What too strict a method obscures about the validity of outcome measures

Desmet, Mattias; Nieuwenhove, Kimberly Van; Smet, Melissa De; Meganck, Reitske; Deeren, Bram; Huele, Isabel Van; Decock, Elien; Raemdonck, Eveline; Cornelis, Shana; Truijens, Femke; Zeuthen, Katrine; Schiepek, Günter

doi:10.1080/10503307.2020.1865584

Cited by 17 publications

(18 citation statements)

References 34 publications

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“…Qualitative data indicate that these patients may appreciate how the development of the personalized questionnaire informed by idiographic systems modeling and questionnaire completion for a couple of months promoted insight whereas the regular completion of the same questionnaire for a longer period of time resulted in fatigue. These findings support the advantages of obtaining personalized process-related outcomes in psychotherapy (Barber & Solomonov, 2019; Desmet et al, 2021), which needs to be balanced with the possible disadvantages of repeated testing (Bos et al, 2015). However, future studies might consider the revision of questionnaires to address such fatigue.…”

Section: Discussionsupporting

confidence: 58%

Personalized high-frequency monitoring of a process-oriented psychotherapeutic approach to seizure disorders: Treatment utilization and participants’ feedback.

Michaelis¹,

Edelhäuser²,

Hülsner

et al. 2022

Psychotherapy

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High-frequency monitoring of psychological variables has been recommended to monitor and manage psychotherapeutic processes. However, high-frequency monitoring might be regarded as burdensome for participating patients. This feasibility study applied the concept of high-frequency treatment monitoring in patients with seizures and psychiatric comorbidities in an outpatient neurology service. The treatment monitoring entailed the development of a personalized process questionnaire, daily online monitoring, and regular reflection of the current time series graphs. Participants' feedback on user-friendliness and usefulness of this treatment monitoring was evaluated quantitatively and qualitatively. Participants' compliance rates (CRs) of daily self-assessments after 6 months were correlated with their quantitative feedback on user-friendliness and usefulness and the number of scheduled treatment sessions during this time period. Twenty patients, 15 women/5 men, median age 48 years (range: 23-73 years), were recruited. The median number of scheduled sessions was 11 sessions (range: 6-22). Participants reported a high overall satisfaction with the user-friendliness and usefulness of treatment monitoring. No notable correlations could be found between CRs and quantitative feedback nor between CRs and the number of scheduled treatment sessions. Personalized high-frequency monitoring of psychological variables seems to be feasible to monitor and manage process-oriented psychotherapeutic care in patients with seizures and psychiatric comorbidities. The results support the user-friendliness and usefulness of high-frequency monitoring and suggest that high-frequency monitoring may be suitable for monitoring of low-frequent treatment sessions and patients with attendance issues. This document is copyrighted by the American Psychological Association or one of its allied publishers.This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

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Section: Discussionsupporting

confidence: 58%

Personalized high-frequency monitoring of a process-oriented psychotherapeutic approach to seizure disorders: Treatment utilization and participants’ feedback.

Michaelis¹,

Edelhäuser²,

Hülsner

et al. 2022

Psychotherapy

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“…commentary on 18 papers on therapists’ experiences and reflections from the first year of pandemic by Ellman and Vorus, 2021 ). The low concordance between qualitative and quantitative evaluations has also attracted attention in outcome studies ( Desmet et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Loss of Rituals, Boundaries, and Relationship: Patient Experiences of Transition to Telepsychotherapy Following the Onset of COVID-19 Pandemic

