For whom does a match matter most? Patient-level moderators of evidence-based patient–therapist matching
| Autor: | David R. Kraus, James F. Boswell, Michael J. Constantino, Alice E. Coyne |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Adult
Matching (statistics) Evidence-based practice Multilevel model PsycINFO Moderation Anxiety Disorders Mental health law.invention Psychotherapy Psychiatry and Mental health Clinical Psychology Treatment Outcome Randomized controlled trial law Ethnicity medicine Humans Anxiety medicine.symptom Psychology Minority Groups Clinical psychology |
| Zdroj: | Journal of Consulting and Clinical Psychology. 90:61-74 |
| ISSN: | 1939-2117 0022-006X |
| DOI: | 10.1037/ccp0000644 |
| Popis: | OBJECTIVE A double-blind, randomized controlled trial tested the effectiveness of a personalized Match System in which patients are assigned to therapists with a "track record" of effectively treating a given patient's primary concern(s) (e.g., anxiety). Matched patients demonstrated significantly better outcomes than those assigned through usual pragmatic means. The present study examined patient-level moderators of this match effect. We hypothesized that the match benefits would be especially pronounced for patients who presented with (a) greater overall problem severity, and (b) greater problem complexity (i.e., number of elevated problem domains). We also explored if patient racial/ethnic minority status moderated the condition effect. METHOD Patients were 218 adults randomized to the Match or as-usual assignment condition, and then treated naturalistically by 48 therapists. The primary outcome was the Treatment Outcome Package (TOP), a multidimensional assessment tool that also primed the Match algorithm (based on historical, therapist-level effectiveness data), and assessed trial patients' symptoms/functioning and demographic information at baseline. Moderator effects were tested as patient-level interactions in three-level hierarchical linear models. RESULTS The beneficial match effect was significantly more pronounced for patients with higher initial severity (-0.03, 95% CI -0.05, -0.01) and problem complexity (-0.01, 95% CI -0.02, -0.004), yet the high correlation between severity and complexity called into question the uniqueness of the complexity moderator effect. Moreover, the match effect was more pronounced for racial/ethnic minority patients (i.e., nonwhite; -0.05, 95% CI -0.09, -0.01). CONCLUSIONS Measurement-based matching is especially effective for patients with certain characteristics, which further informs mental health treatment personalization. (PsycInfo Database Record (c) 2021 APA, all rights reserved). |
| Databáze: | OpenAIRE |
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