Dose-effect relations and responsive regulation of treatment duration: The good enough level.
Abstract
This study examined rates of improvement in psychotherapy as a function of the number of sessions attended. The clients (N=1,868; 73.1% female; 92.4% White; average age=40), who were seen for a variety of problems in routine primary care mental health practices, attended 1 to 12 sessions, had planned endings, and completed the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the beginning and end of their treatment. The percentage of clients achieving reliable and clinically significant improvement (RCSI) on the CORE-OM did not increase with number of sessions attended. Among clients who began treatment above the CORE-OM clinical cutoff (n=1,472), the RCSI rate ranged from 88% for clients who attended 1 session down to 62% for clients who attended 12 sessions (r=-.91). Previously reported negatively accelerating aggregate curves may reflect progressive ending of treatment by clients who had achieved a good enough level of improvement.
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Individuals recover faster when they are offered fewer sessions.
“Interestingly, it has also been found that individuals recover faster when they are offered fewer sessions (Barkham et al., 2006).”
From Exposure and CBT for chronic back pain: An RCT on differential efficacy and optimal length of treatment (2018) · cites this paper as Barkham et al., 2006
The finding that Exposure-short outperformed Exposure-long replicates the findings of Barkham and colleagues that individuals recover faster when they are offered fewer sessions.
“replicating the findings of Barkham and colleagues (Barkham et al., 2006) that individuals recover faster when they are offered fewer sessions.”
From Exposure and CBT for chronic back pain: An RCT on differential efficacy and optimal length of treatment (2018) · cites this paper as Barkham et al., 2006
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- Authors
- Barkham, M., Connell, J., Stiles, W. B., Miles, J. N. V., Margison, F., Evans, C., & Mellor-Clark, J.
- Affiliations
- University of Leeds (GB)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2006
- Volume
- 74
- Issue
- 1
- Pages
- 160-167
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- OpenAlex
- W2152984622
- Cited by
- 293
- References
- 54
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 19 · 2023: 16 · 2022: 13 · 2021: 12 · 2020: 26 · 2019: 19 · 2018: 13 · 2017: 19 · 2016: 12 · 2015: 17 · 2014: 15 · 2013: 18 · 2012: 13
- FWCI
- 15.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NHS Priorities and Needs Research & Development Levy
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- psychotherapy outcome, number of treatment sessions, treatment duration, dose-response relationship, CORE-OM, primary care mental health
- MeSH terms
- Adaptation, Psychological, Adolescent, Adult, Aged, Aged, 80 and over, Anxiety Disorders, Child, Depressive Disorder, England, Female, Humans, Male, Middle Aged, Patient Care Planning, Personality Assessment, Primary Health Care, Problem Solving, Psychotherapy, Quality Assurance, Health Care, Statistics as Topic, Time Factors, Episode of Care, Outcome Assessment, Health Care
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