Lancashire Traumatic Stress Service
Information on Outcomes

If you are considering using our service then it seems reasonable to us that you might want to know something about how effective we are and how other patients have felt about using our service.

Below we provide regularly updated information about clinical outcomes and patient experience.

We collect information about symptoms and about patient experience at each appointment and so we always have information from a patient’s last visit to the service. This information is included in some of the tables below.

GRAPH  1

This graph provides information on the levels of symptoms at the time of the initial assessment and at the time of the completion of treatment.

There are two graphs . The first – the one in red is a summary of the pre and post scores on the Clinician Administered PTSD Scale for DSM IV (CAPS for DSMIV).

The graph shows that for those patients who do complete treatment, there is, on average, a clinically significant reduction in their levels of trauma symptoms.

Since the introduction of DSM 5 the LTSS has switched to using the Clinician Administered PTSD Scale for DSM5 (CAPS for DSM5). The second graph – the one in blue is a summary of the pre and post scores on this new measure and continues to show that for those individuals who complete treatment, there is a clinically significant reduction in their levels of trauma symptoms.

A comparison of average Pre and Post CAPS for DSM IV Scores for Completed Treatment Cases

A comparison of average Pre and Post CAPS for DSM 5 Scores for Completed Treatment Cases from April 2015

CAPS FOR DSM 5 CATEGORIES

0-20     MILD

20-40   MODERATE

40-60   SEVERE

60-80   EXTREME

GRAPH 2

This graph illustrates changes in symptoms of depression (BDI) and anxiety (BAI) for those patients who complete treatment.

Again the graph shows that for those patients who do complete treatment, there is a significant reduction in levels of anxiety and depression.

A comparison of average Pre and Post BDI and BAI scores for Completed Treatment Cases to June 2018

GRAPH 3

This graph shows changes in scores on the three assessments that all patients complete at every appointment they attend.  This means that the scores include those patients who completed treatment and those patients who, for whatever reason, dropped out before the completion of treatment.

There are three separate assessments

PHQ-9 -  This assessment helps to determine the level of severity of depression.

GAD-7 -  This assessment helps to determine the level of anxious feelings.

WSAS -  This assessment helps to determine changes in levels of social  inclusion, work, leisure and relationships.

The scores on all three of these measures show that there are, on average, positive improvements in the areas we assess.    

A comparison for average initial and final PHQ-9, GAD-7 and WSAS scores for all treatment cases to June 2018

GRAPH 4

This graph shows changes in scores on the three assessments that all patients complete at every appointment they attend.  This means that the scores include those patients who completed treatment..

There are three separate assessments

PHQ-9 -  This assessment helps to determine the level of severity of depression.

GAD-7 -  This assessment helps to determine the level of anxious feelings.

WSAS -  This assessment helps to determine changes in levels of social  inclusion, work, leisure and relationships.

The scores on all three of these measures show that there are, on average, positive improvements in the areas we assess.

A comparison for average initial and final PHQ-9, GAD-7 and WSAS scores for all completed treatment cases to June 2018

Overall we think that it is important to give you good information about how we perform as a service. Clearly we don’t help everyone who comes. However for those patients who complete their therapy with us, there is a good chance that there can be a clinically significant reduction in symptoms.

We are also concerned that the service you receive feels acceptable to you and we know that developing a good relationship with the person you see will be very important.

For this reason we ask all patients to complete a very short questionnaire at the end of each appointment (Session Rating Scale) to provide some feedback on their experience of our service .

We ask for comments on the following:-

  1. Relationships – did you feel heard, understood and respected?
  2. Goals and Topics – did we work with you on areas that were important to you?
  3. Approach and Method – did the therapist’s approach work well for you?
  4. Overall – was today’s session right for you?

Each question is scored out of 10, so a score of 40 would mean that the session had gone well.

The average score across all the individual appointments we have provided in the service is 39.

Session Rating Scale 

The Session Rating Scale (SRS) assesses the client's perception of the client-therapist alliance (i.e. the quality of the relational bond with the therapist and whether the therapist shares his or her therapeutic objective).

Along with the Outcome Rating Scale (ORS) it is part of the internationally recognised Partners for Change Outcome Management System (PCOMS).

This system is a client feedback program for improving the treatment outcomes of adults and children participating in a behavioural health care intervention. It is designed to improve the retention of participants in treatment and to assist them in reaching reliable and clinically significant change. 

Client ratings are discussed as necessary in order to maintain the client's engagement in treatment, optimize the client-therapist alliance, and provide a means for transitioning into the treatment session by focusing on client-identified concerns.

If client ratings are very low, the therapist may choose to modify the type and amount of treatment.

 

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