Therapist effects in the National Institute of Mental Health Treatment of Depression Collaborative Research Program

Elkin, Irene; Falconnier, Lydia; Martinovich, Zoran; Mahoney, Colleen

doi:10.1080/10503300500268540

Cited by 109 publications

(85 citation statements)

References 50 publications

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“…Interestingly, this range is comparable with the existing literature, where some studies have reported TEs near zero (e.g. Ehlers et al, 2013;Elkin et al, 2006;Owen, Tao, & Rodolfa, 2010) while other studies have reported TEs of 10% or higher (e.g. Boswell, Castonguay, & Wassermann, 2010).…”

Section: Discussionsupporting

confidence: 79%

“…The sample contained 17 therapists who treated between 4-11 patients each. Using the same sample, Elkin, Falconnier, Martinovich and Mahoneya (2006) could not find variance associated with therapists, whereas Kim and colleagues (2006) identified a TE of approximately 8%. The small sample size, along with other issues, has been identified as a cause of these contrary results (CritsChristoph & Gallop, 2006;Elkin, Falconnier, & Martinovich, 2007;Lutz & Barkham, 2015;.…”

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confidence: 90%

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Reliability of Therapist Effects in Practice-Based Psychotherapy Research: A Guide for the Planning of Future Studies

Schiefele

Lutz

Barkham

et al. 2016

Adm Policy Ment Health

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Section: Discussionsupporting

confidence: 79%

mentioning

confidence: 90%

Reliability of Therapist Effects in Practice-Based Psychotherapy Research: A Guide for the Planning of Future Studies

Schiefele

Lutz

Barkham

et al. 2016

Adm Policy Ment Health

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“…However, the present study's findings are in contrast to Elkin et al (2006) who did not find significant therapist effects. In the present study, the results indicated that although therapist effects were statistically significant, they were not large enough to analyze using multilevel modeling.…”

Section: Discussioncontrasting

confidence: 57%

Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs

et al. 2017

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Multiple randomized clinical trials have shown that cognitive processing therapy (CPT) and prolonged exposure (PE) are evidence-based treatments for posttraumatic stress disorder (PTSD). However, additional research should verify the effectiveness of CPT and PE in conditions more reflective of clinical practice. The present study evaluated the effectiveness of CPT and PE at reducing veterans' self-reported PTSD symptoms as measured by total scores on the PTSD Checklist (PCL). This study involved a retrospective review of 2,030 charts. 750 veterans from 10 U.S. states who received CPT or PE in individual psychotherapy from the Veterans Health Administration were included in the study (N participants in CPT = 376; N participants in PE = 374). The study used multilevel modeling to evaluate the absolute and relative effectiveness of both treatments and to determine the relationship between patient-level factors and total PCL scores during treatment. Results showed that both CPT and PE were equally effective at reducing total PCL scores, but that the effectiveness of both therapies was reduced when compared to results obtained in randomized clinical trials. Patients who completed therapy reported significantly larger reductions on the PCL than patients who did not complete therapy. On average, patients who did not complete a full course of therapy reported little to no improvement on the PCL. Encouragingly, as a group these patients did not report an increase in the severity of their total PCL scores prior to dropping out from therapy. Patients who reported more severe total PCL scores at baseline experienced significantly larger reductions in PCL scores during therapy, but veterans at all levels of initial PTSD symptom severity benefited from treatment. Older veterans and Hispanic veterans had higher total PCL scores at baseline.However, veterans across all ages and three racial/ethnic groups (Caucasian, African American, Hispanic) experienced equivalent rates of symptom reduction. Therapist effects were small, but -ivstatistically significant. The study discusses the significance of these findings in light of prior research on trauma-focused therapy, future directions for research, and implications for practice.-v- Acknowledgements

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“…This evidence base has, however, been criticised for being founded on studies with typically small sample sizes (e.g., often around 20-120 patients with 5-20 therapists). Accordingly, studies utilizing large-scale routine practice data sets have been recommended (Elkin, Falconnier, Martinovich, & Mahoney, 2006). In contrast to traditional or high-intensity delivery models of therapies, considerably less attention has been paid to therapist effects with low-intensity interventions (e.g., Almlov, Carlbring, Kallqvist, Paxling, & Cuipers, 2011), despite increasing use of such interventions in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Therapist effects and moderators of effectiveness and efficiency in psychological wellbeing practitioners: A multilevel modelling analysis

Firth

Barkham

Kellett

et al. 2015

Behaviour Research and Therapy

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Article available under the terms of the CC-BY-NC-ND licence (https://creativecommons.org/licenses/by-nc-nd/4.0/) eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/ Reuse Unless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. Results: Therapist effects accounted for 6-7% of outcome variance that was moderated by greater initial symptom severity, treatment duration, and non-completion of treatment.Clinically effective PWPs achieved almost double the change per treatment session. As treatment durations increased beyond protocol guidance, outcomes atrophied. Treatment noncompletion was particularly detrimental to outcome.Conclusions: PWPs appear to be differentially effective and efficient despite ostensibly delivering protocol driven interventions. Implications for services, training, and supervision are outlined.

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Therapist effects in the National Institute of Mental Health Treatment of Depression Collaborative Research Program

Cited by 109 publications

References 50 publications

Reliability of Therapist Effects in Practice-Based Psychotherapy Research: A Guide for the Planning of Future Studies

Reliability of Therapist Effects in Practice-Based Psychotherapy Research: A Guide for the Planning of Future Studies

Effectiveness of Cognitive Processing Therapy and Prolonged Exposure in the Department of Veterans Affairs

Therapist effects and moderators of effectiveness and efficiency in psychological wellbeing practitioners: A multilevel modelling analysis

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