Outcome Benchmarks for Adaptations of Research-Supported Treatments for Adult Traumatic Stress

Abstract

This article provides benchmark data on within-group effect sizes from published randomized controlled trials (RCTs) that evaluated the efficacy of research-supported treatments (RSTs) for adult traumatic stress. Agencies can compare these benchmarks to their treatment group effect size to inform their decisions as to whether the way they are adopting or adapting one of these RSTs is satisfactory or needs to be modified or replaced by a different intervention approach. These benchmarks also have potential utility for future implementation of research efforts about these RSTs that can assess what service provision conditions are associated with effect sizes that resemble the benchmarks provided in this study.Keywords research-supported treatments in real-world settings, traumatic stress, meta-analysis, prolonged exposure therapy, cognitive processing therapy, EMDR Much progress has been made in recent decades in the development of interventions and programs with established efficacy in the treatment or prevention of various psychosocial problems. Rigorous systematic reviews and meta-analyses of randomized controlled trials (RCTs) have identified interventions thatwhen provided under relatively ideal service provision conditions-consistently obtain statistically and clinically significant outcomes. These interventions have been termed as research-supported treatments (RSTs; APA Presidential Task Force on Evidence-Based Practice, 2006). In the treatment of traumatic stress among adults, for example, these RSTs include prolonged exposure therapy (PE), cognitive processing therapy (CP), and eye movement desensitization and reprocessing (EMDR; Bisson et al.

Within-Group Effect-Size Benchmarks for Trauma-Focused Cognitive Behavioral Therapy With Children and Adolescents

“…One implication of our study, therefore, is that efforts are needed to help community-based practitioners understand and utilize the benchmarks provided in this and other emerging benchmark studies, such as the studies by Rubin et al (2014) and Rubin and Yu (2015). For example, those practitioners might need assistance regarding what pre- to postoutcome measures to use and in calculating their within-group effect sizes.…”

“…To address the problem of limited availability of control groups in community-based intervention settings, a benchmarking strategy is gaining attention in clinical psychology (Minami, Wampold, Serlin, Kircher, & Brown, 2007;Spilka & Dobson, 2015) and social work (Rubin, 2014;Rubin et al, 2014;Rubin & Yu, 2015). This strategy involves calculating within-group effect sizes for clients treated in settings where control groups are not feasible, and comparing them to within-group effect-size benchmarks which have been calculated from synthesizing existing RCT data.…”

“…A recent study by Rubin, Parrish, and Washburn (2014) provided benchmarks regarding research-supported treatments for traumatic stress among adults. The current study provides benchmarks for an intervention widely recognized for its effectiveness in treating traumatized children and youth: TF-CBT.…”

“…J. Cohen et al, 2008). A contrasting approach emphasizes not only issues with fidelity but also issues often faced in nonresearch settings trying to implement research supported interventions such as (1) limited resources for staffing, supervision, training, and evaluation of outcomes; (2) the differences in clientele needs and preferences regarding intervention approaches and how they are delivered; (3) higher staff turnover and high client attendance concerns; and (4) workers with larger and more diverse caseloads including more ethnic minority clients (Briere & Scott, 2014; Drake et al, 2001; Rubin, Parrish, & Washburn, 2014). This approach acknowledges potential external validity limitations of RCTs and emphasizes the need for satisfactory ways to modify and adapt intervention(s) to the practice setting and its clients rather than try to achieve maximum treatment fidelity.…”

Therapeutic OQ-45 Outcome Differences

“…For nearly two decades, researchers and clinicians have emphasized the importance of utilizing research-supported treatments (RSTs; Chambless et al, 1996; Johnson, 2008; Rubin, Parrish, & Washburn, 2014; Wampold, 2001). Rating scales, like the widely used Outcome Questionnaire-45 (OQ; Lambert et al, 1996), have been used as tools to gauge the effectiveness of therapy.…”