Abstract
Psychotherapy outcome can be enhanced by early identification of potential treatment failures before they leave treatment. In adults, compelling data are emerging that provide evidence that an early warning system that identifies potential treatment failures can be developed and applied to enhance outcome. The present study reports an analysis of early warning algorithms to identify treatment failures among child/adolescent patients (ages 3–18). The progress of 300 patients who had completed treatment was analyzed to see if algorithms could identify those children who ultimately had a negative outcome. Results indicated that the rationally derived method had a 77% success rate for identifying child/adolescent patients who were reliably worse or had deteriorated by the time that therapy was terminated.
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Achenbach, T. M. (1991). Manual for the child behavior checklist and 1991 profile. Burlington: University of Vermont, Department of Psychiatry.
Breslin, F., Sobell, L. C., Buchan, G., & Cunningham, J. (1997). Toward a stepped-care approach to treating problem drinkers: The predictive validity of within-treatment variables and therapist prognostic ratings. Addiction, 92, 1479–1489.
Brown, G. S., & Lambert, M. J. (1998). Tracking patient progress: Decision making for cases that are not benefiting from therapy. Paper presented at the 29th Annual Meeting of the Society for Psychotherapy Research, Snowbird, UT.
Burlingame, G. M., Wells, M. G., Hoag, M., Hope, C., Nebeker, S., Konkel, K., McCollam, P., Peterson, G., Lambert, M. J., Latkowski, M., Ferre, R., & Reisinger, C. (1996). Administration and scoring manual for the Y-OQ.2. Setauket, NJ: American Professional Credentialing Services.
Burlingame, G. M., Mosier, J. I., Wells, M. G., Atkin, Q. G., Lambert, M. J., Whoolery, M., & Latkowski, M. (2001). Tracking the influence of mental health treatment: The development of the Youth Outcome Questionnaire. Clinical Psychology and Psychotherapy, 8, 361–379.
Burlingame, G., Cox, J., Wells, A., & Lambert, M. (2003). Youth Outcome Questionnaire: Updated psychometric properties. In M. Maruish (Ed.), The 2003 Behavioral outcomes and guidelines source book. New York: Faulkner and Gray.
Conners, C. K. (1990). Conners’ rating scales manual. North Towanda, NY: Multi-Health Systems.
Durham, C. J., McGrath, L. D., Burlingame, G. M., Schaalje, G. B., Lambert, M. J., & Davies, D. R. (2002). The effects of repeated administrations on self-report and parent-report scales. Journal of Psychoeducational Assessment, 20, 240–257.
Haas, E., Hill, R., Lambert, M. J., & Morrill, B. (2002). Unraveling the early response mystery: Do early responders maintain treatment gains? Journal of Clinical Psychology, 58, 1157–1172.
Jacobson, N. S., & Traux, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12–19.
Kazdin, A. E. (1995). Scope of child and adolescent psychotherapy research: Limited sampling of dysfunctions, treatments, and client characteristics. Journal of Clinical Child Psychology, 24, 125–140.
Kordy, H., Hannöver, W., & Richard, M. (2001). Computer assisted feedback driven active quality management for psychotherapy provision: The Stuttgart-Heidelberg model. Journal of Consulting and Clinical Psychology, 69, 173–183.
Lambert, M. J. (1983). Introduction to assessment of psychotherapy outcome: Historical perspective and current issues. In M. J. Lambert, E. R. Christensen, & S. S. DeJulio (Eds.), The assessment of psychotherapy outcome (pp. 3–32). New York, NY.
Lambert, M. J., & Bergin, A. E. (1994). The effectiveness of psychotherapy. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 143–189). New York: John Wiley and Sons.
Lambert, M. J., Hansen, N. B., & Finch, A. E. (2001a). Patient-focused research: Using patient outcome data to enhance treatment effects. Journal of Consulting and Clinical Psychology, 69, 159–172.
Lambert, M. J., Hansen, N. B., Umphress, V., Lunnen, K., Okiishi, J., Burlingame, et al. (1996). Administration and scoring manual for the outcome questionnaire (OQ 45.2). Wilmington, DE: American Professional Credentialing Services.
Lambert, M. J., Huefner, J. C., & Reisinger, C. W. (2000). Quality improvement: Current research in outcome management. In G. Stricker, W. G. Troy, & S. A. Shueman (Eds), Handbook of quality management in behavioral health (pp. 95–110). New York, Kluwer Academic/Plenum Publishers.
