The differential effectiveness of group psychotherapy was estimated in a meta-analysis of 111 experimental and quasi-experimental studies published over the past 20 years. A number of client, therapist, group, and methodological variables were examined in an attempt to determine specific as well as generic effectiveness. Three different effect sizes were computed: active versus wait list, active versus alternative treatment, and pre-to posttreatment improvement rates. The active versus wait list overall effect size (0.58) indicated that the average recipient of group treatment is better off than 72% of untreated controls. Improvement was related to group composition, setting, and diagnosis. Findings are discussed within the context of what the authors have learned about group treatment, meta-analytic studies of the extant group literature, and what remains for future research.

Accountability, cost effectiveness, and continuous quality improvement are essential features of all managed health care systems. However, application of these principles to mental health treatments has lagged behind other health care services. In this article, administrative, practice, and technical issues are addressed through a joint effort between academically based researchers and administrators from two large managed health care organizations. Principles related to the measurement of outcome, instrument selection, and obstacles to the implementation of an ongoing program to assess mental health treatment outcomes are identified. Finally, principles for successfully changing mental health provider behavior toward outcome assessment and the implications of such for mental health delivery systems are discussed.

The demand that providers of mental health services be accountable for the services they provide has highlighted the importance of identifying and tracking the relationship between service, cost, and outcome in the current context of managed behavioural health care. In order to meet this demand, it is imperative that clinicians, researchers, and administrators have reliable and valid measures with which to document and track treatment outcomes. In the arena of child and adolescent care, there is a gap between traditional diagnostic measures and measures specifically designed to track outcomes. This study reports the comprehensive development and testing of a new outcome measure, the Youth Outcome Questionnaire, designed cooperatively by clinicians, researchers, and managed care administrators in order to meet the needs of all three. Multiple clinical samples and normative groups were assessed and results suggest that the instrument meets recommended standards of reliability, validity, and sensitivity to change. The process of development and testing serve as an illustration of the types of issues which must be addressed by those charged with the responsibility for documenting treatment outcomes.

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Group interventions for individuals facing cancer or HIV disease have drawn considerable attention among researchers and clinicians over the past 20 years. There is growing evidence that group services may be helpful, but which interventions are most effective for participants at which phases in the trajectory of disease has been less clear. Moreover, professionals working in different intervention settings (e.g., primary prevention vs. clinical care) and different disease sites (cancer vs. HIV disease) often have little awareness of relevant advances in other fields. Efforts to integrate findings in the literature may accelerate research and advance the standard of clinical care. The current article, the first in a series of four special reports, critically evaluates the efficacy of group interventions led by professional or trained facilitators for individuals confronted by cancer or HIV, across the spectrum of illness from elevated risk through advanced disease. We examine psychosocial and functional outcomes for different interventions directed toward different patient subgroups, trace common themes, highlight limitations, and offer recommendations for further research.