Therapist-Level Moderators of Patient-Therapist Match Effectiveness in Community Psychotherapy

AbstractBased on patient-reported outcomes data analyzed at the provider level, there is evidence that psychotherapists can possess effectiveness strengths and weaknesses when treating patients with different presenting concerns. These within-therapist differences hold promise for personalizing care by prospectively matching patients to therapists ’ historical effectiveness strengths. In a double-masked randomized controlled trial (RCT; NCT02990000), such matching outperformed pragmatically determined usual case assignment—which leaves personalized, measurement-based matching to chance—in naturalistic outpatient psychotherapy (Constanti no et al., JAMA Psychiatry 78:960–969, 2021). Demonstrating that personalization can be even more precise, some research has demonstrated that the strength of this positive match effect was moderated by certain patient characteristics. Notably, though, it could also be that matching is especially important for sometherapists to achieve more effective outcomes. Examining this novel question, the present study drew on the Constantino et al. (JAMA Psychiatry 78:960 –969, 2021) trial data to explore three therapist-level moderators of matching: (a) effectiveness “spread” (i.e., greater performance variability across patients’ presenting problem domains), (b) overestimation of their measurement-based and problem-specific effectiveness, and (c) the freque ncy with which they use patient-reported routine outcomes monitoring in their p...
Source: Administration and Policy in Mental Health and Mental Health Services Research - Category: Psychiatry Source Type: research