Tracking Behavioral Progress Within a Children's Mental Health System

Abstract

In recent years, children's mental health agencies have been called on to demonstrate increased accountability for the services they provide. At the same time, the advent of managed care approaches to service provision for children and their families has placed increased emphasis on the use of outcome measures to monitor client progress as well as track system efficiency. In this article, we begin by discussing the role of behavioral adjustment as an outcome variable for children's mental health. Then, the Vermont Community Adjustment Tracking System (VT-CATS), which includes four behavioral instruments designed to provide intensive, ongoing, and interpretable behavioral assessment of a service system's most challenging children and adolescents, is described. Next, the adjustment indicator checklists that compose VT-CATS are described, including the rationale behind their development, structures, and psychometric properties. Finally, the ability of VT-CATS to address agencies' multiple evaluation demands is discussed, including examples of behavior tracking of individual clients, evaluation of the impact of an intervention, and the use of behavioral data to guide service system policy.