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For outcome research of other treatments see treatment outcomes.
The broad summary of psychotherapy research into the effectiveness of different approaches suggests that they are generally of comparable effectiveness and that the variance in improvement is distributed across a number of different factors.
The study of the outcome of clinical interventions is an important area of clinical research for a number of reasons.
Examples of potential uses for outcome measures include:
- To help clinicians answer the question of whether a user is responding to the treatment they are being offered
- To contribute to the quality evaluation of individual clinicians’ practice, as part of continuing professional development and performance review.
- To evaluate the extent to which measured change in a user is clinically significant – i.e. change that makes a difference to the everyday lives of users and is not just statistically significant
- To compare outcomes between similar services (e.g. psychological therapy services provided to outpatients as part of a Community Mental Health Team or services for people with learning difficulties; counselling services in primary care; family therapy services for children) in different areas.
- To compare outcomes between individual clinicians working in the same service, in order to see if they are achieving comparable results.
- To compare outcomes between different user groups within the same service; for example, is the service achieving better outcomes for users with depression than those with anxiety or with white users than with those from ethnic minority groups?
- As a pointer to the need for further investigation or action as part of a quality improvement process.
- To contribute to performance monitoring and audit of a service.
- To provide feedback to a service about the course of response (recovery or deterioration) of those receiving help.
- To provide information for the development of practice-based evidence, to help to build up a picture of the effectiveness of various therapeutic approaches with the range and diversity of problems found in routine clinical practice.
- To provide purchasers of services with data on efficacy and efficiency of therapy services.
- To help purchasers evaluate different therapetic orientations with regard to efficiency and effectiveness.
(List developed from Sperlinger, 2002)
Types of outcome
It is important that outcome is considered in its widest form and does not focus only on symptom reduction. Quality of life, social performance, educational attainment, economic outcomes etc should be considered in any rounded assessment.
Factors effecting outcome
A number of factors can effect therapy outcome:
- Spontaneous remission
- Client variables in determining clinical outcome
- Therapist variables in determining clinical outcome
Assessment of outcome in psychological therapy
- Assessment of outcome in psychological therapy
- Routine outcome measurement
- Staff attitudes to clinical outcome assessment
Evaluation of outcome
- Main article: Evaluation of outcome in psychotherapy
- Client treatment matching
- Mental health program evaluation
- Psychotherapeutic processes
- Relapse prevention
- Side effects
- Therapeutic processes
- Treatment dropouts
- Treatment duration
- Treatment effectiveness evaluation
- Treatment termination
- Wampold, B. (2001). The Great Psychotherapy Debate. New Jersey:Lawrence Erlbaum.
- Thornicroft, G. & Tansella, M. (1996)(eds) Mental Health Outcome Measures. Berlin: Springer
- Ogles, B.M., Lambert, M.J. and Fields, S.A. (2002).Essentials of Outcome Assessment. Wiley
- Andrews, G., et al. (1994) The measurement of consumer outcome in mental health.
Sydney: Clinical Research Unit for Anxiety Disorders
- Berger, M. (1996) Outcomes and effectiveness in clinical practice. Leicester: British Psychological Society
Clifford, P. (1998) M is for outcome. Journal of Mental Health, 7, 19-24
- Fitzpatrick, F., Davey, C., Buxton, M., and Jones, D. (1998) Evaluating patient-based outcome measures for use in clinical trials. Health Technology Assessment, 2, 14
- Froyd, J., Lambert, M., and Froyd, J. (1996) A review of practices of psychotherapy outcome measurement. Journal of Mental Health, 5, 11-15
- Huxley, P. (1998) Outcomes management in mental health. Journal of Mental Health, 7, 273-283
- Ruggeri, M. (1996) Satisfaction with psychiatric services. In G. Thornicroft and M. Tansella (eds) Mental Health Outcome Measures. Berlin: Springer
- Slade, M., Thornicroft, G. and Glover, G. (1999) The feasibility of routine outcome measures in mental health. Social Psychiatry and Psychiatric Epidemiology, 34, 243-249
- Stedman, T., Yellowlees, P., Mellsop, G., Clarke, R., and Drake, S. (1997) Measuring consumer outcomes in mental health. Canberra: Department of Health and Family Services
- Wolpert, M., Wilkinson, I., and Fuggle, P. (2001) Minimum standards for evaluating outcome in clinical practice. Leicester: British Psychological Society (DCP
Children & Young People SIG)