An Objective Outcome Measure for Counseling and
Treatment
The Pre-Post Inventory (PPI) is designed for objective pretest-posttest "outcome" comparisons. This test
provides an outcome measure for intervention, counseling or treatment effectiveness. The same test is
administered twice and the computer compares pretest and posttest results. The pretest (before treatment or
at intake) serves as a baseline against which the posttest (after treatment) is compared.
The Pre-Post Inventory
is an objective pretest-posttest
outcome assessment instrument or test. It has 148 items and takes 30 minutes to
complete. The Pre-Post Inventory has 7 scales (measures):
1. Truthfulness Scale,
2.
Self-Esteem Scale, 3. Resistance Scale,
4. Distress Scale,
5. Alcohol Scale,
6.
Drugs Scale, and
7. Stress Coping Abilities Scale.
The Pre-Post Inventory provides objective outcome measures for counseling (individual and group) and
treatment settings.
Seven Pre-Post Inventory Scales
(Measures)
Truthfulness Scale:
Determines how truthful
the client was while completing the test. This scale identifies
defensiveness, denial, problem minimization and faking.
Self-Esteem Scale: Reflects a client's
explicit valuing and appraisal of self. Self-Esteem incorporates an attitude
of acceptance-approval versus rejection-disapproval. It measures a person's
perception of self.
Resistance Scale: Measures resistance to
help and uncooperativeness. This scale varies directly with the client's
attitude and outlook. Some people resist help; whereas, others accept it.
Distress Scale: Measures pain, misery and
suffering. Distress incorporates pain imposed by physical and mental abuse.
Distress also includes anguish, anxiety and depression.
Alcohol Scale: Measures the severity of
alcohol use and related problems. Alcohol refers to beer, wine and other liquors.
Drugs Scale: Measures illicit drug use and abuse. Drugs refer to
marijuana, crack, cocaine, amphetamines, barbiturates and heroin. The Drugs Scale is independent of
the Alcohol Scale. It measures the severity of drug use.
Stress Coping Abilities Scale: Measures the client's ability to cope
effectively with tension, stress and pressure. Stress exacerbates emotional and mental health symptoms.
This scale is a non-introversive way to screen the presence of identifiable (diagnosable) mental health
problems.
* * * * *
More than just another alcohol or drug test. In addition to
alcohol and drugs, the Pre-Post Inventory assesses other important areas of
inquiry like truthfulness, self-esteem, resistance, distress and stress coping
abilities. This test is designed for counseling and treatment outcome.
The Pre-Post Inventory measures attitudes and
behaviors important to counseling and treatment outcome. Paper-pencil test
administration takes 30 minutes, and data entry as well as computer scoring
and
printing
reports takes 2½ minutes on-site.
Test Booklets
The Pre-Post Inventory test booklet is provided free. This
booklet contains 148 items, which are written at a 5th to 6th
grade level. If the client can read the newspaper, they can read the Pre-Post
Inventory. And, these test booklets are available in English and Spanish.
Reports
In brief, there are three Pre-Post Inventory reports. The
Pretest report is generated the first time a client is tested. The Posttest
report is produced when the same person is tested the second (and subsequent)
time. When the Posttest is scored, the evaluator has the option of printing the
Comparison report. The Comparison report results from a computer-generated
comparison of pretest and posttest results. Scale scores are summarized in terms
of having improved, stayed the same or gotten worse.
PRE-POST INVENTORY
An example Pre-Post Inventory report is presented at the end
of this webpage for review. If you would like to review these reports now,
simply click on the
Pre-Post Inventory Example Report link.
Software The
Pre-Post Inventory is available in Windows format.
Windows diskettes require
a one-time computer setup procedure after which Pre-Post Inventory data (25
or 50 applications) diskettes are used. Training manuals are provided, and new
test users can be walked through these procedures over Risk & Needs Assessment,
Inc.'s (Risk & Needs) telephone line.
Proprietary data diskettes contain 25 or 50 test
applications. These 3½" data diskettes score, interpret and print
Pre-Post Inventory reports on-site. Click on the
Pre-Post Comparison Report link to review the Comparison Report.
