The aim of the of the research was to try and establish the appropriate outcome measurement techniques and in turn use the research outcome to establish whether psychotherapy is effective.The length of therapy and its relation to effective treatment was also observed.
It is a challenge to measure outcome in psychotherapy but despite this huddle, a few clinicians still monitor outcome. Research has built evidence that if a patient’s progress is monitored, then it becomes less of a task to measure the resulting patient outcome.
A sharp increase in the cost of medical care was the driving force that led more and more clinicians to start getting involved in patient outcome measurement. This resulted in the need to identify effective methods by which this could be achieved. Several methods with different characteristics have been suggested by Ogles, Lambert, and Masters (1996).
The different characteristics of these methods include the content, time orientation of the instrument and the method of data collection. The psychological element that is measured by an instrument is referred to as the content of the measure; multiple elements can however be measured using the same instrument depending on the scope of the measurement.
Papers written by between-study meta-analytic review writers employ a sample of studies and then code the treatment effect size and a numerical code of the length of experience of the therapist and or the different levels of education of the therapist e.g. a master’s clinician versus a PhD. These are then correlated to establish the relationship between the effect size and level of experience.
Investigations done within a study carried to establish the relationship between years of therapist training and outcome were reanalyzed using meta-analytic methods. The outcome was that out of 154 comparisons, thirty nine showed that patients who seek assistance from paraprofessionals stood a better chance of having their issues resolved than those who saw professionals.
Other sub comparisons also indicated that patients got better results seeing therapists who were still or had just completed training. Long practicing paraprofessionals were found to be more effective than the beginners. Hattie et al. (1984) review interestingly noted that the amount of training received by paraprofessionals had a positive effect on the patient outcome.
As would be expected, different indices of change are bound to be obtained if different methodologies are used to arrive at them (Smith, Glass, & Miller, 1980). Some researchers for example base their measurement on behavioral observations while some on specific change.
The Time orientation instrument measures traits that set each individual apart from the rest in the long run and states which only define the individual over a short period of time. This is of importance because it attaches some sort of time frame on the length of the patient outcome measurement.
With all these options to choose from, it is necessary that a few points be noted upon which the appropriate method is then selected. The points that are important in this selection are that it has to be applicable, practical and strong.
Reliability, validity, and sensitivity to change are also vital in ensuring an effective instrument. A good instrument is one that captures the most important characteristics of the targeted group (Newman, Ciarlo, & Carpenter, 1999). In most cases Depression and anxiety disorders are the commonest and most important of these (Narrow, Rae, Robins, & Regier, 2002).
With all the above in mind, it was clear that the task of choosing one particular method of measurement is not easy. A few options of the most commonly used and perhaps the ones perceived to give the best estimates were given. Behavior and Symptoms Identification Scale (BASIS-32) instrument employs a 5-point Likert scale to asses the mental health of a patient (Eisen, Grob, & Klein, 1986).
Its advantages are that is flexible and can be administered as a self report or an interview. The second instrument suggested was the Brief Symptom Inventory (BSI) which is administered in Two-week test–retes.
Its predictive validity is strong in different clinical settings and has been widely used in research including HIV projects (Derogatis, 1993).It is however a n expensive instrument and its nine subscales are largely associated and this brings doubt as to how unique each measured element is from each other.
The main problem encountered during the research was the difficult task of trying to establish a suitable measurement method. This was particularly tasking because there was a need to strike a balance between accuracy, cost and effectiveness.
This was however dealt with by employing more than just one method of measurement and using the consumer report as a from of comparison to ascertain whether the research was anything close to what consumers said.
It was concluded that psychotherapy is indeed effective. It was also established that lengthier and more rigorous therapy is more effective that brief therapy. This was according to readers’ ratings by Consumer reports magazine after the research.
The consumers were rating in terms of problem resolution, satisfaction and emotional change during therapy. The authors of the magazine compared Outcome Questionnaire scores to consumer reports that were taken at least six months after therapy. From this it was established that the Consumer report satisfaction rates seemed overly generalized and too optimistic.