Vestfold Counseling Office of Family Affairs, Regional Office for Children, Youth and Family Affairs, Tønsberg, Norway.
J Consult Clin Psychol. 2009 Aug;77(4):693-704. doi: 10.1037/a0016062.
Despite the overall efficacy of psychotherapy, dropouts are substantial, many clients do not benefit, therapists vary in effectiveness, and there may be a crisis of confidence among consumers. A research paradigm called patient-focused research--a method of enhancing outcome via continuous progress feedback--holds promise to address these problems. Although feedback has been demonstrated to improve individual psychotherapy outcomes, no studies have examined couple therapy. The current study investigated the effects of providing treatment progress and alliance information to both clients and therapists during couple therapy. Outpatients (N = 410) at a community family counseling clinic were randomly assigned to 1 of 2 groups: treatment as usual (TAU) or feedback. Couples in the feedback condition demonstrated significantly greater improvement than those in the TAU condition at posttreatment, achieved nearly 4 times the rate of clinically significant change, and maintained a significant advantage on the primary measure at 6-month follow-up while attaining a significantly lower rate of separation or divorce. Mounting evidence of feedback effects with different measures and populations suggests that the time for routine tracking of client progress has arrived.
尽管心理治疗总体上是有效的，但仍有大量的患者中途退出，许多患者并未从中受益，治疗师的效果也存在差异，消费者可能对其信心不足。一种名为“以患者为中心的研究”的研究范式——通过持续的进展反馈来提高治疗效果的方法——有望解决这些问题。尽管已经证明反馈可以改善个体心理治疗的效果，但尚无研究检验伴侣治疗。本研究调查了在伴侣治疗中向客户和治疗师提供治疗进展和联盟信息的效果。社区家庭咨询诊所的门诊患者（N=410）被随机分配到以下两个组之一：常规治疗（TAU）或反馈。与 TAU 组相比，反馈组的夫妻在治疗后改善更为显著，达到了近 4 倍的临床显著变化率，并在 6 个月随访时在主要指标上保持显著优势，同时离婚或分居率显著降低。越来越多的证据表明，不同的措施和人群中都存在反馈效应，这表明现在是时候对客户的进展进行常规跟踪了。
