Duration of psychological therapy: relation to recovery and improvement rates in UK routine practice. [corrected]

Br J Psychiatry. 2015 Aug;207(2):115-22. doi: 10.1192/bjp.bp.114.145565. Epub 2015 May 7.


Background: Previous studies have reported similar recovery and improvement rates regardless of treatment duration among patients receiving National Health Service (NHS) primary care mental health psychological therapy.

Aims: To investigate whether this pattern would replicate and extend to other service sectors, including secondary care, university counselling, voluntary sector and workplace counselling.

Method: We compared treatment duration with degree of improvement measured by the Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) for 26 430 adult patients who scored above the clinical cut-off point at the start of treatment, attended 40 or fewer sessions and had planned endings.

Results: Mean CORE-OM scores improved substantially (pre-post effect size 1.89); 60% of patients achieved reliable and clinically significant improvement (RCSI). Rates of RCSI and reliable improvement and mean pre- and post-treatment changes were similar at all tested treatment durations. Patients seen in different service sectors showed modest variations around this pattern.

Conclusions: Results were consistent with the responsive regulation model, which suggests that in routine care participants tend to end therapy when gains reach a good-enough level.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Counseling
  • Female
  • Humans
  • Length of Stay
  • Male
  • Mental Disorders / therapy*
  • Middle Aged
  • Patient Outcome Assessment
  • Psychotherapy / methods*
  • Self Report
  • Treatment Outcome
  • United Kingdom
  • Young Adult