The Effects of Providing Therapists With Feedback on Patient Progress During Psychotherapy: Are Outcomes Enhanced?

Lambert, Michael J.; Whipple, Jason L.; Smart, David W.; Vermeersch, David A.; Nielsen, Stevan L.; Hawkins, Eric J.

doi:10.1080/713663852

Cited by 366 publications

(231 citation statements)

References 18 publications

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“…Feedback also improves attendance rates, though results are mixed as to whether all clients benefit or just those NOT. Specifically, Lambert et al (2001) found that clients who were NOT in a feedback condition attended significantly more sessions (9.68 vs. 5.03) than NOT clients in a TAU condition. Conversely, Slade et al (2008) found that all clients, not just those NOT, in a feed back condition with clinical support tools at tended 1.5 more sessions compared to TAU.…”

mentioning

confidence: 95%

Evaluating the efficacy of client feedback in group psychotherapy.

Slone¹,

Reese²,

Mathews-Duvall³

et al. 2015

Group Dynamics: Theory, Research, and Practice

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Monitoring progress in psychotherapy routinely (i.e., client feedback) has yielded positive results for improving both outcome and retention in individual and couple therapy; however, evidence of client feedback efficacy in a group format is limited. Using a randomized cluster design, group therapy participants (N = 84) were assigned to a client feedback or treatment-as-usual (TAU) condition in a university counseling center. Clients in the feedback condition used the Partners for Change Outcomes Management System (PCOMS; Duncan, 2011). Feedback participants had significantly larger pre-post group therapy gains (d = 0.41) and higher rates of reliable and clinically significant change when compared to TAU participants on the Outcome Rating Scale . Clients in the feedback condition also attended more group sessions compared to TAU participants. Study implications and future recommendations are provided.

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mentioning

confidence: 95%

Evaluating the efficacy of client feedback in group psychotherapy.

Slone¹,

Reese²,

Mathews-Duvall³

et al. 2015

Group Dynamics: Theory, Research, and Practice

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“…Warren and Rice (1972) also showed reduced PT by providing four 30-minute support sessions focused on making use of the therapy on offer. Another set of PT studies (e.g., Hawkins, Lambert, Vermeersch & Tuttle, 2004;Lambert et al 2001) investigated the effect of providing therapists with feedback on patient outcomes during therapy, in order to highlight those patients failing to improve and therefore at risk of PT. Lambert et al (2001) found that feedback increased the number of sessions completed for those patients who had been shown to be struggling to improve, but decreased the number of META-ANALYSIS OF PSYCHOTHERAPY ATTENDANCE 7 sessions completed when feedback demonstrated improvement.…”

Section: Narrative Overview Of Strategies To Promote Psychotherapy Atmentioning

confidence: 99%

Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Oldham¹,

Kellett²,

Miles³

et al. 2012

Journal of Consulting and Clinical Psychology

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Objective: Rates of non-attendance for psychotherapy hinder the effective delivery of evidencebased treatments. Although many strategies have been developed to increase attendance, the effectiveness of these strategies has not been quantified. The aim of the present study was to undertake a meta-analysis of rigorously controlled studies to quantify the effects of interventions to promote psychotherapy attendance.Method: The inclusion criteria were that studies (1) concerned attendance at individual or group psychotherapy by adults, (2) used a randomised controlled trial design to test an attendance strategy, and (3) used an objective measure of attendance. Computerised literature searches and hand searching resulted in a total of 31 RCTs that involved 33 independent tests of strategies for reducing treatment refusal and premature termination (N = 4,422). Effect sizes from individual studies were meta-analysed and moderator analyses were conducted.Results: Interventions had a small-to-medium effect on attendance across studies (d + = .38).Interventions to reduce treatment refusal and premature termination were similarly effective (d + = .37 and .39, respectively). Choice of appointment time or therapist, motivational interventions, preparation for psychotherapy, informational interventions, attendance reminders, and case management were the most effective strategies. Diagnosis also moderated effect sizes; samples with a single diagnosis benefited more from attendance interventions than samples that had a variety of diagnoses.Conclusions: Interventions to increase attendance at adult psychotherapy are moderately effective.However, relatively few studies met the strict study inclusion criteria. Further methodologically sound and theoretically informed interventions geared at increasing attendance are required. META-ANALYSIS OF PSYCHOTHERAPY ATTENDANCE 3Interventions to Increase Attendance at Psychotherapy:A Meta-Analysis of Randomised Controlled Trials A substantial proportion of clinical time is wasted because of patient non-attendance at scheduled adult psychotherapy appointments (Pekarik, 1985). The financial costs of nonattendance are marked (Hicks & Hickman, 1995; Kleine, Stone, Hicks & Pritchard, 2003), with patients not receiving help (Joshi, Maisami & Coyle, 1986) and therapists losing confidence as a result (Sledge, Moras, Hartley & Levine, 1990). Service efficiency is impaired when nonattendance rates are high (Rusius, 1995). Garfield (1994) noted that some patients fail to attend at assessment and essentially reject treatment. Hampton-Robb, Qualls, and Compton (2003) estimated that such treatment refusal (TR) occurs for 40% of referrals, on average. Premature termination (PT) occurs when patients fail to complete agreed treatment contracts (i.e., they 'drop-out' of therapy). A meta-analysis of 123 studies reported a PT rate of 46.8% (Wierzbicki & Pekarik, 1993) across treatment modalities. High PT rates are troubling in light of evidence that PT is associated with poor clinical outcome (Barret...

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“…In these published studies each therapist was asked to practice as they routinely do with half their case load while using the OQ-Analyst information with the other half of their case load. In this meta-analytic review of the OQ system data from 6 studies were combined ( n = 6,151) and re-analyzed [26,27,28,29,30,31]. …”

Section: Review Of Evidence Basementioning

confidence: 99%

Maximizing Psychotherapy Outcome beyond Evidence-Based Medicine

Lambert¹

2017

Psychother Psychosom

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103

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Despite evidence that psychotherapy has a positive impact on psychological disorders, 30% of patients fail to respond during clinical trials, and as many as 65% of patients in routine care leave treatment without a measured benefit. In addition, therapists appear to overestimate positive outcomes in their patients relative to measured outcomes and are particularly poor at identifying patients at risk for a negative outcome. These problems suggest the need for measuring and monitoring patient treatment response over the course of treatment while applying standardized methods of identifying at-risk cases. Computer-assisted methods for measuring, monitoring, identifying potential deteriorators, and providing feedback to clinicians are described along with a model that explains why feedback is likely to be beneficial to patients. The results of 12 clinical trials are summarized and suggest that deterioration rates can be substantially reduced in at-risk cases (from baseline rates of 21% down to 13%) and that recovery rates are substantially increased in this subgroup of cases (from a baseline of 20% up to 35%) when therapists are provided this information. When problem-solving methods are added to feedback, deterioration in at-risk cases is further reduced to 6% while recovery/improvement rates rise to about 50%. It is suggested that the feedback methods become a standard of practice. Such a change in patterns of care can be achieved through minimal modification to routine practice but may require discussions with patients about their clinical progress.

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The Effects of Providing Therapists With Feedback on Patient Progress During Psychotherapy: Are Outcomes Enhanced?

Cited by 366 publications

References 18 publications

Evaluating the efficacy of client feedback in group psychotherapy.

Evaluating the efficacy of client feedback in group psychotherapy.

Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials.

Maximizing Psychotherapy Outcome beyond Evidence-Based Medicine

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