Enhancing the effect of psychotherapy through systematic client feedback in outpatient mental healthcare: A cluster randomized trial.

Figures & data

Figure 1. Enrollment.

Table I. Characteristics of patients in both treatment conditions.

	Condition
	TAU			TAU-PCOMS
	N	%		N	%
Sex
Male	286	35.0		351	38.3
Female	531	65.0		565	61.7
Diagnosis
Anxiety disorder	341	41.7		422	46.1
Depressive disorder	240	29.4		260	28.4
Psychosomatic disorder	140	17.1		139	15.2
Developmental disorder	41	5.0		54	5.9
Otherwise	55	6.7		41	4.5
Age	817	M = 37.04	SD = 13.8	916	M = 37.91	SD = 13.0
OQ-45 total at intake	817	M = 73.89*	SD = 21.18	916	M = 76.12	SD = 20.57
MHC-SF total at intake	776	M = 2.43	SD = 0.96	695	M = 2.38	SD = 0.93

Note: OQ-45 = Outcome Questionnaire, MHC-SF = Mental Health Continuum-Short Form. TAU = Treatment as Usual, PCOMS = Partners for Change Outcome Management System. *p ≤ 0.05.

Table II. Three level model and dummy variables of the effect of systematic client feedback, ITT-analysis.

	Measure
	OQ-45		MHC-SF
	Estimate	SE	Estimate	SE
Fixed effects
Intercept	53.345***	4.555	2.959***	0.207
Dummy TAU-PCOMS center	0.917	0.665	−0.099**	0.034
Dummy TAU center	−1.574**	0.563	0.043	0.032
Female	2.739**	1.001	−0.003	0.046
Anxiety disorder	6.049**	2.170	0.033	0.101
Depressive disorder	14.793***	1.995	−0.480***	0.104
Psychosomatic disorder	7.234**	2.106	−0.056	0.110
Developmental disorder	5.598*	2.453	−0.090	0.137
Age	0.626**	0.199	−0.022*	0.009
Age^2	−0.008***	0.002	0.000*	0.000
Log10Time	−7.656***	0.492	0.256***	0.021
Condition	1.939*	0.887	−0.060	0.048
Condition*Log10Time	−2.051**	0.651	0.064*	0.030
Random effects
Level 1 (measurement)
Residual	172.191	10.924	0.292	0.020
Level 2 (patient)
Variance intercept	237.114	17.583	0.547	0.037
Covariance Log10Time/intercept	18.282	7.23	−0.025	0.015
Variance Log10Time	13.234	5.297	0.041	0.010
Level 3 (therapist)
Variance intercept	0.000	0.000	0.000	0.000
Covariance time/intercept	0.000	0.000	0.000	0.000
Variance Log10Time	1.369	0.81	0.002	0.001

Note. OQ-45 = Outcome Questionnaire, MHC-SF = Mental Health Continuum-Short Form, ITT = Intention to Treat, TAU = Treatment as Usual, PCOMS = Partners for Change Outcome Management System, Time is in days. *p < 0.05; **p < 0.01; ***p ≤ 0.001.

Figure 2. Growth curves of the OQ-45.ITT.

Figure 3. Growth curves of the MHC-SF.ITT.

Table III. Three level model and dummy variables of the effect of systematic client feedback, PP-analysis.

	Measure
	OQ-45		MHC-SF
	Estimate	SE	Estimate	SE
Fixed effects
Intercept	57.688***	5.792	2.783***	0.263
Dummy PCOMS center	0.891	2.130	−0.066	0.106
Dummy TAU center	−1.912**	0.735	0.058	0.035
Female	2.011	1.348	−0.017	0.061
Anxiety disorder	4.269	2.870	0.053	0.129
Depressive disorder	14.411***	2.946	−0.480***	0.132
Psychosomatic disorder	6.344*	3.114	−0.063	0.140
Developmental disorder	5.832	4.394	−0.126	0.199
Age	0.470	0.267	−0.011	0.012
Age^2	−0.006	0.003	0.000	0.000
Log10Time	−7.866***	0.441	0.259***	0.021
Condition	3.177	2.307	−0.105	0.114
Condition*Log10Time	−2.160**	0.823	0.104**	0.008
Random effects
Level 1 (measurement)
Residual	167.288	11.826	0.298	0.022
Level 2 (patient)
Variance intercept	227.087	21.884	0.547	0.046
Covariance Log10Time/intercept	15.099	8.701	−0.034	0.018
Variance Log10Time	16.709	6.070	0.040	0.012
Level 3 (therapist)
Variance intercept	0.000	0.000	0.000	0.006
Covariance time/intercept	0.000	0.000	0.000	0.002
Variance Log10Time	0.544	0.747	0.002	0.002

Note. OQ-45 = Outcome Questionnaire, MHC-SF = Mental Health Continuum-Short Form, PP = Per Protocol, Time is in days. TAU = Treatment as Usual, PCOMS = Partners for Change Outcome Management System. *p < 0.05;**p < 0.01;***p ≤ 0.001.

Figure 4. Growth curves of the OQ-45.PP.