title: Extreme deviations from expected recovery curves and their associations with therapeutic alliance, social support, motivation, and life events in psychosomatic in-patient therapy.
abstract: OBJECTIVE
  Within the clinical support tools (CST) of the OQ-Analyst, the "Assessment for Signal Cases" (ASC) evaluates the therapeutic alliance, social support, motivation, and life events. We investigated whether the ASC covers domains of importance in treatment weeks with extreme deviations from expected recovery curves (ERCs).
  
  
  METHODS
  Psychosomatic in-patients were monitored weekly with the ASC and the "Outcome Questionnaire" (OQ-45). The ERCs of the OQ-45 empirical algorithm were used to define treatment weeks with extreme positive deviations (EPD), extreme negative deviations (END), or without extreme deviations (NO). Associations between the ASC scales and EPD as well as END were analyzed by multilevel models.
  
  
  RESULTS
  While each ASC scale was positively associated with EPD, only the social support and life events scales were negatively related to END.
  
  
  CONCLUSIONS
  CSTs prioritizing social support and life events might be more effective in preventing treatment failure.
authors.affiliation: a Deparment of Psychology , University of Regensburg , Regensburg , Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Probst
authors.affiliation: b Department of Psychology , Brigham Young University , Provo , UT , USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lambert
authors.affiliation: c Department of Psychosomatics , University Clinic of Regensburg, Regensburg , Germany.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Loew
authors.affiliation: d Clinic for Psychosomatic Medicine and Psychotherapy , University Clinic of Ulm , Ulm , Germany.
authors.forename: Reiner W
authors.initials: RW
authors.lastname: Dahlbender
authors.affiliation: c Department of Psychosomatics , University Clinic of Regensburg, Regensburg , Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Tritt
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011369:Professional-Patient Relations; D011602:Psychophysiologic Disorders / Q000628:therapy*; D011613:Psychotherapy / Q000379:methods*; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: clinical support tools; considerable change; monitoring; psychosomatics; psychotherapeutic process