Patterns of symptomatology over time and their relation to outcome.

Abstract

The purpose of this study was to examine the association between characteristics of the symptomatology change curve (i.e., initial symptomatology, rate of change, and curvature) and final treatment outcome using a multilevel approach to account for therapist effects. The sample consisted of community clients (N = 492) seen by 204 student therapists at a training clinic. Linear, quadratic, and cubic trajectories of anxiety and depression symptomatology, as assessed by the Shorter Psychotherapy and Counselling Evaluation (sPaCE; Halstead, Leach, & Rust, 2007) were estimated. The multilevel quadratic trajectory best fit the data and depicted a descending curve (partial U-shaped). The quadratic growth parameters (intercept, slope, quadratic) were used as predictors of final treatment outcome as assessed by the Outcome Questionnaire-45.2 (OQ-45.2; Lambert et al., 1996). Patterns for two different successful outcomes, as conceptualised by (a) change in general symptomatology and (b) reliable improvement, were identified. For symptom change, successful outcomes followed a pattern of low initial levels of depression and anxiety, high initial rates of change, and high (flattening after initial drop) curvature, and the pattern applied to both within- and between-therapist levels. For reliable improvement at within-therapist level, successful outcomes followed a pattern of high initial rate of change and high curvature. For reliable improvement at between-therapist level, successful outcomes were associated with a pattern of low initial levels of depression and anxiety. Implications for clinical practice are discussed.

Outcomes in clients transitioning from in‐person counselling to telehealth counselling with trainees

“…Participants were drawn from a larger longitudinal research project (Aoyagi, Holzapfel, & Bludworth, 2019a; Aoyagi, Holzapfel, Bludworth, & Tracey, 2019b; Cheung, 2019; Holzapfel et al, 2016, 2018; Jimenez‐Arista, Holzapfel et al, 2016a; Jimenez‐Arista, Levy et al, 2016b; Jimenez‐Arista et al, 2017, 2018; Spille et al, 2020; Xu & Tracey, 2015) examining associations between process and outcome variables. The current sample consisted of 15 clients, who worked with 14 counsellor trainees providing services at a counsellor training centre housed within a large public university in the southwestern United States between the spring and the summer of 2020.…”

The practice of psychotherapy in Quebec: What have we learned from clinicians, and where should we take it from here.

“…Researchers have examined it from every angle and have demonstrated that it has positive effects on mental health, and can reduce the economic burden of mental illness (American Psychological Association, 2013; Australian Psychological Society, 2010; Fansi, Jehanno, Lapalme, Drapeau, & Bouchard, 2016; Hunsley, Elliott, & Therrien, 2014; Vasiliadis, Dezetter, Latimer, Drapeau, & Lesage, 2017), while many psychologists and other clinicians have made it the core of their clinical practice (Hunsley, Ronson, & Cohen, 2013; Ionita & Fitzpatrick, 2014). The November 2018 issue of Canadian Psychology , which was entirely dedicated to psychotherapy, illustrates the richness of the literature on psychotherapy, with papers that discuss such critical issues as the need for publicly funded psychotherapy and for greater access to psychotherapy, including in remote areas, the importance of self-care and of well-being amongst therapists, change and improvement with psychotherapy, the economic implications of offering therapy, the legal and ethical considerations related to treating specific populations, differences between various groups of practitioners, or the strengths and weaknesses of the methods used to examine the efficacy of therapy (Gajic-Veljanoski et al, 2018; Jimenez-Arista, Tracey, & Levy, 2018; Kalegeropoulos, Roquet, Sztopa, Bradley, & Drapeau, 2018; Laverdière, Kealy, Ogrodniczuk, & Morin, 2018; Lints-Martindal, Carlson, Goodwin, & Thompson, 2018; Maranzan et al, 2018; Mathews, 2018; McPhail, Stephens, & Heasman, 2018; Sanders & Hunsley, 2018; Tasca, Town, Abbass, & Clark, 2018). More importantly perhaps, psychotherapy has also recently received attention from policymakers.…”