Peer review of psychodynamic psychotherapy. Experimental studies of the American Psychological Association/CHAMPUS program.

Abstract

Two factorial experiments examined the effects of reviewer theoretical orientation, documented treatment progress, and patient concurrence data on the peer review of clinical treatment reports that described long-term psychodynamic psychotherapy with a depressed, female outpatient. The experiments employed an unobtrusive methodology; peer reviewers believed that their evaluations would affect the disposition of actual mental health insurance claims. Subjects (n = 105) were American Psychological Association/Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) peer reviewers of a psychodynamic, behavioral, or eclectic theoretical orientation. The psychodynamic reviewers, compared with the behavioral and eclectic reviewers, were more positive in their ratings of treatment and more generous in their future care reimbursement recommendations. Additionally, the data demonstrated that APA/CHAMPUS peer review was sensitive to reported treatment progress, and that reviewers of diverse orientations were equally responsive to documented progress in psychodynamic psychotherapy. The patient concurrence manipulation had little effect on the dependent measures. Implications for mental health quality assurance programs are discussed.