Here is a little context to why the Y-OQ matters for your child while in treatment. Serious, probing and comprehensive research on the efficacy of family-choice behavioral healthcare treatment began, formally with wilderness’ Outdoor Behavioral Healthcare Industry Council (OBHIC) in conjunction with the Association of Experiential Education (AEE) in 2013 and then strongly encouraged in the broader NATSAP association in 2016. Because of this vast collection of empirical data, there is a large, and growing, objective database of the industry and with this, a very active research focus to analyze how treatment works inside the various models and practices in the family-choice treatment industry. Full disclosure: the research is in its infancy. As a consumer of treatment programs or any intervention, you should ask about outcomes and if the treatment program is participating in long term third party research. (Tip: “Participation” means that the treatment program submits data on their program, but a third party research team at UNH compiles all the de-identified member programs’ data and is then able to analyze large n’s.)
Over the years, I’ve asked Mike Petree, MA, whose company Remote Research Director helps treatment programs and associations collect outcomes and client progress data, to keep All Kinds of Therapy readers informed of what the research shows. In this blog, Mike will explain one of the major tools used in the research.
What is the Y-OQ?
The Y-OQ 2.01 is a parent self reporting tool that was created at BYU to track progress - or in other words, an “exceptionally sensitive metric of changes in functioning.” (The Y-OQ-SR asks the teen/client to track and compare a subjective perspective of the same time data.) The Y-OQ is used with the families in many short term programs (wilderness therapy or residential treatment) bi-weekly, or monthly in longer-term residential treatment.
What does the Y-OQ measure?
- Intrapersonal Distress (ID) - Anxiety, depression, fearfulness, etc.
- Somatic Distress (S) - Headache, stomach, bowel, dizziness, etc.
- Interpersonal Relationships (IR) - Attitude, communication and interaction with parents, adults, and peers.
- Critical Items (CI) - Paranoid ideation, suicide, hallucinatory, delusions, etc.
- Social Problems (SP) - Delinquent or aggressive behaviors, breaking social mores.
- Behavioral Dysfunction (BD) - Organize and complete tasks, handle frustration, impulsivity, inattention.
How do these measurements track your child’s treatment? What changes over time are expected?
The YOQ utilizes a Reliable Change Index (RCI) to specify the amount of change a client must show on a specific psychometric instrument between measurement occasions for that change to be reliable, i.e., larger than that reasonably expected (“a significant change”) due to measurement error alone.
Evidence of reliable change is, therefore, the heart of evidence-based practice.
How can therapists and families use the Y-OQ before, during & after a treatment program or intervention?
The pre-treatment or admittance Y-OQs are used to establish a baseline frame of reference for all subsequent surveys; these baseline scores allow a therapist to quickly evaluate a student’s strengths and weaknesses (including possible danger to self), and also provide a framework of understanding for initial discussions with the parents.
Parents can compare this baseline over time, to track their child’s progress throughout and after treatment. The subscale scores (the individual “ID, S, IR, CI, SP and BD scores” in each YOQ battery) can be used to better understand the client’s distress, and also for treatment planning.
How does a treatment program utilize the Y-OQ longitudinal results?
- It is normed, valid and used internationally.
- It is one of the most credible and encompassing mental health measures available.
- It was specifically designed to track treatment outcomes.
- Changes over treatment are objectively and subjectively measured; this record provides external evidence that positive change is occurring.
Mike, is there anything else that people need to know?
In my opinion the YOQ and the OQ 45.2 are the very best tools for tracking client progress. There are other systems out there but you get more for your dollar with OQ Measures. Also, if you use these measures and review the results with your clients, they will get more gains in less time than treatment as usual. So, using these measures is actually a treatment intervention.
Thank you Mike Petree for the 101 course about the Y-OQ. I will be asking you more questions about this at a later date.
ABOUT THE AUTHOR
Mike Petree, MA, has been a therapist at a wilderness therapy program and a non profit IOP in New York City. He is now a champion of independent outcomes-based research. He has a masters in Counseling Psychology from Northwestern Oklahoma State University. He now runs Petree Consulting Inc and the Remote Research Director Service. Please feel free to contact him at firstname.lastname@example.org to find out more about the research that is underway, as well as implications research has already revealed.
Mike previously contributed the blog "Independent Outcome Research".