title: Change what? Identifying quality improvement targets by investigating usual mental health care.
abstract: Efforts to improve community-based children's mental health care should be based on valid information about effective practices and current routine practices. Emerging research on routine care practices and outcomes has identified discrepancies between evidence-based practices and "usual care." These discrepancies highlight potentially potent quality improvement interventions. This article reviews existing research on routine or "usual care" practice, identifies strengths and weaknesses in routine psychotherapeutic care, as well as gaps in knowledge, and proposes quality improvement recommendations based on existing data to improve the effectiveness of children's mental health care. The two broad recommendations for bridging the research-practice gap are to implement valid, feasible measurement feedback systems and clinician training in common elements of evidence-based practice.
authors.affiliation: University of California-San Diego, 3020 Children's Way, San Diego, CA, 92123, USA. agarland@ucsd.edu
authors.forename: Ann F
authors.initials: AF
authors.lastname: Garland
authors.forename: Leonard
authors.initials: L
authors.lastname: Bickman
authors.forename: Bruce F
authors.initials: BF
authors.lastname: Chorpita
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000592:standards / Q000639:trends*; D002648:Child; D002662:Child Health Services / Q000592:standards / Q000639:trends*; D003156:Community Mental Health Services / Q000592:standards / Q000639:trends*; D055317:Evidence-Based Practice / Q000639:trends; D005196:Family Therapy / Q000639:trends; D005544:Forecasting; D006301:Health Services Needs and Demand / Q000639:trends; D006302:Health Services Research / Q000639:trends; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000639:trends; D011613:Psychotherapy / Q000639:trends; D011785:Quality Assurance, Health Care / Q000639:trends*; D016896:Treatment Outcome; D014481:United States