Outcome assessment: From conceptualization to implementation.

Abstract

Brief Therapy CenterA method of assessing outcome after psychotherapy in private practice or clinics is described. Use of this system is illustrated by reference to the progress and rate of recovery of 27 patients seen by a private practice clinician in comparison with base rates from a prior study. The results suggested more rapid recovery in the patients treated by an experienced clinician committed to a brief, solutionfocused psychotherapy. The methodology reported, based on weekly assessment of patient progress and the use of clinical significance markers, has implications for routine clinical practice as well as for managed health care practices and social policy decisions.Clinicians have remained rather skeptical about the relevance and value of psychotherapy process and outcome research, looking elsewhere for guidance in directing their clinical practice (Talley, Strupp, & Butler, 1994). Although there is a rich database supporting the efficacy of many psychotherapies (summarized by Lambert & Bergin, 1994), health delivery providers in general, and psychotherapists in particular, are being challenged to document the outcome of the treatments they provide to given patients. Much of this documentation is focused on demonstrating that more expensive, time-intensive treatments produce better outcomes than less expensive interventions. Andrews (1995) has argued that the push for outcome research is a worldwide phenomenon independent of any specific payment system. It appears that psychotherapists will be involved in outcome assessment either by choice or by default. Professional psychologists are seemingly well suited to the task of being practitioner-scientists and using outcome assessment to the advantage of their patients.Outcome assessment has a long history, dating back to the 1930s (see Lambert, 1983, for a review). Early efforts at outcome assessment represented by small, well-controlled studies were driven by psychological theories and scientific considera-

Reciprocal influence model of working alliance and therapeutic outcome over individual therapy course.

“…The OQ-10.2 (Lambert et al, 1998) consists of 10 items designed to track client progress during the psychotherapy process. It measures the therapeutic outcome in terms of symptomatic change in two domains: psychological well-being (5 items) and psychological distress (5 items) (Seelert, Hill, Rigdon, & Schwenzfeier, 1999).…”

Models of Psychotherapy Outcome: Are They Applicable in Training Clinics?

“…However, since the seminal article on the dose-effect response, numerous replications have reported considerable variability in obtained response curves (e.g., Barkham et al, 1996;Kopta, Howard, Lowry, & Beutler, 1994;Lambert, Okiishi, Finch, & Johnson, 1998;Lambert et al, 1996;Lueger, Lutz, & Howard, 2000). It is possible that this variability may, in part, reflect differences in service site and the usage of trainees in the provision of services.…”

Efficacité thérapeutique, motivation autodéterminée et soutien aux besoins interpersonnels du client auprès d'adultes en psychothérapie brève /

“…Le problème est que la grande majorité de ces instruments n'ont pas été conçus dans le but d'évaluer ce concept (Hill & Lambert, 2004) ou ont été élaborés dans le but d'évaluer des symptômes spécifiques (p. ex., l'Inventaire de dépression de Beck) (Lambert, Okiishi, Finch, & Johnson, 1998). C'est pour fournir au système de soins de santé un instrument de mesure spécifiquement conçu pour évaluer l'efficacité thérapeutique que la Mesure d'Impact a été élaborée (Lambert, Hasen, Umphress, Lumen, Okiishi, & Burlingame, 1996).…”

“…Cette variable est évaluée par l'entremise de la Mesure d'Impact (MI), traduction française de I'Outcome Questionnaire-45.2 (OQ : Lambert et al, 1996). Ce questionnaire a été conçu pour les (Lambert et al, 1998). Les tests-retests varient entre 0,7 et 0,8 tandis que la cohérence interne est autour de 0,90 (Lambert et al, 1998).…”

“…Ce questionnaire a été conçu pour les (Lambert et al, 1998). Les tests-retests varient entre 0,7 et 0,8 tandis que la cohérence interne est autour de 0,90 (Lambert et al, 1998). …”