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The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
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Related Experiment Video

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Clinical errors as a lack of context responsiveness.

Matteo Bugatti1, James F Boswell1

  • 1Department of Psychology, University at Albany, State University of New York.

Psychotherapy (Chicago, Ill.)
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Summary

Evidence-based treatments require responsiveness to patient cues. This case study highlights how failing to address markers like low expectations can lead to premature termination of transdiagnostic therapy.

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Area of Science:

  • Psychotherapy research
  • Clinical psychology
  • Treatment effectiveness

Background:

  • Standardized treatments aim to reduce errors but may lack within-session flexibility.
  • Transdiagnostic treatments offer tailored interventions but require responsiveness to individual patient needs.
  • Context-Responsive Psychotherapy Integration provides a framework for using evidence-based strategies based on process markers.

Observation:

  • A case study examined a transdiagnostic treatment that terminated prematurely after seven sessions.
  • The analysis focused on clinical decision-making and responsiveness to process markers.
  • Three potential clinical errors were identified due to a lack of responsiveness to specific markers.

Findings:

  • Failure to identify and respond to process markers, such as low outcome expectations, self-strivings, and outcome monitoring, can negatively impact therapeutic process and outcomes.
  • The case illustrated how a lack of responsiveness to these markers may contribute to treatment dropout.

Implications:

  • Clinical decision-making requires careful attention to process markers for effective evidence-based treatment.
  • Complementary frameworks like Context-Responsive Psychotherapy Integration may enhance therapist responsiveness.
  • Addressing markers like outcome expectations is crucial for successful treatment completion.