Doing Better Therapy

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The Children’s Psychiatric Symptom Rating Scale (CPSRS)


The Children’s Psychiatric Symptom Rating Scale (CPSRS) is a tool designed to help investigators capture the judgements of clinicians and use them to improve the quality of patient care.  For years Four Winds has used rating scales to capture therapists’ judgements regarding the nature and severity of symptoms patients are experiencing both at admission and discharge.  This information has made it possible to track the effectiveness of treatment and form a more complete understanding of the problems experienced by people seeking treatment in this setting.  However, when Four Winds began treating pre-adolescent children it quickly became clear that existing rating scales, which had been designed with adults in mind, were no longer appropriate.  
In response, the Four Winds Hospital Psychological Assessment Service developed a rating scale that targets the problems most often seen in children seeking mental health services.  This rating scale was designed so that it could be used by any qualified mental health professional without requiring any additional specialized training.  The result was the CPSRS.  This user-friendly scale includes explicitly stated definitions of the problems being rated and clearly defined anchor points reflecting the severity of those problems. 
At the Annual Meeting of the American Psychiatric Association David L. Pogge, John Stokes, Derek Nagy and Philip D. Harvey presented a poster entitled “Capturing Clinical Judgements of Psychiatric Symptoms in Children: A Brief Scale for Research and Clinical Applications.”  This 
summarized a series of studies of the reliability and validity of the CPSRS.  To test the inter-rater reliability of the CPSRS, two raters independently rated patients’ symptoms on the basis of a review of their chart and a structured interview.  The high level of agreement in their ratings confirmed the reliability of this scale when ratings are based on the kind of information typically available to clinicians.  
To determine the validity of the CPSRS, ratings by staff clinicians of 200 child inpatients were correlated with other rating scales, information from medical records, and psychological tests.  The correlations of the CPSRS with these other variables confirmed its validity.  When the validity of the CPSRS was compared to that achieved with common research rating scales that require more extensive and specific training, the CPSRS appeared equally valid for all of the variables examined.
A reliable and valid rating scale is important in measuring the effectiveness of a treatment. Using such a scale offers 
clinicians the opportunity to quantify their observations and use this information to determine the effectiveness of 
treatment.  This study suggests that the CPSRS is a user-friendly, reliable, and valid rating scale that can be utilized by any 
appropriately trained mental health professional in clinical or research settings to capture clinical judgments concerning the most common psychiatric symptoms experienced by children.

Link to the Children’s Psychiatric Symptom Rating Scale: 

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