Prevention of Treatment Failure: The Use of Measuring, Monitoring, and Feedback in Clinical Practice
For individuals in the U.S. & U.S. territories
Empirical evidence shows that treatment failure is a significant problem and one that practitioners routinely overlook. A substantial minority of patients either fail to gain a benefit from the treatments offered to them, or they outright worsen by the time they leave treatment. Intervening in a timely fashion with such individuals cannot occur if practitioners are unaware of which cases are likely to have this outcome.
Prevention of Treatment Failure describes procedures and techniques that can be used by clinical practitioners and administrators to identify patients who are at risk for treatment failure. The book summarizes evidence that convincingly shows that a shift in routine care is needed, and that such a shift can be accomplished easily through integrating specific methods of monitoring patient treatment response on a frequent basis in routine care.
Treatment response is placed in the context of historical views of healthy functioning and operationalized through the use of brief self-report scales. Providing alert-signals to therapists, along with problem-solving tools, is suggested as an evidence-based practice that substantially reduces patient deterioration and increases the chances of the return to normal functioning.
The book also provides illustrations on how accumulated data resulting from monitoring patient treatment response can be used to improve systems of care.
I. Foundations and Contexts for a New Paradigm
- Setting the Stage for Formally Tracking Client Change: The Context of Care
- What Is Psychotherapy Outcome and How Is It Measured in Contrasting Research Paradigms?
II. Measuring and Predicting Treatment Outcome
- Measures for Tracking Patient Treatment Response and Their Characteristics
- Predicting Negative Treatment Outcome: Methods and Estimates of Accuracy
III. The Evidence Base
- Using Progress Feedback to Inform Treatment: Conceptual Issues and Initial Findings
- Beyond Progress Feedback: The Effects of Clinical Problem-Solving Tools
IV. Illustrations of Practice-Based Evidence for Outcomes Management at the System Level
- Therapist Effects
- Using Outcome Data to Improve the Effects of Psychotherapy: Some Illustrations
- Summary, Implications, and Future Directions
About the Author
Michael J. Lambert, PhD, is a professor of psychology at Brigham Young University and holds the Susa Young Gates University Professorship. He also holds an honorary professorship in the School of Psychology at the University of Queensland, Brisbane, Australia.
He has been in private practice throughout his career. His research spans 38 years, emphasizing psychotherapy outcome and the measurement of change. He has edited, authored, or coauthored nine academic research-based books and 40 book chapters and has published more than 150 scientific articles on treatment outcome.
Dr. Lambert received Brigham Young University's highest honor for faculty research, the Maeser Award, in recognition of his cumulative research accomplishments and the Distinguished Psychologist Award from Division 29 (Psychotherapy) of the American Psychological Association. In 2003, he was the recipient of the Distinguished Career Research Award from the Society for Psychotherapy Research for his lifetime contributions to research on professional practice.
In 2004, he edited Bergin and Garfield's Handbook of Psychotherapy and Behavior Change, the most authoritative summary of the effects of psychological treatments. His current research focuses on reducing treatment failure and nonresponse through the use of advanced statistical methods and computer applications.