Collaborative assessment as an intervention in the treatment of mental Illness: a systematic review

Abstract

Background

Three meta-analyses suggested that the psychological assessment as a therapeutic intervention approach might have therapeutic effects but had unspecific inclusion criteria.

Methods

We searched four databases for RCTs that reported on the use of psychological assessment as an intervention. Two reviewers independently selected papers, extracted data, and assessed study quality.

We conducted and reported the systematic review following the PRISMA statement. We assessed the Risk of bias in included studies using the Risk of Bias tool and graded the strength of the evidence with GRADE.

Results

We included two RCTs: The first study investigated Therapeutic Assessment (TA) combined with Manual-Assisted Cognitive Behavior Therapy (MACT) compared with MACT only in 16 outpatients with personality disorders. The trial found among completers (n = 7) no difference in borderline symptomatology but a possible difference regarding suicidality favoring MACT + TA. The trial did not provide any outcomes relating to readiness for treatment. The other trial investigated TA compared with a Goal-focused Pretreatment Intervention in a sample of 74 outpatients with personality disorders. The results found no intervention effects on symptomatology but suggested that TA might improve patient expectancy for future treatment among completers of the intervention. Both trials were judged at a high risk of bias and with very low certainty of evidence.

Discussion

We found no support for the clinical effect of psychological assessment as a therapeutic intervention due to the high risk of bias and low certainty of the evidence.

Keywords:

• Assessment
• therapeutic assessment
• collaborative assessment

Authors’ contributions

SA, ORH, NR, OJS, and JRG conceptualized the systematic review. ORH & JRG carried out literature screening and full-text reading and tabulation. ORH was responsible for writing the first draft of the manuscript. All authors have discussed, reviewed, and approved the manuscript.

Disclosure statement

The authors declare there are no competing interests in this review. The authors have no allegiance to TA or CA groups.

Additional information

Funding

This systematic review was funded by Region Zealand Mental Health Service and Trygfonden (ID: 152461)

Notes on contributors

Oliver Rumle Hovmand

Oliver Rumle Hovmand, MD, PhD-student.

Jasmin Rejaye Gryesten

Jasmin Rejaye Gryesten, MA psychology, PhD-student.

Ole Jakob Storebø

Ole Jakob Storebø, MA psychology, PhD, Head of the Center for Evidence-Based Psychiatry and professor at the University of Southern Denmark.

Nina Reinholt

Nina Reinholt, MA psychology, PhD.

Sidse M. Arnfred

Sidse M. Arnfred, MD, PhD, Professor at the University of Copenhagen, head of the Psychiatric Research Unit, Region Zealand Mental Health Services.