Defining a "Gold Standard" for Measuring the Effectiveness of Behavioral Therapy

Development of a core set of indicators for behavorial health

From 1998 to 2000, a partnership between the American College of Mental Health Administration and five major U.S. accrediting organizations produced a consensus set of indicators for behavioral health services.

Indicators are particular aspects of health care that can be quantified and measured to assess whether a process or outcome occurs.

The college, founded in 1979, is an interdisciplinary leadership group composed of a range of stakeholders in behavioral health, including public and private providers, purchasers, consumers, advocates, individual practitioners, researchers/academics and managed care companies.

The Problem

Historically, the behavioral health field has had no "gold standard" for measuring performance and outcomes. In 1997, the American College of Mental Health Administration initiated a national dialog on achieving consensus in quality measurement with a series of annual meetings known as the Santa Fe Summits.

The American College of Mental Health Administration and five national accrediting organizations — jointly known as the Accreditation Organization Workgroup — began a process of reaching agreement on what is important to measure and how to measure it. The five accrediting organizations included:

Along with the Robert Wood Johnson Foundation (RWJF), a number of other organizations supported the efforts of the Accreditation Organization Workgroup, including the MacArthur Foundation, Eli Lilly, the Substance Abuse and Mental Health Services Administration, and the Health Care Financing Administration (now known as the Centers for Medicare and Medicaid Services).

Key Results

  • The Accreditation Organization Workgroup met six times, resulting in the development and dissemination of a proposed consensus set of indicators.
  • An important byproduct of this project has been the development of a new level of collaboration among the accrediting organizations.


The workgroup has disseminated more than 700 copies of their 2001 Interim Report: A Proposed Consensus Set of Indicators for Behavioral Health to American College of Mental Health Administration members, conference attendees and accrediting organizations. The report also is available online.

After the Grant

While agreement on what is important to measure has been reached, the problems of data collection, measurement, implementation and reporting — or, how to measure it — have yet to be addressed. In addition, more work is needed to apply these general behavioral health indicators to children's and substance abuse services. The workgroup believes that this next step will require a national dialogue within the field.

Concurrent with the release of the workgroup's report, the Substance Abuse and Mental Health Services Administration organized a Carter Center Forum to develop "common" indicators for behavioral health. The forum adopted the workgroup's proposed indicators with some modifications and will continue the dialog at a meeting in 2003.


RWJF supported this project through a grant of $45,000.