Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2012

Open Access 01-12-2012 | Research article

The short-term effect on alliance and satisfaction of using patient feedback scales in mental health out-patient treatment. A randomised controlled trial

Authors: Marit By Rise, Lasse Eriksen, Hilde Grimstad, Aslak Steinsbekk

Published in: BMC Health Services Research | Issue 1/2012

Login to get access

Abstract

Background

The main aim was to investigate the effect of using two brief feedback scales in mental health out-patient treatment six weeks after starting treatment, compared to treatment as usual. Hypotheses were that use of feedback scales would improve treatment alliance and patient satisfaction.

Methods

An open parallel-group randomised controlled trial was conducted in an out-patient unit in a mental health hospital in Central Norway. Eight therapists trained in using the feedback scales in the Partners for Change Outcome Management System (PCOMS) treated the intervention group. Seventeen therapists treated the controls, providing treatment without using feedback scales. The main outcome measures were treatment alliance and patient satisfaction.

Results

Seventy-five patients participated. There were no differences between the groups in the intention to treat (ITT) analyses on alliance (mean difference = 0.08, 95% CI −0.44, 0.59, p = 0.760) or satisfaction (mean difference = 0.24, 95% CI −1.85, 2.32, p = 0.819), and no statistically significant differences between the groups in the per protocol (PP, n = 58) analyses on alliance (mean difference = 0.32, 95% CI −0.84, 3.16, p = 0.137) or satisfaction (mean difference = 1.16, 95% CI −0.84, 3.16, p = 0.248) six weeks after the treatment started. The effect size in favour of the PCOMS group increased from 0.07 for alliance and 0.06 for satisfaction in the intention to treat analysis to 0.40 on alliance and 0.31 for satisfaction in the per protocol analysis. Among the other outcomes, the PCOMS group had better motivation for treatment (estimated mean difference ITT: 0.29, 95% CI 0.00 to 0.57, p = 0.05, PP: 0.28, 95% CI 0.04, 0.52, p = 0.024).

