Rates of Change in Naturalistic Psychotherapy: Contrasting Dose-Effect and Good-Enough Level Models of Change
Most research on the dose-effect model of change has combined data across patients who vary in their total dose of treatment and has implicitly assumed that the rate of change during therapy is constant across doses. In contrast, the good-enough level model predicts that rate of change will be relat...
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| Veröffentlicht in: | Journal of consulting and clinical psychology 2009-04, Vol.77 (2), p.203-211 |
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| creator | Baldwin, Scott A Berkeljon, Arjan Atkins, David C Olsen, Joseph A Nielsen, Stevan L |
| description | Most research on the dose-effect model of change has combined data across patients who vary in their total dose of treatment and has implicitly assumed that the rate of change during therapy is constant across doses. In contrast, the good-enough level model predicts that rate of change will be related to total dose of therapy. In this study, the authors evaluated these competing predictions by examining the relationship between rate of change and total dose in 4,676 psychotherapy patients who received individual psychotherapy. Patients attended 6.46 sessions on average (
SD
= 4.14, range = 3-29,
Mdn
= 5). The results indicated that although patients improved during treatment, patients' rate of change varied as a function of total dose of treatment. Small doses of treatment were related to relatively fast rates of change, whereas large doses of treatment were related to slower rates of change. Total dose had a nonlinear relationship with the likelihood of clinically significant change. Given the variability in rates of change, it appears that time limits for treatment uniform to all patients would not adequately serve patients' needs. |
| doi_str_mv | 10.1037/a0015235 |
| format | Article |
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SD
= 4.14, range = 3-29,
Mdn
= 5). The results indicated that although patients improved during treatment, patients' rate of change varied as a function of total dose of treatment. Small doses of treatment were related to relatively fast rates of change, whereas large doses of treatment were related to slower rates of change. Total dose had a nonlinear relationship with the likelihood of clinically significant change. Given the variability in rates of change, it appears that time limits for treatment uniform to all patients would not adequately serve patients' needs.</description><identifier>ISSN: 0022-006X</identifier><identifier>EISSN: 1939-2117</identifier><identifier>DOI: 10.1037/a0015235</identifier><identifier>PMID: 19309180</identifier><identifier>CODEN: JCLPBC</identifier><language>eng</language><publisher>Washington, DC: American Psychological Association</publisher><subject>Adolescent ; Adult ; Behavior Change ; Biological and medical sciences ; Change ; Changes ; Correlation analysis ; Dosage ; Female ; Human ; Humans ; Individual Psychotherapy ; Male ; Medical sciences ; Mental Disorders - diagnosis ; Mental Disorders - epidemiology ; Mental Disorders - therapy ; Middle Aged ; Models, Psychological ; Outcomes of Treatment ; Patients ; Prediction ; Prevalence ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychotherapies. Psychological and clinical counseling ; Psychotherapy ; Psychotherapy - methods ; Psychotherapy - statistics & numerical data ; Studies ; Surveys and Questionnaires ; Time limits ; Treatment Duration ; Treatment Outcome ; Treatment Outcomes ; Treatments ; Uniforms ; Variability ; Young Adult</subject><ispartof>Journal of consulting and clinical psychology, 2009-04, Vol.77 (2), p.203-211</ispartof><rights>2009 American Psychological Association</rights><rights>2009 INIST-CNRS</rights><rights>Copyright American Psychological Association Apr 2009</rights><rights>2009, American Psychological Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a447t-f8c9341329ad5c4e218a1918cb4106df68286d4e175b236d422ec998d26c08e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27911,27912,30986,30987</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ833344$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21285135$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19309180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baldwin, Scott