title: Feedback and therapist effects in the context of treatment outcome and treatment length.
abstract: OBJECTIVE
  This study estimates feedback and therapist effects and tests the predictive value of therapists' and patient attitudes toward psychometric feedback for treatment outcome and length.
  
  
  METHODS
  Data of 349 outpatients and 44 therapists in private practices were used. Separate multilevel analyses were conducted to estimate predictors and feedback and therapist effects.
  
  
  RESULTS
  Around 5.88% of the variability in treatment outcome and 8.89% in treatment length were attributed to therapists. There was no relationship between the average effectiveness of therapists and the average length of their treatments. Initial impairment, early alliance, number of diagnoses, feedback as well as therapists' and patients' attitudes toward feedback were significant predictors of treatment outcome. Treatments tended to be longer for patients with a higher number of approved sessions by the insurance company, with higher levels of interpersonal distress at intake, and for those who developed negatively (negative feedback) over the course of their treatment.
  
  
  CONCLUSIONS
  Therapist effects on treatment outcome and treatment length in routine care seem to be relevant predictors in the context of feedback studies. Therapists' attitudes toward and use of feedback as well as patients' attitudes toward feedback should be further investigated in future research on psychometric feedback.
authors.affiliation: a Department of Clinical Psychology and Psychotherapy , University of Trier , Trier , Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lutz
authors.affiliation: a Department of Clinical Psychology and Psychotherapy , University of Trier , Trier , Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Rubel
authors.affiliation: a Department of Clinical Psychology and Psychotherapy , University of Trier , Trier , Germany.
authors.forename: Anne-Katharina
authors.initials: AK
authors.lastname: Schiefele
authors.affiliation: a Department of Clinical Psychology and Psychotherapy , University of Trier , Trier , Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Zimmermann
authors.affiliation: b Hull York Medical School & Department of Health Sciences , University of York , York , UK.
authors.forename: Jan Rasmus
authors.initials: JR
authors.lastname: Böhnke
authors.affiliation: c Otto-Selz-Institute for Applied Psychology , University of Mannheim , Mannheim , Germany.
authors.forename: Werner W
authors.initials: WW
authors.lastname: Wittmann
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005246:Feedback; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D011613:Psychotherapy / Q000706:statistics & numerical data*
keywords: attitudes towards feedback; feedback effects; patient reported outcome; patient-focussed (psychotherapy) research; therapist effects