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Duration of psychological therapy: relation to recovery and improvement rates in UK routine practice. [corrected]
William B Stiles1, Michael Barkham2, Sue Wheeler2
1William B. Stiles, PhD, Department of Psychology, Miami University, Oxford, Ohio, and Department of Psychology, Appalachian State University, Boone, North Carolina, USA; Michael Barkham, PhD, Centre for Psychological Services Research, Department of Psychology, University of Sheffield, UK; Sue Wheeler, PhD, Institute for Lifelong Learning, University of Leicester, UK stileswb@miamioh.edu.
Background:
Previous studies have reported similar recovery and improvement rates regardless of treatment duration among patients receiving National Health Service (NHS) primary care mental health psychological therapy.
Aims:
To investigate whether this pattern would replicate and extend to other service sectors, including secondary care, university counselling, voluntary sector and workplace counselling.
Method:
We compared treatment duration with degree of improvement measured by the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) for 26 430 adult patients who scored above the clinical cut-off point at the start of treatment, attended 40 or fewer sessions and had planned endings.
Results:
Mean CORE-OM scores improved substantially (pre-post effect size 1.89); 60% of patients achieved reliable and clinically significant improvement (RCSI). Rates of RCSI and reliable improvement and mean pre- and post-treatment changes were similar at all tested treatment durations. Patients seen in different service sectors showed modest variations around this pattern.
Conclusions:
Results were consistent with the responsive regulation model, which suggests that in routine care participants tend to end therapy when gains reach a good-enough level.
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