Relationship to CBT outcome and dropout of decision support tools of the written case formulation, list of treatment goals and plot of symptom scores.

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Publisher: Elsevier Science Publishers
Document Type: Report; Brief article
Length: 345 words

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Abstract :

Keywords Outcome; Dropout; Case formulation; Decision support; Measurement-based care; Private practice Highlights * Decision support tools had small effects on end-of-treatment symptoms and larger effects on dropout. * Decision support tools were more consistently related to dropout than to outcome. * We speculate that the effects of the decision support tools on dropout were mediated by the therapeutic alliance. Abstract Many patients who receive cognitive behavior therapy (CBT) for mood and anxiety disorders fail to respond or drop out of treatment. We tested the hypotheses that therapist use of each of three decision support tools, a written case formulation, a list of treatment goals, and a plot of symptom scores, was associated with improved outcome and reduced dropout in naturalistic CBT provided to 845 patients in a private practice setting. We conducted regression analyses to test the hypotheses that the presence of each tool in the clinical record was associated with lower end-of-treatment scores on the Beck Depression Inventory (BDI) and the Burns Anxiety Inventory (BurnsAI), and lower rates of premature and uncollaborative dropout. We found that the presence of a written case formulation in the clinical record was associated with lower rates of both types of dropout. A list of treatment goals was associated with lower end-of-treatment scores on the BDI and the BurnsAI, and a lower rate of uncollaborative but a higher rate of premature dropout. A plot of symptom scores was associated with lower end-of-treatment scores on the BDI, and lower rates of both types of dropout. Results suggest that therapist use of a written case formulation, list of treatment goals, and a plot of symptom scores can contribute to improved outcome and reduced dropout in CBT. Author Affiliation: (a) University of California, Berkeley, USA (b) Oakland Cognitive Behavior Therapy Center, USA * Corresponding author. Oakland Cognitive Behavior Therapy Center, 5625 College Avenue, Suite 215, Oakland, CA, 94618, USA. Article History: Received 26 April 2020; Revised 30 December 2020; Accepted 19 April 2021 Byline: Vael Gates (a), Megan Hsiao (b), Garret G. Zieve (a), Rebecca Courry (b), Jacqueline B. Persons [persons@oaklandcbt.com] (b,a,*)

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Gale Document Number: GALE|A664259799