The Brief Adjustment Scale-6 (BASE-6) was recently developed and initially examined as a brief, reliable, no-cost survey for measuring general psychological functioning within Measurement-Based Care (MBC). This study aims to further evaluate the psychometric properties of the BASE-6 in both clinical and nonclinical populations. More specifically, psychometric properties including reliability and validity, generalizability for different race/ethnic samples, and clinical utility within the context of MBC were examined. Three adult samples participated in this study: online community participants (Sample 1: n = 394), college students (Sample 2: n = 249), and individuals receiving outpatient clinical services (Sample 3: n = 80). Participants within the clinical sample regularly completed the BASE-6 while receiving evidence-based treatment in a community based psychological training clinic, where the practice of MBC is standard. Results showed that the BASE-6 had a high level of internal consistency and good test-retest reliability. It showed high convergent validity through a significant positive correlation with total and subscale scores of the Depression Anxiety Stress Scale-21 (DASS-21). Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) results supported a unidimensional model that strongly fit the data. All results were uniform across samples. When comparing the clinical and nonclinical samples, participants from the clinical sample demonstrated higher scores in total and most of the single items of the BASE-6. Finally, within the clinical sample, the BASE-6 was sensitive enough to capture change over time by demonstrating a large effect size of pre-post treatment changes and significant linear change in multilevel growth modeling. These results support the BASE-6 as a reliable and valid measure that has a one-factor structure, regardless of race/ethnicity and participants’ clinical status. Additionally, it can sensitively detect clinical change in individuals over the course of the treatment. Thus, the BASE-6 appears to accurately monitor overall psychological adjustment. / M.S. / The Brief Adjustment Scale-6 (BASE-6) is a short, no-cost survey that assesses general psychological adjustment. It can be used in a psychotherapy setting to evaluate overall functioning of individuals on a regular basis. This study aims to further investigate the BASE-6 in both clinical and nonclinical populations, more specifically, whether the BASE-6 questionnaire is reliable, consistent, and valid with various race/ethnic populations. Additionally, it was examined if the BASE-6 can sensitively capture the change in psychological adjustment over the course of treatment. Three adult groups participated in this study: online community participants (Sample 1: n = 394), college students (Sample 2: n = 249), and individuals receiving outpatient clinical services (Sample 3: n = 80). Participants within the clinical sample regularly completed the BASE-6 while receiving psychotherapy in a community based psychological training clinic. Results showed that the BASE-6 was a reliable, consistent measure and the items all measured the same construct – general psychological adjustment. The BASE-6 was also highly correlated with depression, anxiety, and stress. Results did not differ across samples or race/ethnicity. When comparing the clinical and nonclinical samples, participants from the clinical sample showed higher scores of the BASE-6. Finally, within the clinical sample, the BASE-6 was sensitive enough to capture change over time by demonstrating large treatment changes from the beginning until the end of the treatment. These results support the BASE-6 as a reliable and valid measure regardless of race/ethnicity and participants’ clinical status. Additionally, it can sensitively detect clinical changes in clients over the course of the treatment. Thus, the BASE-6 appears to accurately monitor overall psychological adjustment.

Measurement Based Care (MBC) is considered to be an evidence-based practice. Despite its well-documented efficacy, it is underutilized in the clinical community for various reasons, including clinician and patient buy-in. A key component to the successful implementation of MBC is the routine administration of Patient Reported Outcome Measures (PROMs). There is a lack of research describing the utilization of MBC in a telehealth setting. As technological innovations continue, a greater number of clinics are offering telemental health services. Additionally, the COVID-19 pandemic caused a majority of underprepared clinics to begin implementing telehealth. The present study sought to evaluate patient compliance with PROMs in MBC after an abrupt shift to telehealth due to the COVID-19 pandemic. Participants were collected from a clinical population at a community based psychological training clinic. The participants were separated into groups: modality 1 (in-person services, n = 17), modality 2 (telehealth services, n = 17), and modality 3 (hybrid of modalities 1 and 2, n = 10), to assess the effect of modality on mean PROM compliance. The participants were separated into groups adult (≥18 years of age, n = 23) and child (<18 years of age, n = 17), to assess the effect of maturity on mean PROM compliance. Results showed that mean PROM compliance was significantly higher in the in-person modality than the telehealth modality. Results also showed that PROM compliance was significantly higher in adults than in children. There was not a significant interaction effect of modality and maturity on PROM compliance. Additionally, results showed that PROM compliance decreased significantly after the switch from in-person services to telehealth services in the hybrid modality. These findings show that clinics may face significant barriers to the implementation of MBC after a sudden shift to telehealth caused by an unforeseen stressful event. / M.S. / Measurement-Based Care (MBC) is an effective practice for the treatment of patients in psychological practices. It is a collaborative process that involves the clinician and patient tracking treatment progress and outcomes through the use of consistently administered measures known as Patient Reported Outcome Measures (PROMs). Although MBC has been shown to be effective, there is little literature regarding its use in a telehealth setting. As a greater number of clinics begin offering telehealth services, questions regarding patient adherence to interventions have arisen. Furthermore, the global COVID-19 pandemic forced a majority of underprepared clinics to offer telehealth services. The current study sought to better understand potential barriers to the implementation of MBC in a telehealth setting. Participants were collected from patients receiving therapy at a community based psychological training clinic. The participants were separated into the groups: in-person services (n = 17), telehealth services (n = 17), and hybrid of in-person and telehealth (n = 10), to assess the effect of modality on mean PROM compliance. The participants were separated into groups adult (≥18 years of age, n = 23) and child (<18 years of age, n = 17), to assess the effect of maturity on mean PROM compliance. Results showed that patients in the in-person therapy group were more likely to complete their measures than patients in the telehealth therapy group, regardless of their maturity. Additionally, adult patients were more likely to complete their measures than child patients, regardless of the modality. Results also showed that patients who experienced both in-person and telehealth services were more likely to complete their measures before the switch to telehealth. These findings show that clinics may face significant barriers to the implementation of MBC after a sudden shift to telehealth caused by an unforeseen stressful event.