Presidential address: What we have learned from a decade of research aimed at improving psychotherapy outcome in routine care

Abstract

The findings of a decade-long program of research aimed at tracking patient treatment response are summarized. Outcome measures were developed and applied on a weekly basis with patients undergoing therapy in routine practice. Treatment response was defined as reliable and clinically significant change, and longitudinal statistical models for identifying poor progress were applied. The author was able to estimate the amount of therapy necessary for recovery, study early dramatic improvers, and assess the consequences of providing practitioners with alarm signals when patients were off track for a positive outcome. Results indicate that integrating treatment response research into routine mental health care reliably improved positive outcomes and reduced negative outcomes. Future directions for this line of action research are suggested.

The following list of individuals made significant contributions to various aspects of the research reported in this summary. Without their help the findings reported here would never have emerged. In addition to their intellectual contributions and tireless efforts I have been lucky enough to have enjoyed their company and emotional support. They are listed in alphabetic order: Ed Anderson, Steffi Bauer, Matthew Bishop, Jeb Brown, Gary Burlingame, Taige Bybee, Kara Cattani-Thompson, Arthur Finch, Eric Haas, Corinne Hannan, Wolfgang Hannover, Nathan Hansen, Cory Harmon, Derek Hatfield, Eric Hawkins, Scott Kadera, Hans Kordy, Wolfgang Lutz, Kevin Masters, Stevan Nielsen, Ben Ogles, John Okiishi, Robert Percevic, Bernd Puschner, Matthias Richard, Karstin Slade, David Smart, Glen Spielmans, Richard Tingey, Val Umphress, David Vermeersch, Jason Whipple, Bob Wong.

I would also like to thank Brigham Young University, the College of Social Home and Family Life, and the Counseling and Career Center for their generous financial contributions in support of this program of research. An atmosphere has been created in which success is encouraged. I would also like to thank the therapists and clients at the counseling center, and in many other settings, who joined with us in exploring new methods for enhancing patient outcome.