Psychological Feedback
Conditions
Keywords
Psychotherapy feedback
Brief summary
Feedback in psychotherapy involves clients monitoring therapy process and progress, and on a frequent basis clients register these data into online questionnaires. These data are then fed back to the therapist, hence informing about the process and progress in therapy. This information can be shared with the client, something that may enhance the client involvement in evaluating and planning of the therapy. The same data can be used for research purpose. This randomized controlled multicenter study within Norwegian couple and family contexts will explore the effects of feedback in natural settings, and it collaborates closely with a similar American study in Chicago/Evanston, Ill.
Detailed description
The improvement rate in psychotherapy is generally regarded as 50%, while 10% of clients deteriorate after therapy. This indicates a potential for improvement. Research shows that in therapies with the lack of progress, the clients rarely express dissatisfaction about progress to their therapists, and parallel, these therapists consider the therapies to proceed in the right direction. There is therefore a need for more knowledge about (a) how to obtain reliable information about the therapy progress and process monitored frequently during the course of therapy, and (b) that this information is fed back to the therapist and the client so that they (c) jointly can evaluate and adjust the aims and means for improving the therapy, something that may (d) enable them to test more appropriate approaches. This clinical practice should also enhance the client collaboration and empowerment in therapy, hopefully leading to higher recovery rate, shorter treatments, and reduced drop-out. To date, there is limited research on whether and how the use of feedback can contribute to improved outcomes. Such research is especially lacking in couple and family therapy. In a 3-year Norwegian pilot project at the Center for Family and relationships, Modum Bad, Department of Child and Adolescent Mental Health, Sørlandet Sykehus, and at Ålesund family counseling office, the online-based feedback system STIC (Systemic Therapy Inventory of Change) has been implemented and tested. The clinical experience is positive, and the system is considered suitable. This project has evolved parallel to a similar project at the Family Institute at Northwestern University, Evanston, Ill., supervised by the founder of the STIC system, professor William M. Pinsof. The project now enters a new phase by conducting a randomized, controlled trial (RCT) at three Norwegian couple- and family therapy sites in collaboration with five American psychotherapy sites to investigate whether the use of ongoing feedback is associated to more effective therapy compared with therapy without use of feedback.
Interventions
OTHERSTIC feedback system
This condition includes the use of the STIC feedback system.
Sponsors
Stiftelsen Helse og Rehabilitering
Modum Bad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
12 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* individuals, * couples, * families in Norwegian couple- and family therapy contexts
Exclusion criteria
* psychosis, * current drug and alcohol abuse, * violent and threatening behavior, * not enable to understand Norwegian or English language.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Beck Depression Inventory II | The BDI was completed at the start and end of treatment. In this study the treatment length varied from two to 22 sessions. | The Beck Depression Inventory (BDI-II - Beck et al., 1995a) is a widely used 21-item self-report questionnaire assessing cognitive, affective, motivational, and physiological symptoms of depression and variation over time. Items are scored on a scale from 0 to 3 and the sum-score expressed the depth of the depression, graded from no clinical depression (0-9), through mild (10-19), moderate (20-29) and severe depression (30-63). The BDI shows adequate psychometric properties (Beck et al., 1995b). |
Countries
Norway
Participant flow
Recruitment details
Data were collected from 2013 to 2016 from three couple and family therapy sites in Norway.
Participants by arm
| Arm | Count |
|---|---|
| The Use of STIC Feedback System This condition included the use of the STIC feedback system. | 165 |
| Treatment as Usual This condition did not include the use of the STIC feedback system. | 163 |
| Total | 328 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 68 | 76 |
Baseline characteristics
| Characteristic | The Use of STIC Feedback System | Treatment as Usual | Total |
|---|---|---|---|
| Age, Continuous | 40.28 Years STANDARD_DEVIATION 9.73 | 39.47 Years STANDARD_DEVIATION 8.63 | 39.86 Years STANDARD_DEVIATION 9.69 |
| Beck Depression Inventory | 15.10 Unit on a scale STANDARD_DEVIATION 11.38 | 16.02 Unit on a scale STANDARD_DEVIATION 11.56 | 15.36 Unit on a scale STANDARD_DEVIATION 11.47 |
| Sex: Female, Male Female | 86 Participants | 86 Participants | 172 Participants |
| Sex: Female, Male Male | 79 Participants | 77 Participants | 156 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 165 | 0 / 163 |
| other Total, other adverse events | 5 / 165 | 3 / 163 |
| serious Total, serious adverse events | 0 / 165 | 0 / 163 |
Outcome results
Primary
Beck Depression Inventory II
The Beck Depression Inventory (BDI-II - Beck et al., 1995a) is a widely used 21-item self-report questionnaire assessing cognitive, affective, motivational, and physiological symptoms of depression and variation over time. Items are scored on a scale from 0 to 3 and the sum-score expressed the depth of the depression, graded from no clinical depression (0-9), through mild (10-19), moderate (20-29) and severe depression (30-63). The BDI shows adequate psychometric properties (Beck et al., 1995b).
Time frame: The BDI was completed at the start and end of treatment. In this study the treatment length varied from two to 22 sessions.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| The Use of STIC Feedback System | Beck Depression Inventory II | Start of treatment | 15.10 score on a scale | Standard Deviation 11.38 |
| The Use of STIC Feedback System | Beck Depression Inventory II | End of treatment | 10.78 score on a scale | Standard Deviation 11.28 |
| Treatment as Usual | Beck Depression Inventory II | Start of treatment | 16.02 score on a scale | Standard Deviation 11.56 |
| Treatment as Usual | Beck Depression Inventory II | End of treatment | 9.35 score on a scale | Standard Deviation 10.58 |
p-value: <0.05Mixed Models Analysis