Assessing the need of young people using online counselling services: how useful are standardised measures?

Abstract

Clinical assessments for children and young people entering a mental health service help to identify the prevalence of need within that population, support intervention recommendations, and enable service evaluation. Evidence related to the use of standardised measures in an ever-expanding online environment, for the purpose of identifying need, is limited. This study explores the reliability of using a standardised measure to detect clinical need in an online therapeutic environment, and the measures assessed are as follows: Strengths and Difficulties Questionnaire (SDQ), Young Person's CORE (YP-CORE) and the Short Warwick and Edinburgh Wellbeing Scale (SWEMWBS). A deep-dive approach is used to inform practitioner assessment of young people, followed by a Weighted Cohen's Kappa (Κw) to measure the interrater reliability between this and the individuals' self-rated outcome. Composite case studies represent the complexities of presentation among the sample population. The interrater reliability between self-rated and practitioner rated assessment varied between Κw=.222 and Κw=0.446 depending on the measure. High levels of need and low levels of well-being were found among the sample (YP-CORE Avg.=26.9, SDQ Avg.=19.56, SWEMWBS Avg.=18.1). The findings demonstrate a fair to moderate reliability when assessing concordance between service users and practitioners, which suggests standardised measures are a reliable indicator of need. Higher levels of need were present than those seen previously in general or face-to-face clinical populations, which suggests using such measures in an online therapeutic environment influences the way in which assessments are responded to.