Methodological Challenges of Characterizing Usual Care Psychotherapeutic Practice

Garland, Ann F.; Hurlburt, Michael S.; Brookman‐Frazee, Lauren; Taylor, Robin M.; Accurso, Erin C.

doi:10.1007/s10488-009-0237-8

Cited by 60 publications

(55 citation statements)

References 55 publications

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“…Data from this study were collected as part of a larger observational study examining treatment processes and outcomes for children with DBPs in UC (refer to Garland, Brookman-Frazee, et al, 2010 and Garland, Hurlburt, Brookman-Frazee, Taylor, & Accurso, 2010 for more details on clinic settings, client recruitment, and data collection procedures).…”

Section: Methodsmentioning

confidence: 99%

“…Inter-rater reliability on intensity coding was adequate (Cichetti, 1994), as assessed by double-coding of 31% (379) of the coded sessions resulting in an intra-class correlation coefficient of .78 across all codes. Details on the coders (non-clinician research assistants), coder training (didactics, manual review, and criterion testing), and reliability analyses are found in Garland, Hurlburt, and colleagues (2010).…”

Section: Methodsmentioning

confidence: 99%

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Searching for Elements of Evidence-Based Practices in Children's Usual Care and Examining Their Impact

Garland

Accurso

Haine‐Schlagel

et al. 2014

Journal of Clinical Child & Adolescent Psychology

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Objective Most of the knowledge generated to bridge the research - practice gap has been derived from experimental studies implementing specific treatment models. Alternatively, this study uses observational methods to generate knowledge about community-based treatment processes and outcomes. Aims are to (1) describe outcome trajectories for children with disruptive behavior problems (DBPs), and (2) test how observed delivery of a benchmark set of practice elements common in evidence-based (EB) treatments may be associated with outcome change, while accounting for potential confounding variables. Method Participants included 190 children ages 4–13 with DBPs and their caregivers, plus 85 psychotherapists, recruited from six clinics. All treatment sessions were video-taped and a random sample of four sessions in the first four months of treatment was reliably coded for intensity on 27 practice elements (benchmark set and others). Three outcomes (child symptom severity, parent discipline, and family functioning) were assessed by parent report at intake, four, and eight months. Data were collected on several potential covariates including child, parent, therapist, and service use characteristics. Multi-level modeling was used to assess relationships between observed practice and outcome slopes, while accounting for covariates. Results Children and families demonstrated improvements in all three outcomes, but few significant associations between treatment processes and outcome change were identified. Families receiving greater intensity on the benchmark practice elements did demonstrate greater improvement in the parental discipline outcome. Conclusion Observed changes in outcomes for families in community care were generally not strongly associated with the type or amount of treatment received.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Searching for Elements of Evidence-Based Practices in Children's Usual Care and Examining Their Impact

Garland

Accurso

Haine‐Schlagel

et al. 2014

Journal of Clinical Child & Adolescent Psychology

Self Cite

View full text Add to dashboard Cite

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“…A primary virtue of adopting core EBIs is that they equip clinicians with fundamental techniques that can be judiciously applied to clients presenting with diverse, comorbid, and/or emerging clinical problems (Barth et al 2014; Chorpita et al 2005, 2007). Core elements also represent a comfortable middle ground between molar versus molecular specification of treatment processes that is well-suited for describing the eclectic clinical practices favored in usual care (Barth et al 2014; Garland et al 2010b). …”

Section: Need For Efficient Fidelity Measures To Support Ebi Quality mentioning

confidence: 99%

Validity of Therapist Self-Report Ratings of Fidelity to Evidence-Based Practices for Adolescent Behavior Problems: Correspondence between Therapists and Observers

Hogue

Dauber

Lichvar

et al. 2014

Adm Policy Ment Health

113

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Developing therapist-report fidelity tools to support quality delivery of evidence-based practices in usual care is a top priority for implementation science. This study tested the reliability and accuracy of two groups of community therapists who reported on their use of family therapy (FT) and motivational interviewing/cognitive-behavioral therapy (MI/CBT) interventions during routine treatment of inner-city adolescents with conduct and substance use problems. Study cases (n = 45) were randomized into two conditions: (a) Routine Family Therapy (RFT), consisting of a single site that featured family therapy as its standard of care for behavioral treatment; or (b) Treatment As Usual (TAU), consisting of five sites that featured non-family approaches. Therapists and trained observational raters provided FT and MI/CBT adherence ratings on 157 sessions (104 RFT, 53 TAU). Overall therapist reliability was adequate for averaged FT ratings (ICC = .66) but almost non-existent for MI/CBT (ICC = .06); moreover, both RFT and TAU therapists were more reliable in reporting on FT than on MI/CBT. Both groups of therapists overestimated the extent to which they implemented FT and MI/CBT interventions. Results offer support for the feasibility of using existing therapist-report methods to anchor quality assurance procedures for FT interventions in real-world settings, though not for MI/CBT.

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“…Die Identifizierung möglicher Diskrepanzen zwischen den Empfehlungen der Leitlinien und deren tatsächlicher Umsetzung in Routineeinrichtungen ist jedoch ein entscheidender Schritt, um mögliche Defizite in der Anwendung leitliniengetreuer Interventionen zu reduzieren und hierüber die Versorgungssituation zu verbessern [Garland et al, 2010].…”

Section: Hintergrundunclassified

Versorgung Zwangserkrankter mit kognitiver Verhaltenstherapie als Behandlungsmethode erster Wahl

et al. 2015

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Hintergrund: Die kognitive Verhaltenstherapie (KVT) mit Exposition und Reaktionsverhinderung stellt die Behandlungsmethode erster Wahl für Patienten mit Zwangsstörung dar. Ziel der vorliegenden Studie war die Bestimmung des Anteils an Patienten mit einer Zwangsstörung, die in Deutschland eine KVT mit Exposition und Reaktionsverhinderung erhalten. Methode: Hierzu wurden die Daten aus einer Befragung zur Behandlungsvorgeschichte einer Stichprobe von 369 Patienten mit einer Zwangsstörung nach ICD-10 analysiert. Ergebnisse: Insgesamt berichteten 60% der Patienten, in ihrer Behandlungsvorgeschichte mindestens einmal eine KVT mit Expositionsübungen erhalten zu haben. Bei 37% war dies die erste Behandlung. 46% gaben an, mindestens einmal eine KVT mit therapeutenbegleiteten Expositionsübungen erhalten zu haben. Durchschnittlich vergingen 6 Jahre zwischen Beginn der Zwangsstörung und Beginn der ersten Behandlung. Schlussfolgerungen: Zwei Fünftel der Patienten unserer Stichprobe berichteten, dass sie noch nie eine KVT mit Exposition und Reaktionsverhinderung erhalten hatten, obwohl es sich dabei um die Methode erster Wahl bei Zwangsstörungen handelt. Wir diskutieren potenzielle Hürden aufseiten der Patienten, Ärzte und Therapeuten sowie Maßnahmen, die zur Verbesserung der Versorgungssituation beitragen könnten.

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Methodological Challenges of Characterizing Usual Care Psychotherapeutic Practice

Cited by 60 publications

References 55 publications

Searching for Elements of Evidence-Based Practices in Children's Usual Care and Examining Their Impact

Searching for Elements of Evidence-Based Practices in Children's Usual Care and Examining Their Impact

Validity of Therapist Self-Report Ratings of Fidelity to Evidence-Based Practices for Adolescent Behavior Problems: Correspondence between Therapists and Observers

Versorgung Zwangserkrankter mit kognitiver Verhaltenstherapie als Behandlungsmethode erster Wahl

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