Therapy outcome research, health care policy, and the continuing lack of accumulated knowledge.

Abstract

Design characteristics in therapy outcome research were evaluated for their inherent potential in responding to questions raised by clinicians, consumers, and policymakers. Attention was directed at the generalizability of findings, the assessment and definition of benefit, and the cost involved. A review of 302 outcome studies published in 3 clinical journals from 1978/1979 and 1986/1987 indicated that the number of published outcome studies has decreased over time, that the experimental designs used are largely unable to provide answers for policymakers, and that it is primarily the quality of measurement and documentation of change that has improved. Publication trends reflect a continuing lack of replication studies, insufficient attempts to describe the clinical meaning of findings, and a widespread disregard for considerations of statistical power. WOLFGANG LINDEN, PhD, received his doctorate from McGill University in 1981. He is currently an associate professor in the clinical psychology program at the University of British Columbia. Although his clinical research focuses on cardiovascular disease, he maintains an active interest in professional issues.

Empirical Values and the Culture of Family Therapy*

“…Making basic knowledge useful for clinical work is complex. (Linden & Wen, 1990;Kazdin, Siegel, & Bass, 1990). Further, it represents uncharted territory.…”

Relationship of satisfaction to symptom change, follow-up adjustment, and clinical significance.

“…Professionals in the mental health fields, including clinical psychologists, have shown an ambivalence toward the formal assessment of psychotherapy outcome. Although an increasingly large number of outcome studies have appeared in recent decades, there has been a distinct lack of published outcome research originating from standard practice settings (Linden & Wen, 1990; Stiles, Shapiro, & Elliott, 1986).…”

Clinical health psychology: A specialty for the 21st century.

“…It has been noted before that much of the outcome literature in psychology is noncumulative. For example, Linden and Wen (1990) reviewed 302 treatment outcome studies published in three prominent psychology journals and found that only 3% incorporated replications of previous work, despite psychology's purported value of replication as a cornerstone in science. These authors also found that the literature was wholly lacking when it came to the cost–benefit analyses that provide critical information for policymakers.…”