Cited by 788Psychotherapy Techniques and ApplicationsMental Health Treatment and AccessDigital Mental Health Interventions

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The psychotherapy dose-response effect and its implications for treatment delivery services.

Hansen, Nathan B., Lambert, Michael J., Forman, Evan M.·2002·Clinical Psychology: Science and Practice

DOI 10.1093/clipsy.9.3.329

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Abstract

To date, few studies have been published on the doseresponse relationship, but there is general consensus that between 13 and 18 sessions of therapy are required for 50% of patients to improve. Reviewing the clinical trials literature reveals that in carefully controlled and implemented treatments, between 57.6% and 67.2% of patients improve within an average of 12.7 sessions. Using naturalistic data, however, revealed that the average number of sessions received in a national database of over 6,000 patients was less than five. The rate of improvement in this sample was only about 20%. These results suggest that patients, on average, do not get adequate exposure to psychotherapy, nor do they recover from illness at rates observed in clinical trials research.

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Angeli, N. (2022) · Digital Archive @ GSU · doi:10.57709/1759589 · Cited by 2
How to Include Analytic Patients in Research and How This Affects Treatment
Clemence, A. J., Tillman, J. G., & Poston, J. M. (2015) · Psychoanalytic Inquiry · doi:10.1080/07351690.2015.987599 · Cited by 2
“The fact that some patients deteriorate across the course of mental health treatment is a welldocumented phenomenon (e.g., Mohr, 1995), with some evidence suggesting that deterioration occurs in approximately 8% of patients across treatment settings (Hansen, Lambert, and Forman, 2002).”
Background
Preparing Child Psychologists for Managed Care: Educational and Training Considerations
Pickar, D. B., & Lindsey, R. L. (2008) · Brief Treatment and Crisis Intervention · doi:10.1093/brief-treatment/mhn024 · Cited by 2
“The myth of the superior effectiveness of long-term over short-term therapy pervaded the field for many years, but metaanalytic dose-effects research has consistently shown that by the eighth session of therapy, 50% of clients show clinically significant improvement (Hansen et al., 2002).”
Background
Are psychiatric Crisis Assessment and Treatment team clinicians on the psychotherapy front line?
Monshat, K., Bosanac, P., Khorsen, G., Gaynor, N., Nittoli, S., & Castle, D. J. (2012) · Australasian Psychiatry · doi:10.1177/1039856211430148 · Cited by 2
Does Dosage in Abstinence Education Matter?
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Initial data on a 5-item measure of OCD symptom severity and change: The obsessive compulsive session change index (OCSCI)
Collins, L. M., & Coles, M. E. (2016) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2016.06.010 · Cited by 2
Positive Interventions and Their Effectiveness with Clinical Populations
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Client Deterioration in Individual Psychotherapy: A Systematic Review
Lazar, E. (2017) · Cited by 2
What is the appropriate time to measure outcome and process factors in psychodynamic psychotherapy?
Costa, C. P. D., Padoan, C. S., Hauck, S., Teche, S. P., & Eizirik, C. L. (2019) · Trends in Psychiatry and Psychotherapy · doi:10.1590/2237-6089-2017-0151 · Cited by 2
Seeking Help in the “Perfect Storm”: Why Residents and Faculty Access an On-Site Wellness Program
Ey, S., Ladd, B. O., Soller, M. V., & Moffit, M. (2021) · Global Advances in Health and Medicine · doi:10.1177/21649561211017471 · Cited by 2
“Employee Assistance Plans (EAPs) in which all employees are eligible for a limited number of sessions with a contracted counselor in the community are typically underutilized by physicians.(20) Medical trainees may have difficulty finding community providers with flexible hours to accommodate their residency schedule…”
Background
Choice, voice and collaboration: using preference accommodation and feedback in trauma therapy
Mahon, D. (2021) · Mental Health and Social Inclusion · doi:10.1108/mhsi-06-2021-0032 · Cited by 3
A Qualitative Approach to Understanding the Holistic Experience of Psychotherapy Among Clients
Seow, E., Sambasivam, R., Chang, S. S. H., Subramaniam, M., Lu, H. S., Assudani, H. A., Tan, C.-Y. G., & Vaingankar, J. A. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.667303 · Cited by 2
Professional Care for Unwanted Same-Sex Attraction: What Does the Research Say?
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The Effects of Using Clinical Support Tools to Prevent Treatment Failure
Washington, T. K. (2010) · ScholarsArchive (Brigham Young University) · Cited by 2
Self-efficacy and its relation to skills coaching in the context of dialectical behavior therapy augmented with a mobile phone app
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Preliminary Findings of a Four-Session Psychoeducational Group for Combat-Related Posttraumatic Stress Disorder
Stolee, J. D., Hoyt, T., & Brinton, C. T. (2020) · Military Behavioral Health · doi:10.1080/21635781.2020.1742824 · Cited by 2
“…significant decrease in PTSD symptoms over the course of the group, with 20% of group attendees experiencing clinically significant improvement (results perhaps comparable to patients in naturalistic settings receiving less than five sessions of individual treatment; see Hansen et al., 2002).”
Result
Spanish Versions of the Outcome Rating Scale and the Session Rating Scale: Normative Data, Reliability, and Validity
Andrade‐González, N., Rodrigo-Holgado, I., Fernández-Rozas, J., Cáncer, P. F., Lahera, G., Fernández-Liria, A., Rubio, G., & Miller, S. D. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.663791 · Cited by 2
“In addition, Hansen et al. (2002) Frontiers in Psychology | www.frontiersin.org 1 August 2021 | Volume 12 | Article 663791 found that the rate of improvement for patients treated in routine practice settings was lower than for patients participating in clinical trials.”
Background
Accountability in couple therapy for depression : a mixed methods study in a naturalistic setting in Finland
Kuhlman, I. (2013) · Jyväskylä University Digital Archive (University of Jyväskylä) · Cited by 2
Left behind: A review of therapist and process variables influencing dropout from individual psychotherapy
Roos, J. (2011) · PsycEXTRA Dataset · doi:10.1037/e530142013-001 · Cited by 2
The Impact of Measuring
van Vreeswijk, M., Broersen, J., & Spinhoven, P. (2012) · doi:10.1002/9781119962830.ch20 · Cited by 2
The effects of meta-communication training on therapeutic process and outcome at a university counseling center
McKay, T. L. (2011) · Human Biology · Cited by 2
The therapist experience of client non-response
Hopper, S. A. R. (2015) · White Rose eTheses Online (University of Leeds, The University of Sheffield, University of York) · Cited by 2
Effectiveness of Relational Equine-Partnered Counseling (REPC) on Reduction of Symptoms of PTSD in Military Veterans: a Single Case Design
Sheade, H. E. (2015) · University of North Texas Digital Library (University of North Texas) · doi:10.12794/metadc804906 · Cited by 2
Nurturing Expertise at Mental Health Agencies
Goldberg, S. B., Babins‐Wagner, R., & Miller, S. D. (2017) · Wiley eBooks · doi:10.1002/9781119165590.ch10 · Cited by 2
A Decade of Dividedness: A Preregistered Systematic Review of the Cybersecurity Self-Efficacy MethodsPreprint
Borgert, N., Jansen, L., Böse, I., Friedauer, J., Sasse, M. A., & Elson, M. (2023) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/ybec9 · Cited by 3

