Department of Psychological and Quantitative Foundations.
Counseling Center.
Psychotherapy (Chic). 2019 Jun;56(2):309-317. doi: 10.1037/pst0000197. Epub 2018 Nov 26.
Accurate estimations of progress in psychotherapy are necessary for therapists to identify clients at risk of deterioration and potentially reduce premature terminations. This need has resulted in a large body of literature examining the rate and trajectory of change in psychotherapy; however, few studies have tested these dose-response relationships outside of global measures of mental health. Moreover, there is a paucity of research examining the relationship between progress in treatment, treatment length, and premature termination. In this study, we conducted multivariate multilevel analyses to test the good-enough level model across the three domains of the phase model of psychotherapy: psychological symptoms, life functioning, and well-being. In addition, we tested changes in well-being, psychological symptoms, and life functioning, treatment length, and an interaction between treatment progress and treatment length as predictors of premature termination. Data for this study consisted of 438 clients who were treated by 57 therapists within a brief therapy model. Results failed to support the good-enough level model for changes in well-being, psychological symptoms, and life functioning, such that the rate of change across all three scales did not significantly vary as a function of treatment length. However, exploratory analyses revealed a significant interaction effect between changes in well-being, treatment length, and premature termination, indicating that clients who experienced high rates of change in well-being early in treatment were more likely to prematurely terminate treatment. Clinical implications and future research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
准确评估心理治疗的进展对于治疗师识别可能恶化的患者并可能减少过早终止治疗非常必要。这种需求导致了大量文献研究心理治疗中的变化率和轨迹;然而,很少有研究在全球心理健康测量之外测试这些剂量反应关系。此外,研究治疗进展、治疗时间和过早终止之间关系的研究很少。在这项研究中,我们进行了多元多层分析,以检验心理治疗阶段模型的三个领域中的“足够好”水平模型:心理症状、生活功能和幸福感。此外,我们还测试了幸福感、心理症状和生活功能的变化、治疗时间以及治疗进展与治疗时间之间的相互作用作为过早终止的预测指标。这项研究的数据来自于在短程治疗模式下由 57 名治疗师治疗的 438 名患者。结果未能支持幸福感、心理症状和生活功能变化的“足够好”水平模型,即所有三个量表的变化率都没有显著随治疗时间的变化而变化。然而,探索性分析显示幸福感变化、治疗时间和过早终止之间存在显著的交互作用效应,表明治疗早期幸福感变化率高的患者更有可能过早终止治疗。讨论了临床意义和未来的研究。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。