Using the Assessment for Signal Clients as a feedback tool for reducing treatment failure.
OBJECTIVE
The Clinical Support Tools (CSTs) were developed to help therapists organize and target potential problems that might account for negative outcomes in psychotherapy. The core of CST feedback is the Assessment for Signal Clients. The purpose of this study was to describe and identify patterns of problems that typically characterize off-track cases.


METHODS
The responses and scores from 107 off-track clients from a hospital-based outpatient clinic were analyzed.


RESULTS
A cluster analysis of the 107 off-track clients revealed three client types: those whose problems were characterized by alliance and motivational difficulties; those characterized by social support and life event difficulties; and those whose problems had an indistinguishable pattern. Log-linear modeling showed that if patients had less therapeutic alliance problems they were also less likely to have motivational problems. Findings were also consistent with the cluster analysis, which showed that a relatively higher percentage of not-on-track participants received signal alerts for the social support items and scale.


CONCLUSIONS
Individuals whose progress goes off-track while in psychotherapy appear to have their greatest difficulty with social support, followed closely by motivation for therapy and therapeutic alliance.
a Department of Psychology , Brigham Young University , Provo , UT , USA.
Melissa M
MM
White
a Department of Psychology , Brigham Young University , Provo , UT , USA.
Michael J
MJ
Lambert
a Department of Psychology , Brigham Young University , Provo , UT , USA.
Benjamin M
BM
Ogles
a Department of Psychology , Brigham Young University , Provo , UT , USA.
Stevie B
SB
Mclaughlin
b Department of Counseling and Psychological Services , Brigham Young University , Provo , UT , USA.
Russell J
RJ
Bailey
a Department of Psychology , Brigham Young University , Provo , UT , USA.
K Morgan
KM
Tingey
D000328:Adult; D016000:Cluster Analysis; D005246:Feedback; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D009042:Motivation; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D011369:Professional-Patient Relations; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D012944:Social Support; D017211:Treatment Failure
Assessment for Signal Clients; progress feedback; psychotherapy outcome; therapeutic alliance; treatment failure