Critical questions for any eating disorder treatment provider or facility:
“Is your treatment effective?”
“Are your clients getting better?”
“If so, how can you tell?”
At Columbus Park, we’re proud to report an effect size of 0.93 for the treatments that we’ve delivered between April 2015 and December 2021. As 2021 comes to a close, we want to tell you more about what that number means, why it’s so important to us (and our patients!), and why it’s worth seeking out evidence-based eating disorder treatment.
Measuring Outcomes Reliably
In behavioral health treatment, it’s common for providers — if they report outcomes at all — to report outcomes in terms of how satisfied patients say they are with treatment. But there isn’t clear evidence that patient satisfaction is actually a close match for treatment success. Patients might say that they feel satisfied without actually seeing any measurable improvement in their symptoms. For example, a patient might feel comforted by their work with a clinician, even if their disordered eating behaviors don’t improve.
To know that our treatments really are working as intended, we need standardized measures that show how symptoms change across the course of treatment. What’s more, we need to be able to compare our own patients’ results with the results of other patients who are experiencing similar challenges. That’s why we developed a tracking system designed to give us that information and help us tailor treatment to every patient’s unique needs and trajectory.
How We Measure Progress
At Columbus Park, we use a survey questionnaire from ACORN (A Collaborative Outcomes Resource Network) designed specifically for eating disorder patients. Patients answer eleven questions about the frequency of problems and symptoms at the beginning of each treatment session.
When the items on the questionnaires are viewed collectively, they provide a measure of what’s called global distress. Global distress is the factor common to virtually all patient self-report outcome measures used in psychotherapy, and it allows us to compare our data to ACORN’s database of over 750,000 cases.
ACORN then uses multivariate statistics to calculate projected change and what’s called effect size. Essentially, effect size is a measure of the effect of treatment. ACORN Criteria for Effectiveness (ACE) pegs a 0.5 effect size as the threshold for “effective” and 0.8 as the threshold for “highly effective.”
That means that Columbus Park’s effect size of 0.93 is well above the threshold for highly effective treatment. In other words, we know our treatment works.
Why Our Approach Works
There are three key reasons that we’re able to provide such effective treatment at Columbus Park:
- We tailor treatment to the data. Because patients complete the questionnaire at every treatment session and our clinicians review patient progress every week, we know right away if something’s not working. We’re able to adjust treatment immediately to make sure that patients are responding as intended and seeing steady improvement of their symptoms.
- We rely on evidence-based treatment models. We only use structured treatments that are backed up by extensive research on their effectiveness, and we implement them with fidelity to the original treatment model.
- We’re committed to ongoing training and professional development. Our recruiting process for clinicians is rigorous, but what happens after hiring is just as important. All of our clinicians participate in ongoing training and consultation to ensure that they’re at the cutting edge of our field. Having such a committed team with deep expertise in eating disorder treatment makes our evidence-based models all the more powerful.
Whether you turn to Columbus Park or another reputable provider for your eating disorder treatment, know that results matter — and that they are measurable. Be sure to ask about the evidence base for your treatment and the practice’s process for tracking outcomes.
Columbus Park’s Outcomes Tracking Tool
- The System: Columbus Park works with a consulting and data analytics firm, The Center for Clinical Informatics (CCI), to guide our outcome collection practices. CCI specializes in the measurement of treatment outcomes for behavioral health care. CCI connected us to the ACORN clinical information system (ACORN Toolkit), a comprehensive clinical information system that contains outcome data for close to one million episodes of care and almost three million completed questionnaires. Use of this platform has been shown to improve treatment outcomes over time. (Brown, Simon, Cameron & Minami; 2015).
- The Questionnaire: To develop reliable questionnaires, ACORN uses an inventory of 394 items which have been tested and validated for use in behavioral health care. From these items, Columbus Park was guided in narrowing it down to 11 items/questions that relate to several different domains, including symptoms, social, functioning, risk, substance use, and therapeutic alliance. The final survey questionnaire consists of 11 questions about the frequency of problems and symptoms (e.g. “In the last week, how often did you feel preoccupied with your shape and/or weight? 0 = Never; 1 = Hardly Ever; 2 = Sometimes; 3 = Often; 4 = Very Often”). The questionnaire is delivered on a tablet computer at the beginning of each treatment session. When the items on the questionnaires are viewed collectively, they provide a measure of what’s called global distress.
- Global Distress: Global distress is the factor common to virtually all patient self-report outcome measures used in psychotherapy, and it allows Columbus Park data to be compared against a database of over 750,000 cases. Multivariate statistics are used to calculate projected change and what’s called the severity adjusted effect size. Essentially, effect size is a measure of the magnitude – or size – of the treatment effect. ACORN Criteria for Effectiveness (ACE) sets 0.5 effect size as the threshold for “effective” and .8 as the threshold for “highly effective” treatment.
If you or a loved one is struggling with an eating disorder, please reach out to our team at firstname.lastname@example.org to discuss treatment options, including our comprehensive DBT-ED.