title: Do we know when our clients get worse? an investigation of therapists' ability to detect negative client change.
abstract: Routine clinical judgment is often relied upon to detect client deterioration. How reliable are therapists' judgments of deterioration? Two related studies were conducted to investigate therapist detection of client deterioration and therapist treatment decisions in situations of deterioration. The first study examined therapists' ability to detect client deterioration through the review of therapy progress notes. Therapist treatment decisions in cases of client deterioration were also explored. Therapists had considerable difficulty recognizing client deterioration, challenging the assumption that routine clinical judgment is sufficient when attempting to detect client deterioration. A second study was a survey of therapists asking how they detect client deterioration and what treatment decisions they make in response. Symptom worsening was the most commonly stated cue of deterioration.
authors.affiliation: Department of Psychology, Indiana University of Pennsylvania, 15701, USA. hatfield@iup.edu
authors.forename: Derek
authors.initials: D
authors.lastname: Hatfield
authors.forename: Lynn
authors.initials: L
authors.lastname: McCullough
authors.forename: Shelby H B
authors.initials: SH
authors.lastname: Frantz
authors.forename: Kenin
authors.initials: K
authors.lastname: Krieger
mesh_terms: D000339:Affect; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003657:Decision Making; D006801:Humans; D007600:Judgment; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome