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Cited by 18Psychotherapy Techniques and ApplicationsPsychological Treatments and AssessmentsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The dose–effect and good enough level models of change for specific psychological concerns.

Niileksela, Christopher R., Ghosh, Arpita, Janis, Rebecca A.·2021·Journal of Consulting and Clinical Psychology
DOI 10.1037/ccp0000635
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Abstract

OBJECTIVE: Most research on the dose-effect (DE) and good-enough level (GEL) models of change has used general outcome measures. The purpose of this study was to determine if predictions from these models generalize to specific presenting concerns and outcome measures. METHOD: , p. 151) during sessions was used. An analysis of reliable and clinically significant improvement (RCSI) and latent growth curve models (LGCMs) were used for clients attending different numbers of sessions across eight scales from the CCAPS-34 to examine the: (a) amount of change from the first to last session, (b) rates of RCSI, (c) shape of change trajectories, and (d) rates of change across sessions. RESULTS: Across all CCAPS-34 scales, clients who attended more sessions tended to experience more improvement, had higher rates of RCSI, and the trajectories of change were nonlinear, consistent with the DE model. Clients who attended fewer sessions tended to experience faster rates of change than those who attended more sessions, consistent with the GEL model. CONCLUSIONS: Aspects of both the DE and GEL models appear to generalize to specific outcome measures on the CCAPS-34. Results suggest both individual differences in sensitivity to therapy and amount of therapy received influence therapeutic change. A greater focus on individual needs, especially early in treatment, may be especially important when determining the length of therapy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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  • The majority of change in depression and anxiety has been shown to occur over the first six sessions.

    “We focused on the effects of the first six sessions for our primary analyses because (a) only half of participants continued to receive treatment after this point and (b) the majority of change in depression and anxiety has been shown to occur over the first six sessions (Niileksela et al., 2021;Southward & Sauer-Zavala, 2022).”

    From Within-person changes in aversive reactivity predict session-to-session reductions in anxiety and depression in the unified protocol. (2024) · cites this paper as Niileksela et al., 2021

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Authors
Niileksela, C. R., Ghosh, A., & Janis, R. A.
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2021-03
Volume
89
Issue
3
Pages
200-213
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/ccp0000635
OpenAlex
W3145442440
Cited by
18
References
0
Citations by year
2026: 3 · 2025: 3 · 2023: 6 · 2022: 5 · 2021: 1
FWCI
2.05
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
therapeutic change, number of treatment sessions, presenting concerns, change trajectories, individual differences in treatment response, treatment duration, psychotherapy outcome
MeSH terms
Adult, Mental Disorders, Counseling, Female, Humans, Male, Psychotherapy, Surveys and Questionnaires, Severity of Illness Index, Students, Universities, Treatment Outcome, Young Adult, Self Report

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