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Session Title: Place Randomized Trials and Alternatives in a Field Setting: Examples From Psychotherapy Research
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Panel Session 106 to be held in Lone Star E on Wednesday, Nov 10, 4:30 PM to 6:00 PM
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Sponsored by the Quantitative Methods: Theory and Design TIG
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| Chair(s): |
| Lee Sechrest, University of Arizona, sechrest@u.arizona.edu
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| Discussant(s):
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| Frederick Newman, Florida International University, newmanf@fiu.edu
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| Abstract:
Two large scale program evaluation studies researching the effects of feedback systems about patients progress in ambulatory psychotherapy have been conducted in Germany. One study used a longitudinal place randomized design where the randomization took place at the therapist level. The intervention group had access to a new feedback system and the control group did treatment as usual. The other study used a simple follow-up design without a control group. All therapists had access to the same feedback system but got feedback about their patients where they stood compared to other patients.
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Evaluating a Feedback System in Ambulatory Psychotherapy Using a Longitudinal Place Randomized Trial
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| Manuel Voelkle, Max-Planck-Institute for Human Development Berlin, voelkle@mpib-berlin.mpg.de
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In Spring 2005, the TK (a German health insurance company) started the project quality monitoring in ambulatory psychotherapy. Core of the project is a new monitoring system, which provides continuous feedback to therapists and patients on the progress of the therapy. In addition, the traditional procedure of calling in expert opinion is complemented/replaced by psychometric information. The goal of the evaluation was to determine whether the new system improves the therapy. Causal evidence was important to the stakeholders but randomization of individual patients was not possible, so we used a place randomized trial where the therapist was the unit of randomization. Large improvements in mental health (client and therapist ratings) between beginning and end of psychotherapy were found in Brief Symptom Inventory (BSI), Inventory of Interpersonal Problems (IIP), SF-12 Health Survey (SF-12), Beck Depression Inventory (BDI), impairment severity score(BSS) and Global Assessment of Functioning Scale (GAF).
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Evaluating a Feedback System in Ambulatory Psychotheray Using a Classical Pre-Post Test Design With a One Year Follow-up
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| Andrés Steffanowski, University of Mannheim, andres@steffanowski.de
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Aim of the project was evaluating a new assessment for quality assurance in ambulatory psychotherapy Bavaria, providing individual feedback about the therapeutic process in comparison to reference groups – a feature that usually in this setting is not available.
Client and therapist are documenting the therapy progress using hand-held computers by answering questions about symptom severity (e.g. depression, anxiety and stress), life satisfaction, therapeutic relationship and problem domains. The results demonstrate impressive and stable effects with the treated patients. These effects lie in the upper third of internationally comparative meta-analytical studies.
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Comparing Two Different Research Designs in Program Evaluation.
Problems, Advantages, Pitfalls and Implications for Causal Evidence
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| Werner Wittmann, University of Mannheim, wittmann@tnt.psychologie.uni-mannheim.de
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It is demonstrated and discussed what different kinds of unexpected problems and pitfalls showed up during the studies.
The two research designs are compared with respect to threats in terms of internal, statistical conclusion, construct and external validity they have to face. The results on similar outcome instruments are compared and the implications for causal evidence and generalization of results are discussed.
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