Value-Added Model Estimates of Behavioral Health Provider Contributions to Strength Development

Behavioral health service reforms have evolved to focus on access, screening, evidence-based practices, process measures, and medication adherence as an accountability framework. However, attention to outcomes, including personal recovery, has been limited. This study introduced and explored a strengths-based Value-Added Model (VAM) to measure provider effectiveness using longitudinal data from the Adult Needs and Strengths Assessment (ANSA). Drawing from a statewide sample of 14,940 adults receiving publicly funded behavioral health services over two fiscal years, the study operationalized provider impact on strength development. Four VAM specifications were tested, incorporating contextual and clinical covariates to isolate provider-level effects. Results demonstrated significant variation in provider contributions to strength development with strong concordance across model-based rankings. Across three models, race/ethnicity (Hispanic and White), rural residence, level of need (LON), and episode status were significant. When existing strengths were added, only being Hispanic, White, or Black, episode status, outpatient LON, and the number of existing strengths predicted agencies’ effect on strength development. These findings underscore the potential utility of strengths-based VAMs as a promising advancement in behavioral health accountability, capturing providers’ roles in promoting recovery. Emphasizing the cultivation of strengths, the VAMs offer actionable insights for systems-level improvement and support the development of recovery-focused care frameworks. To refine behavioral health VAMS, additional research is needed to better understand the relationships among having and developing strengths, client characteristics, LON, and recovery.