If you would like to receive copies of the bibliographies below, please email Deirdre.Hiatt@mhn.com. EMPLOYEE ASSISTANCE PROGRAM (EAP) and Psychotherapy Outcomes Schwartz, J., Hiatt, D., Hargrave, G.E., and Shaffer, I. (2007). Improving Aftercare Effectiveness. Behavioral Healthcare, 27(4), 32-34. This article describes the results of a short structured phone interview about follow-up after psychiatric discharge with 20 high volume facilities. Several reported differences were found between facilities that had high vs. low rates of followup after discharge. abstinence; therapist recommendation of a 12-step program was related to patient attendance. Based on the data, as well as other literature, the organization has accepted outpatient treatment as an appropriate level of care. Hargrave, G. E. and Hiatt, D. (2000). Incorporating Psychiatric Practice Success: Treatment records. Behavioral Health Accreditation & Accountability Alert, 5(11), 1. Treatment record documentation is important for risk management, continuity of care, and effective treatment. This article discusses research finding a correlation between adequacy of documentation as rated by peer reviewers and patient-rated outcome. In addition, it describes a program for improving documentation that has resulted in a steady increase in the percentage of providers whose records meet standards. Hargrave, G.E. and Hiatt, D. (2005). The EAP Treatment of Depressed Employees: Implications for Return on Investment. Employment Assistance Quarterly, 19(4), 39-49. This article applies calculations from the outcome literature on lost productive work time to the EAP treatment of depressed employees. Pre and post-treatment measures were obtained on 11,756 employees who accessed treatment over a seven-year period. 66% of these employees reported at least moderate symptoms of depression at the time of intake. After treatment, approximately half of the depressed subjects reported no such symptoms. Applying results from research conducted by Stewart, Ricci, Chee, Hahn, & Morganstein (2003) to the present study indicated substantial cost savings associated with the EAP treatment of depression. The article provides a model for calculating return on investment (ROI) by reducing lost productive work time (LPT). Hiatt, D. and Hargrave, G. E., (2001). Data indicate encouraging outcomes for office-based services. Alcoholism & Drug Abuse Weekly, 13(5), 4-5. This article describes a 2-year follow-up of patients who received office-based outpatient treatment for substance abuse. About half the patients reported being clean and sober in the 90 days before a telephone interview. Attendance at 12-step programs was the primary factor relating to Hiatt, D. (1999). Data collection. Outcomes & Accountability Alert, 4(10), 1, 10-11. This article describes an outcomes measurement program developed for the Iowa Community Mental Health Centers. The results of two of the centers are presented, showing a high level of overall satisfaction with treatment. The centers have found the program useful in demonstrating positive outcomes to payers and improving the quality of services. Hiatt, D., Hargrave, G. E, and Palmertree, M. (1999). Effectiveness of job performance referrals. Employee Assistance Quarterly, 14(4), 33-43. Supervisors who referred employees to an EAP rated job performance elements as significantly improved after treatment. Attendance was the job element rated lowest before EAP services and showed the greatest improvement of all reported job elements. Significant improvement was found for behavior/conduct, quality and quantity of work, and interpersonal relationships. The EAP therapists also rated job performance functioning as having improved. Consistent with findings in previous studies, those who received job performance referrals were more likely than the self-referred to be male and to have substance abuse and occupational problems. Supervisors rated the EAP services very highly.
