Introducing the association of psychology training clinics’ collaborative research network: A study on client expectancies.

Abstract

A nationwide collaborative research netviiork has been developed by the Association of Psychology Training Clinics (APTC) to carry out research with the potential to improve services provided in training clinic settings. Six APTC member clinics participated in this inaugural study. In addition to demonstrating that the APTC research network can recruit clients for participation in multisite research and randomize enrolled participants to conditions effectively across the network, findings from this study also conürihute to our growing understanding of the problem of premature termination within psychology training clinics. More specifically, the results conñrm earlier single-site reports in the literature that a high rate of premature termination is a common problem within psychology training clinics (multisite M = 69.4%) and that the most typical client outcome at the end of treatment is no reliable change in symptomatic distress. Findings indicate that clients' pretreatment expectations of treatment duration are positively correlated with the number of treatment sessions subsequently attended and are pi:Edictive of clients' symptom severity at termination. However, expectancy education was not associated with a reduction in premature termination. Notably, there is a positive correlation between prior treatment exposure and cuirent, prospective treatment expectations. Implications for training and policy are discussed with future directions for research suggested.

How much therapy is enough? The dose–response effect and its moderators in a psychology training clinic

“…as well as the mean baseline OQ-45 score reported by similar training clinic studies (75.78 [SD = 24.32];Callahan & Hynan, 2005; 77.15 [SD = 25.02];Callahan et al, 2014).…”

“…In line with the GEL model, it is also possible that individuals who are “fast responders” to treatment do not need more than one course of treatment to improve, leading to a longer time‐to‐response among those with a past treatment history. Importantly, previous research across a network of training clinics has found that a history of prior treatment was associated with client expectations for a longer treatment duration, which itself predicted a greater number of sessions attended as well as client severity at termination (Callahan et al, 2014). Unlike some prior research suggesting that initial severity of depressive symptoms impacts treatment outcomes (Mulder et al, 2006; Teri & Lewinsohn, 1986; Tunvirachaisakul et al, 2018), we did not find significant effects of the initial severity of either depressive or anxious symptoms, or overall distress on time to achieve change.…”

“…Indeed, access to information about typical patterns of client change may be particularly important in the training clinic context (Hansen, Lambert, & Forman, 2006). Despite some studies showing that student clinicians can achieve outcomes comparable with those of licensed professionals (e.g., Nyman, Nafziger, & Smith, 2010), several studies have shown suboptimal outcomes among clients of training clinics, namely high rates of premature termination (Al‐Jabari, Murrell, Callhan, Cox, & Lester, 2019; Aubuchon‐Endsley & Callahan, 2009; Callhan, Aubuchon‐Endlsey, Borja, & Swift, 2009; Callahan et al, 2014; Swift, Callahan, & Levine, 2009; Swift & Greenberg, 2012) and high rates of failure to achieve reliable change (RC; Callahan et al, 2014; Callahan & Hynan, 2005; Carr, Saules, Koch, & Waltz, 2017; Kadera, Lambert, & Andrews, 1996; Swift, & Callhan, 2008). Additional information regarding typical patterns of change may help trainee clinicians and their supervisors to more accurately identify clients who are at risk for failing to make progress and to more effectively intervene with these at‐risk clients (Worthen & Lambert, 2007).…”

The Role of Expectations in Treatment Outcome and Symptom Development in Anxiety Disorders

“…A recent study found that when clients were provided with information regarding the relationship between treatment efficacy and the number of sessions attended (i.e., that, on average, 50% of the clients showed a clinically significant change after 13-18 sessions), they were significantly less likely to drop out [52]. However, a recent study by Callahan et al [53] found that clients' pretreatment expectations regarding the duration of treatment remained unchanged after an education session. Conversely, clients' previous experiences with therapy were significantly related with the number of sessions attended and treatment outcome.…”

Can Trainees Effectively Deliver Dialectical Behavior Therapy for Individuals With Borderline Personality Disorder? Outcomes From a Training Clinic

“…Psychology training clinics, where student clinicians learn to conduct therapy while receiving extensive supervision, are practice settings that have not been sufficiently explored. This gap in the literature is particularly noteworthy given that, as one research team notes, “psychology training clinics are ground zero in the training and development of professional psychologists” (Callahan et al., , p. 102). Research has also demonstrated that a majority of trainees will work with at least one client with suicidal ideation or behavior (e.g., Dexter‐Mazza & Freeman, ; Kleespies, Penk, & Forsyth, ).…”