uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
How Much Therapy Is Enough?: Comparing Dose-Effect and Good-Enough Models in Two Different Settings
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Linkoping Univ, Dept Behav Sci & Learning, SE-58183 Linkoping, Sweden..
Linkoping Univ, Dept Behav Sci & Learning, SE-58183 Linkoping, Sweden..
Linkoping Univ, Dept Behav Sci & Learning, SE-58183 Linkoping, Sweden..
Linkoping Univ, Dept Behav Sci & Learning, SE-58183 Linkoping, Sweden..
2016 (English)In: Psychotherapy, ISSN 0033-3204, E-ISSN 1939-1536, Vol. 53, no 1, 130-139 p.Article in journal (Refereed) PublishedText
Abstract [en]

The Dose-Effect model holds that longer therapy leads to better outcome, although increasing treatment length will yield diminishing returns, as additional sessions lead to progressively less change in a negatively accelerating fashion. In contrast, the Good-Enough-Level (GEL) model proposes that patients, therapists, or patients-with-therapists decide on ending treatment when treatment outcome is satisfactory, meaning that patients who change faster will have shorter treatments. If true, this means that aggregating among patients with different treatment lengths would yield biased results. Most previous research has shown that symptom change rate depends on treatment length, but all of these studies used data from University counseling centers in the United States. There is a need to test if previous results hold in different settings. Two datasets from Swedish community-based primary care (n = 640) and psychiatric care (n = 284) were used. Patients made session-wise ratings on the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM). Multilevel models indicated better fit for a model in which treatment length moderated symptom change rate. In the primary care sample, patients in longer treatments achieved more symptom change from pre- to posttreatment, despite having slower rate of improvement. The most important aspect of the GEL model was supported, and no evidence was found for a negatively accelerating Dose-Effect curve. Results cannot be generalized beyond about 12 sessions, due to scarcity of data for longer treatments.

Place, publisher, year, edition, pages
2016. Vol. 53, no 1, 130-139 p.
Keyword [en]
psychotherapy, naturalistic research, outcome research, GEL model, Dose-Effect
National Category
Psychology (excluding Applied Psychology)
URN: urn:nbn:se:uu:diva-282481DOI: 10.1037/pst0000039ISI: 000371345200013PubMedID: 26928273OAI: oai:DiVA.org:uu-282481DiVA: diva2:917120
Available from: 2016-04-05 Created: 2016-04-05 Last updated: 2016-04-05Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Falkenström, Fredrik
By organisation
Psychiatry, University Hospital
In the same journal
Psychology (excluding Applied Psychology)

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 57 hits
ReferencesLink to record
Permanent link

Direct link