Hargrave, G. E. and Hiatt, D. (1998). Developing a behavioral healthcare provider profiling system. In C. E. Stout and G. A. Theis (Eds.), The Complete Guide to Managed Behavioral Healthcare. New York: John Wiley & Sons, Inc. This book chapter describes the MHN system of profiling behavioral healthcare service providers. It examines the recent emphasis on demonstrated effectiveness of treatment. It then describes the procedures used in developing the profiling system, focusing on measures of efficiency (timeliness in scheduling appointments, completion of paperwork, average number of sessions utilized) and effectiveness (patient satisfaction, degree of problem resolution). Finally, the uses of provider profiles are discussed. Hiatt, D. and Hargrave, G. E. (1997). Quality and the bottom line: Do shareholders really have a different agenda. Behavioral Healthcare Tomorrow, June, 48-52. This article focused on the delivery of managed behavioral healthcare from a researcher s perspective. It notes that market forces require companies to demonstrate that their programs have added value. This emphasis on quality has necessitated the development of large-scale research programs to demonstrate treatment effectiveness. Outcome research that was formerly the domain of academic settings, and consequently did not always generalize to clinical practice, has now become much more applied. This benefits both shareholders and stakeholders. Hiatt, D. and Hargrave, G. E. (1995). Characteristics of highly effective therapists in managed behavioral provider networks. Behavioral Healthcare Tomorrow, July August, 19-22. This article describes MHN s response to the increasing requirements for managed behavioral healthcare plans to create report cards and adopt quantifiable approaches to quality management. The authors describe one aspect of their company s quality management program, which uses standardized assessments of client satisfaction, problem resolution, and appropriateness of care to identify highly effective therapists. This process has yielded useful results that indicate some of the characteristics of highly effective therapists in such areas as experience, gender, and personality type. Hargrave, G. E. and Hiatt, D. (1995). An analysis of outpatient psychotherapy quality improvement indicators. Managed Care Quarterly, 3(1), 1-3. Two studies investigated relationships among quality improvement indicators in a large outpatient mental health delivery system. Results showed patient satisfaction with treatment, good agreement between treatment outcome ratings by patients and therapists, modest agreement between patient satisfaction and problem resolution ratings, and a significant relationship between peer reviewer ratings of therapists and client satisfaction ratings. Although reflecting significant improvement, GAF ratings were not related to clients or therapists ratings of problem resolution. Overall, the studies support the use of these ratings in quality improvement programs and suggest directions for further research. Employment Assessments Hargrave, George E. (2001). Risk assessment of workplace violence: Ethical and procedural issues in evaluating employees. Journal of Threat Assessment, 1(2), 1-20. Mental health professionals are frequently called upon to assess employees whose behaviors are seen as posing threats of workplace violence. This article discusses the ethical and procedural issues involved in these evaluations. It addresses legal-ethical concerns associated with determining risk, the impact of assessment decisions on the employee s job, requirements of relevant employment law, and with communicating results to others. Since workplace risk assessment frequently involves the potential of targeted violence, the procedures are discussed within the U.S. Secret Service framework for analyzing targeted violence. Hargrave, G. E., Hiatt, D., Ogard, E. and Karr, C. (1994). Comparison of the MMPI and MMPI-2 for sample of peace officers. Psychological Assessment, 6(1), 27-32. One hundred sixty-six officers completed the MMPI and MMPI-2 in one sitting. Results showed an overall concordance of 78% for the two tests when normal, high-point, add two-point codetypes were grouped together and compared. A subset of well-defined profiles produced a concordance rate of 90%. Comparison of profile characteristics showed that
half of the subjects produced the same high-point, one- third produced the same two-point code, 70% produced normal profiles on both tests, and all MMPI and MMPI-2 scales were highly correlated. When the MMPI was compared to the MMPI-2 scored on original norms, two scales were found to differ significantly: Males and females both scored lower on scale D of the revised test; on scale Mf of the MMPI-2, females scored higher and males scored lower. Hiatt, D. and Hargrave, G. E. (1994). Psychological assessment of gay and lesbian law enforcement applicants. Journal of Personality Assessment, 63(1), 80-88. Psychological profiles and measures of law enforcement job performance were compared for gay, lesbian, and heterosexual samples. No differences were found in selection rates or ratings of job performance. Compared to heterosexual men, gay men scored higher on MMPI scale 5 and lower on CPI scales Wb and Sc. No significant MMPI or CPI differences were found for lesbian and heterosexual women. Hargrave, G. E. and Hiatt, D. (1991). A psychological skills analysis for fire fighters. California Fire Journal, July, 16, 34. This survey research was designed to identify psychological attributes that impair or enhance the job performance of firefighters. Forty-six supervisors from four fire protection agencies rated 72 behavioral descriptions for their impact on firefighter