Cited by 294Psychotherapy Techniques and ApplicationsMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Dose-effect relations and responsive regulation of treatment duration: The good enough level.

Barkham, Michael, Connell, Janice, Stiles, William B., Miles, Jeremy N. V., Margison, Frank, Evans, Chris, Mellor-Clark, John·2006·Journal of Consulting and Clinical Psychology

DOI 10.1037/0022-006x.74.1.160

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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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Authors: Barkham, M., Connell, J., Stiles, W. B., Miles, J. N. V., Margison, F., Evans, C., & Mellor-Clark, J.
Affiliations: University of Leeds (GB)
ORCID: Barkham, Michael
Connell, Janice
Stiles, William B.
Miles, Jeremy N. V.
Evans, Chris
Venue: Journal of Consulting and Clinical Psychology
Publisher: American Psychological Association (APA)
Published: 2006
Volume: 74
Issue: 1
Pages: 160-167
ISSN: 0022-006X (ISSN-L)
1939-2117
DOI: 10.1037/0022-006x.74.1.160
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
Health Sciences › Medicine › Psychiatry and Mental health › 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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Dose-effect relations and responsive regulation of treatment duration: The good enough level.

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