Conclusion

Six weeks after starting treatment, there were no effects on alliance and satisfaction from using two brief feedback scales. Since the per protocol analyses showed higher effect sizes, future investigations in a larger study with longer follow-up are warranted.
Appendix
Available only for authorised users
Literature
1.
Longtin Y, Sax H, Leape LL, Sheridan SE, Donaldson L, Pittet D: Patient participation: current knowledge and applicability to patient safety. Mayo Clin Proc. 2010, 85: 53-62. 10.4065/mcp.2009.0248.CrossRefPubMedPubMedCentral
2.
May C, Montori VM, Mair FS: We need minimally disruptive medicine. BMJ. 2009, 339: b2803-10.1136/bmj.b2803.CrossRefPubMed
3.
Crawford M, Rutter D, Manley C, Weaver T, Bhui K, Fulop N, et al: Systematic review of involving patients in the planning and development of health care. BMJ. 2002, 325: 1263-10.1136/bmj.325.7375.1263.CrossRefPubMedPubMedCentral
4.
5.
Cegala DJ, Street RL, Clinch CR: The impact of patient participation on physicians' information provision during a primary care medical interview. Health Commun. 2007, 21: 177-185. 10.1080/10410230701307824.CrossRefPubMed
6.
Tritter JQ: Revolution or evolution: the challenges of conceptualizing patient and public involvement in a consumerist world. Health Expect. 2009, 12: 275-287. 10.1111/j.1369-7625.2009.00564.x.CrossRefPubMed
7.
8.
Carr S: Participation, power, conflict and change: theorizing dynamics of service user participation in the social care system of England and Wales. CSP. 2007, 27: 266-276.
9.
Stringer B, Van Meijel B, De Vree W, Van der Bijl J: User involvement in mental health care: the role of nurses. a literature review. J Psychiatr Ment Health Nurs. 2008, 15: 678-683. 10.1111/j.1365-2850.2008.01285.x.CrossRefPubMed
10.
Hickey G, Kipping C: Exploring the concept of user involvement in mental health through a participation continuum. J Clin Nurs. 1998, 7: 83-88. 10.1046/j.1365-2702.1998.00122.x.CrossRefPubMed
11.
Coulter A: The autonomous patient. 2002, London: Nuffield Trust
12.
Florin J, Ehrenberg A, Ehnfors M: Patient participation in clinical decision-making in nursing: a comparative study of nurses' and patients' perceptions. J Clin Nurs. 2006, 15: 1498-1508. 10.1111/j.1365-2702.2005.01464.x.CrossRefPubMed
13.
Rise MB, Solbjor M, Lara MC, Westerlund H, Grimstad H, Steinsbekk A: Same description, different values. how service users and providers define patient and public involvement in health care. Health Expect. 2011, 10.1111/j.1369-7625.2011.00713.x. [Epub ahead of print]
14.
Cahill J: Patient participation-a review of the literature. J Clin Nurs. 1998, 7: 119-128. 10.1111/j.1365-2702.1998.00132.x.CrossRefPubMed
15.
Happell B, Pinikahana J, Roper C: Attitudes of postgraduate nursing students towards consumer participation in mental health services and the role of the consumer academic. Int J Ment Health Nurs. 2002, 11: 240-250. 10.1046/j.1440-0979.2002.00255.x.CrossRefPubMed
16.
Crow R, Gage H, Hampson S, Hart J, Kimber A, Storey L, et al: The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature. Health Technol Assess. 2002, 6: 1-244.CrossRefPubMed
17.
Haywood K, Marshall S, Fitzpatrick R: Patient participation in the consultation process: a structured review of intervention strategies. Patient Educ Couns. 2006, 63: 12-23. 10.1016/j.pec.2005.10.005.CrossRefPubMed
18.
Marshall S, Haywood K, Fitzpatrick R: Impact of patient-reported outcome measures on routine practice: a structured review. J Eval Clin Pract. 2006, 12: 559-568. 10.1111/j.1365-2753.2006.00650.x.CrossRefPubMed
19.
Bjertnaes OA, Sjetne IS, Iversen HH: Overall patient satisfaction with hospitals: effects of patient-reported experiences and fulfilment of expectations. BMJ Qual Saf. 2011, 10.1136/bmjqs-2011-000137.
20.
Svensson B, Hansson L: Satisfaction with mental health services. a user participation approach. Nord J Psychiatry. 2006, 60: 365-371. 10.1080/08039480600937090.CrossRefPubMed
21.
Gelso C, Carter J: Components of the psychotherapy relationship. J Couns Psychol. 1994, 41: 296-306.CrossRef
22.
Gelso C, Carter J: The relationship in counseling and psychotherapy: Components, consequences, and theoretical antecedents. TCP. 1985, 13: 155-243.
23.
Bordin E: The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy (Chic). 1979, 16: 252-260.CrossRef
24.
Martin DJ, Garske JP, Davis MK: Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. J Consult Clin Psychol. 2000, 68: 438-450.CrossRefPubMed
25.
Howard KI, Moras K, Brill PL, Martinovich Z, Lutz W: Evaluation of psychotherapy. efficacy, effectiveness, and patient progress. Am Psychol. 1996, 51: 1059-1064.CrossRefPubMed
26.
Miller SD, Duncan BL, Brown J, Sorrell R, Chalk MB: Using formal client feedback to improve retention and outcome: making ongoing, real-time assessment feasible. J Brief Therapy. 2006, 5: 5-22.
27.
Harmon SC, Lambert MJ, Smart DM, Hawkins E, Nielsen SL, Slade K, et al: Enhancing outcome for potential treatment failures: therapist client feedback and clinical support tools. Psychother Res. 2007, 17: 379-392. 10.1080/10503300600702331.CrossRef
28.
Lambert MJ, Harmon C, Slade K, Whipple JL, Hawkins EJ: Providing feedback to psychotherapists on their patients' progress: clinical results and practice suggestions. J Clin Psychol. 2005, 61: 165-174. 10.1002/jclp.20113.CrossRefPubMed
29.
Lambert MJ, Shimokawa K: Collecting client feedback. Psychotherapy (Chic). 2011, 48: 72-79.CrossRef
30.
Miller SD, Duncan BL, Sorrell R, Brown GS: The partners for change outcome management system. J Clin Psychol. 2005, 61: 199-208. 10.1002/jclp.20111.CrossRefPubMed
