your care. Then they use this information to improve their treatment with you.

“It’s like when your primary care physician takes your blood pressure and temperature at each visit. Think of this as a mental health temperature check that charts your progress,” he says.

You might do this by filling out a weekly, biweekly or monthly questionnaire. The questions may be about your symptoms or how well you’re doing on a particular goal. Perhaps you’ve been trying to work mindfulness practices into your day.

The result of this approach: You stay as connected and informed as possible about your symptoms and experience with therapy.

An important thing to note is that measurement-based care isn’t a type of therapy. Instead, it can be used alongside therapy. It’s simply a data-driven way to track how well your provider’s approach is working for you.

How does measurement-based care compare to standard treatment?

Measurement-based care has been found to lead to better results. This is true especially for people who tried therapy in the past with disappointing outcomes, according to the JAMA Psychiatry research review.

One example: A study published in The American Journal of Psychiatry looked at people with moderate to severe depression. Researchers found that about 87% of those in the measurement-based care group responded to treatment, compared to about 63% in the standard-treatment group.

What’s more, about 74% in the measurement group achieved remission (showing no signs of depression). Only about 29% of those receiving conventional care did.

It makes sense, right? You want to know if the time, effort and money that you’re putting into therapy is paying off, and sometimes it can be tough to know. Healing isn’t a light switch that just turns on one day. It’s a process. And measurement-based care can help you and your provider see how it’s evolving.

Why don’t more therapists use measurement-based care?

If less than one-fifth of providers are using measurement-based care, there is clearly something standing in the way. For one, it requires providers to give patients regular assessments, which takes some training, time and knowledge.

“There are also many misconceptions on how measurement may or may not be helpful,” DuBois says. “Many providers think that introducing it comes off as cold and disconnected. But that’s not the case. These measures can be warm and compassionate.”

In fact, the JAMA Psychiatry review points out that MBC may help you become more vested in your care. It helps you really understand your goals and the path you’re taking toward them.

And with your progress in front of you, you’re also more likely to expect to reach those goals. It can reinforce the idea that you and your therapist are a team working together.

What’s the biggest benefit of measurement-based care?

One of the most important benefits is that measurement-based care can pinpoint if you’re not responding to treatment. That’s vital information.

It means your provider can make any number of changes. These could include switching medication or altering the dose if working with a psychiatrist or MD, or trying a different treatment approach if in therapy. Ultimately, this can help people feel better faster, according to the JAMA review authors.

Another reason MBC may promote faster healing is that regular assessments can help therapists create a more focused session for their patients, really homing in on what needs to be discussed. That’s according to research in the journal Psychiatric Services.

And remember: These assessments are not a grade. They simply help your therapist pivot when necessary.

For anyone who’s worried about letting down their therapist or wanting to be a good therapy “student,” it can be tough to talk about what is or isn’t working. Sometimes you might not even be aware that things aren’t progressing. Measurement-based care offers an objective way to look at things, minus any awkward conversations.

How can I get started with measurement-based care?

“Measurement-based care can always be a supplement to any form of therapy,” DuBois says. A good place to start is by asking your therapist directly if this is something they offer.

If you’re still looking for a therapist you like, one step you can take is to check whether potential providers are accredited by The Joint Commission, DuBois says. According to The Joint Commission’s website, any accredited behavioral health organization must use a “standardized tool or instrument” to assess how well care is working.

Another option is to simply ask a potential therapist if they have any client outcomes or data that shows how effective their methods are.

Optum offers online mental health treatment through Care on the Optum Store. Upon signing up for care, you can read therapist profiles to see information such as license status and areas of specialization to find someone you like.

Being proactive and engaged in your treatment plan can make a huge difference in how you feel. Measurement-based care is one way to get there.


Additional sources
Less than 20% of mental health providers use measurement-based care:
JAMA Psychiatry (2018). “Implementing Measurement-Based Care in Behavioral Health: A Review”
Regular assessments can help therapists create a more focused session for their patients: Psychiatric Services (2018). “Provider Attitudes and Experience With Measurement-Based Mental Health Care in the VA Implementation Project”
About 87% of people in the measurement-based care group responded to treatment: The American Journal of Psychiatry (2015). “Measurement-Based Care Versus Standard Care for Major Depression: A Randomized Controlled Trial With Blind Raters”