Benefits and challenges in practice-oriented psychotherapy research in Germany: The TK and the QS-PSY-BAY projects of quality assurance in outpatient psychotherapy

Abstract

Despite some controversies between the partners the experiences indicate the importance of practiced-research collaborations to provide relevant information about the delivery of outpatient psychotherapy in the health system.

Building clinicians-researchers partnerships: Lessons from diverse natural settings and practice-oriented initiatives

“…Other concerns observed include the fear that outcome data might reveal negative findings or that results could have negative impact on a clinician's practice-or a treatment center-in terms of performance evaluation, referrals, or income (Adelman et al, 2014;Boswell et al, 2014;Strauss et al, 2014). Not knowing who will have access to outcome data and what will be done with it can also be experienced as a major threat to clinicians' autonomy.…”

“…As evocatively stated by Boswell et al (2014), clinicians "do not like 'big brother' and perhaps with good reason" (page 7). Rightly so, practitioners have questioned the ability of specific outcome results to accurately capture the clients' change, as well as the appropriateness of interpreting any outcome data without proper context or consideration of other sources of information (e.g., how complex the client's problems are, including his/ her life circumstances; McAleavey et al, 2014;Strauss et al, 2014).…”

“…One of the most serious challenges faced by POR is the fact that the tasks involved can be perceived by therapists as being irrelevant or even detrimental to their clinical work. This is a major issue confronted by the implementation of outcome monitoring systems (Boswell et al, 2014;Fernández-Álvarez et al, 2014;Holmqvist et al, 2014;Strauss et al, 2014). Practitioners are not likely to be fully engaged in data collection if they are concerned that it might generate negative reactions from clients, create difficulties in the therapeutic relationship, or simply fail to provide clinically helpful information.…”

“…In addition, diverse POR programs have conducted process studies, focusing on topics such as the use of (or adherence/fidelity to) interventions associated with empirically supported treatments, consistency of routine care with evidence-based practice guidelines, helpful events, therapeutic alliance, and principles of change (Adelman et al, 2014;Fernández-Álvarez et al, 2014;Garland & Brookman-Frazee, 2014;Holmqvist et al, 2014;Koerner & Castonguay, 2014;Strauss et al, 2014;Szapocznik et al, 2014;West et al, 2014). POR studies have also involved the evaluation of assessment measures and DSM-5 diagnostic criteria West et al, 2014).…”

“…A common focus is the assessment of change using standardized outcome monitoring. This involves tracking or predicting the progress of individual, large groups, or specific types of clients (Adelman, Castonguay, Kraus, & Zack, 2014;Boswell, Kraus, Miller, & Lambert, 2014;Castonguay, Pincus, & McAleavey, 2014;Fernández-Álvarez, Gómez, & García, 2014;Holmqvist, Philips, & Barkham, 2014;Koerner & Castonguay, 2014;McAleavey, Lockard, Castonguay, Hayes, & Locke, 2014;Strauss et al, 2014;West et al, 2014). The use of outcome monitoring in day-to-day practice has allowed some of these programs to investigate a number of issues related to specific patterns of change (such as dose-effect and good enough models, predictors of differential response patterns, sudden changes, deterioration, and therapist-client responsiveness), as well as the impact of providing feedback and clinical tools to therapists based on client change.…”