Pre-Post Inventory

PRE-POST INVENTORY

"An objective outcome measure for counseling and treatment"

Description

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)

1. Truthfulness Scale: Determines how truthful the client was while completing the test. This scale identifies defensiveness, denial, problem minimization and faking.
    
2. 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.
    
3. 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.
    
4. Distress Scale: Measures pain, misery and suffering. Distress incorporates pain imposed by physical and mental abuse. Distress also includes anguish, anxiety and depression.
    
5. Alcohol Scale: Measures the severity of alcohol use and related problems. Alcohol refers to beer, wine and other liquors.
    
6. 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.
    
7. 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.

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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 5^th to 6^th 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 MS-DOS or Windows format. MS-DOS diskettes contain all their own software. 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" or 5¼" 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.

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 Reports link.

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 Reports

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 Reports 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.

Note: Scores on the Self-Esteem and Stress Coping Abilities Scales are reversed in that higher scores are associated with better self-esteem and stress coping abilities. There were 175 clients included in this analysis.

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 90^th 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: Orientation and 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).

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.

Orientation and Training Manual: The "Pre-Post Inventory: Orientation and Training Manual" (O&T Manual) explains how the Pre-Post Inventory works. It is a must read for staff that will be using the Pre-Post Inventory. O&T Manual content includes, but is not limited to, the following: instructions for testing, an explanation of how scores are derived, a clarification of how court-related information is used, a description of unique Pre-Post Inventory features and much more.

Computer Operating Guide: Some computer operators want more information than others. Consequently, Risk & Needs provides a One-Page Quick Start, which includes basic instructions for scoring Pre-Post Inventories, and a more comprehensive "Pre-Post Inventory: Computer Operating Guide." The Computer Operating Guide contains instructions for using MS-DOS as well as Windows software. This manual discusses hardware, software, scoring, printing reports, unique program features and much more.

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 Pre-Post Inventory demonstration diskette is available on a 30-day cost free basis. Demo diskettes are in MS-DOS format so that the software is contained on the diskette. This way, the one-time Windows setup program is avoided at the demo level. The examination kit contains a 1-test demo diskette, test booklet (reusable), an answer sheet (can photocopy), a "Pre-Post Inventory: Orientation and Training Manual," One-Page Quick Start and some descriptive information. Risk & Needs does want the demonstration diskette and test booklet returned within 30 days of receipt. To request a free examination kit, click on the Free Examination Kit Request link.

How to Proceed: To become a Risk & Needs test user, click on the Agreement & Proposals link, click on the Print Client User Agreement button and fax the completed form to (602) 266-8227, or mail your completed form to Risk & Needs. Upon its receipt by Risk & Needs, you become a Risk & Needs test user and can order tests. Current Risk & Needs test users can reorder by mail, telephone, fax or e-mail.

Other related links are listed for reference. They are available as needed.

    Test Unit Fee (Cost) webpage link. Explains Risk & Needs' Test Unit Fees or Costs.
    New Client Order webpage link. Explains steps to become a "new Risk & Needs client."
    How to Order webpage link. Explains how Risk & Needs tests can be ordered.

Additional information can be provided upon request. Contact Risk & Needs Assessment, Inc., P.O. Box 44828, Phoenix, Arizona 85064-4828. Risk & Needs' telephone number is (602) 234-3506, our fax number is (602) 266-8227 and our e-mail address is hhl@riskandneeds.com.

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PRE-POST INVENTORY

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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. To review an example comparison report, click on the Comparison Report link.

PRETEST REPORT

The Pretest Report is printed when the client is tested the first time, usually at counseling or treatment program intake. The first page of the Pretest Report begins with the client's name and some basic demographics. From left to right, the Pre-Post Profile lists scale names, presents their attained percentile scores and represents these scores graphically. Evaluators know how the client scored on the Pre-Post Inventory by glancing at the Pre-Post Profile. Specific client responses to important items (e.g., death, suicide, homicide, recovering substance abuse status and attendance at AA and CA meetings) are presented under the heading "Client Needs and Status Responses." Page one concludes with space for staff member observations/ recommendations, their signature and date of the evaluation.

The second page of the Pretest Report summarizes the client's scores on the following scales (measures): Truthfulness Scale, Alcohol Scale, Drugs Scale, Distress Scale, Resistance Scale, Self-Esteem Scale and the Stress Coping Abilities Scale. Each scale paragraph gives the client's attained score, explains what that score means and provides score related recommendations.

