Objective Behavioral Measurement

• Behavioral Assessment by C. F. Nelson, 5/29/96
  • Tell us more... by Steven Locke, MD, 6/3/96
    
    

Dr. Locke,

My Name is (Mr.) Corliss Nelson, MSSW. Thank for your interest in this area. The scale that I have developed over the last six years was first used on an inpatient psychiatric unit. The scale was developed initially as a monitoring tool to indicate change, either positive or negative, in patient behavior over the course of the hospital stay. It became apparent that because a numerical value was used on each point in the scale, the scale could be used not only to monitor, but also measure change. It was therefore useful in itself as a short term goal for desirable behavior. How this works will become apparent later.

One of my primary goals in developing this scale was to make it very understandable and easy to use - with a special emphasis on easy to use.

In a nutshell, the scale measures behavior using ten widely accepted milestones that indicate improvement or change in behavior. The first three categories are used for patients in crisis. These patients are unable to attend groups or activities because their illnesses render them incapable of benefiting from them. Categories 4-10 are for those patients who have stabilized and are able to receive benefit.

It is very important to understand from the beginning that this scale was not designed to measure the achievement of goals or to indicate an increase in awareness of some personal issue. It is an objective scale that monitors the level of social functioning in the broadest terms. As the patient improves and is helped by professionals to sort out difficulties, there should be a corresponding increase in the level of participation in groups and activities, i.e., social functioning. It is this behavior that is observed.

The scale is able to monitor all situations that may be encountered in an activity or group setting, including unexcused absences, being called out of a meeting for an appointment, leaving a group early, etc. It can also indicate whether a group occurred as scheduled.

Most of the categories in the scale have withstood the scrutiny of mental health professionals. Categories 9 and 10 which indicate good social functioning change depending on the setting in which the scale is used. Also, for example, the first three categories are generally not used in outpatient or residential settings.

I have purposely avoided mentioning the actual categories so that you can first reflect on the concept. I would be curious to get your reaction and also reactions from any other interested person.

Thank you

• Inpatient behavior scale by Steven Locke, MD, 7/3/96