Once a Pre-Post Inventory account is
established, ordered diskettes are mailed to users. Ninety-seven (97%) percent
of new orders are placed in the same day's return mail. When all test
applications are used on a data diskette, that diskette is returned to Risk & Needs where the test data and demographics are downloaded into the Pre-Post Inventory
database for subsequent research analysis. Click on this
Research link to review Pre-Post Inventory research.
The proprietary "delete names" program is
activated by the test user with a few keystrokes to delete all client names from
diskettes before they are returned to Risk & Needs. Deleting all client names
insures client confidentiality and compliance with HIPAA (federal regulation 45
C.F.R. 164.501).
Pre-Post Inventory Database
The Pre-Post Inventory system contains a
proprietary database. Earlier it was noted that all Pre-Post Inventory used
diskettes are returned to Risk & Needs, and the test data along with client
demographics (e.g., age, gender, ethnicity, etc.) are downloaded into the
Pre-Post Inventory database. This database allows ongoing research and testing
program summary - at no additional cost. Ongoing research insures quality
control. Testing program summaries provide program self-evaluation.
No personal information, names, social security numbers, etc. are ever downloaded into any
test database.
Built-in Database
The Pre-Post Inventory permits ongoing research and annual program summary -- at no additional cost.
As discussed earlier, when the 25 or 50 test applications on a diskette are used, that
diskette is returned to Risk & Needs, checked for any viruses and downloaded into the Pre-Post
Inventory expanding database. Advantages of a built-in database are many and include database
(research) analysis and annual summary reports. To review an example summary
report, click on this
Annual Summary Report link.
After downloading test data returned diskettes are destroyed.
In summary, having all used Pre-Post Inventory tests'
diskettes centrally filed at Risk & Needs' offices in the Pre-Post Inventory database
has many advantages. Database analysis permits ongoing cost efficient research
that includes scale alpha coefficients, frequency distributions, correlations,
ANOVA, cross-tab statistics along with reliability, validity and accuracy determinations.
Annual Summary Report
Risk & Needs can access each of its tests' built-in databases for statistical analysis and
summarization of all tests administered in a year. Annual Summary Reports are prepared for state,
department, agency and even some individual providers -- at no cost to them. These reports are provided
as a professional courtesy to large volume test users. Summary reports include demographics,
court-history when relevant, and test statistics (reliability, validity and accuracy). Has anyone offered
to summarize your testing program? Annually? At no additional cost to you? Minimum testing volume for
annual reports is 350 tests. There is no maximum limit. Risk & Needs' annual reports range in size
from 350 tests to over 55,000 tests annually. An example Annual Summary Report can be viewed by clicking
on this
Annual Summary Report link.
Research
Reliability, validity and accuracy.The Pre-Post Inventory
has a built-in database that insures inclusion of all tests administered in a
confidential (no names) manner. And, these reliability, validity and accuracy
statistics are reported in the document titled "Pre-Post Inventory: An Inventory
of Scientific Findings."
Reliability of the Pre-Post
Inventory
Within-test reliability, or inter-item reliability
coefficient alphas for the Pre-Post Inventory are presented in the table below.
As demonstrated in the table, alpha coefficients for all Pre-Post Inventory
scales are well above the professionally accepted standard of .75. Indeed, all
of the Pre-Post Inventory scales are at or above .82. These high reliability
statistics are very impressive for an outcome test. These results show that
the Pre-Post Inventory is a very reliable outcome assessment test.
The Pretest and Posttest test booklets are
the same. The Pretest is administered before treatment, and the Posttest is
administered after treatment. The following table sets forth Pretest and
Posttest reliability coefficients side-by-side.
Pretest-Posttest reliability coefficients demonstrate that
the Pre-Post Inventory maintains high test-retest reliability. The Pre-Post
Inventory can be re-administered because the Posttest reliability coefficients
are just as high as the Pretest reliability coefficients.
All Pre-Post Inventory scales have alpha coefficients well
above the professionally accepted standard of .75 and are highly reliable. And,
all of these coefficient alphas are significant at the p<.001 level.
People interested in an outcome test might
initially inquire about the test's Pretest-Posttest relationship. Scores
between the Pretest and Posttest vary to an unknown degree because the impact of
the intervention (treatment) is unknown until demonstrated by the outcome
test. Establishing this relationship is the purpose of the Pre-Post
Inventory, that is to measure the impact of the intervention (treatment).
