The Effect of Patient Progress Feedback on Psychotherapy Outcome

Abstract

Background: There is evidence that outpatient psychotherapy is effective in treating mental disorders. However, 5-10% of the patients get worse during treatment. Patients and Methods: This randomised, controlled trial investigates the effect of systematic feedback of patients' progress to therapists on the outcome of psychotherapy. A total of 230 adult patients were randomly assigned to three conditions: progress monitoring with feedback, progress monitoring without feedback, no progress monitoring. Subsequently, they were treated with cognitive behavioral therapy in an outpatient clinic. Feedback was based on three self-report questionnaires: Questionnaire for the Evaluation of Psychotherapeutic Change (FEP-2), Outcome Questionnaire (OQ-30), and Assessment for Signal Cases (ASC). Variance analyses with repeated measurements were conducted to verify whether feedback enhances treatment outcomes. Results: There were no statistical differences between the three conditions with regard to sociodemographic and disease-relevant variables. Patients' impairment improved significantly in all three groups, but there were no significant differences between groups. Moreover, feedback had no differential effect on patients without initial improvement (n = 49). Discussion and Conclusion: In our study, collective patients' progress feedback to therapists did neither have a global nor a differential effect on treatment outcomes. In order to better demonstrate a potential feedback effect, future studies should aim for a higher frequency of feedback, measure therapists' attitude towards such feedback systems, and use ``clinical support tools.'' (c) 2019 S. Karger AG, Basel