Our Clinical Outcomes Platform

The YOQ has 6 domains of functioning or subscales. Each subscale is added up cumulatively to provide an overall composite score. The overall composite score provides the most holistic and accurate data on current functioning, however, subscales can be very useful in understanding growth throughout treatment. With all subscales, the higher the score, the more distress exists. The subscales are:

• Intrapersonal Distress (ID)- Measure of emotional distress within the child/adolescent. This can include issues of anxiety, depression, fearfulness, hopelessness, and self-harm.
• Somatic (S)- Measure of somatic distress. Soma refers to the body. Items address typical symptoms such as headaches, dizziness, stomachaches, nausea, bowel issues, and pain or weakness in joints.
• Interpersonal Relations (IR)- The purpose of this scale is to assess issues relevant to the adolescent’s relationship with parents, other adults, and peers. This scale captures the adolescent’s attitude toward others, communication, and interaction with friends, cooperativeness, aggressiveness, arguing, and defiance.
• Critical Items- This scale measures specific features that are typically associated with the residential level of care. Such as paranoia, obsessive-compulsive behaviors, hallucination, delusions, suicide, mania, and eating disorders. A high score on any single item should receive serious attention from the provider.
• Social Problems (SP)- This scale measures problematic behaviors that are socially related. Many items describe delinquent or aggressive behavior. Aggressive content found in this scale is of a more serious nature than the aggressiveness found in IR scale. This includes truancy, sexual problems, running away from home, destruction of property, and substance abuse. Items in this subscale are typically slow to change.
• Behavioral Dysfunction (BD)- This subscale assesses the adolescent’s ability to organize tasks, complete assignments, concentrate, handle frustration including times of inattention, hyperactivity, and impulsivity. This is similar to a measure of Executive Functioning.

There are two versions of the YOQ used at Embark. The YOQ-SR (Self Report) is completed regularly by the client in treatment at our program. The YOQ 2.01 is completed by parents/caregivers. It is the same instrument with the same questions but asks caregivers to respond referencing their child.  Correlating the client’s and the parent’s responses can provide insight into how each member views the client’s stress and current progress. It provides insight into family alignment (is each member seeing the distress similarly?). It provides insight into programs on how the family system is responding to program interventions.

The Outcome Questionnaire is the adult version of the YOQ. Because it is designed to be used with an adult population, the subscales are different, but work similarly with each subscale added together to create an overall composite score, with the higher the score the more distress. The subscales are:

• Symptom Distress (SD)- This scale measures subjective (symptom) distress, most related to depression and anxiety.
• Interpersonal Distress (ID)- Includes items that measure satisfaction with, and problems with, interpersonal relations. Items in this scale deal with friendships, family, family life, and marriage, and include components of friction, conflict, isolation, inadequacy, and withdrawal in interpersonal relationships.
• Social Role (SR)- This is a measure of the client’s level of dissatisfaction, conflict, distress, and inadequacy in tasks related to their employment, family roles, and leisure life. These variables are highly related to overall life satisfaction but can exist somewhat independently of intrapsychic symptoms and subjective distress.

The Patient Health Questionnaire-9 is a subset of questions from the full Patient Health Questionnaire, using the 9 items that measure depression. The PHQ 9 has 9 items scoring each of the 9 DSM V depression criteria. This instrument is primarily used to monitor the severity of depressive symptoms and their response to treatment. This instrument also contains a direct safety assessment item which can give an immediate indication of some risk for suicide.  The higher the score the greater likelihood of depression, and the more severe the depression. This instrument is only administered to the client in treatment.

The Family Interaction and Communication Scale is a proprietary instrument that is designed to measure client interaction patterns and overall communication. The items ask each client, along with caregivers, to rate their relationship and interactions with each other. The utility of the FICS is in comparing the specific items between each member of the family. This instrument can facilitate the assessment of family roles, relationship structures, alliances, and alignment between the families. It is given throughout treatment to track each member of the family’s perception over time. In adolescent programs, this is also where the client and caregivers (parents) rate their progress on Master Treatment Plan goals.

The FICS-S (self) is the client version. The FICS- P (Parent) is you guessed it, the parent version.

The Client/Parent Engagement and Satisfaction Questionnaire is a standardized instrument measuring client and family satisfaction with the program. We believe that seeking parent involvement and agreement with our individual program's approach is highly important for the best outcome for the student. It asks a set of five questions that align with the treatment team plus the Ultimate Question (“Would you recommend this program to a friend”). The five treatment team questions fall into these categories:

• Clinical
• Medical
• Front-line Staff
• Experiential
• Academic

Every question is based on a ten-point scale and will be scored according to the NPS scale. With this, we will be able to measure parent satisfaction and engagement as well as better predict client and family alignment with the program.