Presidential address: What we have learned from a decade of research aimed at improving psychotherapy outcome in routine care

Abstract The findings of a decade-long program of research aimed at tracking patient treatment response are summarized. Outcome measures were developed and applied on a weekly basis with patients undergoing therapy in routine practice. Treatment response was defined as reliable and clinically significant change, and longitudinal statistical models for identifying poor progress were applied. The author was able to estimate the amount of therapy necessary for recovery, study early dramatic improvers, and assess the consequences of providing practitioners with alarm signals when patients were off track for a positive outcome. Results indicate that integrating treatment response research into routine mental health care reliably improved positive outcomes and reduced negative outcomes. Future directions for this line of action research are suggested.

[1]  S. L. Nielsen,et al.  Enhancing outcome for potential treatment failures: Therapist–client feedback and clinical support tools , 2007 .

[2]  W. Heiser,et al.  The Outcome Questionnaire (OQ‐45) in a Dutch population: A cross‐cultural validation , 2007 .

[3]  Jennifer E. Johnson,et al.  A comparison of the Outcome Questionnaire‐45 and Outcome Questionnaire‐30 in classification and prediction of treatment outcome , 2006 .

[4]  W. Lutz,et al.  Wie effektiv sind systematische Rückmeldungen des Therapieverlaufs an den Therapeuten? Eine empirische Studie in einem stationär-verhaltenstherapeutischen Setting , 2006 .

[5]  D. Eggett,et al.  An analysis of therapist treatment effects: toward providing feedback to individual therapists on their clients' psychotherapy outcome. , 2006, Journal of clinical psychology.

[6]  W. Lutz,et al.  The probability of treatment success, failure and duration—what can be learned from empirical data to support decision making in clinical practice? , 2006 .

[7]  Michael J. Lambert,et al.  Is It Time for Clinicians to Routinely Track Patient Outcome? A Meta‐Analysis , 2006 .

[8]  E. Forman,et al.  The Psychotherapy Dose‐Response Effect and Its Implications for Treatment Delivery Services , 2006 .

[9]  H. Kordy,et al.  What is the predictive value of responses to psychotherapy for its future course? Empirical explorations and consequences for outcome monitoring , 2006 .

[10]  K. Masters,et al.  A Comparison of Rational Versus Empirical Methods in the Prediction of Psychotherapy Outcome. , 2006 .

[11]  S. L. Nielsen,et al.  A lab test and algorithms for identifying clients at risk for treatment failure. , 2005, Journal of clinical psychology.

[12]  J. Teasdale,et al.  Cognitive therapy for depression: Individual differences and the process of change , 1987, Cognitive Therapy and Research.

[13]  K. Iwl.  How Much Therapy Is Really Enough ? A Session-by-Session Analysis of the Psychotherapy Dose-Effect Relationship , 2005 .

[14]  J. McClure,et al.  CORRECTION , 2004, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[15]  B. Ogles,et al.  The use of outcome measures by psychologists in clinical practice , 2004 .

[16]  E. Hawkins,et al.  The therapeutic effects of providing patient progress information to therapists and patients , 2004 .

[17]  S. Bauer,et al.  Clinical Significance Methods: A Comparison of Statistical Techniques , 2004, Journal of personality assessment.

[18]  E. Hawkins,et al.  Outcome Questionnaire: Is It Sensitive to Changes in Counseling Center Clients? , 2004 .

[19]  David L Streiner,et al.  Diagnosing Tests: Using and Misusing Diagnostic and Screening Tests , 2003, Journal of personality assessment.

[20]  S. L. Nielsen,et al.  Waiting for supershrink: an empirical analysis of therapist effects , 2003 .

[21]  W. Stiles,et al.  Time is of the essence: A selective review of the fall and rise of brief therapy research. , 2003, Psychology and psychotherapy.

[22]  Michael J. Lambert,et al.  Bergin and Garfield's Handbook of Psychotherapy and Behavior Change , 2003 .

[23]  M. Lambert,et al.  An Evaluation of the Dose–Response Relationship in Naturalistic Treatment Settings Using Survival Analysis , 2003, Mental health services research.

[24]  D. Eggett,et al.  Clinical significance of the Outcome Questionnaire (OQ-45.2). , 2003 .

[25]  S. L. Nielsen,et al.  Improving the effects of psychotherapy: The use of early identification of treatment and problem-solving strategies in routine practice. , 2003 .

[26]  G. B. Schaalje,et al.  The Effects of Repeated Administrations on Self-Report and Parent-Report Scales , 2002 .

[27]  R. Hill,et al.  Do early responders to psychotherapy maintain treatment gains? , 2002, Journal of clinical psychology.

