Quality Improvement

Current Research in Outcome Management
  • Michael J. Lambert
  • Jonathan C. Huefner
  • Curtis W. Reisinger
Part of the Issues in the Practice of Psychology book series (IPPS)


At the core of ensuring quality treatment is the assessment of changes in patients following interventions—so-called “outcome research.” This area of research is central to quality improvement because the scientific study of patient change tempers the undocumented and often overstated consequences of psychological and medical practitioners. We attempt here a brief summary of research on psychosocial interventions and its implications for quality management. This research summary examines outcome and process research as they apply both to the individual patient as well as to the delivery system in which the outcome of larger populations becomes an overriding concern. We first review outcome in its historical context, followed by issues of matching patients with treatments and selecting therapists to maximize positive outcomes.


Panic Disorder Behavioral Health Care Impulse Control Disorder Interpersonal Psychotherapy Provider Profile 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Antonuccio, D. O., Danton, W. G., & DeNelsky, G. Y. (1995). Psychotherapy versus medication for depression: Challenging the conventional wisdom with data. Professional Psychology: Research and Practice, 26, 574–585.CrossRefGoogle Scholar
  2. Barber, J. P., & Crits-Christoph, P. (1991). Comparison of the brief dynamic therapies. In P. Crits-Christoph & J. P. Barber (Eds.), Handbook of short-term dynamic therapy (pp. 323-356). New York: Basic Books.Google Scholar
  3. Barlow, D. H. (1988). Anxiety and its disorders: The nature and treatment of anxiety and panic. New York: Guilford.Google Scholar
  4. Bergin, A. E., & Garfield, S. L. (1994). Handbook of psychotherapy and behavior change (4th ed.). New York: Wiley.Google Scholar
  5. Beutler, L. E., Frank, M., Schieber, S. C., Calvert, S., & Gaines, J. (1984). Comparative effects of group psychotherapies in a short-term inpatient setting: An experience with deterioration effects. Psychiatry, 47, 66–76.PubMedGoogle Scholar
  6. Binder, J. L., Henry, W. P., & Strupp, H. H. (1987). An appraisal of selection criteria for dynamic psychotherapies and implications for setting limits. Journal of Psychiatry, 50, 154–166.Google Scholar
  7. Consumer Reports. (1995, November). Mental health: Does therapy help? 734–739.Google Scholar
  8. Cooley, E. F., & LaJoy, R. (1980). Therapeutic relationship and improvement as perceived by clients and therapists. Journal of Clinical Psychology, 36, 562–570.PubMedCrossRefGoogle Scholar
  9. de Beuirs, E., van Balkom, A. J. L. M., Lange, A., Koele, P., & van Dyck, R. (1995). Treatment of panic disorder with agoraphobia: Comparison of fluvoxamine, placebo, and psychological panic management combined with exposure and of exposure in vivo alone. American Journal of Psychiatry, 152, 683–691.Google Scholar
  10. Doherty, W. J., Lester, M. E., & Leigh, G. K. (1986). Marriage encounter weekends: Couples who win and couples who lose. Journal of Marital and Family Therapy, 12, 49–61.CrossRefGoogle Scholar
  11. Elkin, I., Shea, M. T., Watkins, J. T., Imber, S. D., Stosky, S. M., Collins, J. F., Glass, D. R., Pilkonis, P. A., Weber, W. R., Docherty, J. P., Fiester, S. J., & Parloff, M. B. (1989). National Institute of Mental Health treatment of depression collaborative research program: General effectiveness of treatments. Archives of General Psychiatry, 46, 971–982.PubMedCrossRefGoogle Scholar
  12. Fuhriman, A. J., & Burlingame, G. M. (1994). The handbook of group psychotherapy: An empirical and clinical synthesis. New York: Interscience.Google Scholar