et al. 2022

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Telepsychotherapy is an increasingly common way of conducting psychotherapy. Previous research has shown that patients usually have positive experiences of online therapy, however, with large individual differences. The aim of this study was to explore patients’ experiences of transition from in-person psychotherapy sessions to telepsychotherapy during the COVID-19 pandemic, as well as variation in the experiences with regard to the patients’ personality orientation. Seven psychotherapy patients in Sweden were interviewed and the transcripts were analyzed using thematic analysis. Additionally, the participants were asked to rate their dissatisfaction/satisfaction with the transition, how hindering/helpful the transition was, and how unsafe/safe they felt after the transition in comparison to before. Personality orientation on relatedness or self-definition was assessed applying a self-assessment instrument (Prototype Matching of Anaclitic-Introjective Personality Configuration; PMAI). The participants experienced telepsychotherapy as qualitatively different from in-person psychotherapy. They reported several essential losses: the rituals surrounding therapy sessions were lost, including the transitional time and space between their every-day life and the therapy sessions, less therapeutic work was done, the therapists could lose their therapeutic stance, the sense of rapport was impaired, and the patients felt less open and emotionally available. On the other hand, some patients could feel freer online. As six of the participants had an anaclitic personality orientation, the present study could especially contribute to the understanding of how patients with strong affiliative needs and fear of abandonment experience the transition to meeting their therapists via communication technology. The participants’ self-ratings showed that they were only marginally dissatisfied with the transition and experienced the transition as slightly hindering, whereas they felt rather safe after the transition, indicating low concordance between qualitative and quantitative evaluations. New studies are needed to explore the introjective patients’ experiences of the transition. An essential topic is also to collect evidence and to test how the impaired sense of rapport when using communication technology can be remedied by adequate, patient-tailored interventions, a topic that has to be included in psychotherapy education and training.

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“…In the earlier studies, clients who might have been assumed to be improved or recovered had indeed experienced a reduction in self‐reported symptoms, but the clients often moderated or tempered that classification by referring to the need for continuing progress and the experience of ongoing challenges (De Smet et al, 2020). Similarly, some clients thought to have deteriorated based on ROM outcome measures had in fact denied symptoms in the beginning of psychotherapy and reported improvement when interviewed (Desmet et al, 2021). In this case study, we found a similar pattern with the ROM suggesting deterioration while the client's perspective suggested benefit from therapy.…”

Section: Discussionmentioning

confidence: 99%

“…At the same time, ROM outcome classifications are most frequently based on session‐by‐session ratings using brief, global symptom measures which provide only one perspective of change. Several recent mixed methods studies demonstrate that narrative approaches may be useful for providing a more rich, nuanced perspective on client progress and illustrate that categorization using pre‐post ROM and clinical significance categories (via the Jacobson and Truax, 1991, method) may not always be precise (De Smet et al, 2020; Desmet et al, 2021; Roubal et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…For example, patients who were categorized as recovered following treatment often reported having “unresolved or recurring difficulties” that suggested change was an ongoing process (De Smet et al, 2020, p. 30). In a third study, the convergence between pre‐post categories of client outcome and qualitative analysis was moderate to low (Desmet et al, 2021). For example, they describe one patient as having quantitative scores that suggested no change (nonsignificant changes on three outcome measures), but when examining the therapy transcripts and in a follow‐up interview it was clear that the patient “progressively learned to deal with his problems” which he later described in this way, “The most important thing is that therapy helped, sometimes even without really knowing it” (Desmet et al, 2021, p. 7).…”

Section: Introductionmentioning

confidence: 99%

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Treatment success or failure? Using a narrative interview to supplement ROM

2022

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Although routine outcome monitoring (ROM) has been demonstrated to improve therapy efficiency and effectiveness, categorizations of improvement or deterioration using ROM measures (typically global symptoms) may not always be consistent with the lived experience of the client. A recent line of investigation examines these discrepancies and recommends supplementing ROM with additional measures or narrative interviews. In this case study, we use qualitative analysis of a posttreatment interview to specifically examine the client's perspective of discordant outcome when ROM indicated that the client deteriorated during treatment and the client reported retrospective improvement. We find that the interview provides a unique and helpful narrative perspective that supplements ROM.Findings suggest it may be useful to supplement ROM with approaches that extend beyond global symptom measurement and that outcomes from aggregated patient-focused research may be more complex than anticipated.

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What too strict a method obscures about the validity of outcome measures

Cited by 17 publications

References 34 publications

Personalized high-frequency monitoring of a process-oriented psychotherapeutic approach to seizure disorders: Treatment utilization and participants’ feedback.

Personalized high-frequency monitoring of a process-oriented psychotherapeutic approach to seizure disorders: Treatment utilization and participants’ feedback.

Loss of Rituals, Boundaries, and Relationship: Patient Experiences of Transition to Telepsychotherapy Following the Onset of COVID-19 Pandemic

Treatment success or failure? Using a narrative interview to supplement ROM

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