1. Cricket Mitchell, PhD CIMH Evaluation Consultant
CiMH Palette of Measures
Evaluation Training: Revised Child Anxiety and Depression Scale (RCADS)
Cricket Mitchell, PhD
CIMH Evaluation Consultant
Palette of Measures Evaluation Training: RCADS

2. Palette of Measures Evaluation: What You Will Need (slide 1 of 2)
Palette of Measures Data Entry Shell v2 (Excel file)
Developed by CiMH and customized for each participating agency
Holds all data for clients served thru the Palette of Measures project
Demographics, service delivery information, pre- and post- outcome measure data
Palette of Measures Data Dictionary v2 (Word document)
A guide for using the associated data entry shell
Defines each column in the excel file
Palette of Measures Evaluation Training: RCADS

3. Palette of Measures Evaluation: What You Will Need (slide 2 of 2)
Outcome measures from the two-pronged approach
General Outcome Measure
Target-Specific Outcome Measure(s)
For example…
Revised Child Anxiety and Depression Scale (RCADS)
In the public domain, no fee for use
Palette of Measures Evaluation Training: RCADS

4. Overview of Training
Brief Overview of Palette of Measures evaluation protocol
Revised Child Anxiety and Depression Scale (RCADS): Target-specific measure when the focus of treatment is anxiety
Administration
Scoring
Clinical Utility
Instructions for Palette of Measures data entry and data submissions
Data entry: RCADS
Data entry: Demographics & Services
Data submissions to CiMH
Palette of Measures Evaluation Training: RCADS

5. Brief Overview of Palette of Measures Evaluation Protocol
Palette of Measures Evaluation Training: RCADS

6. Outcome Assessment
Palette of Measures providers will track outcomes using data from pre- and post- administrations of standardized measures of functioning
Pre- and Post- a “dose” of treatment / an intervention interval
General measure of youth mental health functioning (e.g., YOQ/YOQ-SR, CANS, Ohio Scales)
Target-specific measure linked to focus of treatment/intervention (e.g., AQ, ECBI, PHQ-9, PTSD-RI, RCADS)
Providers may choose to administer mid-course assessments as well
e.g., at 3-month intervals in usual care
Palette of Measures Evaluation Training: RCADS

7. A note about the use of standardized assessment measures… (slide 1 of 2)
Assessment is the beginning of developing a relationship with the child and family
Demonstrates a desire to know what the child and family are experiencing
By incorporating standardized assessment measures of functioning, the efficiency and thoroughness of assessment is enhanced
Palette of Measures Evaluation Training: RCADS

8. A note about the use of standardized assessment measures… (slide 2 of 2)
Using standardized assessment measures of functioning…
Assists in initial clinical impressions
Provides valuable information to guide treatment/interventions
Assesses sufficiency of treatment delivered
Demonstrates treatment-related improvements in child functioning
Palette of Measures Evaluation Training: RCADS

9. Revised Child Anxiety and Depression Scales (RCADS)
Palette of Measures Evaluation Training: RCADS

10. CIMH RCADS Training
Information on the RCADS and RCADS-P was obtained from:
Psychometric properties of the Revised Child Anxiety and Depression Scale in a Clinical Sample (Bruce Chorpita, Catherine Moffitt, & Jennifer Gray; Behaviour Research and Therapy, 2005)
A psychometric analysis of the Revised Child Anxiety and Depression Scale – Parent version in a clinical sample (Chad Ebesutani, Adam Bernstein, Brad Nakamura, Bruce Chorpita & John Weisz; Journal of Abnormal Child Psychology, 2010)
A psychometric analysis of the Revised Child Anxiety and Depression Scale – Parent version in a school sample (Chad Ebesutani, Bruce Chorpita, Charmaine Higa-McMillan, Brad Nakamura, Jennifer Regan, & Roxanna Lynch; Journal of Abnormal Child Psychology, 2010)
Palette of Measures Evaluation Training: RCADS

11. RCADS and RCADS-P
Please refer to the UCLA Child First website periodically for updated materials
e.g., a User’s Manual was released and posted on this website Feb 2, 2011
Palette of Measures Evaluation Training: RCADS

12. RCADS and RCADS-P Description
Target-specific measure when the focus of treatment is anxiety
Measures the current frequency of anxiety symptoms (and depression)
Parent/caregiver report for ages 6-18
Child self-report for ages 6-18
Valid and reliable
Available in the public domain, provided to partnering agencies by CiMH 12 12

13. RCADS and RCADS-P Description
Parallel versions of the same measure
47 items
4-point Likert scale response options
Never (0)
Sometimes (1)
Often (2)
Always (3)
Six Scale Scores
Separation Anxiety
Generalized Anxiety
Panic
Social Phobia
Obsessions/ Compulsions
Depression
Total Anxiety Score
Total Anxiety and Depression Score 13
TFCBT Evaluation Training 13