Successful treatment should result in lower Posttest scores. In contrast,
ineffective or unsuccessful treatment should result in higher Posttest scale scores.
The Pre-Post Scale Comparison table that
follows presents Pre-Post Inventory scores for 175 clients (male and female)
that completed treatment. In this case, the treatment was counseling for
troubled youths. The Pretest-Posttest interval varied between one and nine
months. In future research, the test-retest interval and nature of
counseling will be clarified.
PRETEST-POSTTEST SCALE COMPARISONS (N=175)
PPI Scales
Pretest Mean Score
Posttest Mean Score
T-Value
Level of Significance
Truthfulness Scale
23.85
21.29
t=3.01
p=.003
Alcohol Scale
15.17
12.97
t=2.77
p=.006
Drugs Scale
19.54
11.99
t=8.13
p<.001
Distress Scale
17.53
11.75
t=8.41
p<.001
Resistance Scale
10.35
8.25
t=4.45
p<.001
Self-Esteem Scale
20.52
30.41
t=7.60
p<.001
Stress Coping Abilities
101.70
124.77
t=7.11
p<.001
The above table presents mean or average
scale scores for each PPI scale. These results indicate that all scales
were statistically significantly different. Posttest scale scores were, on
average, significantly lower than Pretest scale scores for these clients.
The clients showed improvement on all PPI scales after having been in treatment.
The largest pre-post scale score differences occurred on the Self-Esteem,
Distress, Stress Coping Abilities and Drugs Scales. The Resistance and
Alcohol Scales also demonstrated significant pre-post scale score differences.
These treatment measures demonstrate that clients benefited from having been in
treatment. Pretest-Posttest scale comparisons quantify treatment effectiveness.
Much of the Pre-Post Inventory research is summarized in its
"Inventory of Scientific Findings" document. Subsequently, discriminant validity
and accuracy studies have shown impressive reliability, validity and accuracy.
To review a Pre-Post Inventory research study, click on this
Pre-Post Research Study link.
Staff Member Input
Some mental health professionals advocate fully automated
assessment. Risk & Needs does not. The Pre-Post Inventory is to be used in conjunction
with experienced staff judgment. Experienced staff should also interview the
client. For these reasons, the following statement is contained on each Pre-Post
Inventory report: "The Pre-Post Inventory is to be used in conjunction with experienced
staff judgment. No diagnosis or decision should be based solely upon
Pre-Post Inventory results. Consider these results working hypotheses."
Unique Pre-Post Inventory
Features
Truthfulness Scale: Identifies denial, problem minimization
and faking. It is now known that most clients attempt to minimize their
problems. A Truthfulness Scale is a necessary component in contemporary tests.
The Pre-Post Inventory Truthfulness Scale has been validated with the Minnesota Multiphasic
Personality Inventory (MMPI), polygraph exams, other tests and
experienced staff judgment. The Pre-Post Inventory Truthfulness Scale has been
demonstrated to be reliable, valid and accurate. In some respects, the Pre-Post
Inventory Truthfulness Scale is similar to the MMPI's L and F-Scales. It
consists of a number of items that most people agree or disagree with.
Truth-Corrected Scores:
Have proven to be very important for
assessment accuracy. This proprietary truth correction process is comparable to
the MMPI K-Scale correction. The Pre-Post Inventory Truthfulness Scale has been
correlated with the other 6 scales. The Truth Correction equation then converts
raw scores to Truth-Corrected scores. Truth-Corrected scores are more accurate
than raw scores. Raw scores reflect what the client wants you to know.
Truth-Corrected scores reveal what the client is attempting to hide.
Stress Coping Abilities Scale: Measures how well the client
handles stress, tension and pressure. And, we now know that stress exacerbates
emotional and mental health symptomatology. This scale is a non-introversive way
to screen for established (diagnosable) mental health problems. A person scoring
at or above the 90th percentile on the Stress Coping Abilities Scale
should be referred to a certified mental health professional for a more
comprehensive evaluation, diagnosis and treatment plan. This important area of
inquiry is missed by many other assessment tests.
More than just another alcohol or drug test. In addition to
alcohol and drugs, the Pre-Post Inventory assesses other important areas of
inquiry like truthfulness, denial and faking, emotional/mental health problems,
etc. The Pre-Post Inventory is specifically designed for client outcome assessment. It
provides the information needed for comprehensive client outcome screening.
