How many therapists? Practical guidance on investigating therapist effects in randomized controlled trials for eating disorders
Open accessAbstract
Objective: An important question in implementation/dissemination research is whether the efficacy of a given treatment varies in part based on the therapist delivering the treatment. This study sought to provide practical guidance to researchers in the field of eating disorders for building measurement of therapist effects into the design of a typical, relatively small randomized controlled trial (RCT). Method: Using assumptions based on past trials of eating disorder treatments, Monte Carlo simulations were used to examine 12 different scenarios based on crossing the number of therapists (between two and five) and the estimated therapist effect size (small, medium, and large). Patient sample size and study design were held constant. Results: There was reasonable power (≥70%) to detect the therapist effect with three or four therapists and a large effect size. Discussion: Several practical implications for testing therapist effects in RCT are discussed. © 2012 by Wiley Periodicals, Inc. Int J Eat Disord 2012.
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There is a lower therapist effect when interventions follow a manual-based treatment or protocol, when therapists receive solid training in the intervention and have considerable clinical experience.
“However, there is a lower therapist effect when interventions follow a manual-based treatment or protocol, when therapists receive solid training in the intervention and have a considerable clinical experience (Thompson et al. 2012).”
From Trial-Based Cognitive Therapy: Efficacy of a New CBT Approach for Treating Social Anxiety Disorder with Comorbid Depression. (2018) · cites this paper as Thompson et al. 2012
The Introduction says evidence suggests therapist effects are less likely with highly standardized, manual-based treatments or highly skilled, experienced, well-trained therapists. The claim presents this as an established lower therapist effect, whereas the source describes a lower likelihood and qualifies the evidence. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAnother limitation is related to potential therapist effects, which has implications for evaluating the treatment outcome.
“Another limitation is related to potential therapist effects, which has implications for evaluating the treatment outcome (Thompson et al. 2012;Walwyn and Roberts 2010).”
From Trial-Based Cognitive Therapy: Efficacy of a New CBT Approach for Treating Social Anxiety Disorder with Comorbid Depression. (2018) · cites this paper as Thompson et al. 2012
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References 40 · Cited by 4
- Authors
- Thompson, D., Cachelin, F., Striegel‐Moore, R. H., Barton, B., Shea, M., & Wilson, G. T.
- Affiliations
- University of North Carolina at Charlotte (US)
- Wesleyan University (US)
- University of Massachusetts Chan Medical School (US)
- California State University Los Angeles (US)
- Rutgers, The State University of New Jersey (US)
- Corresponding author
- Thompson, Doug
- Venue
- International Journal of Eating Disorders
- Publisher
- Wiley
- Published
- 2012-03-12
- Volume
- 45
- Issue
- 5
- Pages
- 670-676
- ISSN
- 0276-3478 (ISSN-L)
- 1098-108X
- PMC
- PMC3561761
- OpenAlex
- W2103080945
- Cited by
- 4
- References
- 40
- Citations by year
- 2023: 1 · 2019: 1 · 2018: 1 · 2014: 1
- FWCI
- 0.36
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- International Journal of Eating Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship@UMassChan (submittedVersion)
- Wesleyan University Digital Collections (Wesleyan University) (submittedVersion)
- WESLEYAN
- Funders
- National Institute of Mental Health (SC1MH087975)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- therapist effects, eating disorders, randomized controlled trials, sample size determination, statistical power, Monte Carlo simulation, dissemination research, treatment efficacy
- MeSH terms
- Feeding and Eating Disorders, Humans, Psychotherapy, Research Design, Randomized Controlled Trials as Topic, Guidelines as Topic
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