Is It Time for Clinicians to Routinely Track Patient Outcome? A Meta‐Analysis

Empirically supported psychotherapies, treatment guidelines, best practices, and treatment manuals are methods proposed to enhance treatment outcomes in routine practice. Patient-focused research systems provide a compatible and contrasting methodology. Such systems monitor and feed back information about a patient's progress during psychotherapy for the purpose of enhancing outcomes. A meta-analytic review of three large-scale studies is summarized and suggests that formally monitoring patient progress has a significant impact on clients who show a poor initial response to treatment. Implementation of this feedback system reduced deterioration by 4% to 8% and increased positive outcomes. Our interpretation of these results suggests that it may be time for clinicians routinely and formally to monitor patient treatment response.

[1]  G. Andrews A Focus on Empirically Supported Outcomes: A Commentary on Search for Empirically Supported Treatments , 2006 .

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

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

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

[5]  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 .

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

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

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

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

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

[11]  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 .

[12]  D. Schulte,et al.  Zur Validität der Beurteilung des Therapieerfolgs durch Therapeuten , 2002 .

[13]  E. Hawkins,et al.  Using information about patient progress in supervision: Are outcomes enhanced? , 2001 .

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

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

[16]  G. Burlingame,et al.  Pushing the quality envelope: a new outcomes management system. , 2001, Psychiatric services.

[17]  M. Barkham,et al.  Service profiling and Outcomes benchmarking using the CORE-OM: toward practice-based evidence in the psychological therapies : Patient-Focused Research , 2001 .

[18]  M. Lambert,et al.  Patient-focused research: using patient outcome data to enhance treatment effects. , 2001, Journal of consulting and clinical psychology.

[19]  H. Kordy,et al.  Computer-assisted feedback-driven quality management for psychotherapy: the Stuttgart-Heidelberg model. , 2001, Journal of consulting and clinical psychology.

[20]  M. Lambert,et al.  Psychotherapy outcome and quality improvement: introduction to the special section on patient-focused research. , 2001, Journal of consulting and clinical psychology.

[21]  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.

[22]  W. Lutz,et al.  Assessing treatment progress of individual patients using expected treatment response models. , 2001, Journal of consulting and clinical psychology.

[23]  L. Beutler Comparisons among quality assurance systems: from outcome assessment to clinical utility. , 2001, Journal of consulting and clinical psychology.

[24]  M. Newman Recommendations for a Cost-Offset Model of Psychotherapy Allocation Using Generalized Anxiety Disorder as an Example , 2000, Journal of consulting and clinical psychology.

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

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

[27]  P. Kendall,et al.  Normative comparisons for the evaluation of clinical significance. , 1999, Journal of consulting and clinical psychology.

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

[29]  P. Nathan Practice guidelines: Not yet ideal. , 1998 .

[30]  S. Hollon,et al.  Defining empirically supported therapies. , 1998, Journal of consulting and clinical psychology.

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

[32]  Frederick A. Stich,et al.  A meta-analysis of outcome studies comparing bona fide psychotherapies: Empiricially, "all must have prizes." , 1997 .

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

[34]  W. Lutz,et al.  Evaluation of psychotherapy. Efficacy, effectiveness, and patient progress. , 1996, The American psychologist.

[35]  S. Garfield,et al.  Some problems associated with "validated" forms of psychotherapy. , 1996 .

[36]  D. Chambless In Defense of Dissemination of Empirically Supported Psychological Interventions , 1996 .

[37]  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.

[38]  H. Strupp The tripartite model and the Consumer Reports study. , 1996, The American psychologist.

[39]  P. Kendall,et al.  Introduction to the special section: the case for training in the provision of psychological therapy. , 1995, Journal of consulting and clinical psychology.

[40]  D. Mohr Negative Outcome in Psychotherapy: A Critical Review , 1995 .

[41]  D. Chambless,et al.  Training in and Dissemination of Empirically-Validated Psychological Treatments: Report and Recommendations , 1995 .

[42]  D. M. Stein,et al.  Graduate training in psychotherapy: are therapy outcomes enhanced? , 1995, Journal of consulting and clinical psychology.

[43]  S. Garfield Research on client variables in psychotherapy. , 1994 .

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

[45]  Nikolaos Gkantidis,et al.  Clinical Significance , 2022, The SAGE Encyclopedia of Research Design.

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

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

[48]  J. Sines Actuarial versus Clinical Prediction in Psychopathology , 1970, British Journal of Psychiatry.

[49]  P. Meehl,et al.  Clinical versus Statistical Prediction. , 1955 .