Beyond symptom monitoring: Diverse client perspectives on what works (and what does not) in a psychotherapy training clinic
Research Poster Social & Behavioral Sciences 2025 Graduate ExhibitionPresentation by Natalie Pottschmidt
Exhibition Number 47
Abstract
Background: Over fifty years of psychotherapy outcome research have seen the fundamental question of “Is psychotherapy effective?” progress to more nuanced concerns of improving the effectiveness of psychotherapy for individual clients in routine clinical practice. Despite generally positive findings demonstrating the effectiveness of psychological therapies at a group level, outcome research on the individual level shows that up to two-thirds of clients in routine practice settings fail to achieve statistically reliable improvement. One underlying concern with the traditional outcome assessment that informs these findings is that it has relied predominantly on standardized, nomothetic, and symptom-based methods, leading to “the therapist’s dilemma” of having to apply this research to the idiographic, person-centered clinical setting. The current study will attempt to address these limited standards for assessment by seeking to understand frequently overlooked perspectives from end users of MBC: clients and therapists. Method: This study takes place within naturalistic practice at a community mental health clinic associated with a doctoral clinical psychology training program (“the Clinic”). As a community mental health facility, the Clinic serves clients from a wide variety of backgrounds to present with diverse concerns for treatment. Adult clients who routinely attend individual psychotherapy at the Clinic will be recruited to supplement the standard nomothetic measure with an idiographic, patient-generated measure (PGM). This will allow us to compare clients' individual perspectives about their change in therapy with the traditional, statistical method of change determination. Results are not available at this time; the poster will present preliminary findings.
Importance
Altogether, this study has the potential to inform (1) the personalization of clinical practice in line with a precision approach to healthcare and (2) specific policy and procedural recommendations for the Clinic based on client feedback, along with data-informed areas for targeted training and supervision. Furthermore, as the field of psychotherapy outcome assessment continues to evolve, data from this study may inform research methods for administering and understanding combined nomothetic and idiographic assessments of change.
DEI Statement
One aim of this research study is to determine whether there are certain groups of clients at the Clinic whose concerns and change in psychotherapy are better captured by personalized assessments of change than standardized ones. Relevant to DEI issues, many standardized measures of outcome assessment have been developed with majority-identity "normative" samples. The Clinic where this study takes place, a community mental health center, is one of the few that will accept clients with medical assistance, who face not only low economic resources but often unemployment, physical disabilities, and/or serious mental illness. It is critical to understand individual perceptions and use of assessment in order to maximize its benefit for these clients, who represent multiple intersecting marginalized communities.