job performance. The results showed strong agreement among supervisors ratings. Various behavioral attributes were rated as contributing to job effectiveness (e.g., good social skills, emotional control, ability to achieve goals); likewise, several characteristics were identified as significantly interfering with job performance (e.g., immaturity, inflexibility, anxiety, poor interpersonal skills). Since the rated behaviors relate to dimensions assessed by psychological evaluation procedures, these results enable personnel selection psychologists to develop psychological profiles associated with firefighter job effectiveness. Hargrave, G. E. and Hiatt, D. (1989). Use of the California Psychological Inventory in law enforcement officer selection. Journal of Personality Assessment, 53 (2), 267-277. This research consisted of two studies which investigated the use of the CPI in law enforcement officer selection. The first study examined pre-employment profiles of academy graduates (N = 579), comparing subjects rated psychologically suited for law enforcement to those rated unsuited by training instructors. Graduates rated unsuited had significantly lower overall CPI profiles. The second study compared pre- employment CPI profiles of law enforcement officers who had experienced serious job performance problems (N = 45) to those of matched officer controls who had experienced no such difficulties. Officers with serious job problems scored lower on scales comprising Gough s Class II group of variables. Scales which primarily differentiated between the two officer groups were So, Sc, Wb and To. Results provide support for the use of the CPI as an effective addition to law enforcement selection procedures. Hiatt, D. and Hargrave, G. E. (1988). MMPI profiles of problem peace officers. Journal of PersonalityAssessment, 52(4), 722-731. The MMPI profiles of officers who had been involved in serious disciplinary actions were compared with those of a matched group of officers who had not been involved in such actions. A MANOVA found the profiles of the two groups to be significantly different, with scales F, 5, 6, and 9 being significantly higher and scale L significantly lower for the Problem group. In addition, subjects in the Problem group were twice as likely to have a high point elevation above T-score 70 as their Nonproblem counterparts. Overall, these results indicate that any degree of psychopathology, as reflected by MMPI profile elevations, increases the likelihood of serious job performance problems. In addition, a presentation of self as conventional and moderately defended is associated with a lesser likelihood of job difficulty, while such characteristics as hypersensitivity, impulsivity, and poor frustration tolerance contribute to significant job problems. Hargrave, G. E. and Hiatt, D. (1988). F+4+9+Cn: An MMPI measure of aggression in law enforcement officers and applicants. Journal of Police Science and Administration, 16(4), 268-273. The sum of MMPI scales F, 4, 9, and Cn was investigated as an index of aggression in law enforcement applicants and officers. A discriminant function analysis was performed
on 52 aggressive applicants (two fights within the past two years) and 52 no-fight applicant controls, matched on age, sex, education, race/ethnicity, and military service. The index correctly classified 63% of the subjects (p <.05). Cross validation was conducted on a sample of 12 incumbent officers who had been disciplined for assaultiveness and 12 non-assaultive controls matched on the same variables in sample 1 with the addition of agency and date of hire. The discriminant score derived in the applicant sample correctly classified 75% of the cross-validation sample of officers (p <.01). For the two samples, 60% of the aggressive applicants and 67% of the aggressive officers were correctly identified; comparably, a respective 65% and 83% of the non-aggressive subjects were accurately classified. Hiatt, D. and Hargrave, G. E. (1988). Predicting job performance problems with psychological screening. Journal of Police Science and Administration, 16(2), 122-125. The pre-employment psychological screening decisions of suitability for law enforcement positions were compared for officers subsequently found to have either satisfactory or unsatisfactory job performance. Psychologists screening decisions were based upon the MMPI, CPI, and a semi-structured clinical interview. Results indicated that psychologists decisions accurately classified 69% of the sample, with the primary classification error being an incorrect designation of subjects as suitable who later performed in an unsatisfactory manner. Officers with unsatisfactory job performance scored significantly higher on scales 6 and 9 of the MMPI and lower on scale Ai of the CPI. Hargrave, G. E. and Hiatt, D. (1987). Screening law enforcement cadets with the MMPI: An analysis of adverse impact for blacks and Hispanics. Journal of Police and Criminal Psychology, 3(1), 14-20. The MMPI was investigated for adverse impact against blacks and Hispanics in a simulated employment selection procedure. Law enforcement academy cadets, who had received no pre-employment psychological screening, took the MMPI upon their first training day. The sample consisted of 184 males and 87 females with a mean age of 25.8 years. Twenty-five subjects were black; 35 were Hispanic; and the remainder were white. Two clinical psychologists conducted a blind sort of the profiles, judging each as acceptable or unacceptable for employment as a law enforcement officer. Significant agreement was found for clinicians judgments of suitability with no significant difference being found for either their overall acceptance rates or their