Exploring therapist effectiveness across multiple domains over time.

Despite the common assumption that increased therapist experience correlates with improved client outcomes, studies reveal inconsistent relationships between therapist experience and therapy effectiveness. Some studies have demonstrated a slight worsening of client outcomes as therapists gain more experience. Yet, there are few studies that have examined how therapists change in their client outcomes over time, especially across different outcomes (e.

Sudden gains and deteriorations: Modeling the impact across outcomes with university counseling center clients.

Objective: This study examines the longitudinal impact of sudden gains/deteriorations across the outcomes associated with the phase model.

Method: In a sample of 16,657 clients who completed the Behavioral Health Measure-20, we identified sudden gains/deteriorations and employed multilevel piecewise analyses to assess their impact on subsequent treatment phases.

Results: We found that: (1) Following a sudden gain in the well-being outcome, the mean-level for the symptom outcome increased (meaning symptoms improved), and the rate of change decreased, (2) Following a sudden gain in the symptom outcome, the mean-level for the life functioning outcome increased, (3) Following a sudden deterioration in the well-being outcome, the mean-level and rate of change for the symptom outcome decreased, and (4) Following a sudden deterioration in the symptom outcome, the mean-level for the life functioning outcome decreased.

Defining early positive response to psychotherapy: An empirical comparison between clinically significant change criteria and growth mixture modeling.

Several different approaches have been applied to identify early positive change in response to psychotherapy so as to predict later treatment outcome and length as well as use this information for outcome monitoring and treatment planning. In this study, simple methods based on clinically significant change criteria and computationally demanding growth mixture modeling (GMM) are compared with regard to their overlap and uniqueness as well as their characteristics in terms of initial impairment, therapy outcome, and treatment length. The GMM approach identified a highly specific subgroup of early improving patients.

Good-enough level and dose-effect models: Variation among outcomes and therapists.

Objective: The current study examined the good-enough level (GEL) and dose-effect model on three outcome variables: well-being, symptom distress, and life functioning, while accounting for therapist effects. The dose-effect model assumes the rate of change is consistent across clients, and the GEL model assumes that the rate of change will vary according to the total length of treatment.

Method: The sample included 13,664 clients who completed 2-100 sessions of therapy.

Dose-effect relationship in routine outpatient psychotherapy: does treatment duration matter?

Objective: There is an ongoing debate concerning how outcome variables change during the course of psychotherapy. We compared the dose-effect model, which posits diminishing effects of additional sessions in later treatment phases, against a model that assumes a linear and steady treatment progress through termination.

Method: Session-by-session outcome data of 6,375 outpatients were analyzed, and participants were categorized according to treatment length.