Original Article
Measuring goal progress using the goal-based outcome measure in Jigsaw – A primary care youth mental health service
Aileen O'Reilly,
Niamh McKenna,
Amanda Fitzgerald,
Corresponding Author
Aileen O'Reilly
Jigsaw – The National Centre for Youth Mental Health, Dublin 2, Ireland
School of Psychology, University College Dublin, Dublin 4, Ireland
Correspondence
Aileen O'Reilly, Jigsaw – The National Centre for Youth Mental Health, 16 Westland Square, Dublin 2, Ireland; Email: [email protected]
Search for more papers by this authorNiamh McKenna
School of Psychology, University College Dublin, Dublin 4, Ireland
Search for more papers by this authorAmanda Fitzgerald
School of Psychology, University College Dublin, Dublin 4, Ireland
Search for more papers by this authorAileen O'Reilly,
Niamh McKenna,
Amanda Fitzgerald,
Corresponding Author
Aileen O'Reilly
Jigsaw – The National Centre for Youth Mental Health, Dublin 2, Ireland
School of Psychology, University College Dublin, Dublin 4, Ireland
Correspondence
Aileen O'Reilly, Jigsaw – The National Centre for Youth Mental Health, 16 Westland Square, Dublin 2, Ireland; Email: [email protected]
Search for more papers by this authorNiamh McKenna
School of Psychology, University College Dublin, Dublin 4, Ireland
Search for more papers by this authorAmanda Fitzgerald
School of Psychology, University College Dublin, Dublin 4, Ireland
Search for more papers by this authorAbstract
Background
Jigsaw is a primary care youth mental health service designed to increase access to and utilisation of mental health supports for 12- to 25-year-olds. Effectiveness in community youth mental health services is typically assessed using standardised instruments. The aim of this study was to examine the effectiveness of Jigsaw’s brief intervention model of support using an idiographic tool, the goal-based outcome (GBO) measure. The study also aimed to explore the type of goals set by young people engaging with this service.
Method
The study sample consisted of a secondary dataset of 4839 young people aged 12–25 years (63.5% female, 36.5% male) who engaged with one of Jigsaw’s 13 brief intervention services. Overall, 7366 goals set using the GBO were examined. Inductive thematic analysis was conducted to examine the type of goals set by young people, and inferential analyses were used to examine statistical and reliable changes in goal progress.
Results
The goals young people set focused on developing coping mechanisms and personal growth and managing interpersonal difficulties. Mean scores for progress towards goals improved significantly from pre- to postintervention. The reliable change index (RCI) indicated that change greater than 2.82 points represents reliable change on the GBO, with 78.6% of young people showing reliable improvement. Demographic characteristics did not impact goal progress.
Conclusion
These findings suggest Jigsaw’s brief intervention model of support is effective in assisting young people reach their goals and that the GBO is a suitable measure for young people attending a community-based youth mental health service.
References
- Ashworth, M., Guerra, D., & Kordowicz, M. (2019). Individualised or standardised outcome measures: A co-habitation? Administration and Policy in Mental Health and Mental Health Services Research, 46, 425–428.
- Batty, M.J., Moldavsky, M., Foroushani, P.S., Pass, S., Marriott, M., Sayal, K., & Hollis, C. (2013). Implementing routine outcome measures in child and adolescent mental health services: From present to future practice. Child and Adolescent Mental Health, 18, 82–87.
- Bor, W., Dean, A.J., Najman, J., & Hayatbakhsh, R. (2014). Are child and adolescent mental health problems increasing in the 21st century? A systematic review. Australian & New Zealand Journal of Psychiatry, 48, 606–616.
- Bradley, J., Murphy, S., Fugard, A.J., Nolas, S.M., & Law, D. (2013). What kind of goals do children and young people set for themselves in therapy? Developing a goals framework using CORC data. Child and Family Clinical Psychology Review, 1, 8–18.
10.53841/bpscypf.2013.1.1.8 Google Scholar
- Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.
10.1191/1478088706qp063oa Google Scholar
- Bromley, C., & Westwood, S. (2013). Young people’s participation: Views from young people on using goals. Clinical and Family Psychology Review, 1, 41–60.
10.53841/bpscypf.2013.1.1.41 Google Scholar
- Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46.
- Collishaw, S. (2015). Annual research review: secular trends in child and adolescent mental health. Journal of Child Psychology and Psychiatry, 56, 370–393.
- Connell, J., & Barkham, M. (2007). CORE-10 user manual, version 1.1. CORE System Trust & CORE Information Management Systems Ltd, 1–40.