  13. Gaston, L. (1990). The concept of the alliance and its role in psychotherapy: Theoretical and empirical considerations. Psychotherapy, 27, 143–153.CrossRefGoogle Scholar
  14. Hargrave, G. E., & Hiatt, D. (1995). Analysis of outpatient psychotherapy: Quality improvement indicators. Managed Care Quarterly, 3, 72–75.PubMedGoogle Scholar
  15. Hattie, J. A., Sharpley, C. F., & Rogers, H. F. (1984). Comparative effectiveness of professional and paraprofessional helpers. Psychological Bulletin, 95, 534–541.PubMedCrossRefGoogle Scholar
  16. Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41, 159–164.PubMedCrossRefGoogle Scholar
  17. Imber, S. D., Pilkonis, P. A., Sotsky, S. M., Elkin, I., Watkins, J. T., Collins, J. F., Shea, M. T., Weber, W. R., & Glass, D. R. (1990). Mode-specific effects among three treatments for depression. Journal of Consulting and Clinical Psychology, 58, 352–359.PubMedCrossRefGoogle Scholar
  18. Jensen, J. P., Bergin, A. E. & Greaves, D. W. (1990). The meaning of eclecticism: New survey and analysis of components. Professional Psychology: Research and Practice, 21, 124–130.CrossRefGoogle Scholar
  19. Jorm, A. F. (1989). Modifiability of trait anxiety and neuroticism: A meta-analysis of the literature. Australian and New Zealand Journal of Psychiatry, 23, 21–29.PubMedCrossRefGoogle Scholar
  20. Kadera, S. W., Lambert, M. J., & Andrews, A. A. (1996). How much therapy is really enough? A session-by-session analysis of the psychotherapy dose-effect relationship. Journal of Psychotherapy Research and Practice, 5, 132–151.Google Scholar
  21. Kazdin, A. E. (1986). Comparative outcome studies of psychotherapy: Methodological issues and strategies. Journal of Consulting and Clinical Psychology, 54, 95–105.PubMedCrossRefGoogle Scholar
  22. Koss, M. P., & Shiang, J. (1994). Research on brief psychotherapy. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 664–700). New York: Wiley & Sons.Google Scholar
  23. Lafferty, P., Beutler, L. E., & Crago, M. (1991). Differences between more and less effective psychotherapists: A study of select therapist variables. Journal of Consulting and Clinical Psychology, 57, 76–80.CrossRefGoogle Scholar
  24. Lambert, M. J. (1979). Characteristics of patients and the relationship to outcome in brief psychotherapy. Psychiatric Clinics of North America, 2, 111–123.Google Scholar
  25. Lambert, M. J., & Anderson, E. M. (1996). Assessment for the time-limited psychotherapies. Annual Review of Psychiatry, 15, 23–47.Google Scholar
  26. 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 & Sons.Google Scholar
  27. Lambert, M. J., Bergin, A. E., & Collins, J. L. (1977). Therapist induced deterioration in psychotherapy patients. In A. S. Gurman & A. M. Razin (Eds.), Effective psychotherapy: A handbook of research (pp. 452–481). New York: Pergamon.Google Scholar
  28. Lambert, M. J., Dejulio, S. S. & Stein, D. M. (1978). Therapist interpersonal skills: Process, outcome, methodological considerations, and recommendations for future research. Psychological Bulletin, 85, 467–489.PubMedCrossRefGoogle Scholar
  29. Lieberman, M. A., Yalom, I. D., & Miles, M. B. (1973). Encounter groups: First facts. New York: Basic Books.Google Scholar
  30. Lorr, M. (1965). Clients’ perceptions of therapists. Journal of Consulting Psychology, 29, 146–149.PubMedCrossRefGoogle Scholar
  31. Malan, D. H. (1976). The frontier of brief psychotherapy. New York: Plenum Press.CrossRefGoogle Scholar
  32. Marmor, J. (1979). Short-term dynamic psychotherapy. American Journal of Psychiatry, 136, 149–155.PubMedGoogle Scholar
  33. Michelson, L. K., & Marchione, K. (1991). Behavioral, cognitive, and pharmacological treatment of panic disorder with agoraphobia: Critique and synthesis. Journal of Consulting and Clinical Psychology, 59, 100–114.PubMedCrossRefGoogle Scholar
