Personalization of Psychotherapy Based on Client Preferences vs. Routine Outcome Monitoring with PCOMs: A Naturalistic Study

• Santangelo, Pablo Rafael ^[1] ; Conde, Karina ^[1] ; Millaman Rickert, Gabriela Emilia ^[1] ; Mattiello, Marcos Emanuel ^[1] ; Lao, Germán ^[1] ; Pocorena, Victoria ^[1]
  1. [1] Universidad Nacional de Mar del Plata

     Universidad Nacional de Mar del Plata

     Argentina

     
• Localización: Revista de Psicoterapia, ISSN-e 2339-7950, ISSN 1130-5142, Vol. 36, Nº. 132, 2025 (Ejemplar dedicado a: Eye Movement Desensitization and Reprocessing), págs. 86-97
• Idioma: inglés
• DOI: 10.5944/rdp.v36i132.44869
• Títulos paralelos:
  • Personalización de la Psicoterapia Basada en las Preferencias de los Pacientes vs. Monitoreo Rutinario de Resultados con PCOMs: Un Estudio Naturalístico
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    Tener en cuenta las preferencias de los pacientes y realizar un monitoreo rutinario de resultados son componentes de una práctica basada en evidencia. Objetivos: comparar la efectividad, por un lado, de ajustar los procesos terapéuticos a las preferencias de rol o actividad de los pacientes, y por otro, del monitoreo rutinario de resultados utilizando el PCOMS. Método: diseño experimental con tres grupos de terapeutas por asignación aleatoria mediante tablas de números aleatorios. Muestra: Terapeutas N9, Pacientes N101. Las evaluaciones se realizaron en la admisión, en la tercera, octava y última sesión de tratamiento.  Se utilizaron modelos de ecuaciones de estimación generalizada (GEE) para analizar los efectos de la adherencia a diferentes enfoques terapéuticos sobre las dimensiones de la escala CORE-OM. Resultados: La psicoterapia monitoreada con el PCOMS obtuvo mejores resultados, diferencia significativa, que el tratamiento estándar y el tratamiento ajustado por las preferencias de los pacientes. En la segunda evaluación (tercera de tratamiento) los resultados de los dos tratamientos experimentales fueron similares. Conclusiones: El monitoreo rutinario de resultados es una estrategia que produce mejores resultados que el tratamiento habitual en el contexto marplatense. Ajustar los tratamientos a las preferencias de los pacientes es un área prometedora de buenos resultados.

  • English

    Taking client preferences into account and conducting routine outcome monitoring are components of evidence-based practice. The objective of this study was to compare the effectiveness, on the one hand, of adjusting therapeutic processes to clients' role or activity preferences, and on the other, of routine outcome monitoring using PCOMS. Method: experimental design with three groups of therapists randomly assigned through random number tables. Sample: Therapists N9, Clients N101. Evaluations were conducted at intake, in the third, eighth, and final treatment session. Data analysis. Generalized estimating equation (GEE) models were used to analyze the effects of adherence to different therapeutic approaches on the dimensions of the CORE-OM scale. Results. Psychotherapy monitored with PCOMS achieved better results, with a significant difference, compared to standard treatment and treatment adjusted to client preferences. In the second evaluation (third treatment session), the results of the two experimental treatments were similar. Conclusions: Routine outcome monitoring is a strategy that yields better results than usual treatment in the Mar del Plata context. Adjusting treatments to client preferences is a promising area for good outcomes.

