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心理治疗中基于经验且具有临床实用性的决策制定:治疗反应模型的差异预测

Empirically and clinically useful decision making in psychotherapy: differential predictions with treatment response models.

作者信息

Lutz Wolfgang, Saunders Stephen M, Leon Scott C, Martinovich Zoran, Kosfelder Joachim, Schulte Dietmar, Grawe Klaus, Tholen Sven

机构信息

Department of Psychology, University of Berne, Switzerland.

出版信息

Psychol Assess. 2006 Jun;18(2):133-41. doi: 10.1037/1040-3590.18.2.133.

Abstract

In the delivery of clinical services, outcomes monitoring (i.e., repeated assessments of a patient's response to treatment) can be used to support clinical decision making (i.e., recurrent revisions of outcome expectations on the basis of that response). Outcomes monitoring can be particularly useful in the context of established practice research networks. This article presents a strategy to disaggregate patients into homogeneous subgroups to generate optimal expected treatment response profiles, which can be used to predict and track the progress of patients in different treatment modalities. The study was based on data from 618 diagnostically diverse patients treated with either a cognitive-behavioral treatment protocol (n = 262) or an integrative cognitive-behavioral and interpersonal treatment protocol (n = 356). The validity of expected treatment response models to predict treatment in those 2 protocols for individual patients was evaluated. The ways such a procedure might be used in outpatient centers to learn more about patients, predict treatment response, and improve clinical practice are discussed.

摘要

在临床服务的提供过程中,结果监测(即对患者治疗反应的反复评估)可用于支持临床决策(即根据该反应对结果期望进行反复修订)。在已建立的实践研究网络背景下,结果监测可能特别有用。本文提出了一种将患者分解为同质亚组的策略,以生成最佳预期治疗反应概况,可用于预测和跟踪不同治疗方式下患者的进展。该研究基于618名诊断各异的患者的数据,这些患者接受了认知行为治疗方案(n = 262)或认知行为与人际综合治疗方案(n = 356)。评估了预期治疗反应模型对预测这两种方案中个体患者治疗情况的有效性。讨论了在门诊中心使用这种程序来更多地了解患者、预测治疗反应并改善临床实践的方式。

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