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Abstract Couple and family therapy has well‐established benefits. Although the majority of clients benefit, some worsen, some show no positive change, and some drop out early. This suggests that existing treatment modalities requ...
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Abstract Couple and family therapy has well‐established benefits. Although the majority of clients benefit, some worsen, some show no positive change, and some drop out early. This suggests that existing treatment modalities require further advancement. One promising avenue to achieve advancement involves instituting, as the standard of care, formalized client feedback, which has been shown to improve outcomes. This paper is a non‐systematic review that outlines several formalized feedback systems currently available and highlights each system's utility with application to couple and family therapy. While couple and family therapists have unique obstacles in therapy due to multiple therapeutic alliances, the use of formalized feedback has potential to strengthen alliances and improve outcomes for all clients who participate. We advocate for the use of formalized feedback in the training of new therapists and to augment the supervision process. Practitioner points Encourage the couple and family therapy field to implement the use of formalized client feedback systems both clinically and in research Demonstrate the importance of implementing formalized client feedback systems to decrease premature termination and improve client outcomes Provide information about existing client feedback systems to give practitioners the opportunity to choose a method that most benefits their clients
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Abstract Clients are frequently recognized as perhaps having the largest impact on the eventual success or failure of treatment; however, researchers and clinicians alike often give inadequate attention to clients’ perspectives o...
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Abstract Clients are frequently recognized as perhaps having the largest impact on the eventual success or failure of treatment; however, researchers and clinicians alike often give inadequate attention to clients’ perspectives on psychotherapy processes and outcomes. Researchers who do examine client variables in psychotherapy often conduct research about the client rather than from the client . The purpose of this article is to introduce a special issue focused on the client's perspective in psychotherapy. Specifically, the articles in this issue present case studies and quantitative and qualitative research that seek to (a) demonstrate how to tailor interventions according to the client's perspective and (b) identify common themes in clients’ perspectives about their experiences in psychotherapy.
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The process of monitoring treatment outcome, also known as "client feedback," is increasingly becoming a recommended practice for psychotherapy. One concern, however, is how to integrate such a process into the work that psychothe...
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The process of monitoring treatment outcome, also known as "client feedback," is increasingly becoming a recommended practice for psychotherapy. One concern, however, is how to integrate such a process into the work that psychotherapists typically do. Three clinical examples are presented, illustrating how a client feedback system can be used in conjunction with a specific theoretical framework, interpersonal process therapy (Teyber, 2006). The examples highlight that client feedback not only can be of minimal disruption to the psychotherapy process, but may also offer the potential to augment a clinician's approach to helping. Theoretical and research support are provided for each example.
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High psychiatric readmission rates continue while evidence suggests that care is not perceived by patients as "patient centered." Research has focused on aftercare strategies with little attention to the inpatient treatment itself...
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High psychiatric readmission rates continue while evidence suggests that care is not perceived by patients as "patient centered." Research has focused on aftercare strategies with little attention to the inpatient treatment itself as an intervention to reduce readmission rates. Quality improvement strategies based on patient-centered care may offer an alternative. We evaluated outcomes and readmission rates using a benchmarking methodology with a naturalistic data set from an inpatient psychiatric facility (N = 2,247) that used a quality-improvement strategy called systematic patient feedback. Benchmarks were constructed using randomized clinical trials (RCTs) from inpatient treatment for depression, RCTs from patient feedback in outpatient settings, and national data on psychiatric hospital readmission rates. A systematic patient feedback system, the Partners for Change Outcome Management System (PCOMS), was used. Overall pre-post effect sizes were d = 1.33 and d = 1.38 for patients diagnosed with a mood disorder. These effect sizes were statistically equivalent to RCT benchmarks for feedback and depression. Readmission rates were 6.1% (30 days), 9.5% (60 days), and 16.4% (180 days), all lower than national benchmarks. We also found that patients who achieved clinically significant treatment outcomes were less likely to be readmitted. We tentatively suggest that a focus on real-time patient outcomes as well as care that is "patient centered" may provide a path toward lower readmission rates in addition to other evidence-based strategies after discharge.
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Software architectural styles that represent structural characteristics of software programs range from specific ones that can be applied to a particular domain to generic ones that can be applied to any domain. If a specific arch...
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Software architectural styles that represent structural characteristics of software programs range from specific ones that can be applied to a particular domain to generic ones that can be applied to any domain. If a specific archi- tectural style is available for the target system to be devel- oped, it is appropriate to apply it together with its associated modeling method. However, no quantitative evaluation on the efficiency of specific architectural styles has as yet been reported.
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Research demonstrating the effectiveness of treatment with youth from low socioeconomic backgrounds is limited. To address this limitation, we evaluated pre-post psychotherapy treatment outcomes with youth presenting with depressi...
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Research demonstrating the effectiveness of treatment with youth from low socioeconomic backgrounds is limited. To address this limitation, we evaluated pre-post psychotherapy treatment outcomes with youth presenting with depression-related diagnoses (N = 469) at a public behavioral health agency after they implemented a systematic client feedback approach as a quality improvement strategy. Clients were ethnically diverse youth at or under the poverty line. Treatment outcome was measured with the Outcome Rating Scale (Miller, Duncan, Brown, Sparks, & Claud, 2003) and the Child Outcome Rating Scale (Duncan. Sparks, Miller, Bohanske, & Claud, 2006). Benchmark methodology was used to compare effect size estimates to those achieved in randomized clinical trials. Average treatment effect sizes for the public behavioral health depression samples of children and adolescents (d = 1.39 and d = 1.69, respectively) were clinically superior to a waitlist benchmark drawn from clinical trials of youth depression, and clinically equivalent to a treatment benchmark drawn from youth depression clinical trials. Findings demonstrate that mental health services for depressed youth in poverty across an agency can be effective, and systematic client feedback may be a useful strategy to improve treatment outcomes.