• Referencias bibliográficas
  • Anker, M. G., Duncan, B. L., & Sparks, J. A. (2009). Using client feedback to improve couple therapy outcomes: a randomized clinical trial...
  • APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271–285....
  • Barber, J., & Resnick, S. G. (2022). Collect, share, act: A transtheoretical clinical model for doing measurement-based care 850 M. Barkham...
  • Barkham, M., De Jong, K., Delgadillo, J., & Lutz, W. (2023). Routine outcome monitoring and feedback in psychological in therapies. Open...
  • Bovendeerd, B., De Jong, K., De Groot, E., Moerbeek, M., & De Keijser, J. (2022). Enhancing the effect of psychotherapy through systematic...
  • Brattland, H., Koksvik, J. M., Burkeland, O., Gråwe, R. W., Klöckner, C., Linaker, O. M., ... & Iversen, V. C. (2018). The effects of...
  • Calsyn, R. J., Winter, J. P. & Morse, G. A. (2000). Do consumers who have a choice of treatment have better outcomes? Community Mental...
  • Castonguay, L. G., Barkham, M., Youn, S. J., & Page, A. C. (2021). Practice-based evidence: Findings from routine outcome monitoring....
  • Clinton, D. & Sandell, R. (2014). Psychotherapy Preferences and Experiences Questionnaire (PEX) A short introduction.
  • Connors, E. H., Janse, P., de Jong, K., & Bickman, L. (2024). The Use of Feedback in Mental Health Services: Expanding Horizons on Reach...
  • Cooper, M., Duncan, B., Golden, S., & Toth, K. (2021). Systematic client feedback in therapy for children with psychological difficulties:...
  • Cooper, M., Norcross, J. C., Raymond-Barker, B. & Hogan, T. P. (2019). Psychotherapy preferences of laypersons and mental health professionals:...
  • Cooper, M., Stewart, D., Sparks, J., & Bunting, L. (2013). School-based counseling using systematic feedback: A cohort study evaluating...
  • Cooper, M., van Rijn, B., Chryssafidou, E., & Stiles, W. B. (2022). Activity preferences in psychotherapy: What do patients want and how...
  • Delevry, D. & Le, Q. A. (2019). Effect of Treatment Preference in Randomized Controlled Trials: Systematic Review of the Literature and...
  • Duncan, B. L., Miller, S. D., Sparks, J. A., Claud, D. A., Reynolds, L. R., Brown, J. y Johnson, L. D. (2003). The Session Rating Scale: Preliminary...
  • Duncan, B. L., Reese, R. J., Lengerich, A. J., DeSantis, B., Comeau, C. V., & Johnson-Esparza, Y. (2021). Measurement-based care in integrated...
  • Duncan, B. & Sparks; J. (2019) The Partners for Change Outcome Management System. Sistema de Socios para la Gestión del Cambio. Manual...
  • Eigenhuis, E., van Buuren, V. E., Boeschoten, R. E., Muntingh, A. D., Batelaan, N. M., & van Oppen, P. (2024). The Effects of Patient...
  • Faye Jacobsen, C., Karstoft, K. I., Falkenström, F., Nielsen, J., Lunn, S., & Poulsen, S. (2024). Client preferences, therapy activities...
  • Fierro, C. (2020). Formación de grado en psicología en Argentina: período 2009-2015 [Tesis Doctoral, Universidad Nacional de San Luis, Argentina]....
  • Hepner, K. A., Farmer, C. M., Brooks Holliday, S., Bharil, S., Kimerling, R. E., McGee-Vincent, P., McCaslin, S. E., & Rosen, C. (2019)....
  • Hess, T. (2017). Client Preference: Does Simply Asking Make a Difference? (Doctoral dissertation). Southern Illinois University at Edwardsville.
  • Jonášová, K., Čevelíček, M., Doležal, P., & Řiháček, T. (2024). Psychotherapists’ experience with in-session use of routine outcome monitoring:...
  • Kodet, J., Reese, R. J., Duncan, B. L., & Bohanske, R. T. (2019). Psychotherapy for depressed youth in poverty: Benchmarking outcomes...
