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Six Sigma in psychological services

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Viewing 18 posts - 1 through 18 (of 18 total)
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  • #24891

    Leandro Cesar Longo
    Participant

    I’m a Manufacturing Black Belt and I have a psychological clinic. I’ve been working at my clinic everyday from 6pm to 11pm.
    I’ve been thinking about implement the SS metholology on psychological procedures. Can I implement it? Is there anyone working with this?

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    #59732

    ROSS
    Member

    Leandro,
    Of course six sigma can be applied to the psychological services area. Let’s start with what your business critical to quality characteristics are. You would know them best. It could be not using restraints or reducing depressions. You then can look at the process you have in place to prevent these things from occuring — and you can standardize and improve this process based on data you collect. Does that make sense? What do you consider to be your most important business issues?
    Tony

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    #59733

    Mel Alexander
    Participant

    One example of how six-sigma statistical approaches may be applied in psychological studies is in finding ways to reduce anxiety levels of patients diagnosed with general anxiety disorder (GAD). GAD tests are usually measured according to the Hamilton Rating Scale for Anxiety (HAM-A) consistent with the Diagnostic and Statistical Manual, 3rd edition. HAM-A tests are computed by taking the sum of 14 anxiety-related items (e.g., anxious mood, tension, insomnia, fears, etc.) with each item score rated as 0 (not present), 1(mild), 2(moderate), 3(severe), or 4(very severe).
    To test the effectiveness of three different therapies (or other treatments), subjects would be randomly assigned to one of three treatment groups. After a treatment period (of say 10 weeks), HAM-A scores would be collected after treatment (as well as before)to see if the effect of the mean HAM-A scores had changed. ANOVA could be used to tell which treatment resulted in the biggest reduction in anxiety levels as a recommended therapy.

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    #59737

    BenWah
    Participant

    I’d start with Jack Welch and BillyBob, they seem to be in the most dire need.

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    #59738

    Golinski
    Participant

    Very good, and whem you start it, please send me a report

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    #59734

    Arturo Ruiz Falcó
    Participant

    Mel, I fully agree your proposed statistical analysis…but just a little remark, ANOVA exists since early 1900 and Six Sigma was coined about 80 years later. Therefore, this analysis is what a competent psychologist was expected to do since 100 years ago. Why do you need to label it as “Six Sigma”? Does it add some credibility to your conclusions? Following this approach, Intelligent Coefficient studies, which I assume are based on Gauss distribution (nearly 300 years old), would be another glory of Six Sigma.
    I think Six Sigma is a wonderful innitiative which uses the best statistical methods that were developed in the past, but I believe it is frivolous to name statisticals methods introduced by great men as Gauss, Fisher, Box, etc., as “Six-Sigma statistical approaches”. Gospel, which is even older than Gauss distribution, says…”to Caesar what is Caesar´s…” In my modest opinion, the great merit of Six Sigma is not to invent the Statistical Methods, but to increase the use of them by ordinary engineers.
    Regards
    Arturo

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    #59739

    Mike Carnell
    Participant

    Leandro,
    I am not sure what you intend to work on in the clinic, the clients or the processes for the clients. If it is the clients you could very easily fing the typical curriculum delivered in a SS program deficient in analyzing the thing you need to analyze. If you read some of the studies that psychologists do the tools are very sophisticated and the analysis can be difficult. (i.e. check out some of the covariance stuff)
    If it is your business processes there really isn’t any issue with implementing it.
    Good luck.

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    #59735

    Mike Carnell
    Participant

    Arturo,
    Excellent response. Thanks.

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    #59740

    Leandro Cesar Longo
    Participant

    Mike;
    I’ve been working with a measure form ( clients satisfaction) to improve the business processes, but today I’m thinking about working with the measurable tests, for example the personality and intelligence test WISC, This is a important test in Brazil for diagnostic of children. The original test has a very good statistical base.
    Thank you for your response.
    Good Luck too.

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    #59736

    Eoin Barry
    Participant

    Arturo –
    Well put. Clinical physcologists and bio statisticians have been applying statistics for years.
    Best wishes,Eoin

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    #59741

    Mike Carnell
    Participant

    Leandro,
    I do not have any background in the social sciences but it is some interesting stuff to read from an analysis standpoint. I would think if you are working with children the idea of covariance would be important since there should be some dramatic effects from maturation interacting with all the other factors you are trying to analyze.
    Good luck.

