title: Can treatment research inform decision makers? Nonexperimental method issues and examples among older outpatients.
abstract: Outcome research does not seem to have informed policymakers, decision makers, or practitioners. It is proposed that reporting of improvement-deterioration rates and greater use of single-sample, pretreatment-posttreatment designs in community clinic settings will facilitate communication and, perhaps, mitigate the external validity problem of psychotherapy experiments. The Edwards-Nunnally method (D. C. Speer, 1992) was used to investigate change rates from a single cohort of older adult outpatients (N = 92). The cohort improvement rate was 51%, and the deterioration rate was 5%. However, improvement rates for clients with major depression and adjustment disorders were greater than 70%. Change rates of student and staff therapists and of clients treated in the clinic and in their homes were not significantly different. Deteriorated clients are briefly described.
authors.affiliation: Department of Aging and Mental Health, Florida Mental Health Institute, University of South Florida, Tampa 33612.
authors.forename: D C
authors.initials: DC
authors.lastname: Speer
mesh_terms: D000275:Adjustment Disorders / Q000523:psychology / Q000628:therapy*; D000368:Aged; D000553:Ambulatory Care; D015331:Cohort Studies; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D011613:Psychotherapy / Q000379:methods*; D016896:Treatment Outcome