A computer adaptive testing version of the Addiction Severity Index-Multimedia Version (ASI-MV): The Addiction Severity CAT.

The purpose of this study was to develop and validate a computer adaptive testing (CAT) version of the Addiction Severity Index-Multimedia Version (ASI-MV), the Addiction Severity CAT. This goal was accomplished in 4 steps. First, new candidate items for Addiction Severity CAT domains were evaluated after brainstorming sessions with experts in substance abuse treatment. Next, this new item bank was psychometrically evaluated on a large nonclinical (n = 4,419) and substance abuse treatment (n = 845) sample. Based on these results, final items were selected and calibrated for the creation of the Addiction Severity CAT algorithms. Once the algorithms were developed for the entire assessment, a fully functioning prototype of an Addiction Severity CAT was created. CAT simulations were conducted, and optimal termination criteria were selected for the Addiction Severity CAT algorithms. Finally, construct validity of the CAT algorithms was evaluated by examining convergent and discriminant validity and sensitivity to change. The Addiction Severity CAT was determined to be valid, sensitive to change, and reliable. Further, the Addiction Severity CAT's time of completion was found to be significantly less than the average time of completion for the ASI-MV composite scores. This study represents the initial validation of an Addiction Severity CAT based on item response theory, and further exploration of the Addiction Severity CAT is needed. (PsycINFO Database Record

Questioning the measurement precision of psychotherapy research.

Recent developments in psychometric theory have important implications for the development and validation of the instruments used in psychotherapy research. This article illustrates how the advances in latent trait and item response theory (IRT) have distinct advantages over classical test theory. The basic assumptions of IRT (unidimensionality, local independence, and monotonicity) and the concepts common to all four of the basic IRT models (item characteristic curve, item information function, and test information function) are reviewed. IRT methods are illustrated using responses to a psychotherapy outcome instrument from a large data set of a commercial health plan.

Youth therapeutic alliance in intensive treatment settings.

Therapeutic alliance (TA), the helping relationship that develops between a client and clinician, has received little attention in child treatment studies until recently, though it is the factor found to be most predictive of clinical outcomes. Furthermore, TA is cited as one of the most important components to effective therapy according to practicing clinicians. This study examines the TA that develops between teacher/counselors and children in 2 settings, a partial hospital/day school and a wilderness camp. An important finding in this study is the lack of relationship between the teacher/counselor's view of TA and the youth's view. Moreover, this correlation does not improve according to how long the counselors have known or have treated the youth. The implications of this and other findings are discussed.

Using administrative data to assess the process of treatment services for adolescents with substance use disorders.

In 1998, the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration (SAMHSA) convened an expert panel comprised of a multidisciplinary group of providers, researchers, managed care representatives and public policymakers known as the Washington Circle (WC) to improve the quality and effectiveness of treatment for substance use disorders through the use of performance measures. The initial goals of the panel included developing, testing and implementing performance measures in health plans and encouraging collaboration with key stakeholders to ensure widespread adoption of the measures. The WC focused its initial efforts on the prevention, recognition and treatment of adults with alcohol and other drug (AOD) disorders who receive health care through private and/or public sector health plans (McCorry et al. 2000). In 2002, CSAT, aware of the need to improve access and quality of treatment for adolescents, supported the Washington Circle in the establishment of a special subcommittee focused specifically on adolescent treatment issues. This article introduces the work of the Washington Circle and describes the Adolescent Subcommittee's progress in developing performance measures for the treatment of adolescents with substance use disorders.