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Treatment Effectiveness Tests
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Pre-Post InventoryThe Pre-Post Inventory is a test that is administered to a client more than once. It is typically given the first time (pretest) upon client admission into a treatment, counseling or intervention program, and before treatment has occurred. Then, after treatment is completed, the Pre-Post Inventory is administered to the same client again. This second testing is called the posttest (2nd test) which generates the "Comparison Report." The Pre-Post Inventory contains eight scales (measures): Truthfulness, Depression, Self-Esteem, Anxiety, Distress, Alcohol, Drugs and Stress Management. It consists of 161 items and takes 30 minutes to complete. Historically, when a person completed a prescribed counseling or treatment program they were assumed to be cured, rehabilitated or made well. Today these assumptions are being challenged. Some people, for whatever reason, do not benefit or improve from intervention, counseling or treatment (hereinafter referred to as treatment). Distinguishing between people that benefit from treatment and those that do not is a challenging task. Earlier approaches found that treatment staff opinions can be subjective and diverse (Broome, Flynn, Knight & Simpson, 2007). And any objective approach to identifying positive or negative treatment effects is subject to theoretical, methodological and meaningful opinions and viewpoints. To acknowledge, assuage and answer many of these questions, the Pre-Post Inventory rationale is summarized. Pretest – posttest baseline methodology is the foundation upon which the Pre-Post Inventory is based. The Pre-Post Inventory is administered prior to or upon treatment program intake. This test administration is called the pretest or pre-treatment test. Then the same test is administered again upon treatment completion and this is called the posttest. The pretest serves as the baseline or test against which the posttest is compared. The same test is administered twice.  Many mental health professionals, treatment staff, program administrators and others accept baseline theory and methodology, whereas others may not. If you don’t accept baseline methodology you should not use the Pre-Post Inventory. The composition of the Pre-Post Inventory scales (measures) is important because they are the Pre-Post Inventory’s outcome measures. The eight areas of inquiry represented by the eight Pre-Post Inventory scales measure treatment outcome or change. The eight Pre-Post Inventory scales (measures) are:
A concern with any assessment instrument or test is determining whether the respondent was truthful while being tested. Treatment outcome assessments are no exception in that the accuracy and reliability of client (patient, offender) answers is often questioned (Kingi & Hauora, 2003). An important and unique component of the Pre-Post Inventory is its built-in Truthfulness Scale. Clients (patients, offenders) often attempt to minimize their problems or portray themselves in an overly favorable light. When this happens, assessment results are not accurate or useful; indeed they may be misleading, because they are distorted. The Pre-Post Inventory Truthfulness Scale identifies client (patient, offender) denial, problem minimization and attempts to “fake good.” Other Pre-Post Inventory scales were included because of their prominence in intervention, counseling and treatment settings. Stress or the improper management of stress seems to underlie many, if not most, other disorders. Inclusion of the other Pre-Post Inventory scales was clear-cut. The eight Pre-Post Inventory scales assess common problem areas and disorders that are often involved in most treatment settings. In the event that a patient’s treatment plan does not include any of these eight areas of inquiry, omitted problems/disorders will likely not be treated. It is recommended that the Pre-Post pretest be administered as part of a treatment program intake screening. Then decisions can be made about including elevated (70 to 89th percentile) and severely elevated (90 to 100th percentile) pretest scale scores (more specifically the problems/disorders they represent) in the patient’s treatment plan. Exceptions to treatment plan inclusion should be noted in the “comments and recommendations” section of the pretest and comparison reports. Such a procedure would often help explain “no change” or “negative change” comparison report results. Referral and treatment program omissions are discussed in the www.pre-post-inventory.com website on the “Anomalies and Outliers” web page. In some instances, non-treatment may explain little or even negative pre-post scale score change. No one treatment outcome or effectiveness test is appropriate for use in all treatment settings or milieus. Other considerations are the pretest scale scores. When a pretest score is at or below the 69th percentile it is in the “no-problem” range, which means there may be little need for treatment. Said another way, there may be little room for change. This should be noted; in these instances little or no positive change would be likely. Such low pretest scale score situations may help explain “little change” and “negative change” pretest-posttest scale comparisons. These caveats are intended to help Pre-Post Inventory users understand the test and its applications. Perhaps the most informative Pre-Post Inventory resource is its website www.pre-post-inventory.com. If you have questions or suggestions, please call Professional Online Testing Solutions, Inc. at 1 (800) 231-2401 or email us at info@online-testing.com. Numerous studies (Andrews, Bonta & Hoge, 1990; Freidmann, Hendrickson, Gerstein & Zhang, 2004) have demonstrated the importance of matching problem severity with treatment intensity. Other studies attest to the value of intervention, counseling and treatment (Bergin & Garfield, 1994). However, after completion of treatment the question remains “Was treatment effective?” “Did the client positively change?” Mental health professionals, treatment staff, program administrators, referral agencies, patients and their families want to know when treatment results in positive change. Other treatment advantages are many and include relapse research, decreased recidivism, acknowledging treatment effectiveness, etc. Pre-Post Inventory database research is ongoing. We hope it will facilitate test improvements, updates and improved treatment outcome results in the future. We would like the Pre-Post Inventory to be included in such research. Our test user feedback is important. Contact us by phone, email or letter with suggestions, questions and concerns. P.O. Box 32974 Phoenix, Arizona 85064-2974 Telephone: 1 (800) 231-2401 Email: info@online-testing.com Abstract The Pre-Post Inventory is administered to a client (patient, offender) twice – once before entering treatment (pretest) and again upon treatment completion (posttest). The same test is administered twice. Pretest scale scores serve as a baseline for subsequent posttest test comparison. The Pre-Post Inventory is a multimodal or multiscale self-report assessment instrument or test. The eight Pre-Post Inventory scales (Truthfulness, Distress, Anxiety, Depression, Self-Esteem, Alcohol, Drugs and Stress Management) scores are evidence based. They provide a broad and relevant outcome spectrum for assessing treatment-related change. When interested in client change or treatment outcome, we recommend consideration of the Pre-Post Inventory. References Andrews, D. A., Bonta, J., & Hoge, R. D. (1990). Classification for effective rehabilitation: Rediscovering psychology. Criminal Justice and Behavior, 17, 19-52. Bergin, A. E. & S. L. Garfield, eds. (1994). Handbook of Psychotherapy and Behavior Change, 4th Edition. New York: Wiley. Freidmann, P. D., Hendrickson, J. C., Gerstein, D. R. & Zhang, Z. (2004). The effect of matching comprehensive services to patients’ needs on drug use improvement in addiction treatment. Addiction, 99 (8): 962-972. Kingi, T. K. & Hauora, T. P. (2003). Developing Measures to Monitor the Impact of Outcomes on a Specific Cultural Group such as Maori. Massey University, Auckland NZ. To review this tests Scale Description go to www.pre-post-inventory.com. |
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