Using patient-focused research in evaluating treatment outcome in private practice.

The increasing emphasis on therapist accountability and empirical demonstration of psychotherapeutic treatment effectiveness points to the need for practicing therapists to integrate treatment evaluation methods into routine clinical practice. Unfortunately, most private practitioners have little involvement in carrying out evaluation procedures. In this study we demonstrate how patient-focused research was used to track the progress and outcome of patients seen by a clinical psychologist in private practice. Twenty-nine adults and 40 children/adolescents were evaluated on a weekly basis to assess the number of sessions required to reach improvement (reliable change) and recovery (clinically significant change). Dose-response survival analysis results indicated that 50% of adults reached clinically significant change in 54 sessions, and 50% of youth met the same standard in 14 sessions. These results were compared with outcome in large-scale studies. Implications of this study for integrating treatment evaluation methods into clinical practice are discussed. Copyright 2002 Wiley Periodicals, Inc. J Clin Psychol 58: 1213-1225, 2002.