The third page of the Pretest Report begins with a summary of the "10 Point Recency Measures" for alcohol, drugs, and dangerousness items. These scales print each measure's name, attained score and a brief descriptive statement appropriate to the client's attained score. These measures are explained in the "PPI: Orientation and Training Manual." Significant Items (direct admissions or unusual answers) are printed for the Alcohol, Drugs, Distress and Resistance Scales. Social Stressors (Multiple Choice) consists of a printout of the client's selected answers to multiple choice items #135 through #148. And, page three ends with a reproduction of all the client's answers to Pre-Post Inventory test items.

NAME: Example Report

-3- PRETEST REPORT 10
POINT
RECENCY MEASURES: LAST 30         DAYS --------------------------------------- MEASURE POINTS
DESCRIPTION ------------- ------ -------------------------------------------- ALCOHOL               8 Client acknowledges has a
drinking problem DRUGS 2 Clarify       client's answers to #26 & #46
DANGEROUSNESS 0 No suicidal or         homicidal admissions SIGNIFICANT ITEMS: The following
self-report responses represent areas            that help in understanding the client's
problems, situation or needs. ALCOHOL DRUGS       ------- ----- 20. When drinks, cannot stop
Lack of items may                   be deceptive. 42. Problem in last 30


      days Review

Truthfulness

Scale.

56.

Not
      
                           confident won't   abuse 72.
                           Abused
         drinking last 30 days DISTRESS RESISTANCE -------- 
        ---------- Lack of items may be 
       deceptive. 10. Says doesn't want or




 need help Review Truthfulness Scale. 35. Doesn't want advice 69. No
       confidence in staff SOCIAL STRESSORS (MULTIPLE CHOICE) ----------------------------------

135. Undecided about treatment         142. No alcohol treatment
136. Drugs not a problem               143. Drug treatment helped little
137. Drinking a moderate problem       144. No need for alcohol treatment
138. Not suicidal or homicidal         145. No need for drug treatment
139. Some distress problems            146. Not sure if needs counseling
140. Last 30 days: drinking same       147. No treatment in last 30 days
141. No drug problem                   148. Not in program last 30 days


      COMMENTS: _______________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________
      
                           PPI RESPONSES   (TEST #1)
                           -------------------------
         1- 50 2224214424 5341242442 4413343145 5345243345 2223243523 
        51-100 2324143314 5225313244 2241243212 4223242443 2245144212 
       101-148 1511531211 2424323333 2142321212 1232242422 44344344




 Risk & Needs Assessment, Inc., P.O. Box 44828, Phoenix, AZ 85064-4828
       Pre-Post Inventory Copyright (c) 1996. ALL RIGHTS RESERVED

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POSTTEST 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.

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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 first page of the Comparison Report begins with the client's name and some basic demographics. The Pre-Post Scale Comparison explains differences between Pretest and Posttest scale scores. Scale names are presented on the left, difference (Pretest minus Posttest scores) scores are listed for each scale, and a scale-by-scale comparison statement is set forth. These comparison statements explain what each score means.  Ten point "Recency" comparisons for the Alcohol, Drugs, and Dangerousness items are presented, Pre-Post changes are noted, and a Comparison Results statement explains the difference or change scores. Client Program Ratings are presented for items 69, 79, 142, 143, 147 and 148. The Results statements (right side of page) explain what the change scores mean. Reference to the Pre-Post Inventory test booklet clarifies each of these six items. The "PPI: Orientation and Training Manual" explains how the PPI Comparison Report works.

The second page of the Comparison Report begins with a comparison of the client's Pretest-Posttest Self-Ratings of items #15, 74, 136 and 137. The Pretest-Posttest comparison of Multiple Choice items is straightforward. Items #135 through #148 are compared, and the results of these comparisons are summarized in terms of positive changes, remained the same or become worse. Space is then provided for staff observations/recommendations, signature and testing date.

We hope this Pre-Post Inventory webpage has been interesting and helpful. Additional information can be provided upon request. Contact Risk & Needs Assessment, Inc., P.O. Box 44828, Phoenix, Arizona 85064-4828. Risk & Needs' telephone number is (602) 234-3506, our fax number is (602) 266-8227 and our e-mail address is hhl@riskandneeds.com.

Copyright 2003 - Risk & Needs Assessment, Inc. - All Rights Reserved