Are Samples in Randomized Controlled Trials of Psychotherapy Representative of Community Outpatients? A New Methodology and Initial Findings.

Abstract

To determine the extent to which published randomized controlled trials (RCTs) of psychotherapy can be generalized to a sample of community outpatients, the authors used a method of matching information obtained from outpatient charts to inclusion and exclusion criteria from published RCT studies. They found that 80% of the patients in their sample who had diagnoses represented in the RCT literature were judged eligible for at least 1 published RCT; however, 58% of the patients had primary diagnoses such as adjustment disorder or dysthymia, which were not represented in the existing psychotherapy outcome literature. The most common reasons that patients in their sample did not match with published RCTs for psychotherapy are listed, and the implications of these findings for research and practice are discussed.

Supervision for treatment of depression: An experimental study of the role of therapist gender and anxiety

“…While these differences in outcome of CBT for depression might be attributed to different patient samples (e.g., Kazdin, 2008;Westen & Morrison, 2001), the evidence is that most patients treated in naturalistic settings would meet the criteria for RCTs (Schindler, Hiller, & Witthoft, 2011;Stirman, DeRubeis, Crits-Christoph, & Brody, 2003;Stirman, DeRubeis, Crits-Christoph, & Rothman, 2005). Thus, patient complexity cannot fully explain differences in outcome of treatment for depression (Gibbons et al, 2013;Weisz, JensenDoss, & Hawley, 2006).…”

Tratamientos con apoyo empírico. Una aproximación a sus ventajas, imitaciones y propuestas de mejora

“…No hay estudios sobre por qué los pacientes buscan psicoterapia: por quejas del Eje I, clínicas o subclínicas, o por cuestiones personales (relaciones problemáticas, dificultades laborales), o si se presentan con un panorama difuso que requiere clarificación de objetivos (Westen, Novotny y Thompson-Brenner, 2004a) o de conductas problema. Estudios en contextos aplicados muestran que entre un tercio y la mitad de los pacientes no pueden diagnosticarse con el DSM porque sus problemas no encajan o porque tienen niveles sub-umbral para las categorías (Stirman, DeRubeis, Crits-Christoph y Brody, 2003;Westen, Novotny y Thompson-Brenner, 2004a). Raave (2003, pp.…”

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“…Finally, from recent analysis of treatments for mental health issues, it is clear that such issues are quite serious so the findings may not be applicable to milder disturbances (Stirman, DeRubeis, Crits-Christoph, & Brody, 2003).…”