Skip to main content

Quality Improvement

Current Research in Outcome Management

  • Chapter
Handbook of Quality Management in Behavioral Health

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • 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.

    Article  Google Scholar 

  • 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 

  • Barlow, D. H. (1988). Anxiety and its disorders: The nature and treatment of anxiety and panic. New York: Guilford.

    Google Scholar 

  • Bergin, A. E., & Garfield, S. L. (1994). Handbook of psychotherapy and behavior change (4th ed.). New York: Wiley.

    Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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 

  • Consumer Reports. (1995, November). Mental health: Does therapy help? 734–739.

    Google Scholar 

  • Cooley, E. F., & LaJoy, R. (1980). Therapeutic relationship and improvement as perceived by clients and therapists. Journal of Clinical Psychology, 36, 562–570.

    Article  PubMed  Google Scholar 

  • 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 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Fuhriman, A. J., & Burlingame, G. M. (1994). The handbook of group psychotherapy: An empirical and clinical synthesis. New York: Interscience.

    Google Scholar 

  • Gaston, L. (1990). The concept of the alliance and its role in psychotherapy: Theoretical and empirical considerations. Psychotherapy, 27, 143–153.

    Article  Google Scholar 

  • Hargrave, G. E., & Hiatt, D. (1995). Analysis of outpatient psychotherapy: Quality improvement indicators. Managed Care Quarterly, 3, 72–75.

    PubMed  Google Scholar 

  • Hattie, J. A., Sharpley, C. F., & Rogers, H. F. (1984). Comparative effectiveness of professional and paraprofessional helpers. Psychological Bulletin, 95, 534–541.

    Article  PubMed  Google Scholar 

  • Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986). The dose-effect relationship in psychotherapy. American Psychologist, 41, 159–164.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • Kazdin, A. E. (1986). Comparative outcome studies of psychotherapy: Methodological issues and strategies. Journal of Consulting and Clinical Psychology, 54, 95–105.

    Article  PubMed  Google Scholar 

  • 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 

  • 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.

    Article  Google Scholar 

  • 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 

  • Lambert, M. J., & Anderson, E. M. (1996). Assessment for the time-limited psychotherapies. Annual Review of Psychiatry, 15, 23–47.

    Google Scholar 

  • 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 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • Lieberman, M. A., Yalom, I. D., & Miles, M. B. (1973). Encounter groups: First facts. New York: Basic Books.

    Google Scholar 

  • Lorr, M. (1965). Clients’ perceptions of therapists. Journal of Consulting Psychology, 29, 146–149.

    Article  PubMed  Google Scholar 

  • Malan, D. H. (1976). The frontier of brief psychotherapy. New York: Plenum Press.

    Book  Google Scholar 

  • Marmor, J. (1979). Short-term dynamic psychotherapy. American Journal of Psychiatry, 136, 149–155.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Mohr, D. C. (1995). Negative outcome in psychotherapy: A critical review. Clinical Psychology Science and Practice, 2, 1–27.

    Article  Google Scholar 

  • Nicholson, R. A., & Berman, J. S. (1983). Is follow-up necessary in evaluating psychotherapy? Psychological Bulletin, 93, 261–278.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • Sachs, J. S. (1983). Negative factors in brief psychotherapy: An empirical assessment. Journal of Consulting and Clinical Psychology, 51, 557–564.

    Article  PubMed  Google Scholar 

  • Safran, J., & Muran, J. C. (1995). Special issue on the therapeutic alliance. In Session: Psychotherapy in Practice, 1, 3–8.

    Google Scholar 

  • Schneider, W. J., & Pinkerton, R. S. (1986). Short-term psychotherapy and graduate training in psychology. Professional Psychology: Research and Practice, 17, 574–579.

    Article  Google Scholar 

  • Seligman, M. E. P. (1995). The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist, 50, 965–974.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Sifneos, P. E. (1979). Short-term dynamic psychotherapy. New York: Plenum Press.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Strupp, H. H. (1980). Success and failure in time-limited psychotherapy: Comparison I. Archives of General Psychiatry, 37, 595–603.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer Science+Business Media New York

About this chapter

Cite this chapter

Lambert, M.J., Huefner, J.C., Reisinger, C.W. (2000). Quality Improvement. In: Handbook of Quality Management in Behavioral Health. Issues in the Practice of Psychology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-4195-0_5

Download citation

  • DOI: https://doi.org/10.1007/978-1-4615-4195-0_5

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-6882-3

  • Online ISBN: 978-1-4615-4195-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics