Progress feedback narrows the gap between more and less effective therapists: A therapist effects meta-analysis of clinical trials.

Abstract

Some psychotherapists are more effective than others, which means that patients' treatment outcomes partly depend on therapist effects (TEs). This study investigated whether the use of progress feedback influences TE. Data from N = 4,549 participants and 131 therapists across six clinical trials of progress feedback were analyzed. All trials used the Outcome-Questionnaire-45 (OQ-45) outcome measure and assigned psychotherapy patients to a usual psychological care condition or feedback condition. We examined whether feedback utilization moderated TE using multilevel modeling and random-effects meta-analysis. TE explained a small proportion (intracluster correlation coefficient [ICC] = .011) of variability in posttreatment OQ-45 scores in the pooled multistudy sample, after controlling for intake severity. Feedback utilization was associated with a statistically significant reduction of the magnitude of the TE (ICC = .009) by approximately 18.2%. Secondary analyses of OQ-45 subscales indicated that TEs were statistically significant in relation to symptom distress, but not interpersonal relations or social role. Feedback was associated with better treatment outcomes and narrower variability between therapists. Feedback-informed treatment reduces the gap between more and less effective therapists, leading to more equitable and effective psychological care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).