Excellent Outcomes

Quality care requires measurement and continuous improvement. 

We’re dedicated to evidence-based practices delivered with care and compassion.

 

Measurement allows us to determine how much progress our clients are making, and it helps us determine where and how to improve. This page describes the most statistically significant outcomes measurement systems currently in use at CFS, including:

  • Better Outcomes Now measurement used agency wide at CFS
  • SDQ data used for children in the CFS STRONG Child & Adolescent Day Treatment Program
  • SDQ data for high school students who participate in CFS school-based counseling
  • GROWTH Adult Intensive Outpatient Program QIDS and OASIS data

 

CFS Better Outcomes Now data

For quality assurance and continuous improvement across our agency, CFS administers a client feedback system called “Better Outcomes Now” (BON). Your provider will ask you to contribute feedback to your own progress during your course of treatment. The data is used to create conversations with your provider about your treatment goals, your progress, and your provider’s responsiveness to your needs. This progress tracking is not included in your medical record, and conversations about your progress remain between client and provider.

The BON data from your visit is then deidentified and compiled with data from other CFS clients for research and learning purposes. The aggregate data helps our clinicians improve their work and improves our services to many people over time.

  • The average effect size of all raters currently is 0.87, which represents a “large impact” of treatment.
  • The average effect size at CFS is increasing, with the average effect size of the last 100 raters at 0.93 as of September 2023. This trend is consistent with the existing research which suggests that the use of client outcomes measurement tools like Better Outcomes Now improves and enhances the effectiveness of treatment.

 

SDQ data for STRONG Child & Adolescent Day Treatment Program

Before-and-after treatment data for the STRONG Child & Adolescent Day Treatment program indicates a “very large effect” on reducing mental health symptoms. “Effect size” measurements have become popular in outcomes research because they not only measure the amount of change; they tell us how much of an impact the treatment had. Any effect size larger than .80 is considered large. This data from 2021 and the first 3 quarters of 2022 is from the Strengths and Difficulties Questionnaire (SDQ), a recognized instrument for assessing mental health status for children and young people.

Group   Initial Rating ’21 Final Rating ‘21
Mean102.9463.73
SD30.6836.88
SEM4.305.16
N5151

Effect size:  Cohen’s d = 1.15

 

Group   Initial Rating ’22 Final Rating ‘22
Mean102.7370.68
SD22.1428.64
SEM3.344.32
N4444

Effect size:  Cohen’s d = 1.25

 

SDQ data for high school students who participate in CFS school-based counseling

Students seen by CFS counselors in our School-Based Counseling program during the 2021-22 school year reported improve­ments in nearly all areas of struggle, as well as a reduction in the extent to which their symptoms impact their functioning.

  • Overall Stress: t (51) = 6.51, p < .05
    • Students subjectively reported significant reductions (from pre- to post-measurements) in their levels of overall stress.
  • Emotional Distress: t (51) =3.72, p < .001
    • Students subjectively reported significant reductions (from pre- to post-measurements) in their levels of emotional distress.
  • Behavioral Difficulties: t (51) = 4.40, p < .001
    • Students subjectively reported significant reductions (from pre- to post-measurements) in their levels of behavioral difficulties.
  • Hyperactivity/Concentration Difficulties: t (51) = 4.54, p < .001
    • Students subjectively reported significant reductions (from pre- to post-measurements) in their levels of hyperactivity/concentration difficulties.
  • Difficulties Impact: t (51) = 3.91, p < .01
    • Students subjectively reported significant reductions with the level their difficulties impacted their overall functioning.

CFS Adult Intensive Outpatient Program – a DBT Skills-building IOP data

All clients complete the Quick Inventory of Depressive Symptomatology-Self Report (QIDS) Depression Assessment and Overall Anxiety Severity and Impairment Scale (OASIS) Anxiety Assessment upon admission and at discharge. Additionally, all clients complete regular Columbia Suicide Severity Rating Scale assessments.

Depression

  • The range of possible scores for the QIDS is from 0 to 27. Variance in score from admission to discharge for all patients combined in the period were:
    • Admit Score Average: 17.2
    • Discharge Score Average: 7.4.
    • Practically speaking, this suggests, on average, clients moved from a “Severe” level of depression symptoms to a “Mild” level of depression symptoms.
    • Additionally, this represents a significant reduction in client’s level of depression symptoms, t (13) = -4.13, p < .001.

Anxiety

  • The range of possible scores on the OASIS is from 0 to 20. Variance in score from admission to discharge for all patients combined in the period were:
    • Admit Score Average: 13.1
    • Discharge Score Average: 6.4
    • Practically speaking, this suggests, on average, clients moved from a “Severe” level of depression symptoms to a “Low Moderate” level of anxiety symptoms.
    • Additionally, this represents a significant reduction in client’s level of anxiety symptoms, t (13) = -4.02, p < .001.

Suicide Severity

  • 80% of client at intake reported presence of suicidal ideation (SI)
  • At discharge, 100% of clients reported reductions to their levels of suicidality

Collectively, these scores indicate consistent progress in treatment for clients across all measures.