Monitoring and Evaluation in CVT Program Development | The Center for Victims of Torture

Monitoring and Evaluation in CVT Program Development

Wednesday, March 18, 2015

Jennifer Esala, Ph.D, answers key questions on monitoring and evaluation. Jennifer is a research associate at CVT where she works with international torture rehabilitation centers to support them in effectively managing and using client information and to assist them in assessing the efficacy of their mental health interventions.

 

What is monitoring and evaluation and how does it relate to research?

Monitoring is a systematic process of tracking program or intervention progress against predetermined benchmarks. Evaluation involves assessing the value and quality of a program or intervention.

There is quite a bit of overlap between monitoring and evaluation and research. Both involve systematic data collection and analysis on a defined program or intervention. One key distinction between monitoring and evaluation and research is that research is intended to inform a broader field, while monitoring and evaluation are intended to address internal practices.

For instance, at CVT we conduct monitoring and evaluation on all of our client services, and we use that information to seek ways to improve client care. On the other hand, we are also conducting a research study on our mental health and targeted case management services provided in a primary care clinic (the Healing Hearts project). Our goal with this work is to determine how effective our services are and to provide evidence to the other professionals or researchers about our intervention. While this research will certainly be applied in our own practice, it will provide the field of trauma rehabilitation insights as well.

 

How do you monitor and evaluate your work? What tools do you use?

For our psychological and social work services we collect information about clients’ levels of psychological distress (including anxiety, depression, and PTSD), physical distress, and social functioning. Social functioning includes engagement in social activities, access to safe housing, food, transportation, employment, and more. We measure these constructs at predetermined times to assess whether and to what extent clients are healing in these areas.

 

Why is it important to monitor and evaluate your work?

Monitoring and evaluating our work is core to our provision of services. This information allows us to assure that our services are benefiting clients and provides insights into how we can improve our services. Monitoring and evaluation is essential to demonstrate the value of our work and to continue to develop and enhance our approach.

 

How do you use the data you collect on an individual basis? How does the data influence the care that an individual receives?

Our client information systems are designed to be useful to clinicians. First, the assessments are structured and systematic tools for clinicians to monitor a wide range of distress that a client might experience and can be used to support and inform clinical diagnosis. This process also facilitates the clinician in planning their approach to working with the client.

Second, the follow-up assessments allow the clinicians to see areas in which the client is making meaningful progress and, importantly, to see those areas that need additional attention. Lastly, as appropriate, changes in symptoms can be shared back to the client, which in itself can be therapeutic.

 

How do you use the data you collect to develop programs? Does the long-term collection of data lead us to change our programs?

Data collection allows us to see aggregate gaps in services. We review our data on a regular basis to support program development. For instance, for our international services program in Ethiopia staff identified challenges in programming. Looking to the data for help understanding the problems, we found that fewer clients were coming in with trauma symptoms. Clients were dropping out more frequently, and they weren’t improving as much as we see in other programs. This prompted a deeper review of our data. We found that this population was not fleeing from war – as many of our other client populations are – but were rather often fleeing from forced, indefinite conscription or an authoritarian regime responsible for systematic human rights abuses. From a clinical perspective, these are two different populations with different needs. This prompted CVT to address our clinical focus in our Ethiopia program to better meet the specific needs of this population.

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