[28]  M. J. Bishop,et al.  Comparison of empirically-derived and rationally-derived methods for identifying patients at risk for treatment failure , 2002 .

[29]  S. L. Nielsen,et al.  Enhancing psychotherapy outcomes via providing feedback on client progress: a replication , 2002 .

[30]  S. L. Nielsen,et al.  Improving the Effects of Psychotherapy : The Use of Early Identification of Treatment Failure and Problem-Solving Strategies in Routine Practice , 2002 .

[31]  R. Hill,et al.  Predicting counseling center clients' response to counseling: A 1-year follow-up , 2001 .

[32]  B. Schaalje,et al.  Psychotherapy quality control: the statistical generation of expected recovery curves for integration into an early warning system , 2001 .

[33]  M. Lambert,et al.  A survival analysis of clinically significant change in outpatient psychotherapy. , 2001, Journal of clinical psychology.

[34]  S. L. Nielsen,et al.  The Effects of Providing Therapists With Feedback on Patient Progress During Psychotherapy: Are Outcomes Enhanced? , 2001, Psychotherapy research : journal of the Society for Psychotherapy Research.

[35]  H. Kraemer,et al.  Outcome predictors for the cognitive behavior treatment of bulimia nervosa: data from a multisite study. , 2000, The American journal of psychiatry.

[36]  M. Pollack,et al.  Empirically supported treatments for panic disorder: costs, benefits, and stepped care. , 2000, Journal of consulting and clinical psychology.

[37]  H. Kraemer,et al.  A multicenter comparison of cognitive-behavioral therapy and interpersonal psychotherapy for bulimia nervosa. , 2000, Archives of general psychiatry.

[38]  G. Burlingame,et al.  Outcome Questionnaire: Item Sensitivity to Change , 2000, Journal of personality assessment.

[39]  P. Kendall.  Clinical significance. , 2020, Journal of consulting and clinical psychology.

[40]  R. DeRubeis,et al.  Sudden gains and critical sessions in cognitive-behavioral therapy for depression , 1999 .

[41]  B. Birmaher,et al.  Rapid response to psychosocial treatment for adolescent depression: a two-year follow-up. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[42]  G. Burlingame,et al.  Construct Validity of the Outcome Questionnaire: A Confirmatory Factor Analysis , 1998 .

[43]  B. Ogles,et al.  A multiperspective, multivariable evaluation of reliable change. , 1998, Journal of consulting and clinical psychology.

[44]  M. Lambert,et al.  Concurrent and Construct Validity of the Outcome Questionnaire , 1997 .

[45]  G. Burlingame,et al.  The Reliability and Validity of the Outcome Questionnaire , 1996 .

[46]  P. Pilkonis,et al.  The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. , 1996, Journal of consulting and clinical psychology.

[47]  Gerald L. Stone,et al.  Thinking About Mental Health Policy in University and College Counseling Centers , 1996 .

[48]  M. Lambert,et al.  How Much Therapy Is Really Enough? : A Session-by-Session Analysis of the Psychotherapy Dose-Effect Relationship. , 1996, The Journal of psychotherapy practice and research.

[49]  W. E. Craighead,et al.  The Role of Nonspecific Factors in Cognitive‐Behavior Therapy for Depression , 1994 .

[50]  D. Orlinsky,et al.  Process and outcome in psychotherapy: Noch einmal. , 1994 .

[51]  A. Horvath,et al.  The role of the therapeutic alliance in psychotherapy. , 1993, Journal of consulting and clinical psychology.

[52]  S. Taylor,et al.  Outcome profiles in the treatment of unipolar depression. , 1993, Behaviour research and therapy.

[53]  N. Jacobson,et al.  Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. , 1991, Journal of consulting and clinical psychology.

[54]  L. Horowitz,et al.  Inventory of interpersonal problems: psychometric properties and clinical applications. , 1988, Journal of consulting and clinical psychology.

[55]  Marianne Cooper,et al.  Introduction and overview , 1988, J. Am. Soc. Inf. Sci..

[56]  M. Krause,et al.  The dose-effect relationship in psychotherapy. , 1986, The American psychologist.

[57]  M. Weissman,et al.  Assessment of social adjustment by patient self-report. , 1976, Archives of general psychiatry.

[58]  M. Lieberman,et al.  A study of encounter group casualties. , 1971, Archives of general psychiatry.

[59]  A. Beck,et al.  An inventory for measuring depression. , 1961, Archives of general psychiatry.

[60]  Paul E. Meehl,et al.  Clinical versus Statistical Prediction. , 1955 .