Three ways to give the Pre-Post Inventory. The Pre-Post
Inventory can be administered in three different ways:
1.
Paper-pencil test
booklet format is the most popular testing procedure. Pre-Post Inventory English
and Spanish test booklets and answer sheets are available free.
2. Tests can be
given directly on the computer screen in English or Spanish. Some agencies
dedicate computers for Pre-Post Inventory testing. And,
3. Human
voice audio in English or Spanish is available. This involves a headset. The
client uses the up-down arrow keys. As the client goes from question to answer
with the arrow keys, that question or answer is highlighted on the
monitor and concurrently read to the client. These three test administration modes are
discussed in the "Pre-Post Inventory: Training Manual." Each test administration
mode has advantages and some limitations. Risk & Needs offers these three test modes so
test users can select the administration mode that is optimally suited to their needs.
Selecting a Pre-Post Outcome
Test
If you are selecting an outcome assessment instrument, the
following Comparison Checklist should prove helpful. It lists important
screening test qualities. The "Other" column represents any other test you might
want to compare to the Pre-Post Inventory (PPI).
OUTCOME TEST COMPARISON CHECKLIST
COMPARISON CATEGORIES
PPI
Other
Designed Specifically for Outcome Evaluation
Yes
Test Reliability and Validity Research Provided
Yes
Test Completed in 30 Minutes
Yes
On-Site Reports within 2½ Minutes
Yes
Truthfulness Scale to Detect Faking
Yes
Truth-Corrected Scores for Accuracy
Yes
Three Test Administration Options
Yes
1. Paper-Pencil (English and Spanish)
Yes
2. On Computer Screen (English and Spanish)
Yes
3. Human Voice Audio (English and Spanish)
Yes
Delete Client Names (insures confidentiality)
Yes
HIPAA (federal regulation)
Compliant
Yes
Test Data Input Verification (insures accuracy)
Yes
Available in English and Spanish
Yes
Built-in Database at No Additional Cost
Yes
Annual Database Research (Free)
Yes
Annual Testing Program Summary (Free)
Yes
Alcohol and Drugs Scales
Yes
Self-Esteem Scale
Yes
Resistance Scale
Yes
Distress Scale
Yes
Stress Coping Abilities Scale
Yes
Comparison Report
Yes
Easily Understood Reports
Yes
Helpful Outcome Reports
Yes
Staff Training (Free)
Yes
Examination Kits (Free)
Yes
Very Affordable Test Unit Fee
Yes
Reading Impaired Assessment:Reading impaired clients
represent 20+ percent of the clients tested. This represents a serious problem
to other tests. Risk & Needs has developed an alternative for dealing with this problem:
Human Voice Audio.
Human Voice Audio:
Presentation
of the Pre-Post Inventory is in English and Spanish. Clients' passive vocabularies are often greater than
their active vocabularies. Hearing items read out loud often helps reduce
cultural and communication problems. This test administration mode requires
earphones and simple instructions to orient the client to the up-down arrow keys
on the computer keyboard. Human Voice Audio is an alternative approach for
screening reading impaired clients.
Confidentiality:
Risk & Needs
encourages test users to delete client names from diskettes before they are returned to
Risk & Needs.
Once client names are deleted, they are gone and cannot be retrieved. Deleting client names does not
delete demographics or test data, which is downloaded into the Pre-Post
Inventory database for subsequent analysis. This proprietary "name" deletion
procedure involves a few keystrokes and insures client confidentiality and
compliance with HIPAA (federal regulation 45 C.F.R. 164.501).
Test Data Input Verification: Allows the person that inputs
test data from the answer sheet into the computer to verify the accuracy of
their data input. In brief, test data is input twice, and any inconsistencies
between the first and second data entries are highlighted until corrected. When
the first and second data entries match or are the same, the staff person can
continue. This proprietary Data Input Verification procedure is optional, yet
strongly recommended by Risk & Needs.
Inventory of Scientific
Findings: Much of the Pre-Post
Inventory research has been gathered together in one document titled "Pre-Post
Inventory: An Inventory of Scientific Findings." This document summarizes
Pre-Post Inventory research chronologically -- as the studies were completed.
