MacArthur Competence Assessment Tool-Treatment (MacCAT-T)

Introduction

Structured interview. Allows clinician to test the individual's ability to make a specific decision.

Advantages

• decision-specific

Disadvantages

• long & steep learning curve

Procedure

The interviewer rates abilities in the 6 steps of the process.

• appreciation of the disorder
• understanding of the treatment & risks or discomforts
• appreciation of the treatment benefits
• understanding of the alternate treatments
• reasoning
• expressing a choice

The process involves 3 steps:

• preparation
  • listing relevant information in a worksheet
    • diagnoses
    • features
    • course
    • recommended treatment
    • risks/benefits
• interview
  • disclosure of the informed consent information
  • assessment of the patient's ability to comprehend information & make decisions about treatment
  • suggested structure
    • disclose - tell the patient
    • inquire - see if the patient understands
    • probe - if they are missing information, ask about that
• rating: patient's responses rated on a scale of 0-2