14. RCADS and RCADS-P Administration
Administer pre- and post- a dose of treatment, or an intervention interval
RCADS completed by client
RCADS-P completed by mother/mother figure or father/father figure (when available)
Both can be completed for clinical purposes; however, only one should be entered for outcome tracking purposes
Select parent/caregiver who spends most time with client
Palette of Measures Evaluation Training: RCADS

15. Let’s take a look at the RCADS...
Palette of Measures Evaluation Training: RCADS

16. RCADS and RCADS-P Administration
Approximately 5-10 minutes to complete
Youth are asked to report how often each item applies to them (“...how often each of these things happen to you?”)
Parents/caregivers are asked to report how often each of these items applies to their child
Can be read aloud if desired/necessary
Palette of Measures Evaluation Training: RCADS

17. RCADS and RCADS-P Administration
Encourage honest responses
Informants can easily be influenced by the attitude of the person administering the scale
Let respondents know that this questionnaire will help you, as a clinician, better understand how they are doing and how you can best help them
There are no right or wrong answers
Encourage responses on all items
Palette of Measures Evaluation Training: RCADS

18. RCADS and RCADS-P Scoring
RCADS and RCADS-P Scoring Worksheet
Appropriate for entire age range of 6-18
For each Scale, transfer the values associated with the child or parent’s responses next to the appropriate Question #
Sum the values to determine each Scale score
To obtain the Total Anxiety Score:
Sum the Separation Anxiety, Generalized Anxiety, Panic, Social Phobia, and Obsessions/Compulsions Scale Scores
To obtain the Total Anxiety and Depression Score:
Sum all Scale scores
Palette of Measures Evaluation Training: RCADS

19. RCADS and RCADS-P Scoring
Excel Scoring Programs
Appropriate for children in grades 3-12
Should not be used to score RCADS or RCADS-P measures for children younger than grade 3
Available from UCLA Child First website
Enter the values associated with the child or parent’s responses next to the appropriate Question #
Scale Scores and Total Scores will automatically be calculated
T Scores are also generated
Palette of Measures Evaluation Training: RCADS

20. RCADS and RCADS-P Score Interpretation
T Score Interpretation for children in grades 3-12
T Scores are standardized scores that have a mean (average) of 50 and standard deviation of 10
Automatically generated by UCLA Child First excel scoring programs; also available in User’s Manual
RCADS and RCADS-P
T Scores > 65 are borderline clinically significant
T Scores > 70 are clinically significant
Palette of Measures Evaluation Training: RCADS

21. RCADS and RCADS-P Score Interpretation
Raw score interpretation for children younger than grade 3
**T Scores conversions have not yet been developed for children younger than grade 3**
Use clinical judgment in evaluating raw scores
What is the possible range of scores for this particular scale or total score?
Is this child’s score closer to the high end of the range? Or closer to the low end of the range?
Out of the total number of items assessed on this scale or within this total score, what proportion are endorsed at a 2 (“often”) or 3 (“always”)?
Palette of Measures Evaluation Training: RCADS

22. Clinical Utility of the RCADS
Provides both child self-report and parent/caregiver report of the same set of symptoms
Whenever possible, gathering information on the same construct from multiple informants is recommended
However, research has demonstrated little concordance between child self-report and parent-report (not specific to RCADS)
Disagreement should be viewed as different, yet equally valid perceptions of youth problems
Palette of Measures Evaluation Training: RCADS

23. Clinical Utility of the RCADS
Explicitly designed to assess symptomotology associated with current diagnostic systems
Each scale includes items that correspond to selected DSM-IV anxiety disorders
Separation Anxiety Disorder
Social Phobia
Generalized Anxiety Disorder
Obsessive-Compulsive Disorder
Panic Disorder
Also includes a scale for DSM-IV Major Depression
Palette of Measures Evaluation Training: RCADS

24. Clinical Utility of the RCADS
For children grades 3-12, T Scores at or above the clinical threshold (70) or borderline clinical threshold (65) indicate that the child is experiencing anxiety-related symptoms that are most similar to children who meet diagnostic criteria for that particular disorder or syndrome (e.g., social phobia, generalized anxiety)
Palette of Measures Evaluation Training: RCADS

25. Clinical Utility of the RCADS
Assesses symptoms associated with a range of DSM-IV anxiety diagnoses
Assists in initial clinical impressions and diagnostic formulations
Provides valuable information to guide treatment/interventions
Comparisons of pre/post scores reveal treatment-related improvement in child anxiety
e.g.,
Does the severity of diagnostic-specific anxiety symptoms decrease substantially?
Palette of Measures Evaluation Training: RCADS

26. Palette of Measures Data Entry and Data Submissions
Palette of Measures Evaluation Training: RCADS

27. Palette of Measures Data Entry Shell
There is a separate spreadsheet in the excel workbook (aka database) for each type of data:
Demographics & Services
Pre- General outcome measure
Post- General outcome measure
Pre- Target-specific measure(s)
Post- Target-specific outcome measure(s)
Specific outcome measure spreadsheets included in each agency’s database varies across Palette of Measures project participants
Palette of Measures Evaluation Training: RCADS

