Abstract
To consider the relationships between, therapist variability, therapy modality, therapeutic dose and therapy ending type and assess their effects on the variability of patient outcomes. Multilevel modeling was used to analyse a large sample of routinely collected data. Model residuals identified more and less effective therapists, controlling for case-mix. After controlling for case mix, 5.8 % of the variance in outcome was due to therapists. More sessions generally improved outcomes, by about half a point on the PHQ-9 for each additional session, while non-completion of therapy reduced the amount of pre-post change by six points. Therapy modality had little effect on outcome. Patient and service outcomes may be improved by greater focus on the variability between therapists and in keeping patients in therapy to completion.
Highlights
The past 50 years has seen a concerted effort by researchers to develop more effective models of therapy
2 School of Health and Related Research, University of Sheffield, ScHARR, Regent Court, Regent St., Sheffield S1 4DA, UK. Such models has been the randomised controlled trial (RCT) and results have been summarised by national policy bodies [e.g., Substance Abuse and Mental Health Services Administration (SAMDSA), National Institute for Health and Care Excellence (NICE)] to support the adoption of efficacious, evidence-based treatments into routine clinical practice
We found that the effect that dose and ending type had on patient outcomes varied between therapists
Summary
The past 50 years has seen a concerted effort by researchers to develop more effective models of therapy. The dominant research method for testing the efficacy of such models has been the randomised controlled trial (RCT) and results have been summarised by national policy bodies [e.g., Substance Abuse and Mental Health Services Administration (SAMDSA), National Institute for Health and Care Excellence (NICE)] to support the adoption of efficacious, evidence-based treatments into routine clinical practice. The Australian Department of Health requires Medicare-funded treatments to be evidence-based (Department of Health 2012), and treatment provision decisions made by the American Medicare and Medicaid governmental programs are influenced by the AHRQ (Agency for Healthcare Research and Quality 2002). In the UK, NICE (2016a) policy guidelines are used by the UK Department of Health to decide which treatments are to be funded by the National Health Service. The guidelines note that provision of the latter gives patients more choice, there is greater uncertainty about its effectiveness (NICE 2016b)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Administration and Policy in Mental Health and Mental Health Services Research
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
