Abstract
De auteurs van dit artikel presenteren ‘verwacht-herstelgrafieken’ (expected recovery curves) als maatstaf om de voortgang respectievelijk achteruitgang tijdens een psychotherapeutische behandeling van jongeren te ‘monitoren’. Kinderen (of hun ouders) en adolescenten die in psychotherapie waren, vulden daartoe regelmatig de Youth outcome questionnaire-30 (YOG-30) in. De scores van alle patiënten werden samengenomen in een dataset, waaruit grafieken voor het te verwachten herstel werden afgeleid, uitgaande van de ernst van de symptomen bij intake. Vervolgens werd onderzocht of in het bijzonder verslechtering op deze manier goed te voorspellen was. De resultaten lieten zien dat de toegepaste statistische methode 72% van de patiënten met een negatief therapieresultaat betrouwbaar kon identificeren. Daarmee lijkt de YOG-30 een nuttig instrument om therapeuten in hun dagelijkse praktijk regelmatig van feedback over de vorderingen van hun patiënten te voorzien, met het oog op verbetering van de behandelresultaten. (Samenvatting door de redactie van dit tijdschrift)
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Curves of expected recovery and their predictive validity for identifying treatment failure
The results of the development of expected recovery curves for use in providing treatment response feedback to therapists and enhancing outcome are presented. Child and adolescent patients undergoing a course of psychotherapy (N = 3,712) repeatedly took the Youth Outcome Questionnaire-30 (YOQ-30). Scores across all patients were combined into an aggregate data set for use in generating expected recovery curves anchored by level of severity of symptoms at intake. A mixed linear model of recovery curves was created, based on YOQ-30 scores across sessions and the log transformation of session number. Validation of recovery curves for predicting deteriorators in psychotherapy was examined. Results showed the methodology was able to accurately identify 72% of patients with a deteriorated final outcome. Implications for this methodology are discussed within the context of routine clinical practice.
taige s. bybee, PhD, is Clinical Psychologist in private practice, Provo (Utah), USA.
michael j. lambert, PhD, is Professor and Endowed Chair in Psychology, Brigham Young University, Provo (Utah), USA.
dennis eggett, PhD, Associate Professor, Department of Statistics, Brigham Young University, Provo (Utah), USA.
Correspondence concerning this article should be addressed to: M.J. Lambert, Brigham Young University, 238 TLRB Provo UT 84602, USA.
The authors wish to acknowledge the assistance and contribution of Wim Trijsburg who, at the time of his death, was engaged in a translation of the YOQ-30 (the subject of this research) and validation of the effects of treatment monitoring. He was a generous and open mind.
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Bybee, T.S., Lambert, M.J. & Eggett, D. Curves of expected recovery and their predictive validity for identifying treatment failure. PSIE 33, 272–281 (2007). https://doi.org/10.1007/BF03062308
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DOI: https://doi.org/10.1007/BF03062308