Spanish Versions of the Outcome Rating Scale and the Session Rating Scale: Normative Data, Reliability, and Validity

Routine outcome monitoring (ROM) uses standardized measures to both track and inform mental health service delivery. Use of ROM has been shown to improve the outcome of psychotherapy when applied to different types of patients. The present research was designed to determine the reliability and validity of the Outcome Rating Scale (ORS) and the Session Rating Scale (SRS) in a sample of Spanish patients. After a controlled process of translation into the Spanish that is spoken and written in Spain (i.e., in Europe, as distinct from, e.g., Latin American Spanish), both measures were completed by patients of an outpatient mental health unit during eight sessions of psychotherapy. Sixty mental health patients filled out the ORS and 59 the SRS. In addition, the ORS was completed by 33 people who constituted the non-clinical sample. The cut-off of the ORS was 24.52 points, and the Reliable Change Index (RCI) was 9.15 points. ORS and SRS scores exhibited excellent internal consistency. The temporal stability of the SRS was adequate. The convergent and discriminant validity of the two measures were adequate. Regarding the factorial validity of the ORS and the SRS, in the third psychotherapy session, confirmatory factor analyses evidenced the existence of a unifactorial model. The predictive validity of SRS was acceptable. The ORS was sensitive to changes in patients’ symptoms. In conclusion, compared to the original English versions of the ORS and SRS measures, the Spanish versions of the measures are also reliable and valid.

A retrospective analysis comparing clinical outcome measures pre- and post- the introduction of telehealth in a community-based psychiatry clinic in a tertiary medical centre

AimsThe aim of this retrospective analysis was to look at the effect that telehealth had on patient outcomes and the therapeutic alliance.MethodClinical outcomes measures were collected prospectively as part of routine clinical care. Outcome measures were administered at patients’ initial and final appointment. Information was merged into a single database and imported into IBM SPSS for retrospective analysis. The following measures were administered at the beginning and end of treatment and were used to evaluate patient progress; Health of the Nation Outcome Scale (HoNOS), Life Skills Profile (LSP), Session Rating Scale (SRS), Outcome Rating Scale (ORS).ResultTwo cohorts were derived from the clinic; the first cohort (n = 90; 53 females; 37 males; M = 35.72 years; SD = 12.12 years) comprised of those patients whose care occurred between 23/09/2019 and 22/03/2020 and did not receive telehealth appointments. The second cohort (n = 122; 68 females; 54 males; M = 36.2 years; SD = 12.78 years) were those patients who presented to the clinic and were discharged between 23/03/2020 and 21/09/2020 and received at least one telehealth appointment. In the pre-telehealth cohort, mean HoNOS scores at baseline were 17.87 compared to 13.53 at discharge, mean LSP scores at baseline were 10.76 compared to 9.01 at discharge, mean SRS scores at baseline were 34.17 compared to 36.04 at discharge, and mean ORS scores at baseline were 12.97 compared to 21.28 at discharge. In the post-telehealth cohort, mean HoNOS scores at baseline were 14.45 compared to 10.50 at discharge, mean LSP scores at baseline were 7.85 compared to 7.19 at discharge, mean SRS scores at baseline were 36.04 compared to 35.36 at discharge, and mean ORS scores at baseline were 18.83 compared to 15.85 at discharge.ConclusionResults show that telehealth did not impact negatively on the therapeutic effect of clinical sessions, highlighted by similar reductions in HoNOS and LSP scores. It was seen in the post-telehealth cohort that there was worsening in the subject-rated scales (SRS and ORS) which was not seen in the pre-telehealth face-to-face cohort. Thus, there seems to be a discernible negative difference from the patient's perspective in the clinical sessions. This may be due to the difficulties in therapeutic alliance using the telehealth platform. We appreciate that there are a number of confounding factors, especially the effect of COVID-19 isolation. Telehealth is a useful addition to our assessment and treatment paradigms and its use should continue; however, we should be aware of the potential negative effect on therapeutic alliance.

