Browsing by Author "Holter, Mark C."

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    A Coding System to Measure Elements of Shared Decision Making During Psychiatric Visits
    (2012-08) Salyers, Michelle P.; Matthias, Marianne S.; Fukui, Sadaaki; Holter, Mark C.; Collins, Linda; Rose, Nichole; Thompson, John; Coffman, Melinda; Torrey, William C.
    Objective: Shared decision making is widely recognized to facilitate effective health care. The purpose of this study was to assess the applicability and usefulness of a scale to measure the presence and extent of shared decision making in clinical decisions in psychiatric practice. Methods: A coding scheme assessing shared decision making in general medical settings was adapted to mental health settings, and a manual for using the scheme was created. Trained raters used the adapted scale to analyze 170 audio-recordings of medication check-up visits with either psychiatrists or nurse practitioners. The scale assessed the level of shared decision making based on the presence of nine specific elements. Interrater reliability was examined, and the frequency with which elements of shared decision making were observed was documented. The association between visit length and extent of shared decision making was also examined. Results: Interrater reliability among three raters on a subset of 20 recordings ranged from 67% to 100% agreement for the presence of each of the nine elements of shared decision making and 100% for the agreement between provider and consumer on decisions made. Of the 170 sessions, 128 (75%) included a clinical decision. Just over half of the decisions (53%) met minimum criteria for shared decision making. Shared decision making was not related to visit length after the analysis controlled for the complexity of the decision. Conclusions: The rating scale appears to reliably assess shared decision making in psychiatric practice and could be helpful for future research, training, and implementation efforts.
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    The Comparative Effectiveness of a Model of Job Development versus Treatment as Usual
    (2018) Carlson, Linda; Smith, Galen; Rapp, Charles A.; Mariscal, E. Susana; Holter, Mark C.; Ko, Eunjeong; Kukla, Marina; Fukui, Sadaaki; School of Social Work
    Job development is critical to assisting people with serious disabilities to obtain jobs, but little is known about the actual methods that make job development effective. Using a post-only quasi-experimental design, this study examined the effects of the Conceptual Selling® method on the number of job development contacts and number of job placements. By controlling for employment specialists' characteristics (age, length of time in current position, years of human service experience, and years of business experience), the authors determined that the employment specialists trained in the Conceptual Selling® method had more job development contacts per employer, leading to more effective job placements for employers contacted, than the control group.
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    Consumer Outcomes After Implementing CommonGround as an Approach to Shared Decision Making
    (APA, 2017-03) Salyers, Michelle P.; Fukui, Sadaaki; Bonfils, Kelsey A.; Firmin, Ruth L.; Luther, Lauren; Goscha, Rick; Rapp, Charles A.; Holter, Mark C.; Psychology, School of Science
    Objective: The authors examined consumer outcomes before and after implementing CommonGround, a computer-based shared decision-making program. Methods: Consumers with severe mental illness (N=167) were interviewed prior to implementation and 12 and 18 months later to assess changes in active treatment involvement, symptoms, and recovery-related attitudes. Providers also rated consumers on level of treatment involvement. Results: Most consumers used CommonGround at least once (67%), but few used the program regularly. Mixed-effects regression analyses showed improvement in self-reported symptoms and recovery attitudes. Self-reported treatment involvement did not change; however, for a subset of consumers with the same providers over time (N=83), the providers rated consumers as more active in treatment. Conclusions: This study adds to the growing literature on tools to support shared decision making, showing the potential benefits of CommonGround for improving recovery outcomes. More work is needed to better engage consumers in CommonGround and to test the approach with more rigorous methods.