Authors: Hansen, N. B., Lambert, M. J., & Forman, E. M.
Affiliations: Yale University (US)
Brigham Young University (US)
Drexel University (US)
ORCID: Hansen, Nathan B.
Lambert, Michael J.
Forman, Evan M.
Venue: Clinical Psychology: Science and Practice
Publisher: American Psychological Association (APA)
Published: 2002
Volume: 9
Issue: 3
Pages: 329-343
ISSN: 0969-5893 (ISSN-L)
1468-2850
DOI: 10.1093/clipsy.9.3.329
OpenAlex: W2114544903
Semantic Scholar: 1968734f94d02eb6e4d193bdfdd42f5931ab250d
Cited by: 783
References: 102
Citations by year: 2026: 18 · 2025: 14 · 2024: 25 · 2023: 28 · 2022: 34 · 2021: 45 · 2020: 54 · 2019: 43 · 2018: 72 · 2017: 41 · 2016: 35 · 2015: 45 · 2014: 50 · 2013: 47 · 2012: 45
FWCI: 15.06
Type: journal article
Language: en
Open access: closed
Licence: doi.wiley.com/10.1002/tdm_license_1.1 (tdm, 4991 d)
Locations: Clinical Psychology Science and Practice (publishedVersion)
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 › Applied Psychology › Digital Mental Health Interventions
Keywords: number of treatment sessions, treatment outcomes, naturalistic data, psychotherapy utilization

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The psychotherapy dose-response effect and its implications for treatment delivery services.

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