acceptance rates of the different racial/ethnic groups. Also, there was no violation of the four-fifths rule. Analysis of variance found significant variability between groups on scales L and 6 (Pa) of the MMPI. Hargrave, G. E. and Hiatt, D. (1987). Law enforcement selection with the interview, MMPI, and CPI: A study of reliability and validity. Journal of Police Science and Administration, 15(2), 110-117. Psychologists decisions of psychological suitability, based on psychological test data alone, interview data alone, and test and interview data combined, were compared to performance criteria at the end of academy training. Criteria consisted of academy attrition and ratings of emotional suitability completed by training instructors and peers. Ninetyfive cadets who had not undergone psychological testing as a component of selection took the MMPI and CPI on the first day of academy training. Each was also interviewed by two psychologists. There was significant agreement between the two psychologists for ratings of test data, interview data, and test and interview combined. Predictions of suitability were most accurate when interview and test data were combined to predict the criteria. These results support the use of both psychological testing and interview data in making pre-employment selection decisions. Hargrave, G. E. (1987). Issues on psychological screening. California Peace Officer, September, 45-46. This article summarizes the presentation to law enforcement administrators at the November, 1986 conference of the California Peace Officers Association. It provides answers to the four most frequently asked questions by law enforcement administrators to staff of the California Commission of Peace Officer Standards and Training (POST). The questions answered were as follows: 1) Who is qualified to conduct pre-employment psychological screening of peace officers? 2) What is the typical disqualification rate of psychological screening? 3) What is job-relevant psychopathology referred to in the POST Standard? and 4) Does psychological screening discriminate against females or racial/ethnic minorities?
Hargrave, G. E., Hiatt, D. and Gaffney, T. (1986). A Comparison of MMPI and CPI test profiles for traffic officers and deputy sheriffs. Journal of Police Science and Administration, 14(3), 250-258. Psychological test profiles of 249 graduates from sheriff s department academies were compared with those of 442 highway patrol academy graduates. All were rated for emotional suitability by their training officers at the end of training. Both deputies and traffic officers appeared to be highly defended, energetic, dominant, well-adjusted, independent, spontaneous, socially ascendant, flexible, and free of anxiety. Deputies scored higher on qualities such as being more dominant, confident, and outgoing. Comparing officers rated high with those rated low suggested that effective deputies must be extremely sociable, outgoing, and gregarious while effective traffic officers reflect more a capacity for typical rewarding social relations. For both groups, scores suggestive of any degree of introversion were undesirable. The data suggest that agency requirements combine with self selection dimensions to obtain an optimal person-organization fit. Hargrave, G. E. (1985). Using the MMPI and CPI to screen law enforcement applicants: A study of reliability and validity of clinicians decisions. The Journal of Police Science and Administration, 13(1), 221-223. This article presents research which assessed the reliability and validity of clinicians test-based decisions using the MMPI or the CPI. Law enforcement academy cadets who had not undergone psychological testing as a component of selection were administered one of the tests on the first day of training. Three clinicians independently interpreted the test results for each cadet and rated his/her suitability for law enforcement work. The cadets were followed through training, and their performance was related to the clinicians ratings. For both tests, statistically significant results were obtained for the agreements on clinicians selection decisions and for their accuracy in predicting academy attrition and low ratings of psychological suitability by training instructors. The results obtained added support for the use of the MMPI and CPI in the selection of law enforcement officers. Hargrave, G. E. and Berner, J. G. (1986). A psychological skills analysis for California peace officers. The Police Chief, February, 34-36. This article reports the results of two large-scale surveys conducted by the California Commission on Peace Officer Standards and Training (POST). The first of these sought to determine the frequency of abnormal behavior among law enforcement officers and the impact that such behaviors had upon job performance. The second survey related psychological test interpretative statements to job performance. Supervisors from different types and sizes of law enforcement agencies throughout the state were systematically sampled. Results from the first survey indicated that there is a low incidence of abnormal behavior among law enforcement officers and that when such behaviors occur they detrimentally impact upon job performance. Differences in severity of impact were found for behaviors related to different psychiatric diagnoses. The results from the second survey described 14 psychological attributes, discussing how each contributed to job performance. Attributes discussed were: achievement, flexibility, sensitivity, maturity, intelligence, somatic concerns, mood, social adjustment, anxiety, emotional control, moral- ethical behavior, impression formation, and attitudes. GGWP-03 (01/08) 2008 MHN, Inc. All rights reserved.