  34. Miller, W. R., Taylor, C. A., & West, J. C. (1980). Focused versus broad-spectrum behavior therapy for problem drinkers. Journal of Consulting and Clinical Psychology, 48, 590–601.PubMedCrossRefGoogle Scholar
  35. Mohr, D. C. (1995). Negative outcome in psychotherapy: A critical review. Clinical Psychology Science and Practice, 2, 1–27.CrossRefGoogle Scholar
  36. Nicholson, R. A., & Berman, J. S. (1983). Is follow-up necessary in evaluating psychotherapy? Psychological Bulletin, 93, 261–278.PubMedCrossRefGoogle Scholar
  37. Ogles, B. M., Lambert, M. J., & Sawyer, J. D. (1995). Clinical significance of the National Institute of Mental Health treatment of depression collaborative research program data. Journal of Consulting and Clinical Psychology, 63, 321–326.PubMedCrossRefGoogle Scholar
  38. Pollack, E. J. (1995, Dec. 1). Side effects: Managed care focus on psychiatric drugs alarms many doctors. The Wall Street Journal, p. A1.Google Scholar
  39. Robinson, L. A., Berman, J. S., & Neimeyer, R. S. (1990). Psychotherapy for the treatment of depression: A comprehensive review of controlled outcome research. Psychological Bulletin, 108, 30–49.PubMedCrossRefGoogle Scholar
  40. Sachs, J. S. (1983). Negative factors in brief psychotherapy: An empirical assessment. Journal of Consulting and Clinical Psychology, 51, 557–564.PubMedCrossRefGoogle Scholar
  41. Safran, J., & Muran, J. C. (1995). Special issue on the therapeutic alliance. In Session: Psychotherapy in Practice, 1, 3–8.Google Scholar
  42. Schneider, W. J., & Pinkerton, R. S. (1986). Short-term psychotherapy and graduate training in psychology. Professional Psychology: Research and Practice, 17, 574–579.CrossRefGoogle Scholar
  43. Seligman, M. E. P. (1995). The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist, 50, 965–974.PubMedCrossRefGoogle Scholar
  44. Shapiro, D. A., Rees, A., Barkham, M., Hardy, G., Reynolds, S., & Startup, M. (1995). Effects of treatment duration and severity of depression on the maintenance of gains of cognitive-behavioral and psychodynamic interpersonal psychotherapy. Journal of Consulting and Clinical Psychology, 63, 378–387.PubMedCrossRefGoogle Scholar
  45. Sifneos, P. E. (1979). Short-term dynamic psychotherapy. New York: Plenum Press.Google Scholar
  46. Stein, D. M., & Lambert, M. J. (1995). Graduate training in psychotherapy: Are therapy outcomes enhanced? Special section: The case for training in the provision of psychological therapy. Journal of Consulting and Clinical Psychology, 63, 182–186.PubMedCrossRefGoogle Scholar
  47. Steinbrueck, S. M., Maxwell, S. E., & Howard, G. S. (1983). A meta-analysis of psychotherapy and drug therapy in the treatment of unipolar depression with adults. Journal of Consulting and Clinical Psychology, 51, 856–863.PubMedCrossRefGoogle Scholar
  48. Strupp, H. H. (1980). Success and failure in time-limited psychotherapy: Comparison I. Archives of General Psychiatry, 37, 595–603.PubMedCrossRefGoogle Scholar
  49. Weisz, J. R., Weis, B., Alicke, M. D., & Klots, M. L. (1987). Effectiveness of psychotherapy with children and adolescents: A meta-analysis for clinicians. Journal of Consulting and Clinical Psychology, 55, 542–549.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Michael J. Lambert
    • 1
  • Jonathan C. Huefner
    • 2
  • Curtis W. Reisinger
    • 3
    • 4
  1. 1.Department of PsychologyBrigham Young UniversityProvoUSA
  2. 2.Magellan Behavioral HealthSalt Lake CityUSA
  3. 3.Department of PsychiatryHackensack University Medical CenterHackensackUSA
  4. 4.Department of PsychiatryUMDNJ-New Jersey Medical SchoolNewarkUSA

Personalised recommendations