Abstract

Objective

Despite evidence showing that systematic outcome monitoring can prevent treatment failure, the practical conditions that allow for implementation are seldom met in naturalistic psychological services. In the context of limited time and resources, session-by-session evaluation is rare in most clinical settings. This study aimed to validate innovative prediction methods for individual treatment progress and dropout risk based on basic outcome monitoring.

Methods

Routine data of a naturalistic psychotherapy outpatient sample were analyzed (N = 3902). Patients were treated with cognitive behavioral therapy with up to 95 sessions (M = 39.19, SD = 16.99) and assessment intervals of 5–15 sessions. Treatment progress and dropout risk were predicted in two independent analyses using the nearest neighbor method and least absolute shrinkage and selection operator regression, respectively.

Results

The correlation between observed and predicted patient progress was r = .46. Intrinsic treatment motivation, previous inpatient treatment, university-entrance qualification, baseline impairment, diagnosed personality disorder, and diagnosed eating disorder were identified as significant predictors of dropout, explaining 11% of variance.

Conclusions

Innovative outcome prediction in naturalistic psychotherapy is not limited to elaborated progress monitoring. This study demonstrates a reasonable approach for tracking patient progress as long as session-by-session assessment is not a valid standard.

中文翻译：

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匹配研究和实践：预测个体患者进展和基本常规结果监测的辍学风险

摘要

客观的

尽管有证据表明系统的结果监测可以防止治疗失败，但在自然主义心理服务中很少能满足实施的实际条件。在时间和资源有限的情况下，在大多数临床环境中，逐次评估很少见。本研究旨在验证基于基本结果监测的个体治疗进展和退出风险的创新预测方法。

方法

分析了自然心理治疗门诊样本的常规数据（N  = 3902）。患者接受了多达 95 次认知行为治疗（M  = 39.19，SD  = 16.99），评估间隔为 5-15 次。分别使用最近邻法和最小绝对收缩和选择算子回归在两项独立分析中预测了治疗进展和辍学风险。

结果

观察到的和预测的患者进展之间的相关性为r  = .46。内在的治疗动机、以前的住院治疗、大学入学资格、基线损伤、诊断出的人格障碍和诊断出的饮食失调被确定为辍学的重要预测因素，解释了 11% 的方差。

结论

自然主义心理治疗中的创新结果预测不仅限于详细的进展监测。只要逐次评估不是有效的标准，这项研究就证明了一种跟踪患者进展的合理方法。