- CORC (2017). CORC Outcomes Spreadsheet. Available from: https://www.corc.uk.net/media/1495/corc-outcomes-spreadsheet_v1_mar17.xlsx [last accessed 20 December 2019).
- Donnelly, A., O’Reilly, A., Dolphin, L., O'Keeffe, L., & Moore, J. (2019). Measuring the performance of the Mental Health Continuum-Short Form (MHC-SF) in a primary care youth mental health service. Irish Journal of Psychological Medicine, 36, 201–205.
- Edbrooke-Childs, J., Jacob, J., Law, D., Deighton, J., & Wolpert, M. (2015). Interpreting standardized and idiographic outcome measures in CAMHS: What does change mean and how does it relate to functioning and experience? Child and Adolescent Mental Health, 20, 142–148.
- Edbrooke-Childs, J., Wolpert, M., & Deighton, J. (2016). Introduction to the special section on implementing feedback from outcome measures in child and adult mental health services. Administration and Policy in Mental Health and Mental Health Services Research, 43, 277–278.
- Edbrooke-Childs, J., Wolpert, M., Zamperoni, V., Napoleone, E., & Bear, H. (2018). Evaluation of reliable improvement rates in depression and anxiety at the end of treatment in adolescents. BJPsych Open, 4, 250–255.
- Elliott, R., Wagner, J., Sales, C.M.D., Rodgers, B., Alves, P., & Café, M.J. (2016). Psychometrics of the personal questionnaire: A client-generated outcome measure. Psychological Assessment, 28, 263–278.
- Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62, 107–115.
- Hetrick, S.E., Bailey, A.P., Smith, K.E., Malla, A., Mathias, S., Singh, S.P., … & Moro, M.R. (2017). Integrated (one-stop shop) youth health care: Best available evidence and future directions. Medical Journal of Australia, 207, S5–S18.
- IBM Corp. Released (2019). IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.
- Illback, R.J., & Bates, T. (2011). Transforming youth mental health services and supports in Ireland. Early Intervention in Psychiatry, 5, 22–27.
- Illback, R.J., Bates, T., Hodges, C., Galligan, K., Smith, P., Sanders, D., III, & Dooley, B. (2010). Jigsaw: engaging communities in the development and implementation of youth mental health services and supports in the Republic of Ireland. Journal of Mental Health, 19, 422–435.
- Iyer, S.N., Shah, J., Boksa, P., Lal, S., Joober, R., Andersson, N., … & Malla, A.K. (2019). A minimum evaluation protocol and stepped-wedge cluster randomized trial of ACCESS Open Minds, a large Canadian youth mental health services transformation project. BMC Psychiatry, 19, 273.
- Jacob, J., Costa da Silva, L., Sefi, A., & Edbrooke-Childs, J. (2020). Online counselling and goal achievement: Exploring meaningful change and the types of goals progressed by young people. Counselling and Psychotherapy Research. Advance online publication. https://doi.org/10.1002/capr.12363
- Jacob, J., De Francesco, D., Deighton, J., Law, D., Wolpert, M., & Edbrooke-Childs, J. (2017). Goal formulation and tracking in child mental health settings: when is it more likely and is it associated with satisfaction with care? European Child & Adolescent Psychiatry, 26, 759–770.
- Jacob, J., Edbrooke-Childs, J., Holley, S., Law, D., & Wolpert, M. (2016). Horses for courses? A qualitative exploration of goals formulated in mental health settings by young people, parents, and clinicians. Clinical Child Psychology and Psychiatry, 21, 208–223.
- Jacob, J., Edbrooke-Childs, J., Lloyd, C., Hayes, D., Whelan, I., Wolpert, M., & Law, D. (2018). Measuring outcomes using goals. In M. Cooper & D. Law (Eds.), Working with goals in psychotherapy and counselling (pp. 111–127). Oxford: Oxford University Press.
10.1093/med-psych/9780198793687.003.0006 Google Scholar
- Jacobson, N.S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.
- Joffe, H. (2012). Thematic analysis. In D. Harper & A. Thompson Qualitative research methods in mental health and psychotherapy: An introduction for students and practitioners (pp. 209–223). Wiley-Blackwell.
- Keyes, C.L. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 207–222.
- Kraus, K.R., Edbrooke-Childs, J., Singleton, R., & Wolpert, M. (2021). Are we comparing apples with oranges? Assessing improvement across symptoms, functioning, and goal progress for adolescent anxiety and depression. Child Psychiatry & Human Development. Advance Online Publication. https://doi.org/10.1007/s10578-021-01149-y
- Kwan, B., & Rickwood, D.J. (2020). A routine outcome measure for youth mental health: Clinically interpreting MyLifeTracker. Early Intervention in Psychiatry. 1–11.