A</creatorcontrib><creatorcontrib>Berkeljon, Arjan</creatorcontrib><creatorcontrib>Atkins, David C</creatorcontrib><creatorcontrib>Olsen, Joseph A</creatorcontrib><creatorcontrib>Nielsen, Stevan L</creatorcontrib><title>Rates of Change in Naturalistic Psychotherapy: Contrasting Dose-Effect and Good-Enough Level Models of Change</title><title>Journal of consulting and clinical psychology</title><addtitle>J Consult Clin Psychol</addtitle><description>Most research on the dose-effect model of change has combined data across patients who vary in their total dose of treatment and has implicitly assumed that the rate of change during therapy is constant across doses. In contrast, the good-enough level model predicts that rate of change will be related to total dose of therapy. In this study, the authors evaluated these competing predictions by examining the relationship between rate of change and total dose in 4,676 psychotherapy patients who received individual psychotherapy. Patients attended 6.46 sessions on average (
SD
= 4.14, range = 3-29,
Mdn
= 5). The results indicated that although patients improved during treatment, patients' rate of change varied as a function of total dose of treatment. Small doses of treatment were related to relatively fast rates of change, whereas large doses of treatment were related to slower rates of change. Total dose had a nonlinear relationship with the likelihood of clinically significant change. Given the variability in rates of change, it appears that time limits for treatment uniform to all patients would not adequately serve patients' needs.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Behavior Change</subject><subject>Biological and medical sciences</subject><subject>Change</subject><subject>Changes</subject><subject>Correlation analysis</subject><subject>Dosage</subject><subject>Female</subject><subject>Human</subject><subject>Humans</subject><subject>Individual Psychotherapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental Disorders - diagnosis</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Disorders - therapy</subject><subject>Middle Aged</subject><subject>Models, Psychological</subject><subject>Outcomes of Treatment</subject><subject>Patients</subject><subject>Prediction</subject><subject>Prevalence</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychotherapies. Psychological and clinical counseling</subject><subject>Psychotherapy</subject><subject>Psychotherapy - methods</subject><subject>Psychotherapy - statistics & numerical data</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>Time limits</subject><subject>Treatment Duration</subject><subject>Treatment Outcome</subject><subject>Treatment Outcomes</subject><subject>Treatments</subject><subject>Uniforms</subject><subject>Variability</subject><subject>Young Adult</subject><issn>0022-006X</issn><issn>1939-2117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp90ctu1DAUBmALgdppqcQDIBRVLbAJ-Bw7viyrUctFFSDUBTvrjOMwqTJJaieLefuazlAkFl3Z0vn0-_Iz9gr4B-BCfyTOoUJRPWMLsMKWCKCfswXniCXn6tchO0rplmeleHXADjPiFgxfsPInTSEVQ1Ms19T_DkXbF99omiN1bZpaX_xIW78epnWING5fshcNdSmc7NdjdnN1ebP8XF5___RleXFdkpR6KhvjrZAg0FJdeRkQDEE-z68kcFU3yqBRtQygqxWKvEMM3lpTo_LcBHHM3u1ixzjczSFNbtMmH7qO-jDMyWmJGpRRkOXbJ6XSvAKtbYan_8HbYY59foRTIKUVqPEphPniqCWYjN7vkI9DSjE0bozthuLWAXd_2nB_28j0zT5vXm1C_Q_uvz-D8z2g5KlrIvW-TY8OAU0FD0Gvdy7E1j-OL78aIYSUeXy2G9NIbsyFUczVdSE570entUOHXIh7wjSiUA</recordid><startdate>20090401</startdate><enddate>20090401</enddate><creator>Baldwin, Scott A</creator><creator>Berkeljon, Arjan</creator><creator>Atkins, David C</creator><creator>Olsen, Joseph A</creator><creator>Nielsen, Stevan L</creator><general>American Psychological Association</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>7RZ</scope><scope>PSYQQ</scope><scope>7X8</scope></search><sort><creationdate>20090401</creationdate><title>Rates of Change in Naturalistic Psychotherapy</title><author>Baldwin, Scott A ; Berkeljon, Arjan ; Atkins, David C ; Olsen, Joseph A ; Nielsen, Stevan L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a447t-f8c9341329ad5c4e218a1918cb4106df68286d4e175b236d422ec998d26c08e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Behavior Change</topic><topic>Biological and medical sciences</topic><topic>Change</topic><topic>Changes</topic><topic>Correlation