Efficacy, effectiveness, and expected treatment response in psychotherapy

Lutz, Wolfgang

doi:10.1002/jclp.10169

Cited by 44 publications

(21 citation statements)

References 23 publications

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“…In two recent reviews, Miaskowski 2004) noted that neither the optimal dose (i.e., number of minutes or hours) nor the optimal duration (i.e., total number of weeks) of a psychoeducational intervention for cancer pain management is known. In contrast, work by Howard and colleagues (Howard et al 1986;Lutz et al 2001;Lutz 2003) found that the optimal dose of a psychotherapy intervention was 8 hours for 50% of the patients studied regardless of their specific psychiatric diagnoses. The remaining 50% of these patients needed a higher dose of psychotherapy defined as more time with the therapist.…”

Section: Discussionmentioning

confidence: 87%

The use of a responder analysis to identify differences in patient outcomes following a self-care intervention to improve cancer pain management

Miaskowski

Dodd²,

West³

et al. 2007

Pain

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Previously, we demonstrated, in a randomized clinical trial, the effectiveness of a psychoeducational intervention to decrease pain intensity scores and increase patients' knowledge of cancer pain management with a sample of oncology patients with pain from bone metastasis. In the present study, we evaluated for changes in mood states (measured using the Profile of Mood States), quality of life (QOL; measured using the Medical Outcomes Study Short Form-36 (SF-36)), and pain's level of interference with function (measured using the Brief Pain Inventory (BPI)) from baseline to the end of the intervention first between the intervention and the standard care groups and then within the intervention group based on the patients' level of response to the intervention (i.e., patients were classified as non-responders, partial responders, or responders). No differences were found in any of these outcome measures between patients in the standard care and intervention groups. However, when patients in the intervention group were categorized using a responder analysis approach, significant differences in the various outcome measures were found among the three respondent groups. Differences in the physical and mental component summary scores on the SF-36 and the interference items on the BPI, among the three respondent groups, were not only statistically significant but also clinically significant. The use of responder analysis in analgesic trials may help to identify unique subgroups of patients and lead to the development of more effective psychoeducational interventions.

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Section: Discussionmentioning

confidence: 87%

The use of a responder analysis to identify differences in patient outcomes following a self-care intervention to improve cancer pain management

Miaskowski

Dodd²,

West³

et al. 2007

Pain

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show abstract

“…Research designs in regular care settings with the goal of maximising external validity are often called "effectiveness" studies (in contrast to "efficacy") and are considered to be an increasingly important part of clinical research [17]. In such trials patients are preferably referred in a regular manner to treatment and extensive exclusion criteria should not be used.…”

Section: Introductionmentioning

confidence: 99%

Internet-versus group-administered cognitive behaviour therapy for panic disorder in a psychiatric setting: a randomised trial

et al. 2010

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BackgroundInternet administered cognitive behaviour therapy (CBT) is a promising new way to deliver psychological treatment, but its effectiveness in regular care settings and in relation to more traditional CBT group treatment has not yet been determined. The primary aim of this study was to compare the effectiveness of Internet-and group administered CBT for panic disorder (with or without agoraphobia) in a randomised trial within a regular psychiatric care setting. The second aim of the study was to establish the cost-effectiveness of these interventions.MethodsPatients referred for treatment by their physician, or self-referred, were telephone-screened by a psychiatric nurse. Patients fulfilling screening criteria underwent an in-person structured clinical interview carried out by a psychiatrist. A total of 113 consecutive patients were then randomly assigned to 10 weeks of either guided Internet delivered CBT (n = 53) or group CBT (n = 60). After treatment, and at a 6-month follow-up, patients were again assessed by the psychiatrist, blind to treatment condition.ResultsImmediately after randomization 9 patients dropped out, leaving 104 patients who started treatment. Patients in both treatment conditions showed significant improvement on the main outcome measure, the Panic Disorder Severity Scale (PDSS) after treatment. For the Internet treatment the within-group effect size (pre-post) on the PDSS was Cohen's d = 1.73, and for the group treatment it was d = 1.63. Between group effect sizes were low and treatment effects were maintained at 6-months follow-up. We found no statistically significant differences between the two treatment conditions using a mixed models approach to account for missing data. Group CBT utilised considerably more therapist time than did Internet CBT. Defining effect as proportion of PDSS responders, the cost-effectiveness analysis concerning therapist time showed that Internet treatment had superior cost-effectiveness ratios in relation to group treatment both at post-treatment and follow-up.ConclusionsThis study provides support for the effectiveness of Internet CBT in a psychiatric setting for patients with panic disorder, and suggests that it is equally effective as the more widely used group administered CBT in reducing panic-and agoraphobic symptoms, as well as being more cost effective with respect to therapist time.Trial registrationClinicalTrials.gov NCT00845260

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“…The effect size of psychotherapy is .88, which is within the same order of magnitude -and that is taking all psychotherapeutic approaches together. If the cognitive behavioral therapies are considered separately, their effect size is as high as 1.21 [8,10,16,17].…”

Section: Does It Work?mentioning

confidence: 99%

Future perspectives in psychotherapy

Schnyder

2009

Eur Arch Psychiatry Clin Neurosci

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Efficacy, effectiveness, and expected treatment response in psychotherapy

Cited by 44 publications

References 23 publications

The use of a responder analysis to identify differences in patient outcomes following a self-care intervention to improve cancer pain management

The use of a responder analysis to identify differences in patient outcomes following a self-care intervention to improve cancer pain management

Internet-versus group-administered cognitive behaviour therapy for panic disorder in a psychiatric setting: a randomised trial

Future perspectives in psychotherapy

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