Can treatment research inform decision makers? Nonexperimental method issues and examples among older outpatients

Outcome research does not seem to have informed policymakers, decision makers, or practitioners. It is proposed that reporting of improvement-deterioration rates and greater use of single-sample, pretreatment-posttreatment designs in community clinic settings will facilitate communication and, perhaps, mitigate the external validity problem of psychotherapy experiments. The Edwards-Nunnally method (D. C. Speer, 1992) was used to investigate change rates from a single cohort of older adult outpatients (N = 92). The cohort improvement rate was 51%, and the deterioration rate was 5%. However, improvement rates for clients with major depression and adjustment disorders were greater than 70%. Change rates of student and staff therapists and of clients treated in the clinic and in their homes were not significantly different. Deteriorated clients are briefly described.