Project Summary

PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.

This PCORI-funded implementation project is expanding the use of a system called TOP Match—shown to improve patient mental health outcomes—to connect patients with therapists based on therapists’ strengths.

Mental health centers often assign patients to therapists based on practical things like which therapist can see a patient first. But some therapists have more success in treating certain mental health concerns, like depression or substance use. Considering therapists’ strengths when assigning patients can help improve patient outcomes.

What is the goal of this implementation project?

TOP Match is a system that pairs current patients with therapists based on how well a therapist has treated patients with the same concerns in the past. A PCORI-funded research study found that patients paired with therapists through TOP Match had greater reductions in their primary mental health symptoms, less overall distress by the end of treatment, and more consistent treatment results than patients paired without using TOP Match.

This project is expanding the use of TOP Match to 62 mental health clinics in more than 30 states to improve care for patients with mental health concerns.

What will this project do?

In phase 1 of this project, the project team is putting TOP Match in place at nine clinics in Pennsylvania.

The project team is working with staff at these clinics to create report cards for therapists. These report cards rate therapists as effective, neutral, or ineffective in each of 12 mental health concerns like depression. The ratings are based on how much their past patients report improving on a routine measure called the Treatment Outcome Package, or TOP. Matching has different levels. For example, at the highest level, therapists have been rated effective on the patient’s three top concerns and not ineffective on other concerns.

Then, using the report cards, a coordinator is working with each new patient to select a therapist who is well matched.

At each site, the project team is also:

  • Training clinic staff on how to use TOP Match to assign therapists, using online materials and videos
  • Adding TOP Match to the electronic health record, or EHR, system for clinic staff to use to screen and assign patients
  • Working with champions at each site to promote the use of TOP Match among therapists and clinic staff
  • Providing support to the clinics as needed

In phase 2 of the project, the project team is using materials and lessons learned from phase 1 to expand TOP Match to 53 clinics in other states across the country. The team is helping these sites create new procedures to collect patients’ TOP data for use in matching. The team is also working with phase 2 clinics to train staff, add TOP Match to EHR systems, work with champions, and provide support.

To support further use of the TOP Match program, the project team is also:

  • Creating software that makes it easy for TOP Match to work with any EHR system
  • Updating online training materials for broader use

What is the expected impact of this project?

This project will demonstrate what’s required to put TOP Match in place at diverse mental health clinics. Clinics vary in terms of size, staff, and patients served. They are also located in all parts of the United States.

In phase 1 of this project, at least 140 therapists and 10,000 patients will use TOP Match. Phase 2 will reach at least an additional 700 therapists and 50,000 patients. The project evaluation will confirm that TOP Match works as intended to improve patient mental health symptoms.

More about this implementation project:

Stakeholders Involved in This Project

  • Refresh Mental Health
  • Outcome Referrals, Inc.
  • American Psychological Association
  • Depression and Bipolar Support Alliance
  • The Duke Endowment
  • North American Chapter of the Society for Psychotherapy Research
  • National Alliance on Mental Illness
  • Center for the Elimination of Minority Health Disparities

Implementation Strategies

  • Use clinical decision support
  • Adapt TOP Match components and protocols to work for sites’ existing resources and workflows
  • Integrate TOP Match into clinics’ existing EHRs to support report card generation as well as patient assessment, screening, and assignment
  • Provide sites with tools to support implementation, including scheduling software and guidance for EHR integration
  • Create and support a multidisciplinary implementation team at sites
  • Train clinic staff using web-based resources, including written materials and videos, to conduct the TOP assessments and to match patients to therapists
  • Use a phased implementation approach
  • Identify and prepare local champions at sites
  • Provide technical assistance to sites, including consultation
  • Partner with stakeholder organizations to develop plans for further program scaleup
  • Develop an implementation guide and information technology (IT) tools to support future use of TOP Match at other sites

Evaluation Outcomes

To document implementation:

  • Number of therapists with established report cards
  • Number of sites matching new patients
  • Fidelity of program delivery
  • Number of patients who complete the TOP assessment during the intake process
  • Number of patients matched with a therapist
  • Number of patients who accept the match recommendation
  • Number of patients who initiate treatment
  • Patient and therapist satisfaction

To assess healthcare and health outcomes:

  • Change in patients’ general impairment severity

Project Information

Michael Constantino, PhD
University of Massachusetts Amherst
$1,613,946
Implementing Outcomes-Based Matching of Patients to Mental Health Care Therapists' Strengths

Key Dates

March 2022
December 2027
2022

Initial PCORI-Funded Research Study

This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Matching Patients with Therapists to Improve Mental Health Care

Tags

Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Project Details Type
Last updated: March 15, 2024