The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.
The dose-response effect in routinely delivered psychological therapies: A systematic review
Abstract
The dose-response effect refers to the relationship between the dose (e.g., length, frequency) of treatment and the subsequent probability of improvement. This systematic review aimed to synthesize the literature on the dose-response effect in routine psychological therapies delivered to adult patients with mental health problems. Twenty-six studies were eligible for inclusion. Different methodological approaches have been used to examine the dose-response effect; including survival analysis, multilevel modelling and descriptive cluster analyses. Replicated and consistent support was found for a curvilinear (log-linear or cubic) relationship between treatment length and outcomes, with few exceptions such as eating disorders and severe psychiatric populations. Optimal doses of psychotherapy in routine settings range between 4 and 26 sessions (4-6 for low intensity guided self-help) and vary according to setting, clinical population and outcome measures. Weekly therapy appears to accelerate the rate of improvement compared to less frequent schedules. Most of the reviewed evidence is from university counselling centres and outpatient psychotherapy clinics for common mental health problems. There is scarce and inconclusive evidence in clinical samples with chronic and severe mental disorders.
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“Thereby, the trial definition of 16 sessions follows both trial feasibility considerations as well as psychotherapy dose-response findings, with 4–24 sessions being reported as optimal dose in routine treatment settings (44).”
Citations
Cites
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Journal of Psychotherapy Practice and Research
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Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE–OM
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“, 1996) was used in 11 studies; four used the Behavioural Health Measure (BHM-20; Kopta & Lowry, 2002), three used the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM; Barkham, Gilbert, Connell, Marshall, & Twigg, 2005; Evans et al., 2002), one Figure 2.”
MethodInfluentialThe dose-effect relationship in psychotherapy.
Howard, K. I., Kopta, S. M., Krause, M. S., & Orlinsky, D. E. (1986) · American Psychologist · doi:10.1037/0003-066x.41.2.159 · Cited by 891
The psychotherapy dose-response effect and its implications for treatment delivery services.
Hansen, N. B., Lambert, M. J., & Forman, E. M. (2002) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.9.3.329 · Cited by 783
Jauhar, S., McKenna, P. J., Radua, J., Fung, E., Salvador, R., & Laws, K. R. (2014) · British Journal of Psychiatry · doi:10.1192/bjp.bp.112.116285 · Cited by 517 · cited 2×
“If psychotherapy should exert small effects (e.g., ∼ g= 0.33 in Jauhar et al., 2014), the equivalent response rate would be ∼17%, and applying the conventional 50% dose-response criterion seems meaningless in this context.”
BackgroundResultInfluentialPatterns of symptomatic recovery in psychotherapy.
Kopta, S. M., Howard, K. I., Lowry, J. L., & Beutler, L. E. (1994) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.62.5.1009 · Cited by 455
Patterns of symptomatic recovery in psychotherapy.
Kopta, S. M., Howard, K. I., Lowry, J. L., & Beutler, L. E. (1994) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.62.5.1009 · Cited by 442
Dose-effect relations and responsive regulation of treatment duration: The good enough level.
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Baldwin, S. A., Berkeljon, A., Atkins, D. C., Olsen, J. A., & Nielsen, S. L. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0015235 · Cited by 274
Research works printed but not linked: 1
- 10.1300/J035v18n02 · DOI
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Bandelow, B., Allgulander, C., Baldwin, D. S., Costa, D. L. D. C., Denys, D., Dilbaz, N., Domschke, K., Eriksson, E., Fineberg, N. A., Hättenschwiler, J., et al. (2023) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2022.2086295 · Cited by 158
Measurement-Based and Data-Informed Psychological Therapy
Lutz, W., Schwartz, B., & Delgadillo, J. (2021) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-071720-014821 · Cited by 146
Midgley, N., Mortimer, R., Cirasola, A., Batra, P., & Kennedy, E. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.662671 · Cited by 94
McMain, S., Chapman, A. L., Kuo, J. R., Dixon–Gordon, K. L., Guimond, T. H., Labrish, C., Isaranuwatchai, W., & Streiner, D. L. (2022) · Psychotherapy and Psychosomatics · doi:10.1159/000525102 · Cited by 98
Kline, A. C., Cooper, A. A., Rytwinski, N. K., & Feeny, N. C. (2020) · Behavior Therapy · doi:10.1016/j.beth.2020.04.015 · Cited by 77
Metadata
- Authors
- Robinson, L., Delgadillo, J., & Kellett, S.
- Affiliations
- University of Sheffield (GB)
- Corresponding author
- Delgadillo, Jaime
- Venue
- Psychotherapy Research
- Publisher
- Informa UK Limited
- Published
- 2019-01-20
- Volume
- 30
- Issue
- 1
- Pages
- 79-96
- ISSN
- 1050-3307 (ISSN-L)
- 1468-4381
- OpenAlex
- W2908544178
- Cited by
- 264
- References
- 44
- Citations by year
- 2026: 48 · 2025: 42 · 2024: 38 · 2023: 61 · 2022: 31 · 2021: 23 · 2020: 19 · 2019: 2
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychotherapy Research (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- dose-response relationship, psychotherapy, treatment duration, treatment frequency, treatment outcomes, common mental disorders, outpatient psychotherapy, eating disorders, severe mental illness
- MeSH terms
- Mental Disorders, Humans, Psychotherapy, Outcome Assessment, Health Care
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