It’s innovative, but is it also effective? Evaluation of innovative tools and interventions targeting youngsters in (forensic) mental health

It’s innovative, but is it also effective? Evaluation of innovative tools and interventions targeting youngsters in (forensic) mental health

It's innovative, but is it also effective? Evaluation of innovative tools and interventions targeting youngsters in (forensic) mental health

Symposium70David Buitenweg, GGzE Institute for Mental Health Care, The Netherlands; Ilja Bongers, GGzE Institute for Mental Health Care, The Netherlands; Ashley Parren, GGzE Institute for Mental Health Care, The Netherlands

Room 4CThu 14:00 - 15:30

Forensic psychiatry is positively influenced by developments such as digitalization and the growing focus on recovery. These changes have sparked the development of many innovative tools and interventions for use in adolescent psychiatry. These innovations and tools are attractive alternatives to existing solutions. Still, it is essential that their effectiveness is evaluated scientifically. This symposium covers three evaluations of innovative tools and treatment interventions.

The first presentation focuses on the evaluation of INKT, a digital tool that provides youngsters more insight into the outcomes of their treatment. The assessment of the psychometric quality of the QoL-ME, a personalized and visual quality of life assessment app for youngsters and adults with (forensic) psychiatric problems is discussed in the second presentation.

Presentation 1: Evaluation of a web application providing insight in treatment outcome – made by, for and with youngsters
Background:
Receiving feedback about treatment outcome is beneficial for patients in youth mental healthcare. Nevertheless, there is still a lot to gain when it comes to delivering feedback to youngsters. To provide youngsters with information about their treatment outcome, the innovative web-based feedback tool INKT (short for ‘I Need To Know’) has been developed together with youngsters.

Objective:
The aim of this study is to evaluate the INKT feedback tool.
Method: An observational design with a control and experimental condition in two matched cohorts was used to compare change in treatment outcome among youngsters who are being treated in (forensic) mental healthcare. In the control condition, feedback about treatment outcome was delivered as usual and in the experimental condition youngsters received feedback about treatment via the INKT tool. The primary outcome was behavioural change, measured by the Child Behavior Checklist and Youth Self Report (CBCL & YSR). The Positive Perception Program (PPP) was used to measure the satisfaction with delivered care.

Results:
Results indicate that, using the INKT feedback tool was not related to behavioural change on the subscales of the CBCL and YSR. Although the use of INKT did not influence behaviour. Youngsters who used the INKT feedback tool were more satisfied with treatment and routine outcome monitoring than youngsters in the control group.
Conclusion: The current study underlines the importance of receiving feedback in treatment. Feedback tools such as INKT – made by, for and with youngsters - are a promising way for youngsters to receive feedback.

Presentation 2: Evaluation of a digital, personalized and visual quality of life assessment instrument for youngsters and adults with (forensic)
Background:
Quality of Life (QoL) is an important outcome that contributes to the shift towards strength-based approaches in forensic youth mental health (Barendregt et al., 2018). Methods for QoL assessment, however, are not optimally accessible or personalized and do not always mesh with respondents. Recently, an innovative, digital, visual and personalized QoL assessment app for youngsters and adults with (forensic) psychiatric problems was developed: the QoL-ME (Buitenweg et al., 2019).

Objective:
The picture-based approach to QoL assessment employed in the QoL-ME is one of its main innovative features. This visual approach improves the accessibility of QoL assessment, but may have consequences for the psychometric quality of the QoL-ME. The aim of this study, therefore, was to evaluate the psychometric quality of the QoL-ME by assessing its reliability, validity and responsiveness.

Methods:
The reliability of the subscales of the QoL-ME was assessed using Cronbach’s Alpha. Correlations between the QoL-ME and the Manchester Short Assessment of Quality of Life (MANSA) were computed to assess the construct validity of the QoL-ME. External responsiveness was evaluated by correlating difference scores on the QoL-ME and the MANSA over a period of 6 months.

Results:
Reliability of the subscales of the QoL-ME ranged between .5* and .84*. In accordance with expectations, the language-based section of the QoL-ME correlated strongly (r = between .55 and .76) with the MANSA, whilst the picture-based additional modules of the QoL-ME correlated moderately (r = .3) with the MANSA. Difference scores between MANSA and QoL-ME were not significantly correlated.

Conclusions: The QoL-ME has adequate psychometric properties . In comparison with the psychometric properties of similar picture-based instruments, both the QoL-ME’s reliability and validity can be considered as strong. The responsiveness of the QoL-ME is insufficient, which limits its usefulness in practice.

Presentation 3: Ask me first! actively involving youngsters in risk assessment using the Transition Inventory
Background:
Youngsters in youth forensic psychiatry are generally not actively involved in risk assessment. This is a missed opportunity as active involvement may lead to an improved working alliance, more engagement and stronger predictive validity (Kroner et al., 2020). The Transition Inventory is a self-report instrument that directly involves youngsters in risk assessment (Kroner & Mills, 2015). Before the Transition Inventory can be used in clinical settings, however, more knowledge about its psychometric properties is necessary.

Objectives:
The aim of the current study is to evaluate the psychometric properties of the Dutch version of the Transition Inventory.

Methods:
To investigate the psychometric properties of the Transition Inventory, fifty youngsters aged 14 up to and including 22 years old admitted to the Catamaran, a hospital for youth forensic psychiatry and orthopsychiatry or to a Juvenile Justice Institution fill out the Transition Inventory. In addition, demographic information and results on conventional risk-assessment instruments will be collected. In this study, the reliability of the Transition Inventory will be assessed using Cronbach’s alpha. Convergent validity will be tested using the correlation between the Transition Inventory and conventional instruments for risk assessment such as the SAVRY or SAPROF-YV. Discriminant validity will be analysed through the correlation between the Transition Inventory and the Satisfaction with Life Scale, Empowerment Questionnaire and Cantril’s Ladder. Furthermore, confirmatory factor analysis will be used to assess the construct validity of the Transition Inventory.

Results:
In this presentation, the results of the psychometric evaluation of the Dutch Transition Inventory will be presented. Specifically, results regarding the reliability and validity of the instrument will be outlined and discussed.

Conclusion:
Based on the results regarding the psychometric properties of the Transition Inventory, a conclusion regarding its use in clinical practice will be drawn. In addition, possibilities for potential future research will be explored.
Co-author: Chijs van Niewenhuizen

Assessment and treatment of young and/or adolescent offenders
digital tools, intervention
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