The dose–effect relationship in psychotherapy.

1,389

1,011

A meta-analysis was conducted on controlled clinical trials investigating adaptations of motivational interviewing (AMIs), a promising approach to treating problem behaviors. AMIs were equivalent to other active treatments and yielded moderate effects (from .25 to .57) compared with no treatment and/or placebo for problems involving alcohol, drugs, and diet and exercise. Results did not support the efficacy of AMIs for smoking or HIV-risk behaviors. AMIs showed clinical impact, with 51% improvement rates, a 56% reduction in client drinking, and moderate effect sizes on social impact measures (d ϭ 0.47). Potential moderators (comparative dose, AMI format, and problem area) were identified using both homogeneity analyses and exploratory multiple regression. Results are compared with other review results and suggestions for future research are offered.

Section: Benchmarks For Comparisonmentioning

confidence: 99%

The efficacy of motivational interviewing: A meta-analysis of controlled clinical trials.

Burke¹,

Arkowitz²,

Menchola³

2003

1,389

1,011

“…Psychotherapy researchers are interested in the effects of treatment type and modality to identify the most efficacious treatments, and these may be important variables in establishing any benchmark. Number of weeks in treatment was included, as the dose-effect relationship in psychotherapy is well documented (e.g., Howard, Kopta, Krause, & Orlinsky, 1986). Finally, sample size of the individual studies was included, as studies with smaller sample sizes may have larger effect sizes based on statistical power and publication bias toward studies with statistical significance (Quintana & Minami, 2006).…”

Section: Moderator Analysismentioning

confidence: 99%

Benchmarks for psychotherapy efficacy in adult major depression.

Minami¹,

Wampold²,

Serlin³

et al. 2007

103

135

This study estimates pretreatment-posttreatment effect size benchmarks for the treatment of major depression in adults that may be useful in evaluating psychotherapy effectiveness in clinical practice. Treatment efficacy benchmarks for major depression were derived for 3 different types of outcome measures: the Hamilton Rating Scale for Depression (M. A. Hamilton, 1960A. Hamilton, , 1967, the Beck Depression Inventory (A. T. Beck, 1978;A. T. Beck & R. A. Steer, 1987), and an aggregation of low reactivity-low specificity measures. These benchmarks were further refined for 3 conditions: treatment completers, intent-to-treat samples, and natural history (wait-list) conditions. The study confirmed significant effects of outcome measure reactivity and specificity on the pretreatment-posttreatment effect sizes. The authors provide practical guidance in using these benchmarks to assess treatment effectiveness in clinical settings.

“…They suggest that the intervention tapped into the variables responsible for behavioral change in a predictable manner (Howard, Kopta, Krause,&Orlinsky, 1986).…”

Section: Dose-response Relationmentioning

confidence: 99%

Telephone counseling for smoking cessation: Effects of single-session and multiple-session interventions.

Zhu¹,

Stretch²,

Balabanis³

et al. 1996

304

238

Smokers (N = 3,030) were randomized to receive 1 of 3 interventions: (a) a self-help quit kit, (b) a quit kit plus 1 telephone counseling session, or (c) a quit kit plus up to 6 telephone counseling sessions, scheduled according to relapse probability. Both counseling groups achieved significantly higher abstinence rates than the self-help group. The rates for having quit for at least 12 months by intention to treat were 5.4% for self-help, 7.5% for single counseling, and 9.9% for multiple counseling. The 12-month continuous abstinence rates for those who made a quit attempt were 14.7% for self-help, 19.8% for single counseling, and 26.7% for multiple counseling. A dose-response relation was observed, as multiple sessions produced significantly higher abstinence rates than a single session. The first week after quitting seems to be the critical period for intervention.Telephone counseling has attracted increasing interest as an alternative system for delivery of services in the field of smoking cessation (e.g., Anderson, Duffy, Hallet, & Marcus, 1992;Curry, McBride, Louie, Grothaus, & Wagner, 1992;DeBusk et al., 1994; Lando, Hellerstedt, Pirie, & McGovern, 1992;Orleans et al., 1991;Ossip-Klein et al., 1991;Prochaska, DiClemente, Velicer, & Rossi, 1993;Shiffman, Read, Maltese, Rapkin, & Jarvik, 1985). From the smoker's standpoint, its main attractions are accessibility and convenience. There are no transportation difficulties and fewer scheduling conflicts than in most other cessation programs. Also, receiving counseling in the privacy of one's home provides treatment access to individuals who might not normally seek "counseling" to quit smoking. These factors encourage smokers to use the service (Zhu etal., 1995 cantly increases the success rate (e.g., Orleans et al., 1991;Ossip-Klein et al., 1991), others report only a short-term effect, with the long-term outlook no better than that of selfhelp(e.g., Curry etal., 1992; Lando etal., 1992). Those studies that have shown a significant intervention effect for telephone counseling, however, did not include a randomized design to test for a dose-response relation between the number of sessions and the treatment effect.The present study examined the effects of two levels of telephone counseling and compared them with the effects of a selfhelp approach. The lower intensity counseling consisted of one session before quitting. The higher intensity counseling included the same pre-quit session plus up to five sessions after the smoker had quit. We tested two hypotheses: (a) that counseling would produce a higher abstinence rate than a self-help quit kit, and (b) that multiple sessions of counseling would produce a higher abstinence rate than a single session.