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Replicating and extending the good-enough level model of change: considering session frequency
Robert J Reese1, Michael D Toland, Nathaniel B Hopkins
1University of Kentucky, Educational, School, & Counseling Psychology, 235 Dickey Hall, Lexington 40506-0017, USA. jeff.reese@uky.edu
Summary
The good-enough level model shows therapy dose impacts change rate. Faster change occurs with higher session frequency, not just more sessions.
Area of Science:
- Psychology
- Psychotherapy Research
- Clinical Psychology
Background:
- The good-enough level (GEL) model links psychotherapy change rate to therapy dose.
- Traditional dose-response research often uses session count, neglecting session frequency.
- Session frequency, or how often sessions occur, is a potentially overlooked factor in therapy outcomes.
Purpose of the Study:
- To replicate the GEL model's findings on therapy dose and change rate.
- To investigate if session frequency moderates the relationship between therapy dose and treatment progress.
- To enhance the understanding of psychotherapy dose-response dynamics.
Main Methods:
- Utilized an archived naturalistic dataset from a US university counseling center (n=1,207).
- Measured treatment progress using the Outcome Questionnaire-45 (OQ-45).
- Analyzed the influence of session count and session frequency on the rate of change.
Main Results:
- Replicated findings consistent with the GEL model: fewer sessions correlated with faster rates of change.
- Demonstrated that session frequency significantly influences the rate of change in psychotherapy.
- Clients attending sessions more frequently per week showed more rapid improvement.
Conclusions:
- Session frequency is a critical factor in psychotherapy outcomes, alongside the total number of sessions.
- Clinicians and researchers should consider session frequency when assessing therapy dose and client progress.
- Operationalizing "dose" in psychotherapy research requires incorporating session frequency for a more accurate understanding.
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