Good-enough level and dose-effect models: Variation among outcomes and therapists

Psychother Res. 2016;26(1):22-30. doi: 10.1080/10503307.2014.966346. Epub 2014 Oct 27.

Abstract

Objective: The current study examined the good-enough level (GEL) and dose-effect model on three outcome variables: well-being, symptom distress, and life functioning, while accounting for therapist effects. The dose-effect model assumes the rate of change is consistent across clients, and the GEL model assumes that the rate of change will vary according to the total length of treatment.

Method: The sample included 13,664 clients who completed 2-100 sessions of therapy.

Results: The GEL model was a better fit to the data compared to the dose-effect model for all outcomes. There were fewer changes in life functioning compared to well-being and symptom distress for clients. There were significant therapist effects for changes in symptom distress and life functioning, but not for the rates of change in well-being.

Conclusion: Therapists should consider the rates of change for their own clients as well as by outcome.

Keywords: Dose-Effect; Good-Enough Level; Multilevel-Modeling; Therapieoutcomes; dose-effect; dose-effetto; esiti di terapia; good-enough level; livello sufficientement buono; modelli multilivello; multilevel modeling; therapy outcomes.

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Models, Statistical*
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Psychotherapy / statistics & numerical data*