Department of Psychology, Indiana University of Pennsylvania, 15701, USA.
Clin Psychol Psychother. 2010 Jan-Feb;17(1):25-32. doi: 10.1002/cpp.656.
Routine clinical judgment is often relied upon to detect client deterioration. How reliable are therapists' judgments of deterioration? Two related studies were conducted to investigate therapist detection of client deterioration and therapist treatment decisions in situations of deterioration. The first study examined therapists' ability to detect client deterioration through the review of therapy progress notes. Therapist treatment decisions in cases of client deterioration were also explored. Therapists had considerable difficulty recognizing client deterioration, challenging the assumption that routine clinical judgment is sufficient when attempting to detect client deterioration. A second study was a survey of therapists asking how they detect client deterioration and what treatment decisions they make in response. Symptom worsening was the most commonly stated cue of deterioration.
常规的临床判断通常被用来检测客户的病情恶化。治疗师对病情恶化的判断有多可靠？进行了两项相关研究，以调查治疗师在病情恶化时对客户恶化的检测以及治疗师的治疗决策。第一项研究通过审查治疗进展记录来检查治疗师发现客户恶化的能力。还探讨了治疗师在客户恶化情况下的治疗决策。治疗师很难识别客户的病情恶化，这对试图检测客户恶化时仅依靠常规临床判断的假设提出了挑战。第二项研究是对治疗师的调查，询问他们如何发现客户的恶化以及他们做出了哪些治疗决策。症状恶化是最常提到的恶化迹象。
