Elevating Mental Health Support: What is Measurement-Based Care?

As an LCSW and Provider Lead at Spring Health, I wear two hats—one as a therapist working directly with clients and the other as someone deeply involved in supporting mental health providers. 

Through this dual role, I’ve understood the inherent challenges in quantifying progress in mental health treatment. This endeavor is often intricate and subjective, a hurdle I encounter daily at this intersection of roles.

These challenges are relevant for HR, benefits, and health plan leaders who work hard to offer top-notch support to their members. However, it can be difficult to gauge the effectiveness of mental health benefits utilization and its impact on individuals’ well-being. 

A sizable corporation or health plan may have thousands of members seeking assistance from many mental health providers. The pressing questions for leaders are determining if members are improving and if the care they receive aligns with the desired outcomes.

The solution lies in the practice of measurement-based care (MBC) throughout the treatment process. Measurement-based care is the systematic collection and evaluation of client symptom data at regular intervals. The goal is to leverage this data to guide care and improve outcomes.

Organizations and health plans investing in mental health support want to know their investment is creating positive change. They want to see individuals who are more productive, engaged, less susceptible to burnout, and proactive in tending to their physical and mental health.  

How does measurement-based care work?

Mental health providers can utilize measurement-based care through clinically-validated screening tools in the form of assessments. These tools have been widely tested and are used in therapy and other forms of mental health treatment. They offer providers a dependable means of gauging an individual’s internal state and the severity of their symptoms.  

Multiple opportunities emerge for providers to employ these assessment tools throughout a client’s care journey. They serve as essential aids in gaining a comprehensive understanding of a client’s symptoms, determining the most suitable treatment approach, and identifying the appropriate endpoint for their care.

The initial evaluation and first session

When a person enters care, they complete a series of guided assessments before their first session. These assessments may include well-known tools like the client Health Questionnaire (which screens for depression) and the Generalized Anxiety Disorder scale (designed to identify anxiety symptoms).

As a therapist, I access Spring Health’s Compass platform before my first interaction with a new client. Here, I can review the client’s assessment results, giving me an initial snapshot of their mental health. These assessments might reveal high scores in depression and anxiety, offering a valuable baseline. 

With this information, I’m better equipped to offer guidance and address their specific concerns. We can work together to define their therapy goals, setting another baseline to measure symptom relief. 

I can then focus on assisting the client with making measurable progress in various areas, such as anxiety, depression, and substance use, by conducting regular assessments. 

Regular check-ins throughout care

Throughout the treatment journey, clients can receive regular emails or app check-in notifications reminding them to complete follow-up assessments, in which they answer questions about their symptoms. 

This ongoing feedback serves as a vital gauge for providers to determine the effectiveness of the treatment and whether the client is experiencing relief from their symptoms. If they aren’t improving, a different treatment approach or a combination of modalities may be warranted. This approach offers a quantifiable way to track progress and fosters greater client engagement in their own care. 

Quantitative visualization of client progress can be beneficial throughout care. Depression is a condition that can vary in intensity and duration, influenced by factors such as life events.

During depressive episodes, individuals may feel trapped in a perpetual state of despair. However, providers can gain perspective by examining objective data points, such as a previous PHQ-9 score of 6 compared to a higher current score due to grief over a recent loss.

It becomes a powerful tool to remind clients that their current struggles are not permanent and that better days lie ahead. This realization can be empowering for those grappling with mental health challenges.

Determining when goals are met

When a client has expressed their desire to lead an anxiety-free life, and I observe consistently low scores on the GAD-2 assessment, this may start a conversation where I ask my client if they are ready to move out of care. 

I’d ask them how they feel about this potential transition and engage in a collaborative dialogue. Together, we’d explore what ending care might entail for them and what future support or strategies they might require to maintain their progress and well-being.

A beacon amid the complexity of mental health

Another area where measurement-based care proves invaluable is when there’s a disconnect between a client’s assessment scores and their presentation during sessions. Some clients are “people pleasers” and aim to make a favorable impression on their therapist.

Clinically, this discrepancy can be significant. As a therapist, I often work with high-functioning professionals who can navigate challenging mental health issues. High-functioning anxiety can manifest as proactive behavior driven by anticipation and worry. These individuals excel in their professional roles, but are also at risk of experiencing burnout and attrition.

Individuals and their mental health are inherently complex, and having an objective measurement to reference is incredibly helpful. It serves as a touchpoint for addressing issues that may be challenging to discuss early in treatment, especially before establishing a strong therapeutic alliance. 

I can approach discussions about the client’s assessment or check-in with sensitivity, avoiding any sense of accusation or intrusion. Instead, it becomes an opportunity to reflect on the client’s information, facilitating a more insightful and tailored approach to their treatment. 

We no longer need to navigate blindly when deciphering a client’s evolving needs and progress. 

Objective measures provide clarity

The providers I work with sometimes feel stuck with a client. Despite discussions between the provider and client about therapy goals, the sessions can become entangled in the intricacies of the individual’s mental health journey. The journey is often nonlinear, complex, and confusing. 

Equipping the client-provider pair with objective measures for visualizing which mental health symptoms are waxing and waning over time helps us connect these symptoms with the events and experiences unfolding in the person’s life.

Throughout care, data becomes an invaluable tool, informing the provider about several crucial aspects:

1. Identifying which symptoms are currently more acute.
2. Recognizing areas where improvement has been achieved.
3. Understanding what strategies have proven effective for the client, and how these can be further developed and applied.

Data helps providers embrace a strength-based approach to care. It shifts the focus from “What’s wrong with you?” to “Let me understand who you are and what’s working for you, and then we’ll collaboratively explore how to capitalize on those strengths.”

One of the core tenets of therapy, our North Star, is to meet the client wherever they are in their life journey. Employing self-reported data points from clinically-validated measures as a baseline for treatment empowers providers to do just that.

Making a real difference in people’s lives 

In March 2020, people’s distress readings were very high. Many of my clients found themselves confined to tiny apartments, unable to go to work, walk outside, or connect with friends and family. Their lives were turned upside down, and the persistent feeling of each day being a repetition of the last added to their distress.

As their therapist, I found comfort in the data points I could share with my clients. These data points served as a tangible reflection of their internal states when the world seemed chaotic. I would reassure them by saying, “Just three weeks ago, your anxiety levels were off the charts, and now, they’re much more manageable. I can see this progress in your measurements, demeanor, and the insights you share with me.” 

This approach allowed me to provide a broader perspective during unprecedented social upheaval. It became a way to help clients recognize their progress, which can often be obscured when viewed from the day-to-day grind of life. 

A deeply human approach to better care

As a therapist who relies on Spring Health’s platform, which is driven by measurement-based care, I value the seamless integration of data and personalized treatment. MBC is the intersection between these two elements. 

The information we use in the care process isn’t just data points generated by a computer. Instead, they reflect each client’s unique and individual human experiences. This integration allows us to systematize our responses in real time, adapting to the ever-evolving needs required to navigate a dynamic and changing world.  

Many HR, benefits, and health plan leaders are deeply concerned with ensuring their members thrive and are happy, engaged, and productive. Business leaders need to demonstrate the value of mental health benefits, and as humans and People leaders, they also need to ensure their members are valued and cared for. Measurement-based care is a solution that offers both.

Discover how building a strong therapeutic alliance creates the foundation to assist clients in reaching mutually defined treatment goals.