  • Li, E., Kealy, D., Aafjes-van Doorn, K., McCollum, J., Curtis, J. T., Luo, X., & Silberschatz, G. (2024). “It Felt Like I Was Being Tailored...
  • Lindhiem, O., Bennett, C. B., Trentacosta, C. J. & McLear, C. (2014). Client preferences affect treatment satisfaction, completion, and...
  • Lutz, W., Schwartz, B., & Delgadillo, J. (2022). Measurementbased and data-informed psychological therapy. Annual Review of Clinical Psychology,...
  • McLeod, J. (2015). Client preferences: building bridges between therapy and everyday life. Psychotherapy and Counselling Journal of Australia,...
  • Miller, S. D., Duncan, B. L., Brown, J., Sparks, J. A. y Claud, D. A. (2003). The outcome rating scale: A preliminary study of the reliability,...
  • Østergård, O. K., Randa, H., & Hougaard, E. (2020). The effect of using the Partners for Change Outcome Management System as feedback...
  • Reese, R. J., Norsworthy, L. A., & Rowlands, S. R. (2009). Does a continuous feedback system improve psychotherapy outcome?. Psychotherapy:...
  • Reese, R. J., Toland, M. D., Slone, N. C., & Norsworthy, L. A. (2010). Effect of client feedback on couple psychotherapy outcomes. Psychotherapy:...
  • Santangelo, P. R. (2020). Programa de formación y entrenamiento en psicoterapia: Fundamentos teóricos e implementación. Revista de psicoterapia,...
  • Santangelo, P. R., & Conde, K. (2023). Preferencias psicoterapéuticas: versión argentina de las escalas PEX-1 y C-NIP-v1. 1. Revista de...
  • Santangelo, P. R., Conde, K., Schupp, H. y Paoloni, N. (2021). Evaluación en psicoterapia: Propieda¬des psicométricas de la versión Argentina...
  • Santangelo, P.R, Grave, L., Lao, G., Mattiello, M. y Millaman Rickert, G.E. (2022, 2 de diciembre). Escala de Calificación de Resultados....
  • Schuman, D., Slone, N., Reese, R.J., & Duncan, B. (2014). Using client feedback to improve outcomes in group psychotherapy with soldiers...
  • She, Z., Duncan, B. L., Reese, R. J., Sun, Q., Shi, Y., Jiang, G., ... & Clements, A. L. (2018). Client feedback in China: A randomized...
  • Slone, N. C., Reese, R. J., Mathews-Duvall, S., & Kodet, J. (2015). Evaluating the efficacy of client feedback in group psychotherapy....
  • Solstad, S. M., Castonguay, L. G., & Moltu, C. (2019). Patients’ experiences with routine outcome monitoring and clinical feedback systems:...
  • Swift, J. K. & Callahan, J. L. (2009). The impact of client treatment preferences on outcome: a meta-analysis. Journal of Clinical Psychology,...
  • Swift, J. K., Callahan, J. L., Cooper, M. & Parkin, S. R. (2018). The impact of accommodating client preference in psychotherapy: A meta-analysis....
  • Swift, J. K., Callahan, J. L., Cooper, M. & Parkin, S. R. (2019). Preferences. In J. C. Norcross y B. Wampold (Eds.), Psychotherapy relationships...
  • Swift, J. K., Callahan, J. L. & Vollmer, B. M. (2011). Preferences. In J. C. Norcross (Ed.), Psychotherapy relationships that work (2nd...
  • Thew, G., Fountain, L., & Salkovskis, P. (2015). Service user and clinician perspectives on the use of outcome measures in psychological...
  • Tompkins, K. A., Swift, J. K. & Callahan, J. L. (2013). Working with clients by incorporating their preferences. Psychotherapy, 50(3),...
  • Urbaniak, G. C., & Plous, S. (2013). Research randomizer (Version 4.0) [Computer software]. Retrieved on February 26, 2021, from http://www.randomizer.org/
  • Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The research evidence for what works in psychotherapy (2nd ed.)....
  • Windle, E., Tee, H., Sabitova, A., Jovanovic, N., Priebe, S. & Carr, C. (2020). Association of patient treatment preference with dropout...