28. Palette of Measures Data Entry Shell
In addition to the spreadsheets that hold data...
There is an Instructions spreadsheet
Basic data entry instructions
Contact information for T.A. (Cricket Mitchell)
There is a Data Lists spreadsheet at the end of the workbook that you will not use
Data Lists populate the pull-down menus in other spreadsheets
Palette of Measures Evaluation Training: RCADS

29. Palette of Measures Data Entry: RCADS
Pre-RCADS
PARENT/CAREGIVER REPORT: (ages 6-18)
Date of
RCADS-P (Raw Scale and Total Scores)
Client ID#
Assessment
P-Sep1
P-Gen1
P-Pan1
P-Soc1
P-OC1
P-Dep1
P-TotAnx1
P-TotAnxDep1
There is a separate spreadsheet for Pre-RCADS data, Post-RCADS data, and Mid-RCADS data
In each spreadsheet, there is a separate field for each of the Raw scores for all Scales, Total Anxiety, and Total Anxiety & Depression for both informants
In the event of missing data, please leave fields blank/empty
LA PEI MAP Evaluation Training: RCADS

30. Palette of Measures Data Entry: RCADS
Mid-RCADS
PARENT/CAREGIVER REPORT: (ages 6-18)
Date of
Assessment
RCADS-P (Raw Scale and Total Scores)
Client ID#
Interval P-
SepM
GenM
P-PanM
SocM
OCM
P-DepM
P-TotAnxM
P-TotAnxDepM
For agencies who will conduct mid-treatment assessments, indicate the Assessment Interval in the Mid-RCADS spreadsheet by selecting from the available pull-down menu
e.g., 1st mid-treatment assessment, 2nd mid-treatment assessment
Palette of Measures Evaluation Training: AQ

31. But, before you enter any outcome data, you’ll enter Demographics & Service Delivery Information...
Palette of Measures Evaluation Training: RCADS

32. Palette of Measures Data Entry: Demographics & Services (1 of 2)
Client Information: 
Primary
(DSM-IV code)
Client ID#
DOB
Gender
Ethnicity
Language
Primary Axis I
Secondary Axis I
Therapist ID
Use a unique identifier for Client ID#
Categorical variables will have pull-down menus from which you’ll select an option (e.g., gender, ethnicity, language)
Dates should be entered as xx/xx/xxxx
Axis I diagnoses s/b the numeric DSM-IV code
Therapist ID is optional
Palette of Measures Evaluation Training: AQ

33. Palette of Measures Data Entry: Demographics & Services (2 of 2)
Focus 1 of Treatment
Date of
Total #
Completed
(if Focus 1 not completed)
(if Services not completed)
Focus1
First Session
Last Session
of Sessions
Focus 1?
Reason
Services?
Select Focus from pull-down menu (e.g., anxiety, depression)
The shell will hold data for up to 4 foci, or treatment targets
Enter Date of First Session
The remaining fields are to be completed at the end of treatment targeting this particular focus (e.g., Date of Last, # Sessions)
2 levels of “Completed?”
Treatment targeting this particular focus
Overall service delivery
Palette of Measures Evaluation Training: AQ

34. Palette of Measures Data Submissions (slide 1 of 3)
Data submissions to CiMH will occur twice a year throughout the duration of the project
The end of each May (reflecting all clients served from the initiation of the project through the end of that April)
The end of each December (reflecting all clients served from the initiation of the project through the end of that November)
Note that this is the anticipated schedule; actual data submission dates may vary slightly
An notice will be sent to Palette of Measures site leads approximately one month in advance of each data submission deadline
Palette of Measures Evaluation Training: RCADS

35. Data Submissions (slide 2 of 3)
Providers may choose from among the following methods for submitting their Palette of Measures Excel databases to CiMH:
Use YouSendIt, or another secure web-based transfer site, to submit data electronically
YouSendIt ( is a vendor that supports the secure transfer of electronic data (encrypted and password-protected)
Mail a password-protected CD to CiMH and submit the password separately (via or phone)
an encrypted, password-protected file(s) to CiMH and submit the password separately (via or phone)
Palette of Measures Evaluation Training: RCADS

36. Data Submissions (slide 3 of 3)
After data are submitted, sites continue to enter new data into the same database
Always reflects an ongoing, historical record of clients served through the Palette of Measures project
Every effort is made to distribute reports within two months of each data submission
Aggregate and site/agency-specific reports
Palette of Measures Evaluation Training: RCADS

37. Questions
Palette of Measures Evaluation Training: RCADS

38. The End
Contact Information
Cricket Mitchell, PhD
Cell phone:
Palette of Measures Evaluation Training: RCADS