Lambert, M. J., Whipple, J. L., Bishop, M. J, Vermeersch, D. A., Gray, G. V., & Finch, A. E. (2002a). Comparison of empirically-derived and rationally-derived methods for identifying patients at risk for treatment failure. Clinical Psychology and Psychotherapy, 9, 149–164.
Lambert, M. J., Whipple, J. L., Smart, D. W., Vermeersch, D. A., Nielsen, S. L., et al. (2001b). The effects of providing therapists with feedback on patient progress during psychotherapy: Are outcomes enhanced? Psychotherapy Research, 11, 49–68.
Lambert, M. J., Whipple, J. L., Vermeersch, D. A., Smart, D. W., Hawkins, E. J., Nielsen, S. L., et al. (2002b). Providing therapists with feedback on patient progress as a method of enhancing psychotherapy outcomes: A replication. Clinical Psychology and Psychotherapy, 9, 91–103.
Lueger, R. J., Howard, K. I., Martinovich, Z., Lutz, W., Anderson, E. E., & Grissom, G. (2001). Assessing treatment progress with individual patients using expected treatment response models. Journal of Consulting and Clinical Psychology, 69, 150–158.
Lunnen, K. M., & Ogles, B. M. (1998). A multiperspective, multivariable evaluation of reliable change. Journal of Consulting and Clinical Psychology, 66, 400–410.
Lyons, J. S., Howard, K. I., O’Mahoney, M. T., & Lish, J. D. (1997). The measurement and management of clinical outcomes in mental health. New York: John Wiley & Sons.
Meyer, F., & Schulte, D. (2002). Zur Validitat der Beurteilung des Theapieerfolgs durch Therapeuten (The validity of therapist’s ratings of therapy outcome). Zeitschrift fur Kinishe Psychologie und Psychotherapie.
Mohr, D. C. (1995). Negative outcome in psychotherapy. Clinical Psychology, 2, 1–27.
Richard, M., & Kordy, H. (2002). Early treatment response: Conceptualization, predictive validity and application in quality management. Stuttgart: Center for Psychotherapy Research.
Schulte-Bahrenberg, T., & Schulte, D. (1991). Therapieziesielverandurengen bei Therapeuten (Change in psychotherapy goals in therapists). In D. Schulte (Ed.), Therapeutische entscheidungen (Therapeutic decisions) (pp. 43–56). Gottingen: Hogrefe.
Schulte-Bahrenberg, T., & Schulte, D. (1993). Change of psychotherapy goals as a process of resignation. Psychotherapy Research, 3, 153–165.
Smith, M. L., Glass, G. V., & Miller, T. I. (1980). The benefits of psychotherapy. Baltimore: John Hopkins University Press.
Tang, T. Z., & DeRubies, R. J. (1999a). Reconsidering rapid early response in cognitive-behavioral therapy for depression. Clinical Psychology: Science and Practice, 6, 283–288.
Tang, T. Z., & DeRubies, R. J. (1999b). Sudden gains and critical sessions in cognitive-behavioral therapy for depression. Journal of Consulting and Clinical Psychology, 67, 894–904.
Wells, M. G., Burlingame, G. M., & Lambert, M. J. (1999). Youth Outcome Questionnaire. In M. E. Maruish (Ed.). The use of psychological testing for treatment planning and outcome assessment (2nd ed., pp. 497–453). Mahwah, NJ: Lawrence Erlbaum Associates.
Whipple, J. L., Lambert, M. J., Vermeersch, D. A., Smart, D. W., Nielsen, S. L., & Hawkins, E. J. (2003). Improving the effects of psychotherapy: The use of early identification of treatment failure and problem solving strategies in routine practice. Journal of Counseling Psychology, 50, 59–68.
Wilson, G. T. (1999). Rapid response to cognitive behavior therapy. Clinical Psychology: Science and Practice, 6, 289–292.
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Bishop, M.J., Bybee, T.S., Lambert, M.J. et al. Accuracy of a Rationally Derived Method for Identifying Treatment Failure in Children and Adolescents. J Child Fam Stud 14, 207–222 (2005). https://doi.org/10.1007/s10826-005-5049-1
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DOI: https://doi.org/10.1007/s10826-005-5049-1