This chronological reporting format was established largely because of the
Pre-Post Inventory database, which permits annual database analysis of all tests administered.
Staff Training: Risk &
Needs
'
staff are available to participate in Pre-Post Inventory training programs conducted by statewide programs,
departments and high volume agencies in the United States. Sometimes, smaller
volume providers get together for collective (multiple providers) on-site
training. Risk & Needs typically participates in 4-hour or 6-hour Pre-Post Inventory
training sessions. This training can include hands-on computer scoring, as
desired. Risk & Needs gives attendees certificates attesting to their Pre-Post Inventory training.
Staff training is also provided on Fridays at Risk & Needs' Phoenix offices from 8:30 a.m. to 11:30
a.m. or from 1:30 p.m. to 4:30 p.m. These training sessions are free. To participate, contact
Risk & Needs at least ten days in advance. Participation is on a first call, first scheduled basis.
Test Unit Fee (Cost):
Pre-Post Inventory cost information can be reviewed by
clicking on the
Test Unit Fee
(Cost) link. There is only the one cost or charge, and that is the test unit
fee. Everything else is included at no additional cost to the test user. This
includes test booklets, answer sheets, training manuals, upgrades, ongoing
database research, annual summary testing reports, staff training, and support
services. Do not be misled by some test publishers' à la carte pricing like
separate costs for each test administration as well as for each of the
test-related items listed above. Instead of asking for the test administration
cost, ask for the total cost involved in using a test. We believe Risk & Needs' one test
unit fee is very affordable.
Free Examination Kit:
A 1-test demonstration diskette is available on a 30-day cost free basis. Demo diskettes are in
Windows format. The Examination Kit includes a 1-test demo diskette, installation CD (with instructions),
test booklet, answer sheet and some descriptive materials. Risk & Needs Assessment, Inc. does want the
test booklet and diskette returned within 30 days.
* * * * *
PRE-POST INVENTORY
There are three Pre-Post Inventory reports. The
Pretest
Report is generated
the first time a client is tested (usually at program intake). The
Posttest Report
is produced when the same person is tested the second (and subsequent) time. The Posttest Report is
identical in content to the Pretest Report. The Pretest Report is presented below. When the Posttest is
scored, the evaluator has the option of printing the
Comparison
Report.
The Comparison Report is generated by the computer from Pretest and Posttest results. Several
comparisons are made that highlight Pretest-Posttest differences. Scale scores are
summarized in terms of improvement, no change or decrement.
PRETEST
EXAMPLE REPORT
The Pretest Report is printed when the client is tested the
first time, usually at counseling or treatment program intake.
* * * * *
POSTTEST EXAMPLE REPORT
Upon the second (and subsequent testing's) test
administration of the Pre-Post Inventory, the Posttest Report is generated. The
Pre-Post Inventory Posttest Report can be administered at 30-day intervals (or
longer). Posttests are often administered when there is a change in the client's
counseling or treatment program. They are also administered upon counseling or treatment completion.
Pretest Report format is the same as the Posttest Report format. These
reports are provided so that a record of the client's Pre-Post Inventory
results can be obtained for that moment in time. However, most people
interested in intervention/treatment outcome are most interested in the
Pretest-Posttest comparison and these results are presented in the Comparison
Report. It is the Comparison Report that shows outcome results.
Consequently, many intervention and treatment staff look forward to the
COMPARISON REPORT.
The Comparison Report results from a computer-generated
comparison of Pretest and Posttest results. Scale scores are summarized in terms
of "improved," "stayed the same," or "got worse." Printing of the Comparison
Report is optional. Regardless of the number of Posttest administrations, the
Posttest is always compared to the initial Pretest. The Comparison Report
is explained in the "PPI: Orientation and Training Manual."
The Pre-Post Inventory (PPI) provides an objective outcome measure (Comparison Report) for evaluating
intervention, counseling or treatment effectiveness. The pretest (before treatment) serves as a
baseline against which the posttest (after treatment) is compared.
Additional information can be provided upon request by writing:
Risk & Needs Assessment, Inc. P.O. Box 44828 Phoenix, Arizona 85064-4828.
Our telephone number is (602) 234-3506
Our fax number is (602) 266-8227
and our e-mail address is
sheryl@riskandneeds.com.