Posterior Endoscope-Assisted Diskectomy Is an Effective Technique for Cervical Soft Disk Herniation

Objective To evaluate the clinicoradiologic conditions of patients with a herniated cervical disk who were treated with percutaneous endoscope-assisted cervical diskectomy. Materials and Methods The medical data of 27 patients (16 men and 11 women; mean age: 40.9 years) who were operated on with the posterior endoscope-assisted cervical diskectomy method were reviewed retrospectively. The mean follow-up was 35.1 months, and the patients were assessed with combined preoperative and postoperative visual analog scale (VAS), Prolo Functional Economic Outcome Rating scale, MacNab scale, and clinical imaging. Results The mean preoperative VAS level was 8.6 (range: 7–10), and mean Prolo score was 2.5 (range: 2–5). A postoperative assessment performed 1 week postsurgery found a mean VAS level of 2.1 (range: 0–4). At the final examination, the mean VAS level was 0.81 (range: 0–3), and the mean Prolo score was 4.5 (range: 3–5). The final MacNab scale scores were 62.9%, excellent; 25.9%, good; 7.4%, moderate; and 3.7%, poor. Conclusion Percutaneous endoscope-assisted cervical diskectomy is a suitable and effective treatment method for soft cervical disk herniation.

EFFECTIVENESS OF INDIVIDUALIZED APPROACH FOR PHYSIOTHERAPY OF CHRONIC SHOULDER PAIN AND PHYSICAL FUNCTIONING IN ELITE ATHLETES WITH PHYSICAL DISABILITIES

ABSTRACT Objective: Тo study the potential effectiveness of individual physiotherapy program for wheelchair athletes with shoulder girdle persistent pain and dysfunctions. Materials and methods: Thirteen athletes, members of the Bulgarian National Teams in wheelchair basketball and track and field athletics, with mean age 40.6 ± 10.9 participated in the study. The studied athletes had had a history of persistent pain and shoulder girdle dysfunctions for more than 6 months. Individual physiotherapy programs were applied to the participants for a period of two weeks. The selection of techniques was based on the initial assessment and evaluation. The participants were evaluated before treatment, after the first week of treatment, and at the end of the period with the use of the following specific questionnaires and tests: Goniometry of shoulder flexion and horizontal adduction, Apley’s Scratch test, Active compression test of O’Brien (ACT), Athletic shoulder outcome rating scale and Wheelchair User’s Shoulder Pain Index (WUSPI). Results: Post-treatment effects demonstrated a significant (p<0.05) increase in shoulder flexion (14.6° for the right and 12.7° for the left) and horizontal adduction (21.9° for the right and 18.8° for the left). A corresponding increase in the scores for the Athletic shoulder outcome rating scale was found with 10.92 points difference to the initial score (p<0.05). The WUSPI demonstrated a non-significant improvement of 0.69 points. The results of ACT and Apley scratch test showed a non-significant decrease of 23.1% for the right shoulder and, 15.4% decrease for the left shoulder after 7 days of treatment. Those results remained unchanged in post-treatment testing. Conclusion: This study showed that the individual physiotherapy programs are effective in the management of wheelchair athletes with chronic shoulder pain. The involvement of Mulligan’s manual therapy techniques combined with other types of exercises for the shoulder and the trunk are beneficial for wheelchair athletes with chronic shoulder pain.

Psychometric Evaluation of the Czech Version of Group Cohesiveness Scale (GCS) in a Clinical Sample: A Two-Dimensional Model

The Group Cohesiveness Scale (GCS, 7 items) measures patient-rated group cohesiveness. The English version of the scale has demonstrated good psychometric properties. This study describes the validation of the Czech version of the GCS. A total of 369 patients participated in the study. Unlike the original study, the ordinal confirmatory factor analysis (CFA) supported a two-dimensional solution (RMSEA = 0.075; TLI = 0.986). The analysis demonstrated the existence of two moderately to highly associated (r = 0.79) domains of group cohesiveness—affective and behavioral. The two-dimensional model was invariant across genders, age, education, and time (retest after 6 weeks) up to factor means level. Internal consistency reached satisfactory values for both domains (affective, ω = 0.86; behavioral, ω = 0.81). In terms of convergent validity, only weak association was found between the GCS domains and the group working alliance measured by the Group Outcome Rating Scale (GSRS). This is the first revision of the factor structure of the GCS in the European context. The scale showed that the Czech version of the GCS is a valid and reliable brief tool for measuring both aspects of group cohesiveness.

Improving Youth Mental Health Services Access Using a Single-Session Therapy Approach

This article describes the implementation and evaluation of a single-session therapy (SST) pilot project in a youth community-based mental health clinic. The intent was to improve access to therapy services in order to reduce wait times, support youth's and their caregivers’ functioning, relieve immediate distress and connect youth to resources while waiting for ongoing therapy. Wait times were reduced by 90 days when SST was implemented following intake. Caregivers reported clinically significant improvement in adolescent well-being at one-month follow-up using the Outcome Rating Scale. Clinicians embraced the implementation of SST as a complementary service to multisession therapy in the clinic setting.