Dose-effect relations and responsive regulation of treatment duration: the good enough level

J Consult Clin Psychol. 2006 Feb;74(1):160-7. doi: 10.1037/0022-006X.74.1.160.


This study examined rates of improvement in psychotherapy as a function of the number of sessions attended. The clients (N=1,868; 73.1% female; 92.4% White; average age=40), who were seen for a variety of problems in routine primary care mental health practices, attended 1 to 12 sessions, had planned endings, and completed the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the beginning and end of their treatment. The percentage of clients achieving reliable and clinically significant improvement (RCSI) on the CORE-OM did not increase with number of sessions attended. Among clients who began treatment above the CORE-OM clinical cutoff (n=1,472), the RCSI rate ranged from 88% for clients who attended 1 session down to 62% for clients who attended 12 sessions (r=-.91). Previously reported negatively accelerating aggregate curves may reflect progressive ending of treatment by clients who had achieved a good enough level of improvement.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Child
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy*
  • England
  • Episode of Care
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Patient Care Planning / statistics & numerical data
  • Personality Assessment
  • Primary Health Care
  • Problem Solving*
  • Psychotherapy / statistics & numerical data*
  • Quality Assurance, Health Care / statistics & numerical data
  • Statistics as Topic
  • Time Factors