Monitorování účinnosti v psychoterapii a poradenství
č.7(2016)
Abstrakt
Klíčová slova:
účinnost psychoterapie; monitorování účinku; zpětná vazba; implementace; psychotherapy effectiveness; outcome monitoring; feedback; implementation
Ve výzkumu psychoterapie a poradenství se v posledních letech prosazuje tzv. na praxi orientovaný výzkum, jehož cílem je zkoumat proces a efekt psychoterapeutických a poradenských intervencí v podmínkách běžné praxe. V terapeutických a poradenských zařízeních v západním světě se stále častěji začínají používat softwarové systémy průběžně monitorující efekt nabízené péče. Výzkumy ukazují, že používání zpětnovazebních informací z těchto systémů má pozitivní vliv na účinnost terapeutické a poradenské praxe. V tomto příspěvku budou nastíněny principy fungování těchto systémů a dále budou shrnuty přínosy i limity rutinního monitorování účinnosti a jeho implementace do praxe.
In psychotherapy and counseling research, practice-oriented research has been gaining momentum recently. Its aim is to study the process and the outcome of psychotherapy and counseling interventions in routine practice. In the Western world, therapeutic and counseling facilities are increasingly beginning to use software systems to continually monitor the effect of treatment offered. Research evidence shows that using this outcome information as feedback has a positive impact on the effectiveness of therapy and counseling practice. In this paper, the principles upon which these systems work will be summarized, as well as the benefits and limitations of routine outcome monitoring and its implementation into practice.
účinnost psychoterapie; monitorování účinku; zpětná vazba; implementace; psychotherapy effectiveness; outcome monitoring; feedback; implementation
Reference
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Duncan, B. L., Miller, S. D., Sparks, J. A., Claud, D. A., Reynolds, L. R., Brown, J., & Johnson, L. D. (2003). The Session Rating Scale: Preliminary psychometric properties of a “working” alliance measure. Journal of Brief Therapy, 3(1), 3–12.
Elliott, R., Mack, C., & Shapiro, D. A. (1999). Simplified Personal Questionnaire procedure. Retrieved from http://www.experiential-researchers.org/instruments/elliott/pqprocedure.html
Elliott, R., & Rodgers, B. (2008). Client Change Interview. Retrieved from http://www.drbrianrodgers.com/research/client-change-interview
Evans, C., Connell, J., Barkham, M., Margison, F., McGrath, G., Mellor-Clark, J., & Audin, K. (2002). Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE-OM. British Journal of Psychiatry, 180, 51–60. doi:10.1192/bjp.180.1.51
Evans, C., Mellor-Clark, J., Margison, F., Barkham, M., Audin, K., Connell, J., & McGrath, G. (2000). CORE: Clinical Outcomes in Routine Evaluation. Journal of Mental Health, 9(3), 247–255. doi:10.1080/jmh.9.3.247.255
Garland, A. F., Kruse, M., & Aarons, G. A. (2003). Clinicians and outcome measurement: What’s the use? The Journal of Behavioral Health Services & Research, 30(4), 393–405. doi:10.1007/BF02287427
Hannan, C., Lambert, M. J., Harmon, C., Nielsen, S. L., Smart, D. W., Shimokawa, K., & Sutton, S. W. (2005). A lab test and algorithms for identifying clients at risk for treatment failure. Journal of Clinical Psychology, 61(2), 155–163. doi:10.1002/jclp.20108
Hansen, N. B., Lambert, M. J., & Forman, E. M. (2002). The psychotherapy dose-response effect and its implications for treatment delivery services. Clinical Psychology: Science and Practice, 9(3), 329–343. doi:10.1093/clipsy/9.3.329
Harmon, C., Hawkins, E. J., Lambert, M. J., Slade, K., & Whipple, J. L. (2005). Improving outcomes for poorly responding clients: The use of clinical support tools and feedback to clients. Journal of Clinical Psychology, 61(2), 175–185. doi:10.1002/jclp.20109
Hatfield, D., McCullough, L., Frantz, S. H. B., & Krieger, K. (2010). Do we know when our clients get worse? An investigation of therapists’ ability to detect negative client change. Clinical Psychology and Psychotherapy, 17(1), 25–32. doi:10.1002/cpp.656
Hawkins, E. J., Lambert, M. J., Vermeersch, D. A., Slade, K. L., & Tuttle, K. C. (2004). The therapeutic effects of providing patient progress information to therapists and patients. Psychotherapy Research, 14(3), 308–327. doi:10.1093/ptr/kph027
Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19. doi:10.1037/0022-006X.59.1.12
Knaup, C., Koesters, M., Schoefer, D., Becker, T., & Puschner, B. (2009). Effect of feedback of treatment outcome in specialist mental healthcare: Meta-analysis. The British Journal of Psychiatry, 195(1), 15–22. doi:10.1192/bjp.bp.108.053967
Kraus, D. R. (2012). The Treatment Outcome Package (TOP). Integrating Science and Practice, 2(2), 43–45.
