Using feedback on patient progress to predict the outcome of psychotherapy.

ABSTRACT

The Dose-Response and Phase Models are useful for informing quality assurance research on the expected patterns for separate categories of outcomes in psychotherapy. Moreover, these models predict the sequence of change for outcomes that may be differentially valued by patients, therapists, stakeholders, and cost managers. Valid feedback on the progress of treatment is critical because patients, therapists, and cost managers make decisions about continuation and focus of treatment while psychotherapy is in progress. In this study, the focus is on the validity of feedback data for therapist appraisal of patient progress. Feedback at patient intake, in early sessions of psychotherapy, and at later sessions of psychotherapy is considered. Among the variables examined are patient and therapist agreement on severity, level of severity, evidence of remoralization, and evidence of symptomatic remission. Data are drawn from archived records of 243 psychotherapy cases conducted in several managed care service delivery settings. The implications of a therapist's use of feedback to adjust the therapeutic process in an individual case are discussed.