Session effects, comparability, and managed care in the psychotherapies.

Herron, William G.; Eisenstadt, Edda N.; Javier, Ricardo; Primavera, Louis H.; Schultz, Candace L.

doi:10.1037/h0090219

Cited by 17 publications

(7 citation statements)

References 19 publications

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“…Further examination of the relationship between the number of sessions attended and the outcome for clients in these centers is warranted because some contend that current managed-care accountability procedures are inappropriate. These critics claim that such procedures emphasize usage rather than session-by-session effectiveness and that building effectiveness curves may be more appropriate (Herron, Eisenstadt, Javier, & Primavera, 1994).…”

mentioning

confidence: 97%

Time‐Limited Counseling Outcome in a Nationwide College Counseling Center Sample

Draper

Jennings

Barón

et al. 2002

J of College Counseling

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This study examined the dose-effect relationship between the number of sessions and therapeutic outcome in a large, nationwide counseling center research consortium. A positive relationship was found between the outcome of counseling and the number of sessions attended. The results of this study support the effectiveness of brief psychotherapy. In recent years, the dose-response metaphor borrowed from pharmacology research has gained prominence in psychotherapy outcome research, as well (see Jones, Bigelow, & Preston, 1999, for example). One of the major contributions to this type of research is the influential meta-analysis performed by Howard, Kopta, Krause, and Orlinsky (1986), who proposed a doseeffect model linking the dosage of therapy sessions attended to the improvement clients experienced by attending each session. The log of the number of sessions became the dose, and the normalized probability of improvement was defined as the effect, using probits as the unit of analysis. The researchers constructed their dosage model by probit analysis of 15 previous outcome studies, some dating as far back as 1950, and computed the predicted improvement session by session. The results verified that the longer patients remained in therapy, the greater the gain. Results also revealed that 15% of patients improve between intake and the first session (presumably due to spontaneous remission and the ameliorative effects of having sought treatment), 50% improve after 8 sessions, and 75% improve after 26 sessions. Inspired by these results, other researchers began to analyze the dose effect for

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mentioning

confidence: 97%

Time‐Limited Counseling Outcome in a Nationwide College Counseling Center Sample

Draper

Jennings

Barón

et al. 2002

J of College Counseling

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“…It is unclear, however, at which point the number of therapy sessions begins to have no effect on client progress. Herron et al (1994) found that 10% to 18% of the patients demonstrated improvement by simply initiating therapy, 48% to 58% improved by eight sessions, 75% improved by 26 sessions and 85% improved by 52 sessions.…”

Section: Limitations Of Current Managed Care Organization Strategies mentioning

confidence: 98%

Managed Care's Impact on the Financial Well-Being of Social Workers in Private Practice

Keefe¹,

Hall²

1998

Social Work in Health Care

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The authors used the rosters from the Register of Clinical Social Workers, the American Psychological and American Psychiatric Associations to contrast a random sample of 167 private practicing social workers, 158 psychologists and 187 psychiatrists from across the nation with respect to changes in these practitioners' financial well-being since joining managed care organization panels. Although no statistically significant differences were found between the three groups with respect to many indicators of financial well-being, each of the groups reported that their financial well-being had been adversely affected by managed care organization guidelines. Because the social workers in this study were found to spend a greater percentage of their time in private practice than psychologists and psychiatrists, managed care organizations' policies with respect to financial reimbursement are likely to impact them more adversely than professionals in other disciplines. Other changes in overhead costs, including office staffing, record keeping and malpractice insurance, as required by managed care organizations, were considered by many of the respondents to be among the most prominent issues affecting their financial well-being.

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“…Herron et al (1994) report that long-term therapy is not necessarily better than short-term therapy. It is unclear, however, at which point the number of therapy sessions begins to have no effect on client progress.…”

Section: Certification Of Outpatient Psychotherapy Based On Treatmentmentioning

confidence: 99%

Managed Behavioral Health Care Provider Practice Patterns

Keefe

Hall

2000

Journal of Health & Social Policy

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Managed care is a dominating issue on the public policy agenda. Difficulties in defining and operationalizing it continue to have ramifications for the nation. It is often assumed that the care being reimbursed by managed care organizations is for clients whose psychiatric conditions have been appropriately diagnosed and treated. Based on the responses of a randomly-selected group from the major behavioral health care disciplines, not all care reimbursed is for care which has been appropriately diagnosed and treated. The cost implications of managed care and the ramifications for public health policy are discussed.

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Session effects, comparability, and managed care in the psychotherapies.

Cited by 17 publications

References 19 publications

Time‐Limited Counseling Outcome in a Nationwide College Counseling Center Sample

Time‐Limited Counseling Outcome in a Nationwide College Counseling Center Sample

Managed Care's Impact on the Financial Well-Being of Social Workers in Private Practice

Managed Behavioral Health Care Provider Practice Patterns

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