Kraus, D. R., Castonguay, L. G., Boswell, J. F., Nordberg, S. S., & Hayes, J. A. (2011). Therapist effectiveness: Implications for accountability and patient care. Psychotherapy Research, 21(3), 267–276. doi:10.1080/10503307.2011.563249
Kraus, D. R., Seligman, D. A., & Jordan, J. R. (2005). Validation of a behavioral health treatment outcome and assessment tool designed for naturalistic settings: The treatment outcome package. Journal of Clinical Psychology, 61(3), 285–314. doi:10.1002/jclp.20084
Lambert, M. J. (2013a). Outcome in psychotherapy: The past and important advances. Psychotherapy, 50(1), 42–51. doi:10.1037/a0030682
Lambert, M. J. (2013b). The efficacy and effectiveness of psychotherapy. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (6th ed., pp. 169–218). Hoboken, NJ: John Wiley.
Lambert, M. J., Burlingame, G. M., Umphress, V., Hansen, N. B., Vermeersch, D. A., Clouse, G. C., & Yanchar, S. C. (1996). The reliability and validity of the Outcome Questionnaire. Clinical Psychology and Psychotherapy, 3(4), 249-258. doi:10.1002/(sici)1099-0879(199612)3:4<249::aid-cpp106>3.0.co;2-s
Lambert, M. J., & Ogles, B. M. (2004). The efficacy and efffectiveness of psychotherapy. In M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy and behavior change (5th ed., pp. 307–389). New York, NY: John Wiley.
Lambert, M. J., Whipple, J. L., Hawkins, E. J., Vermeersch, D. A., Nielsen, S. L., & Smart, D. W. (2003). Is it time for clinicians to routinely track patient outcome? A meta-analysis. Clinical Psychology: Science and Practice, 10(3), 288–301. doi:10.1093/clipsy.bpg025
Lambert, M., Whipple, J., Smart, D., Vermeersch, D., Nielsen, S. L., & Hawkins, E. J. (2001). The effects of providing therapists with feedback on patient progress during psychotherapy: Are outcomes enhanced? Psychotherapy Research, 11(1), 49–68. doi:10.1080/713663852
Lambert, M. J., Whipple, J. L., Vermeersch, D. A., Smart, D. W., Hawkins, E. J., Nielsan, S. L., & Goates, M. (2002). Enhancing psychotherapy outcomes via providing feedback on client progress: A replication. Clinical Psychology and Psychotherapy, 9(2), 91–103. doi:10.1002/cpp.324
Lipsey, M. W., & Wilson, D. B. (1993). The efficacy of psychological, educational, and behavioral treatment: Confirmation from meta-analysis. The American Psychologist, 48(12), 1181–1209. doi:10.1037/0003-066X.48.12.1181
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