Univ Maryland, Ctr Counseling, College Pk, MD 20742 USA;Univ Virginia, Dept Athlet, Charlottesville, VA 22903 USA;Univ Iowa, Dept Psychol & Quantitat Fdn, N334 Lindquist Ctr, Iowa City, IA 52242 USA;Univ Maryland, Ctr Counseling, College Pk, MD 20742 USA;Univ Wisconsin, Dept Counseling Psychol, Madison, WI USA;
Lin, Yi-Jiun;Egan, Karen P.;Kivlighan, D. Martin, III;Pickett, Theodore, Jr.;Goldberg, Simon B.;
Accurate estimations of progress in psychotherapy are necessary for therapists to identify clients at risk of deterioration and potentially reduce premature terminations. This need has resulted in a large body of literature examining the rate and trajectory of change in psychotherapy; however, few studies have tested these dose-response relationships outside of global measures of mental health. Moreover, there is a paucity of research examining the relationship between progress in treatment, treatment length, and premature termination. In this study, we conducted multivariate multilevel analyses to test the good-enough level model across the three domains of the phase model of psychotherapy: psychological symptoms, life functioning, and well-being. In addition, we tested changes in well-being, psychological symptoms, and life functioning, treatment length, and an interaction between treatment progress and treatment length as predictors of premature termination. Data for this study consisted of 438 clients who were treated by 57 therapists within a brief therapy model. Results failed to support the good-enough level model for changes in well-being, psychological symptoms, and life functioning, such that the rate of change across all three scales did not significantly vary as a function of treatment length. However, exploratory analyses revealed a significant interaction effect between changes in well-being, treatment length, and premature termination, indicating that clients who experienced high rates of change in well-being early in treatment were more likely to prematurely terminate treatment. Clinical implications and future research are discussed.
GEL model;treatment progress;premature termination;psychotherapy;phase model;