Rates of change in naturalistic psychotherapy: Contrasting dose–effect and good-enough level models of change.

Baldwin, Scott A.; Berkeljon, Arjan; Atkins, David C.; Olsen, Joseph A.; Nielsen, Stevan L.

doi:10.1037/a0015235

Cited by 269 publications

(284 citation statements)

References 34 publications

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“…First, more-intense treatment might indeed not be superior to less-intense treatment. There is some evidence from naturalistic studies indicating that the relationship between treatment dose and response is highly variable 31 and that a relevant proportion of patients already improves significantly after few sessions. 32 Another study, however, found that response rates were low in patient samples receiving only a few sessions.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Psychological Treatments for Depressive Disorders in Primary Care: Systematic Review and Meta-Analysis

Linde

Sigterman

Kriston

et al. 2015

The Annals of Family Medicine

170

109

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PURPOSE We performed a systematic review of the currently available evidence on whether psychological treatments are effective for treating depressed primary care patients in comparison with usual care or placebo, taking the type of therapy and its delivery mode into account. METHODSRandomized controlled trials comparing a psychological treatment with a usual care or a placebo control in adult, depressed, primary care patients were identified by searches in MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and PsycINFO up to December 2013. At least 2 reviewers extracted information from included studies and assessed the risk of bias. Random effects meta-analyses were performed using posttreatment depression scores as outcome. RESULTSA total of 30 studies with 5,159 patients met the inclusion criteria. Compared with control, the effect (standardized mean difference) at completion of treatment was -0.30 (95% CI, -0.48 to -0.13) for face-to-face cognitive behavioral therapy (CBT), -0.14 (-0.40 to 0.12) for face-to-face problem-solving therapy, -0.24 (-0.47 to -0.02) for face-to-face interpersonal psychotherapy, -0.28 (-0.44 to -0.12) for other face-to-face psychological interventions, -0.43 (-0.62 to -0.24) for remote therapist-led CBT, -0.56 (-1.57 to 0.45) for remote therapist-led problem-solving therapy, -0.40 (-0.69 to -0.11) for guided selfhelp CBT, and -0.27 (-0.44 to -0.10) for no or minimal contact CBT.CONCLUSIONS There is evidence that psychological treatments are effective in depressed primary care patients. For CBT approaches, substantial evidence suggests that interventions that are less resource intensive might have effects similar to more intense treatments.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Psychological Treatments for Depressive Disorders in Primary Care: Systematic Review and Meta-Analysis

Linde

Sigterman

Kriston

et al. 2015

The Annals of Family Medicine

170

109

View full text Add to dashboard Cite

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“…These results are consistent with psychotherapy research suggesting that the dose-response relationship is not always uniform or linear. Different persons yield different benefits, despite receiving the same dose, and some persons show improvement with a small dose, whereas others require a stronger dose (Baldwin et al, 2009). Benefits from a universal preventive intervention are likely contingent on preintervention symptomatology; more symptomatic children may require services beyond a universal intervention, despite high levels of caregiver participation.…”

Section: Caregiver Attendance Trajectories and Post-intervention Chilmentioning

confidence: 99%

Participation Patterns Among Mexican–American Parents Enrolled in a Universal Intervention and Their Association with Child Externalizing Outcomes

Mauricio

Tein

Gonzales

et al. 2014

American J of Comm Psychol

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This study used growth mixture modeling to examine attendance trajectories among 292Mexican American primary female caregivers enrolled in a universal preventive intervention and the effects of health beliefs, participation intentions, cultural influences, and intervention group cohesion on trajectory group membership as well as trajectory group differences on a distal higher externalizing children with lower GPAs. Caregivers in the two persistent attender groups reported strong group cohesion and providers rated these caregivers as having strong participation intentions. Children of caregivers in the LRPA group had the lowest T2 child externalizing. Children of caregivers in the MPT group had lower T2 externalizing than did those of the ET group, suggesting partial intervention dosage can benefit families. Despite high levels of attendance, children of caregivers in the HRPA had the highest T2 externalizing, suggesting this high-risk group needed either more intensive services or a longer period for parents to implement program skills to evidence change in child externalizing.

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“…Participants receiving CBT-T averaged one more session than those receiving CBT-IP, but the duration of psychotherapy sessions was significantly longer for the CBT-IP group ( p = 0.001); 69% of CBT recipients received at least eight sessions (defined as ''completers'') and 91% received at least four sessions, which has been cited as a ''minimally effective dose'' of psychotherapy in some studies; 36,79 there were 12% more CBT-T than CBT-IP participants in each of these categories. A support person participated in at least one session for 12 (30%) of the CBT-T participants and 8 (44%) of the CBT-IP participants; among those who had a support person participate, they did so in significantly more of the CBT-T sessions (44%) than the CBT-IP sessions (11%).…”

Section: Cbt Participation and Therapeutic Alliancementioning

confidence: 99%

Telephone and In-Person Cognitive Behavioral Therapy for Major Depression after Traumatic Brain Injury: A Randomized Controlled Trial

Fann

Bombardier

Vannoy

et al. 2015

Journal of Neurotrauma

109

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Major depressive disorder (MDD) is prevalent after traumatic brain injury (TBI); however, there is a lack of evidence regarding effective treatment approaches. We conducted a choice-stratified randomized controlled trial in 100 adults with MDD within 10 years of complicated mild to severe TBI to test the effectiveness of brief cognitive behavioral therapy administered over the telephone (CBT-T) (n = 40) or in-person (CBT-IP) (n = 18), compared with usual care (UC) (n = 42). Participants were recruited from clinical and community settings throughout the United States. The main outcomes were change in depression severity on the clinician-rated 17 item Hamilton Depression Rating Scale (HAMD-17) and the patientreported Symptom Checklist-20 (SCL-20) over 16 weeks. There was no significant difference between the combined CBT and UC groups over 16 weeks on the HAMD-17 (treatment effect = 1.2, 95% CI: -1.5-4.0; p = 0.37) and a nonsignificant trend favoring CBT on the SCL-20 (treatment effect = 0.28, 95% CI: -0.03-0.59; p = 0.074). In follow-up comparisons, the CBT-T group had significantly more improvement on the SCL-20 than the UC group (treatment effect = 0.36, 95% CI: 0.01-0.70; p = 0.043) and completers of eight or more CBT sessions had significantly improved SCL-20 scores compared with the UC group (treatment effect = 0.43, 95% CI: 0.10-0.76; p = 0.011). CBT participants reported significantly more symptom improvement ( p = 0.010) and greater satisfaction with depression care ( p < 0.001), than did the UC group. In-person and telephone-administered CBT are acceptable and feasible in persons with TBI. Although further research is warranted, telephone CBT holds particular promise for enhancing access and adherence to effective depression treatment.

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Rates of change in naturalistic psychotherapy: Contrasting dose–effect and good-enough level models of change.

Cited by 269 publications

References 34 publications

Effectiveness of Psychological Treatments for Depressive Disorders in Primary Care: Systematic Review and Meta-Analysis

Effectiveness of Psychological Treatments for Depressive Disorders in Primary Care: Systematic Review and Meta-Analysis

Participation Patterns Among Mexican–American Parents Enrolled in a Universal Intervention and Their Association with Child Externalizing Outcomes

Telephone and In-Person Cognitive Behavioral Therapy for Major Depression after Traumatic Brain Injury: A Randomized Controlled Trial

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