A Practitioners's Guide to the ALERT System
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Published: October, 2001
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The Required Data Set
Patient Self-Report Tools
WHAT: PBH utilizes two patient self-report instruments
for monitoring clinical change: the Life Status Questionnaire
(LSQ) for adults (18 and over) and the Youth Life Status
Questionnaire (YLSQ) for children and adolescents. The YLSQ
can be completed by the parent (generally for children under
12) or by the adolescent. Higher scores reflect higher levels
of distress, and so treatment generally lowers scores on
these tests.
WHEN: Administer for all outpatient episodes prior
to the first, third, and fifth sessions, and then in increments
of five, at sessions 10, 15, 20, and so on. (Note: the questionnaires
can be administered prior to every session if the clinician
desires.)
WHY: The Y/LSQ are assessment tools sensitive to
changing levels of symptomatic distress for patients in
behavioral health treatment. Frequent administration in
the first five sessions is intended to detect patients with
a clinical profile suggesting risk for suicide or chemical
dependency. In addition, the Y/LSQ can detect patients at
high risk for prematurely terminating treatment due to escalating
levels of distress (generally 10% of a treatment population).
In the case of longer episodes of care for more complex
conditions, administration every 5th session is necessary
to monitor clinical risk. PBH seeks to ensure throughout
each episode of care that patients receive the appropriate
intensity and types of clinical services.
HOW: It is best to use a black pen or a soft pencil
when completing the form, and the circle should be darkened
completely rather than checked. It is helpful to educate
patients on the value of completing the Y/LSQ. An important
element of that education would include a quick review of
the patient's responses in the session, always including
a review of the critical items related to risk. What about
the resistant patient? We would never suggest that you force
someone to complete a form when they are firmly opposed,
but we usually find that there are two reasons people resist
completing them. They often have mistaken ideas about how
the form is used, and secondly, they refuse when they perceive
that the clinician does not value the process. If you convey
that these brief assessment tools can help you track progress
together, most people are willing to complete the forms.
WHO: When a patient has multiple providers for medication
monitoring and psychotherapy, each provider may utilize
the Y/LSQ. However, we request that the Y/LSQ always be
administered by the psychotherapy provider.
Provider Assessment Report (PAR) &
Telephonic Review
The PAR is a one-page assessment form completed by
the clinician following the initial treatment sessions authorized
at intake, designed to provide PBH with data on clinical severity
and risk from the practitioner's perspective. When a treatment
episode requires more visits than authorized upon PAR review,
psychotherapists should initiate telephonic review with a
PBH Outpatient Care Manager. Prescribing practitioners have
two choices: 1) submit a new PAR for ongoing medication management,
or 2) call PBH for a brief telephonic review.
Y/LSQ and PAR data are preferably faxed to (800) 992-2809
with no fax cover sheet, or if necessary, mailed to the
PBH regional office. PARs can be submitted online by providers
with a Web
ID.
Please Note: The most critical information
on these forms for administrative purposes is the Reference
ID - Suffix. Please be sure this number is correct.
Your patient is given this number at the time of the initial
call to PBH, and it is identified prominently on the authorization
form sent to your office.
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