Analyzing Oq 45.2

Analyzing Outcome Assessments – Outcome Quenstionnaire (OQ 45.2)
Anna Dandelakis
Walden University

Abstract
Outcome assessments are instruments used by counselors not only to access the client, but also to access the skills of the counselor. There are many outcome assessment instruments available to mental health counselors and the selection of the proper instrument is the first hurdle. Selection should be based on the research support as well as the psychometrics and practicality of the instrument. The OQ 45.2 is an outcome assessment instrument that has both reliability and validity to assess the psychological functioning of an individual over time as well as provide the counselor with information on how to treat most effectively to gain the change that the client desires through therapy. Assessing a client in the present moment, beginning at the intake interview and on a weekly basis will help manage treatment for the client and allow the counselor to know that the treatment does not need to change as long as the scores from the chosen assessment instrument or demonstrating the positive change for the client.
Analyzing Outcome Assessments – Outcome Questionnaire (OQ 45.2) Within the field of mental health counseling, assessing change in a client is important, especially when working with managed care agencies or third-party payers. However, assessing therapy continually is just as important to the client and the counselor. Outcome assessments can provide a measurement of the counselor’s skills as well as the change in clients. According to Whitson (2009), “many clients would responde positively if counselors could provide data showing that the majority of their clients do make significant improvements” (p. 338). Having this evidence to present to clients will encourage the client that the counselor is competent in his/her work. There are many outcome assessments for counselors to choose from and selection of the proper assessment is not an easy task for any counselor. Consideration for strong, applicable and practical psychometrics are important in the selection of an outcome assessment. This includes the reliability, validity, sensitivity to change and practical use of the instrument (Lambert and Hawkins, 2004). With a great number of outcome assessments available, choosing the correct instrument that benefits the evaluation of treatment is important and should be done with careful considerations. In an attempt to analyze one of these instruments, the Outcome Questionnaire (OQ 45.2) will be analyzed giving consideration to both reliability and validity as well well as the types of scores provided by this instrument and benefits and limitations. Concluding with a discussion concerning the practical use of this instrument in a clinical practice.

Outcome Questionnaire (OQ 45.2) The OQ 45.2 was designed to be used repeatedly in clinical practice to check progress of therapy. This 45 item self report instrument provides the counselor with changes in three specific domains including symptom distress, interpersonal functioning and social role (OQ Measures, 2011). In addition to these three domains, this instrument provides an assessment of critical items associated with risky behaviors such as suicide and drug or alcohol use that needs attention immediately by the counselor (Backstead, Hatch, Lambert, Egett, and Goates, 2003). Estimated time for administering this instrument is three to five minutes. The collection of data begins at the intake interview and according to OQ Measures, 2011, this instrument should be used weekly to be sure not to miss data throughout therapy and track changes effectively. The assessment of an individual’s functional level over the period of treatment can be presented with the correct use of this instrument.
Validity and Reliability Data collected is standardized and this instrument is based on normative data. According to Backstead, et al. (2003), the test/retest relaiblity of this instrument presents that individuals within the range of .78 to .84 indicates stable psychological functioning status, however individuals outside of this range may benefit from psychological intervention. In addition to being a reliable assessment, the instrument is sensitive to change which is the further purpose of outcome assessments. The counselor wants to be able to track change, whether good or bad, to assess the therapeutic intervention being used. Validity of the OQ 45.2 presents that the instrument measures what it is suppose to measure and thus gives a report of the psychological functioning of an individual over time and changes can be seen with effective therapeutic intervention. Thus one can conclude that the OQ 45.2 is both reliable and valid in measuring the psychological improvement with therapeutic intervention.
Scoring
This instrument provides a total score of psychologically functioning over the three domains mentioned earlier, however also provides a reflection of the subscales which may indicate that while the total score shows normal psychological functioning, it is because of the high score in one of the subscales. This report is computer generated through a provider feedback report that gives this information to the counselor. The report also gives information on risk assessments in determinging critical issues that need immediate attention as mentioned before. The scoring is computer generated and done quickly to allow the counselor to discuss the changes with the client and also manage treatment that will be most effective for creating the change that the client seeks in his/her life.
Benefits and Limitations Many benefits and few limitations can be seen with this assessment instrument. Sensitiviety to change in addition to the practical use of this instrument are both benefits that are immediate. The cost of the assessment tools are no extremely high and the reporting of change is accurate. However, one limitation that this instrument could have is if the counselor fails to be consisitent with giving the assessment on a weekly basis to track change. If the tracking is missed, then this could result in missing data that could comprise the result of the measurement.

Practical Use in Clinical Practice According to Lambert and Hawkins (2004), “outcome measure represents another therapeutic technique when it is used skillfully and creatively” (p. 497). The use of the OQ 45.2 begininning with the initial interview will present a baseline of measuring psychological functioning as well as a risk assessment of critical issues that may be present in the client at the present moment. Starting with an assessment instrument such as this will inform the counselor of where the client is in the present time and allow the counselor to define effective treatment strategy that will help increase the score each week to get the client to psychological functioning capacity as deemed normal by the OQ 45.2. After using this assessment each week, there does not present positive changes to the normal range, then the counselor can reevalute the treatment strategy or could consider whether the treatment would be more effective with a counselor of a different competence thus protecting the welfare of the client and being an ethically responsible counselor.
Conclusion
Many outcome assessments instruments are available to counselors and selecting the right instrument for the most practical assessment is the first objective of the counselor. Considerations for the psychometrics of the instrument is extremely important as well as the competence of the counselor in giving and interpreting the scores that the assessment presents. Proper use of the OQ 45.2 will help evaluate the change in the client as well as the skills of the counselor in effective treatment. A client desires change and when change occurs, the counselor has accomplished the ultimate goal and protected the welfare of the client as well as increasing his/her credibility within the profession.
References
Beckstead, D., Hatch, A., Lambert, M., Eggett, D. & Goates, M. (2003). Clinical significance of the outcome questionnaire (OQ-45.2). Retrived from http://www.thefreelibrary.com/Clinical+significance+of+the+Outcome+Questionnaire+% 28OQ-45.2%29.-a0170020110
Lambert, M. J., & Hawkins, E. J. (2004). Measuring outcome in professional practice: Considerations in selecting and using brief outcome instruments. Professional Psychology: Research and Practice, 35, 492–499
OQ Measures (2011). The measure of mental health vital signs. Retrieved from http://www.oqmeasures.com/default.asp
Whiston, S. C. (2009). Principles and applications of assessment in counseling (3rd ed.). Belmont, CA: Brooks/Cole, Cengage Learning

References: Beckstead, D., Hatch, A., Lambert, M., Eggett, D. & Goates, M. (2003). Clinical significance of the outcome questionnaire (OQ-45.2). Retrived from http://www.thefreelibrary.com/Clinical+significance+of+the+Outcome+Questionnaire+% 28OQ-45.2%29.-a0170020110 Lambert, M. J., & Hawkins, E. J. (2004). Measuring outcome in professional practice: Considerations in selecting and using brief outcome instruments. Professional Psychology: Research and Practice, 35, 492–499 OQ Measures (2011). The measure of mental health vital signs. Retrieved from http://www.oqmeasures.com/default.asp Whiston, S. C. (2009). Principles and applications of assessment in counseling (3rd ed.). Belmont, CA: Brooks/Cole, Cengage Learning