Integrity in Mental Health Systems: An Expanded Framework for Managing Uncertainty in Clinical Care
Article first published online: 22 MAR 2013
© 2013 American Psychological Association. Published by Wiley Periodicals, Inc., on behalf of the American Psychological Association.
Clinical Psychology: Science and Practice
Volume 20, Issue 1, pages 78–98, March 2013
How to Cite
[Clin Psychol Sci Prac 20:78–98, 2013]
- Issue published online: 22 MAR 2013
- Article first published online: 22 MAR 2013
- Manuscript Accepted: 18 DEC 2012
- Manuscript Received: 11 NOV 2012
- children's mental health;
- evidence-based treatments;
- service system;
- treatment integrity
This article presents a broad-based framework for evaluating integrity, defined as the structured comparison of observed values (i.e., what did happen) with expected values (i.e., what should happen), across various domains (e.g., practices, outcomes) for the purposes of informing key questions in system contexts (e.g., Is a practice being done properly? How well is it working?). We discuss the application of integrity in serving the goals of the scientific and service systems and potential sources for observed and expected values. An expanded framework regarding integrity analysis is presented detailing multiple domains of measurement (e.g., outcomes, activities, and resources), types of analysis (e.g., across vs. within units), and levels of analysis (e.g., event, episode, multi-episode). Other possible applications of integrity analysis in service systems and ongoing dissemination and implementation efforts are also discussed.