Improving the Efficiency of Psychological Treatment using Outcome Feedback Technology

Jaime Delgadillo, Karen Overend, Michael Lucock, Martin Groom, Naomi Kirby, Dean McMillan, Simon Gilbody, Wolfgang Lutz, Julian A. Rubel, Kim de Jong

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Aims:
This study evaluated the impact of applying computerized outcome feedback (OF) technology in a stepped care psychological service offering low and high intensity therapies for depression and anxiety.

Methods:
A group of therapists were trained to use OF based on routine outcome monitoring using depression (PHQ-9) and anxiety (GAD-7) measures. Therapists regularly reviewed expected treatment response graphs with patients and discussed cases that were “not on track” in clinical supervision. Clinical outcomes data were collected for all patients treated by this group (N = 594), six months before (controls = 349) and six months after the OF training (OF cases = 245). Symptom reductions in PHQ-9 and GAD-7 were compared between controls and OF cases using longitudinal multilevel modelling. Treatment duration and costs were compared using MANOVA. Qualitative interviews with therapists (N = 15) and patients (N = 6) were interpreted using thematic analysis.

Results:
OF technology was generally acceptable and feasible to integrate in routine practice. No significant between-group differences were found in post-treatment PHQ-9 or GAD-7 measures. However, OF cases had significantly lower average duration and cost of treatment compared to controls.

Conclusions:
After adopting OF into their practice, this group of therapists attained similar clinical outcomes but within a shorter space of time and at a reduced average cost per treatment episode. We conclude that OF can improve the efficiency of stepped care.
Original languageEnglish
Pages (from-to)89-97
Number of pages9
JournalBehaviour Research and Therapy
Volume99
Early online date28 Sep 2017
DOIs
Publication statusPublished - Dec 2017

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Psychology
Technology
Health Care Costs
Anxiety
Depression
Therapeutics
Interviews

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Delgadillo, Jaime ; Overend, Karen ; Lucock, Michael ; Groom, Martin ; Kirby, Naomi ; McMillan, Dean ; Gilbody, Simon ; Lutz, Wolfgang ; Rubel, Julian A. ; de Jong, Kim. / Improving the Efficiency of Psychological Treatment using Outcome Feedback Technology. In: Behaviour Research and Therapy. 2017 ; Vol. 99. pp. 89-97.
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abstract = "Aims:This study evaluated the impact of applying computerized outcome feedback (OF) technology in a stepped care psychological service offering low and high intensity therapies for depression and anxiety.Methods:A group of therapists were trained to use OF based on routine outcome monitoring using depression (PHQ-9) and anxiety (GAD-7) measures. Therapists regularly reviewed expected treatment response graphs with patients and discussed cases that were “not on track” in clinical supervision. Clinical outcomes data were collected for all patients treated by this group (N = 594), six months before (controls = 349) and six months after the OF training (OF cases = 245). Symptom reductions in PHQ-9 and GAD-7 were compared between controls and OF cases using longitudinal multilevel modelling. Treatment duration and costs were compared using MANOVA. Qualitative interviews with therapists (N = 15) and patients (N = 6) were interpreted using thematic analysis.Results:OF technology was generally acceptable and feasible to integrate in routine practice. No significant between-group differences were found in post-treatment PHQ-9 or GAD-7 measures. However, OF cases had significantly lower average duration and cost of treatment compared to controls.Conclusions:After adopting OF into their practice, this group of therapists attained similar clinical outcomes but within a shorter space of time and at a reduced average cost per treatment episode. We conclude that OF can improve the efficiency of stepped care.",
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Delgadillo, J, Overend, K, Lucock, M, Groom, M, Kirby, N, McMillan, D, Gilbody, S, Lutz, W, Rubel, JA & de Jong, K 2017, 'Improving the Efficiency of Psychological Treatment using Outcome Feedback Technology', Behaviour Research and Therapy, vol. 99, pp. 89-97. https://doi.org/10.1016/j.brat.2017.09.011

Improving the Efficiency of Psychological Treatment using Outcome Feedback Technology. / Delgadillo, Jaime; Overend, Karen; Lucock, Michael; Groom, Martin; Kirby, Naomi; McMillan, Dean; Gilbody, Simon; Lutz, Wolfgang; Rubel, Julian A.; de Jong, Kim.

In: Behaviour Research and Therapy, Vol. 99, 12.2017, p. 89-97.

Research output: Contribution to journalArticle

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T1 - Improving the Efficiency of Psychological Treatment using Outcome Feedback Technology

AU - Delgadillo, Jaime

AU - Overend, Karen

AU - Lucock, Michael

AU - Groom, Martin

AU - Kirby, Naomi

AU - McMillan, Dean

AU - Gilbody, Simon

AU - Lutz, Wolfgang

AU - Rubel, Julian A.

AU - de Jong, Kim

PY - 2017/12

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N2 - Aims:This study evaluated the impact of applying computerized outcome feedback (OF) technology in a stepped care psychological service offering low and high intensity therapies for depression and anxiety.Methods:A group of therapists were trained to use OF based on routine outcome monitoring using depression (PHQ-9) and anxiety (GAD-7) measures. Therapists regularly reviewed expected treatment response graphs with patients and discussed cases that were “not on track” in clinical supervision. Clinical outcomes data were collected for all patients treated by this group (N = 594), six months before (controls = 349) and six months after the OF training (OF cases = 245). Symptom reductions in PHQ-9 and GAD-7 were compared between controls and OF cases using longitudinal multilevel modelling. Treatment duration and costs were compared using MANOVA. Qualitative interviews with therapists (N = 15) and patients (N = 6) were interpreted using thematic analysis.Results:OF technology was generally acceptable and feasible to integrate in routine practice. No significant between-group differences were found in post-treatment PHQ-9 or GAD-7 measures. However, OF cases had significantly lower average duration and cost of treatment compared to controls.Conclusions:After adopting OF into their practice, this group of therapists attained similar clinical outcomes but within a shorter space of time and at a reduced average cost per treatment episode. We conclude that OF can improve the efficiency of stepped care.

AB - Aims:This study evaluated the impact of applying computerized outcome feedback (OF) technology in a stepped care psychological service offering low and high intensity therapies for depression and anxiety.Methods:A group of therapists were trained to use OF based on routine outcome monitoring using depression (PHQ-9) and anxiety (GAD-7) measures. Therapists regularly reviewed expected treatment response graphs with patients and discussed cases that were “not on track” in clinical supervision. Clinical outcomes data were collected for all patients treated by this group (N = 594), six months before (controls = 349) and six months after the OF training (OF cases = 245). Symptom reductions in PHQ-9 and GAD-7 were compared between controls and OF cases using longitudinal multilevel modelling. Treatment duration and costs were compared using MANOVA. Qualitative interviews with therapists (N = 15) and patients (N = 6) were interpreted using thematic analysis.Results:OF technology was generally acceptable and feasible to integrate in routine practice. No significant between-group differences were found in post-treatment PHQ-9 or GAD-7 measures. However, OF cases had significantly lower average duration and cost of treatment compared to controls.Conclusions:After adopting OF into their practice, this group of therapists attained similar clinical outcomes but within a shorter space of time and at a reduced average cost per treatment episode. We conclude that OF can improve the efficiency of stepped care.

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KW - Stepped care

KW - Depression

KW - Anxiety

KW - IAPT

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