analysis</topic><topic>Dosage</topic><topic>Female</topic><topic>Human</topic><topic>Humans</topic><topic>Individual Psychotherapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental Disorders - diagnosis</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental Disorders - therapy</topic><topic>Middle Aged</topic><topic>Models, Psychological</topic><topic>Outcomes of Treatment</topic><topic>Patients</topic><topic>Prediction</topic><topic>Prevalence</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychotherapies. Psychological and clinical counseling</topic><topic>Psychotherapy</topic><topic>Psychotherapy - methods</topic><topic>Psychotherapy - statistics & numerical data</topic><topic>Studies</topic><topic>Surveys and Questionnaires</topic><topic>Time limits</topic><topic>Treatment Duration</topic><topic>Treatment Outcome</topic><topic>Treatment Outcomes</topic><topic>Treatments</topic><topic>Uniforms</topic><topic>Variability</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baldwin, Scott A</creatorcontrib><creatorcontrib>Berkeljon, Arjan</creatorcontrib><creatorcontrib>Atkins, David C</creatorcontrib><creatorcontrib>Olsen, Joseph A</creatorcontrib><creatorcontrib>Nielsen, Stevan L</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>APA PsycArticles®</collection><collection>ProQuest One Psychology</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of consulting and clinical psychology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baldwin, Scott A</au><au>Berkeljon, Arjan</au><au>Atkins, David C</au><au>Olsen, Joseph A</au><au>Nielsen, Stevan L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ833344</ericid><atitle>Rates of Change in Naturalistic Psychotherapy: Contrasting Dose-Effect and Good-Enough Level Models of Change</atitle><jtitle>Journal of consulting and clinical psychology</jtitle><addtitle>J Consult Clin Psychol</addtitle><date>2009-04-01</date><risdate>2009</risdate><volume>77</volume><issue>2</issue><spage>203</spage><epage>211</epage><pages>203-211</pages><issn>0022-006X</issn><eissn>1939-2117</eissn><coden>JCLPBC</coden><abstract>Most research on the dose-effect model of change has combined data across patients who vary in their total dose of treatment and has implicitly assumed that the rate of change during therapy is constant across doses. In contrast, the good-enough level model predicts that rate of change will be related to total dose of therapy. In this study, the authors evaluated these competing predictions by examining the relationship between rate of change and total dose in 4,676 psychotherapy patients who received individual psychotherapy. Patients attended 6.46 sessions on average (
SD
= 4.14, range = 3-29,
Mdn
= 5). The results indicated that although patients improved during treatment, patients' rate of change varied as a function of total dose of treatment. Small doses of treatment were related to relatively fast rates of change, whereas large doses of treatment were related to slower rates of change. Total dose had a nonlinear relationship with the likelihood of clinically significant change. Given the variability in rates of change, it appears that time limits for treatment uniform to all patients would not adequately serve patients' needs.</abstract><cop>Washington, DC</cop><pub>American Psychological Association</pub><pmid>19309180</pmid><doi>10.1037/a0015235</doi><tpages>9</tpages></addata></record> |
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| subjects | Adolescent Adult Behavior Change Biological and medical sciences Change Changes Correlation analysis Dosage Female Human Humans Individual Psychotherapy Male Medical sciences Mental Disorders - diagnosis Mental Disorders - epidemiology Mental Disorders - therapy Middle Aged Models, Psychological Outcomes of Treatment Patients Prediction Prevalence Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychotherapies. Psychological and clinical counseling Psychotherapy Psychotherapy - methods Psychotherapy - statistics & numerical data Studies Surveys and Questionnaires Time limits Treatment Duration Treatment Outcome Treatment Outcomes Treatments Uniforms Variability Young Adult |
| title | Rates of Change in Naturalistic Psychotherapy: Contrasting Dose-Effect and Good-Enough Level Models of Change |
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