Monitoring Frequency of Client Problems

As a test of their validity, four methods for evaluating client aggregates, or caseloads, to determine frequency of psychosocial problems, were applied jointly. In the context of a small mental health agency planning to expand, client problems were assessed by soliciting staff estimates and client self ratings, comparing the psychometrically measured functioning of clients and controls, and tabulating problem reports from agency records. The methods were systematically implemented and rested on a common scheme for defining problems. Inter-method agreement was evaluated by testing the agreement between estimates of problems, and by comparing the rank orderings ofproblems. In both cases, five of six comparisons revealed inter-method disagreement. Also, comparison of the variance attributable to differences between problems, between methods, and error, showed methods to be a more important determinant of results than problems.