This article outlines strategies and tips providers can use with patients to address increases in symptom severity identified by measurement-informed care (MIC) surveys.
Strategies for responding to increases in symptom severity
Actively address symptom severity increases. A rise in self-reported symptom severity can be cause for concern for both providers and patients while simultaneously being a valuable and critical opportunity for exploration. It might signal issues outside of treatment like changes in health or life events, or it could indicate that the treatment approach or level of care being provided needs to be adjusted. In some cases, it may suggest an increased risk of danger to self or others, and the need to engage in further risk assessment and response. This may include conducting a structured risk assessment, creating a safety plan, adjusting or changing medications, or connecting the patient with emergency services (if clinically indicated).
Collaboratively determine next steps. Open communication is key to determining the next steps. The provider and patient should discuss what's working, and what's not, in treatment, using both symptom and therapeutic alliance scores to identify areas needing focus. This collaborative discussion aims to create a shared understanding of how to best meet the patient’s care needs moving forward. Adjustments may include modifying the treatment plan, adjusting medications, changing clinical approaches, or referring to a higher level of care.
Normalize shifts in care as a natural part of treatment. Treatment progress isn't always linear. It can often take time to find the right medication and dose. Patients (and providers!) may feel discouraged when symptoms worsen. However, educating patients that ebbs and flows in treatment are common, can be very helpful. Setting this expectation early in treatment helps patients understand that adjustments may be needed as treatment progresses to help them obtain symptom relief or achieve treatment goals. We're all complex, and our needs evolve – that's okay!
Key Takeaways
When we observe scores in measurement surveys increasing, the most important action is to collaboratively explore and address it. This is a valuable clinical opportunity to make any necessary adjustments to the treatment plan or services being provided, which ultimately is the best thing we can do for our patients.
Updated