Beauty is in the eye of the beholder: Personalized goals may be more (or less) than meets the eye.

Wampold, Bruce E.

doi:10.1111/cpsp.12150

Cited by 3 publications

(3 citation statements)

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“…Although this measure gives valuable information about patients’ overall therapy success, it may at the same time blur more specific pathways of change that could be uncovered in more tailored research designs (e.g., by examining more standardized treatments that focus on target-specific outcomes; Crits-Christoph, Wilson, & Hollon, 2005; Seligman, 1995). For example, it may be true that the (early) collaborative qualities including alliance influence retrospective therapy-related memories at posttreatment, as the personalized goal setting is directly connected with clinical tasks during therapy (e.g., Wampold, 2016). Clearly, more studies are required to better understand the multiple facets of how patients build their holistic picture of psychotherapy change at the end of therapy (e.g., by applying cognitive question methods; Collins, 2003; Taminiau-Bloem et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…the personalized goal setting is directly connected with clinical tasks during therapy (e.g., Wampold, 2016). Clearly, more studies are required to better understand the multiple facets of how patients build their holistic picture of psychotherapy change at the end of therapy (e.g., by applying cognitive question methods; Collins, 2003;Taminiau-Bloem et al, 2016).…”

Section: Relation Between Alliance and Subjective Change Measuresmentioning

confidence: 99%

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Investigating the impact of early alliance on predicting subjective change at posttreatment: An evidence-based souvenir of overlooked clinical perspectives.

Flückiger¹,

Hilpert²,

Goldberg³

et al. 2019

Journal of Counseling Psychology

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Despite meta-analytic evidence showing that alliance is associated with posttreatment outcomes, several open questions still remain regarding this relation. First, we investigate whether (or not) the progressive aggregation of early alliance assessments increases the alliance-outcome relation across 2 distress and 4 subjective change measures. Second, we investigate whether the alliance-outcome relations using subjective change measures are independent from intake distress and early response. Third, we explore whether the progressive aggregation of the alliance on outcomes becomes particularly apparent between or within therapists again investigating these six outcome measures. Data were drawn from N ϭ 430 patients treated by N ϭ 151 therapists. Patient ratings of early alliance were assessed after Session 1 to 6. For outcome, 2 commonly used distress measures at intake and at posttreatment and 4 measures of retrospectively evaluated subjective change at posttreatment are integrated into a series of multilevel models. The proportion of variance in outcome predicted by alliance scores varied considerably depending on the number of alliance assessments which were aggregated, as well as on the type of outcome assessment (distress vs. subjective change measures) explaining up to 15% of outcome variance. Improvements in the strength of prediction with aggregated alliance assessments were most pronounced for subjective change measures for between-therapist components of the alliance. Examining associations with subjective change measures provides an additional, patient-centered perspective of the relation between early alliance and treatment outcomes. Public Significance StatementDespite ongoing encouragement to systematically consider patient-centered outcomes in clinical research, subjective change measures (i.e., how patients evaluate the change during psychotherapy) are still neglected in guidelines of how to conduct trial research. The present study shows that the alliance-outcome relation is dependent on the number of aggregated alliance assessments, the type of outcome assessment (i.e., distress vs. subjective change measures) and whether intake and early response are adjusted for or not. Aggregated early alliance assessments were shown to relate most strongly to retrospectively evaluated subjective change at posttreatment. Examining associations with subjective change measures provide additional clinical perspectives on process and outcomes when conducting clinical trials and routine outcome monitoring.

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Section: Discussionmentioning

confidence: 99%

Section: Relation Between Alliance and Subjective Change Measuresmentioning

confidence: 99%

Investigating the impact of early alliance on predicting subjective change at posttreatment: An evidence-based souvenir of overlooked clinical perspectives.

Flückiger¹,

Hilpert²,

Goldberg³

et al. 2019

Journal of Counseling Psychology

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“…Yet other meta-analyses, including a comprehensive Cochrane review (Kendrick et al, 2016), have cast doubts on this conclusion (Knaup, Koesters, Schoefer, Becker, & Puschner, 2009). Other issues have arisen as well: It appears that access to regular progress feedback does not result in therapists improving their outcomes over time (Goldberg et al, 2016), clinicians do not readily adopt ROM systems (Boswell, Kraus, Miller, & Lambert, 2015) even if they hold positive attitudes toward ROM (Jensen-Doss et al, 2018), organizational implementation has proved challenging (Mellor-Clark, Cross, Macdonald, & Skjulsvik, 2016), there is a long-standing discussion about which outcomes should be tracked in practice (Ogles et al, 1996; Wampold, 2016), and none of the current approaches have yet emerged as a single universally adopted formal approach to ROM, paralleling the current state of competing evidence-based approaches to psychotherapy (Miller, Hubble, Chow, & Seidel, 2015).…”

mentioning

confidence: 99%

Five types of clinical difference to monitor in practice.

Langkaas

Wampold

Hoffart³

2018

Psychotherapy

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A fundamental part of professional practice is to monitor case progress to inform basic clinical decisions about when to discontinue interventions, when to adjust interventions, and when to proceed as planned. When interpreting observed change, there are at least five distinct types of clinical difference that can occur independently, and mistaking one for another can lead to misinformed clinical decisions. We introduce a distinction between observed difference, detected difference, predicted difference, attainment difference, and induced difference, and use these to analyze current systems for routine outcome monitoring (ROM) in clinical practice. Contrary to what supporting evidence of current ROM systems suggests, we find that-by design-these systems fail to detect and predict potentially harmful treatment and fail to detect and predict likely treatment responders. We discuss implications of the presented classification for professional practice and further development of ROM systems. We argue that clinical practice would benefit from monitoring difference instead of change, as these are not equivalent. We further argue that future research and development efforts should focus on the development of a working approach to monitoring induced difference, improving how to monitor predicted difference, exploring statistical models that better discriminate between various types of clinical cases, and better communicate what can and cannot be interpreted from the clinical differences that are actually monitored, as guided by the presented classification of clinical differences to monitor in practice. (PsycINFO Database Record

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