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Treatment satisfaction compared with outcome in severe dual disorders
R K Ries1, C Jaffe, K A Comtois
1University of Washington, Department of Psychiatry and Behavioral Sciences, and Harborview Medical Center, Seattle 98104, USA.
Community Mental Health Journal
|July 13, 1999
Summary
Patient satisfaction with integrated dual focus treatment was high, with most reporting improvement. However, satisfaction weakly correlated with clinical outcomes, suggesting caution in interpreting satisfaction as a sole measure of treatment success for severely mentally ill patients.
Area of Science:
- Psychiatry
- Mental Health Services
- Clinical Psychology
Background:
- Severely mentally ill (SMI) patients often have co-occurring substance use disorders (dual diagnosis).
- Integrated dual focus treatment aims to address both conditions concurrently.
- Assessing patient satisfaction and perceived outcomes is crucial for treatment evaluation.
Purpose of the Study:
- To evaluate patient-reported satisfaction and outcomes in long-term integrated dual focus treatment.
- To compare patient ratings with case manager assessments of patient outcomes.
- To examine the relationship between treatment satisfaction and clinical outcomes.
Main Methods:
- A cohort of 75 severely mentally ill, dually diagnosed outpatients participated.
- Patients provided ratings on treatment satisfaction and perceived outcomes over one year.
- Case managers also rated patient outcomes during the same period.
Main Results:
- Patient satisfaction ratings for overall care and case management were high (very good to excellent).
- Most patients reported self-rated improvement in their condition.
- Treatment satisfaction showed a weak but significant positive correlation with patient-rated overall outcome (r = .3 to .31, p < .05).
Conclusions:
- High patient satisfaction does not necessarily equate to significant clinical improvement in SMI dual diagnosis patients.
- Treatment satisfaction and clinical outcomes appear to be relatively independent constructs.
- Over-reliance on satisfaction measures alone may overestimate treatment effectiveness; consider objective clinical outcomes.
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