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    #59743

    Dave Davidson Methot
    Participant

    Leandro,
    Interesting question. Similar to one I posted over a year ago in this discussion group. I’m a pyschologist working as quality officer for a children’s treatment center. I’ve been introducing the Six Sigma methodology to our quality program for the past year. As Arturo rightly points out, statistics are not new to psychology. Nor is the use of statistics to examine processes, which Deming and Juran advocated sixty years ago. What I find useful is Six Sigma’s project methodology, DMAIC/DMADV, which allows non-professional staff to think about what they do, whether it’s direct treatment of clients or administrative support services, from the standpoint of efficiency and/or effectiveness.
    Finally, a short note. You mentioned using the WISC. I’m not sure how you could use this as an outcome measure, as intelligence is not usually amenable to change through therapy. You wouldn’t, for example, expect a client’s WISC score to improve dramatically after treatment, thereby providing you with an objective measure of treatment effectiveness. There are other measures used with kids that do measure changes in functioning, and these could be used for outcomes purposes. However, this WISC is not one of these. For more information, check out the State of California, Department of Mental Health website and look at their section on Performance and Outcome measures. There downloadable instruments, complete with training manuals. These might help you in your clinical work.
    And thanks for bringing this issue up (again)!
    Dave

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    #59742

    Robson Quinello
    Member

    Leandro, você por aqui?
    Acredito que quando você terminar àquele trabalho para meu WG, você deveria usá-lo como benchmarking na área de psicologia do trabalho, afinal encontramos potencial para esse trabalho a partir do Political Map e FMEA feito durante meu projeto Seis Sigma…….
    Abraços,
    Robson

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    #59744

    Marita Haberland
    Participant

    in terms of outcomes and treatment it is important to also include in the diagnostic the thing most neglected ; the eating habits which cause the neurotransmitters to malfunction. This is the major error in contemporary mental health delivery systems. Not recognizing the primacy of this messes up the rest of the DMAIC.  And costs a lot more. State tax payers dollars at work here.

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    #59745

    David Davidson Methot
    Participant

    Marita,
    Thanks for your response. While diet is important for overall functioning, I think it may be either pre-mature or simplistic to attribute neurotransmitter functioning on diet alone. The research has shown that there are a variety of factors to take into consideration, including genetic makeup, activity level, environmental factors, social skills, etc. All of these are important considerations, which is why the biopsychosocial model of treatment is to be preferred over the medical model. At least that is my bias. Thus, while diet may not be the whole story, it certainly is an important part of the whole picture that needs to be considered when treating a client, particularly children and the elderly.

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    #59746

    Marita Haberland
    Participant

    David,
    Customers faced with excess insurance costs are angered by the inefficient methods of treatment which are employed by state agencies and HMO’s. Historically good nutrition has not been utilized in all age groups as can be easily seen by stats concerning fiber and fresh produce consumption by all ages.. The new work being done with pro and pre biotics(intestinal bacteria) represents the most cutting edge medical breakthroughs of the new millennium. Also the new information concerning toxic metals (like mercury and pesticides) affect many biochemical processes. The information about the effects of Aspartame  and violent behavior as well as weight gain is  of tremendous diagnostic import. Toxic bodies do not want to exercise, or do many activities which would help the life process . This IS environmental. 
     The most irrational thing to me is that the last letter of A.A.’s founder concerning depletion of Vitamin B1 and circulated by his wife after his death has not to this day been acknowledged within the paradigm of delivery services paid by taxpayers in county and state run alcohol  programs. This is an outrage when you consider outcome-based-solutions in terms of the tremendous amount of recidivism following treatment. Check out what Dr. Joan Larson is doing in her Health Recovery Center in MInneapolis if you are interested in neurotransmitters. Or the work of Dr. Jeffrey Bland in Gig Harbor Washington.To me this area is  ripe for Six Sigma  implementation in psychological services. And one which comes in hands down the least expensive.

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    #59747

    Leandro Cesar Longo
    Participant

    Dave,
    Very good!
    Where do you work?
    I think we don’t have a large number of psyhologists working with the six sigma methodology. A great step to improve the statistical numbers is increase a new method to measure the tests without brazilian tables, for example the original wisc, because ít’s don’t have any table with the brazilian population.
    Good luck,

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    #59748

    Dave Davidson Methot, PhD
    Participant

    Cesar,
    Sorry for the delay in replying to your post. I’ve been away for a few days. I work at an agency in Southern California, near Los Angeles. As more behavioral health agencies are seeking accreditation, quality management is increasingly a required concern, which is how I got involved in it. I’d be happy to assist you in your efforts in Brazil. Feel free to e-mail me directly if you’d like.

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