An exploratory study of patients’ sudden losses during outpatient CBT and therapists’ experience of difficulties

Abstract

Objective Patients’ sudden deterioration in symptomatology, also called sudden losses, is a rarely explored phenomenon. Method Psychological distress of 1,763 patients treated by 140 therapists was monitored after every therapy session. Patient‐reported outcome measures and patients’ therapy satisfaction was assessed. Therapists rated their experience of difficulties for every patient repeatedly over the course of therapy. Results More than one‐quarter of patients (26.5%) experienced at least one sudden loss during therapy. Patients with sudden losses did not differ significantly in psychotherapy outcome and therapy satisfaction from patients without sudden shifts. Therapists did not experience professional self‐doubt more often when working with sudden loss patients. Conclusion Sudden losses were not necessarily harmful for the outcome of psychotherapy and patients’ global therapy satisfaction. The results suggest that sudden losses can be compensated over the course of treatment.

Do I Like Me Now? An Analysis of Everyday Sudden Gains and Sudden Losses in Self-Esteem and Nervousness

“…Importantly, sudden gains are associated with better treatment outcomes both at treatment termination and at follow-up (Shalom & Aderka, 2020). On average, sudden losses are reported in approximately 10% of cases (Helmich et al, 2020; König et al, 2014; Krüger et al, 2014; Lutz et al, 2007, 2013; Lutz & Tschitsaz, 2007; Odyniec et al, 2019). Although they are less common than sudden gains, sudden losses also occur in various mental disorders (Helmich et al, 2020; Krüger et al, 2014; Lutz et al, 2013).…”

Longitudinal measurement invariance of the Behavioral Health Measure in a clinical sample.

“…Essentially, ROM includes clients completing brief measures of psychological functioning, which can be interpreted in session to track clients’ progress or deterioration (Brattland et al, 2018; Lambert, Whipple, & Kleinstäuber, 2018; Shimokawa, Lambert, & Smart, 2010). Obtaining information about what does or does not work for clients in therapy provides an entre for therapists to act against deterioration and promote positive gains in treatment (Odyniec, Probst, Göllner, Margraf, & Willutzki, 2019; Peterson & Fagan, 2017). Indeed, meta-analyses indicate that treatment with ROM is associated with improved treatment outcomes, reduction in the cost of care, shortening the length of treatment, and reducing deterioration risk (Goodman, McKay, & DePhillipis, 2013; Lambert et al, 2018; Miller et al, 2015).…”