An analysis of therapist treatment effects: Toward providing feedback to individual therapists on their clients' psychotherapy outcome

Abstract

This study examined data collected on over 5,000 clients seen by 71 therapists over a 6-year period in a University Counseling Center. Clients were given the Outcome Questionnaire-45 (OQ-45) on a session-by-session basis to track their treatment response. Data were also collected on therapists' theoretical orientation, years of experience, gender, and type of training. Data were analyzed using hierarchical linear modeling (HLM) to see if general therapist traits (i.e., theoretical orientation, type of training) accounted for differences in clients' rate of improvement. Data were then analyzed, again using HLM with therapists as a fixed effect, to compare individual therapists to see if there were significant differences in the efficiency of treatment. In addition, pre- minus posttest OQ-45 scores were examined to see if there were differences in the overall outcome of clients. There was a significant amount of variation among therapists' clients' rates of improvement. Therapist feedback reports were generated to summarize client outcome for individual providers in contrast to center averages and in an attempt to improve client outcome.

Therapist effects and IAPT Psychological Wellbeing Practitioners (PWPs): A multilevel modelling and mixed methods analysis

“…In contrast to the results from RCTs, naturalistic studies drawing on data from routine practice have tended to indicate consistent therapist effects in the region of 5%-8% of the variance in outcome explained (e.g., Baldwin & Imel, 2013, Brown, Lambert, Jones, & Minami, 2005Lutz, Scott, Martinovich, Lyons, & Stiles, 2007;Okiishi, Lambert, Eggett, Nielson, Vermeersch & Dayton, 2006;Saxon & Barkham, 2012). In a context where therapy is being delivered in routine practice and therapists may not be implementing protocol-driven interventions, the resulting variability in therapist effects appears understandable.…”

“…Because of the limited number of PWPs in the current study, patient pre-treatment severity was also controlled for in the modelling. Pre-treatment severity is strongly associated with outcome (Garfield, 1994) and once this is taken into account other variables have little predictive value (Okiishi et al, 2006, Luborsky, McLellan, Diguer, Woody, & Seligman, 1997.…”

Positions Constructed for a Female Therapist in Male Batterers' Treatment Group

“…Positions constructed for a female therapist in male batterers' group treatment In psychotherapy research the gender of the therapist has been found a poor predictor of therapy outcome for both male and female clients (Bowman, Scogin, Floyd, & McKendree-Smith, 2001; Okiishi et al 2006). It has been suggested that how the therapist deals with processing gender issues in the therapy session seems to be much more important than the therapist's gender itself (Blow, Timm, & Cox, 2008).…”

The relationship between clients’ personality traits, working alliance and therapy outcome in a training context

“…Minor differences between professionals and trainees have been found in studies (e.g. Okiishi et al, 2006;Hill & Knox, 2013). More research is needed in this area.…”