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The General Dental Council (GDC) is exploring the concept of revalidation. How then can dentists continue to improve their practice learning from identified personal goals, while providing evidence for a regulatory body and contin...
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The General Dental Council (GDC) is exploring the concept of revalidation. How then can dentists continue to improve their practice learning from identified personal goals, while providing evidence for a regulatory body and continuing to deliver a service? The medical profession has looked to Multisource Feedback (MSF) for much of its answer to this dilemma.MSF, also known as 360deg feedback, can be defined as a process by which multiple individuals, representing discrete informant groups eg dental hygienists, provide feedback to recipients. The concept is based on the premise that practitioners' roles in multidisciplinary teams are fundamental and central to the provision of good client care. MSF assumes that practitioners can be individually assessed in a meaningful way across a number of competencies by this multidisciplinary team. Using advances in behavioural measurement theory, discriminating differences between practitioners can be quantified and reproduced. In addition, useful feedback can be provided as part of a quality improvement model to potentially improve client safety. Practically this involves the use of an online questionnaire distributed to the individual and their chosen raters. Feedback is then generated by collated comments and aggregating scores from the raters compared to self scores and ideally comparative cohort scores eg all practising dentists in the UK. This feedback should be supported by a trained facilitator.
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Valuation judgement bias has been a research topic for several years due to its proclaimed effect on valuation accuracy. However, little is known on the emphasis of literature on judgement bias, with regard to, for instance, resea...
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Valuation judgement bias has been a research topic for several years due to its proclaimed effect on valuation accuracy. However, little is known on the emphasis of literature on judgement bias, with regard to, for instance, research methodologies, research context and robustness of research evidence. A synthesis of available research will establish consistency in the current knowledge base on valuer judgement, identify future research opportunities and support decision-making policy by educational and regulatory stakeholders how to cope with judgement bias. This article therefore, provides a systematic review of empirical research on real estate valuer judgement over the last 30 years. Based on a number of inclusion and exclusion criteria, we have systematically analysed 32 relevant papers on valuation judgement bias. Although we find some consistency in evidence, we also find the underlying research to be biased; the methodology adopted is dominated by a quantitative approach; research context is skewed by timing and origination; and research evidence seems fragmented and needs replication. In order to obtain a deeper understanding of valuation judgement processes and thus extend the current knowledge base, we advocate more use of qualitative research methods and scholars to adopt an interpretative paradigm when studying judgement behaviour.
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This study investigated whether routine monitoring of client progress, often called "client feedback," via an abbreviated version of the Partners for Change Outcome Management System (PCOMS) resulted in improved outcomes for soldi...
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This study investigated whether routine monitoring of client progress, often called "client feedback," via an abbreviated version of the Partners for Change Outcome Management System (PCOMS) resulted in improved outcomes for soldiers receiving group treatment at an Army Substance Abuse Outpatient Treatment Program (ASAP). Participants (N = 263) were active-duty male and female soldiers randomized into a group feedback condition (n = 137) or a group treatment-as-usual (TAU) condition (n = 126). Results indicated that clients in the feedback condition achieved significantly more improvement on the outcome rating scale (d = 0.28), higher rates of clinically significant change, higher percentage of successful ratings by both clinicians and commanders, and attended significantly more sessions compared to the TAU condition. Despite a reduced PCOMS protocol and a limited duration of intervention, preliminary results suggest that the benefits of client feedback appear to extend to group psychotherapy with clients in the military struggling with substance abuse.
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Abstract Although studies have shown that client feedback can improve treatment outcome, little is known about which factors might possibly moderate the effects of such feedback. The present study investigated potential therapist ...
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Abstract Although studies have shown that client feedback can improve treatment outcome, little is known about which factors might possibly moderate the effects of such feedback. The present study investigated potential therapist variables that might influence whether frequent client feedback is effective, including the Big Five personality traits, internal/external feedback propensity and self‐efficacy. Data from two previous studies, a quasi‐experimental study and a randomized controlled trial, were combined. The sample consisted of 38 therapists and 843 clients (55.4% females, mean age?=?42.05?years, SD?=?11.75) from an outpatient mental health institution. The control condition consisted of cognitive‐behavioural therapies combined with low frequency monitoring of clients' symptoms. In the experimental condition, high‐intensity (i.e., frequent) client feedback as an add‐on to treatment as usual was provided. Outcomes were measured as adjusted post‐treatment symptom severity on the Symptom Checklist‐90 and drop out from treatment. The final model of the multilevel analyses showed that therapists with higher levels of self‐efficacy had poorer treatment outcomes, but when high‐intensity client feedback was provided, their effectiveness improved. Furthermore, higher self‐efficacy was associated with a higher estimation of therapists' own effectiveness, but therapists' self‐assessment of effectiveness was not correlated with their actual effectiveness. The results of this study might indicate that therapists with high levels of self‐efficacy benefit from client feedback because it can correct their biases. However, for therapists with low self‐efficacy, client feedback might be less beneficial, possibly because it can make them more insecure. These hypotheses need to be investigated in future research.
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