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Dose-effect relationship in children's psychotherapy services.

M S Salzer1, L Bickman, E W Lambert

  • 1Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia 19104-2648, USA. Salzer@cmhpsr.upenn.edu

Journal of Consulting and Clinical Psychology
|May 4, 1999
PubMed
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This study found no general dose-effect relationship in child psychotherapy, challenging session limits. Clinicians should justify treatment requests, and behavioral health organizations (BHOs) must justify session limits.

Area of Science:

  • Child and Adolescent Psychology
  • Health Services Research
  • Psychotherapy Outcomes

Background:

  • Behavioral health organizations (BHOs) often impose session limits.
  • This practice raises concerns about the psychotherapy dose-effect relationship.
  • Empirical evidence is needed to guide these limitations.

Purpose of the Study:

  • To examine the dose-effect relationship in child psychotherapy.
  • To address the confounding factors of dose, effect, and initial severity.
  • To inform policy regarding session limits in behavioral health care.

Main Methods:

  • Utilized data from 567 outpatient children in the Fort Bragg Evaluation Project.
  • Employed multiple outcome measures and standardized data collection.

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  • Conducted probit and longitudinal growth curve analyses.

    • Main Results:

    • No statistically significant general dose-effect relationship was found in child psychotherapy.
    • The study controlled for initial severity to isolate the dose-effect relationship.
    • Findings indicate current session limits may not be evidence-based.

    Conclusions:

    • The lack of a dose-effect relationship challenges the rationale for arbitrary session limits.
    • Behavioral health organizations (BHOs) need to justify their imposed session limits.
    • Clinicians should provide robust justifications for treatment requests and continued care.