- Law, D. (2011). Goals and goal-based outcomes (GBOs): Some useful information. London: CAMHs Press.
- Law, D. (2019). The goal-based outcome tool: Guidance notes. London: Mind Monkey Associates.
- Law, D., & Bradley, J. (2014). Goal Based Outcomes (GBOs): Some useful information. Version 3. London: CAMHS Press.
- McGorry, P.D. (2007). The specialist youth mental health model: strengthening the weakest link in the public mental health system. Medical Journal of Australia, 187, S53–S56.
- Moran, P., Kelesidi, K., Guglani, S., Davidson, S., & Ford, T. (2012). What do parents and carers think about routine outcome measures and their use? A focus group study of CAMHS attenders. Clinical Child Psychology and Psychiatry, 17, 65–79.
- Norman, S., Dean, S., Hansford, L., & Ford, T. (2014). Clinical practitioner’s attitudes towards the use of routine outcome monitoring within Child and Adolescent Mental Health Services: A qualitative study of two Child and Adolescent Mental Health Services. Clinical Child Psychology and Psychiatry, 19, 576–595.
- Nowell, L.S., Norris, J.M., White, D.E., & Moules, N.J. (2017). Thematic analysis: Striving to meet the trustworthiness criteria. International Journal of Qualitative Methods, 16, 1–13.
- O’Keeffe, L., O’Reilly, A., O’Brien, G., Buckley, R., & Illback, R. (2015). Description and outcome evaluation of Jigsaw: An emergent Irish mental health early intervention programme for young people. Irish Journal of Psychological Medicine, 32, 71–77.
- O’Reilly, A., O’Brien, G., Moore, J., Duffy, J., Longmore, P., Cullinan, S., & McGrory, S. (under review). Evolution of Jigsaw - A National Youth Mental Health Service. Manuscript submitted for publication. (forthcoming) Early Intervention in Psychiatry.
- O'Reilly, A., Illback, R., Peiper, N., O'Keeffe, L., & Clayton, R. (2015). Youth engagement with an emerging Irish mental health early intervention programme (Jigsaw): Participant characteristics and implications for service delivery. Journal of Mental Health, 24, 283–288.
- Patel, V., Flisher, A.J., Hetrick, S., & McGorry, P. (2007). Mental health of young people: A global public-health challenge. The Lancet, 369, 1302–1313.
- Peiper, N., Illback, R.J., O’Reilly, A., & Clayton, R. (2017). Latent class analysis of need descriptors within an Irish youth mental health early intervention program toward a typology of need. Early Intervention in Psychiatry, 11, 37–46.
- Ruble, L., McGrew, J.H., & Toland, M.D. (2012). Goal attainment scaling as an outcome measure in randomized controlled trials of psychosocial interventions in autism. Journal of Autism and Developmental Disorders, 42, 1974–1983.
- Scales, P.C., Benson, P.L., Oesterle, S., Hill, K.G., Hawkins, J.D., & Pashak, T.J. (2016). The dimensions of successful young adult development: A conceptual and measurement framework. Applied Developmental Science, 20, 150–174.
- Settipani, C.A., Hawke, L.D., Cleverley, K., Chaim, G., Cheung, A., Mehra, K., … & Henderson, J. (2019). Key attributes of integrated community-based youth service hubs for mental health: A scoping review. International Journal of Mental Health Systems, 13, 52.
- Shirk, S.R., Karver, M.S., & Brown, R. (2011). The alliance in child and adolescent psychotherapy. Psychotherapy, 48, 17.
- Simmons, M.B., Parker, A.G., Hetrick, S.E., Telford, N., Bailey, A., & Rickwood, D. (2014). Satisfaction scale for youth mental health services. Early Intervention in Psychiatry, 8, 382–386.
- Tryon, G.S., Birch, S.E., & Verkuilen, J. (2018). Meta-analyses of the relation of goal consensus and collaboration to psychotherapy outcome. Psychotherapy, 55, 372–383.
- Twigg, E., Barkham, M., Bewick, B.M., Mulhern, B., Connell, J., & Cooper, M. (2009). The YP-CORE: Development and validation of a young person’s version of the CORE-OM. Counselling and Psychotherapy Research, 9, 160–168.
10.1080/14733140902979722 Google Scholar
- Wolpert, M., Cheng, H., & Deighton, J. (2015). Measurement Issues: Review of four patient reported outcome measures: SDQ, RCADS, C/ORS and GBO–their strengths and limitations for clinical use and service evaluation. Child and Adolescent Mental Health, 20, 63–70.
