GPPRS Findings

    Outcome Assessment (Locke and Dornelas)
    • Behavioral Assessment by C. F. Nelson, 5/29/96
      • (...)
        • so, what are you finding? by Elaine Kersten, 2/8/97

    GPPRS Findings
    by C. F. Nelson, 2/8/97

    Dear Elaine,

    Thank you for your interest in Jeepers. My understanding of the scale’s value has been evolving for several years. I believe there is much to be observed and much to be learned from its use.

    As I believe I have said in some part of these web pages, and as you may have read, GPPRS was originally intended for inpatient psychiatric use. It is capable of measuring patient behavior from the point of significant disorientation to relative stability. It is a totally objective measurement. Everything that is learned is the result of objective observation. Jeepers has also been used successfully in a adolescent residential setting.

    Viewing patients in this way is quite revealing. Patients who behave erratically look erratic on a GPPRS graph. Patients who are withdrawn reveal a particular graphic pattern. Patients who choose not to attend groups are also revealing. We used to call them “flat liners” when looking at the graph because they received the same score of “4” across the graph.

    The essential value of this scale is in how the resulting data, viewed over time, can be analyzed to help focus and clarify treatment goals, and monitor improvement. The GPPRS can often reveal previously unrecognized patterns of behavior, which leads to more effective goal setting and treatment. Added to other observations and historical information gathered in behavioral treatment settings, the level at which a patient participates in group therapy in behavioral treatment settings gives important clues regarding: * motivation for, or resistance to treatment * orientation to, or awareness of surroundings * the degree to which a patient can tolerate or engage in activities with other patients * the degree of focus on somatic ailments * the degree of focus on medical ailments * possible problems with medication

    Important clues regarding progress of the patient during the group session can be observed, recorded and analyzed. The following are some areas of patient focus with the GPPRS in that setting: * ability to stay in the group for the whole session * ability to initiate appropriate conversation * ability to fit into group dynamics * ability to display insight, appropriate affect, and empathy

    Actual progress with the GPPRS can be monitored in two ways. The scale shows the number of groups attended and the level of participation in each group, by using a standard graph format as mentioned above. By initialing his/her name in the chosen box on the graph, the group facilitator simultaneously indicates the presence or absence of the patient in a group session, and the level at which that patient participates. If the patient does not attend the group, the facilitator initials a box that is lower on the scale. There are three levels of patient behavior that suggest group attendance is not appropriate, and one level that shows the patient would benefit from group attendance but has chosen not to attend. Finally, there are two levels that show a lack of attendance for reasons other than behavior and outside the control of the patient.

    I think the Jeepers scale may have value as a predictor of the rate of recidivism in both in inpatient and out patient settings. GPPRS has not been tested in a rigorous manner thus far. I am most interested to find someone who would be willing to put GPPRS under closer scrutiny.

    You mentioned, among other things, cultural differences. GPPRS is likely to be capable of revealing differences among cultural groups. This would be a most interesting study.

    Please respond with any other thoughts, questions, or concerns about the scale.

    Thanks again, Elaine, for your interest.

    C. F. Nelson


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