evaluating personal change

evaluating personal change

During a recent meeting with one of our grant partners, we learned (among other things) about a new tool mental health and substance abuse practitioners can use to measure how well their clients are functioning in the recovery process.

Understanding that how a person spends their time is a viable indicator to mental and physical health, the DLA-20 (Daily Living Assessment) was created and is now recommended by the National Council for Behavioral Health.

The DLA-20 is a brief functional assessment tool for individuals ages 6 years and older, regardless of diagnosis, disability, or cultural background.  It provides a 30-day snapshot of behavior in 20 activities of daily living by considering the following 10 areas:

  1. Health practices
  2. Household stability
  3. Communication
  4. Safety
  5. Managing time
  6. Nutrition
  7. Relationships
  8. Alcohol and drug use
  9. Sexual health and behavior
  10. Personal care and hygiene

Take a look at a handout of the assessment tool here.

There are 5 major benefits to using the DLA-20:

Consistency - standardized with definitions and qualifiers for scoring makes it easier for different people to rate a client the same over time

Sensitivity - every person is different, even if they struggle with the same problems DLA-20 ensures that a client’s unique factors are not lost in the measure and the assessment is accurate

Relevance – a treatment plan created based on client ratings relevant to what the client needs specifically

Customized - services offered to clients are not based just on a diagnosis – they are based on their DLA-20 ratings to focus on the areas they need the most help in

Outcome-Driven – using this tool effectively helps document a clients’ real improvement through repeated measurement

By assessing how well a person functions in specific areas, a practitioner can develop a treatment plan centered around any key difficulties. Setting specific improvement goals, such as taking medications as prescribed or improving nutrition, and working with the client periodically to measure improvement, a practitioner can understand how their client is doing and use the information for coaching and motivation. This practice, overall, is in the field of measurement-based care or MBC.

DLA-20 is among a limited number of rating scales that provide a more standardized way of measuring improvement in a field that has previously struggled to quantify the improvement in ways other than by the provider’s judgement. In other words, the “judgement” measure would be equivalent to treating high blood pressure without using a blood pressure cuff to measure whether a specific treatment is effective.

Insurers, payers, and funders can see demonstrated value in the services provided by clinics, healthcare systems, and community-based services such as counseling programs and case management.

In 2020, Chrysalis will employ “results-based accountability” in our community grants programs, so that we can measure the results of our grant investments. This type of measurement is similar – but not equivalent - to measurement-based care, in that its focus is organizational practice, rather than “symptom” or “behavior” ratings.

Knowing that our grant partners in fields of mental health, substance abuse, and disability (safety, security) are also using DLA-20 to document the success of their services, Chrysalis better understands their effectiveness in improving the lives of girls and women.