| Abstract: | A global scale can provided means for integrating a variety of client/patient assessment techniques to complement each other in a useful manner. Global scales have been applied to service planning and evaluation as well as being useful for the on-going communication of clients' clinical/functioning status. Global scales are attractive to many service programs because of their apparent ease of implementation and their apparent face validity. Furthermore, there is an extensive body of literature describing global scales as hightly reliable and valid when properly implemented and maintained. The literature also suggests that there are some serious pitfalls. While initial implementation of a global scale is easy, the maintenance of a reliable, valid and useful scale appears to require their active use in treatment planning, treatment review and clinical supervision processes. It also requires that more extensive multidimensional ratings be made at intake, review and termination. Furthermore, staff training and development sessions two or three times a year are needed to surface and deal with differences in clinician ratings. Given these sorts of supports, then, a global scale has been demonstrated as a useful tool in service program management as well as clinical process and outcome studies, including studies of cost effectiveness. Since the major use of a global scale is as an integrating construct, a quantitative model is offered to describe the relationship between global scale ratings and multidimensional facets influencing the global ratings. |
