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进展反馈缩小了更有效和不太有效的治疗师之间的差距:一项治疗师效应临床试验荟萃分析。

Progress feedback narrows the gap between more and less effective therapists: A therapist effects meta-analysis of clinical trials.

机构信息

Clinical and Applied Psychology Unit, Department of Psychology, University of Sheffield.

Department of Clinical Psychology and Psychotherapy, University of Trier.

出版信息

J Consult Clin Psychol. 2022 Jul;90(7):559-567. doi: 10.1037/ccp0000747.

Abstract

OBJECTIVE

Some psychotherapists are more effective than others, which means that patients' treatment outcomes partly depend on therapist effects (TEs). This study investigated whether the use of progress feedback influences TE.

METHOD

Data from N = 4,549 participants and 131 therapists across six clinical trials of progress feedback were analyzed. All trials used the Outcome-Questionnaire-45 (OQ-45) outcome measure and assigned psychotherapy patients to a usual psychological care condition or feedback condition. We examined whether feedback utilization moderated TE using multilevel modeling and random-effects meta-analysis.

RESULTS

TE explained a small proportion (intracluster correlation coefficient [ICC] = .011) of variability in posttreatment OQ-45 scores in the pooled multistudy sample, after controlling for intake severity. Feedback utilization was associated with a statistically significant reduction of the magnitude of the TE (ICC = .009) by approximately 18.2%. Secondary analyses of OQ-45 subscales indicated that TEs were statistically significant in relation to symptom distress, but not interpersonal relations or social role. Feedback was associated with better treatment outcomes and narrower variability between therapists.

CONCLUSIONS

Feedback-informed treatment reduces the gap between more and less effective therapists, leading to more equitable and effective psychological care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

有些心理治疗师比其他治疗师更有效,这意味着患者的治疗效果在一定程度上取决于治疗师的影响(TE)。本研究探讨了使用进展反馈是否会影响 TE。

方法

对来自六个使用进展反馈的临床试验的 N = 4549 名参与者和 131 名治疗师的数据进行了分析。所有试验均使用 OQ-45 结果测量法,并将心理治疗患者分配到常规心理护理条件或反馈条件。我们使用多层次建模和随机效应荟萃分析来检验反馈使用是否调节了 TE。

结果

在控制了摄入严重程度后,反馈使用与 TE 大小的统计学显著降低相关(ICC =.009),约为 18.2%。OQ-45 子量表的二次分析表明,TE 与症状困扰相关具有统计学意义,但与人际关系或社会角色无关。反馈与更好的治疗效果和治疗师之间更窄的变异性相关。

结论

反馈信息治疗减少了更有效和不太有效的治疗师之间的差距,从而提供了更公平和有效的心理护理。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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