31.
Tritter JQ, McCallum A: The snakes and ladders of user involvement: moving beyond Arnstein. Health Policy. 2006, 76: 156-168. 10.1016/j.healthpol.2005.05.008.CrossRefPubMed
32.
Arnstein S: A ladder of citizen participation. J Am Plann Assoc. 1969, 35: 216-224. 10.1080/01944366908977225.
33.
Lambert M, Whipple J, Harmon C, Shimokawa K, Slade K, Christofferson C: Clinical support tools manual. 2004, Brigham Young University, Provo UT: Department of Psychology
34.
Reese R, Norsworthy L, Rowlands S: Does a continuous feedback system improve psychotherapy outcome?. Psychotherapy (Chic). 2009, 46: 418-431.CrossRef
35.
Reese RJ, Toland MD, Slone NC, Norsworthy LA: Effect of client feedback on couple psychotherapy outcomes. Psychotherapy (Chic). 2010, 47: 616-630.CrossRef
36.
Anker M, Duncan B, Sparks J: Using client feedback to improve couple therapy outcomes: a randomized clinical trial in a naturalistic setting. J Consult Clin Psychol. 2009, 77: 693-704.CrossRefPubMed
37.
Reese R, Usher E, Bowman D, Norsworthy L, Halstead J, Rowlands S, et al: Using client feedback in psychotherapy training: an analysis of its influence on supervision and counselor self-efficacy. TEPP. 2009, 3: 157-168.
38.
Horvath AO, Del Re AC, Fluckiger C, Symonds D: Alliance in individual psychotherapy. Psychotherapy (Chic). 2011, 48: 9-16.CrossRef
39.
Johansson H, Eklund M: Helping alliance and early dropout from psychiatric out-patient care: the influence of patient factors. Soc Psychiatry Psychiatr Epidemiol. 2006, 41: 140-147. 10.1007/s00127-005-0009-z.CrossRefPubMed
40.
Blais MA: Development of an inpatient treatment alliance scale. J Nerv Ment Dis. 2004, 192: 487-493. 10.1097/01.nmd.0000131911.53489.af.CrossRefPubMed
41.
Beach M, Sugarman J, Johnson RL, Arbelaez JJ, Duggan PS, Cooper LA: Do patients treated with dignity report higher satisfaction, adherence, and receipt of preventive care?. Ann Fam Med. 2005, 3: 331-338. 10.1370/afm.328.CrossRefPubMedPubMedCentral
42.
Joffe S, Manocchia M, Weeks JC, Cleary PD: What do patients value in their hospital care? an empirical perspective on autonomy centred bioethics. J Med Ethics. 2003, 29: 103-108. 10.1136/jme.29.2.103.CrossRefPubMedPubMedCentral
43.
Miller SD, Duncan BL: The outcome and session rating scales: administration and scoring manual. 2004, Chicago, IL: Scott Miller & Barry Duncan
44.
Larsen DL, Attkisson CC, Hargreaves WA, Nguyen TD: Assessment of client/patient satisfaction: development of a general scale. Eval Program Plann. 1979, 2: 197-207. 10.1016/0149-7189(79)90094-6.CrossRefPubMed
45.
Attkisson C, Zwick R: The client satisfaction questionnaire. Psychometric properties and correlations with service utilization and psychotherapy outcome. Eval Program Plann. 1982, 5: 233-237. 10.1016/0149-7189(82)90074-X.CrossRefPubMed
46.
Eisen SV, Dill DL, Grob MC: Reliability and validity of a brief patient-report instrument for psychiatric outcome evaluation. Hosp Commun Psych. 1994, 45: 242-247.
47.
Hibbard JH, Stockard J, Mahoney ER, Tusler M: Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res. 2004, 39: 1005-1026. 10.1111/j.1475-6773.2004.00269.x.CrossRefPubMedPubMedCentral
48.
Steinsbekk A: [Patient Activation Measure]. Tidsskr Nor Laegeforen. 2008, 128: 2316-2318.PubMed
49.
Ware J, Kosinski M, Keller SD: A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996, 34: 220-233. 10.1097/00005650-199603000-00003.CrossRefPubMed
50.
Clements K, Murphy J, Eisen S, Normand S: Comparison of self-report and clinician-rated measures of psychiatric symptoms and functioning in predicting 1-year hospital readmission. Adm Policy Ment Health. 2006, 33: 568-577. 10.1007/s10488-006-0066-y.CrossRefPubMed
51.
52.
53.
Luborsky L, Barber JP, Siqueland L, Johnson S, Najavits LM, Frank LM, et al: The revised helping alliance questionnaire (HAq-II): psychometric properties. J Psychother Pract Res. 1996, 5: 260-271.PubMedPubMedCentral
54.
Horvath AO, Greenberg LS: Development and validation of the working alliance inventory. J Couns Psychol. 1989, 36: 223-233.CrossRef
55.
Meyer B, Pilkonis PA, Krupnick JL, Egan MK, Simmens SJ, Sotsky SM: Treatment expectancies, patient alliance, and outcome: further analyses from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. J Consult Clin Psychol. 2002, 70: 1051-1055.CrossRefPubMed
56.
Vogel PA, Hansen B, Stiles TC, Gotestam KG: Treatment motivation, treatment expectancy, and helping alliance as predictors of outcome in cognitive behavioral treatment of OCD. J Behav Ther Exp Psychiatry. 2006, 37: 247-255. 10.1016/j.jbtep.2005.12.001.CrossRefPubMed
57.
Maclean N, Pound P: A critical review of the concept of patient motivation in the literature on physical rehabilitation. Soc Sci Med. 2000, 50: 495-506.CrossRefPubMed
58.
Johansson H, Jansson JA: Therapeutic alliance and outcome in routine psychiatric out-patient treatment: patient factors and outcome. Psychotherapy (Chic). 2010, 83: 193-206.
Metadata
Title
The short-term effect on alliance and satisfaction of using patient feedback scales in mental health out-patient treatment. A randomised controlled trial
Authors
Marit By Rise
Lasse Eriksen
Hilde Grimstad
Aslak Steinsbekk
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2012
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-12-348

Other articles of this Issue 1/2012

BMC Health Services Research 1/2012 Go to the issue

Research article

How does lean work in emergency care? A case study of a lean-inspired intervention at the Astrid Lindgren Children's hospital, Stockholm, Sweden

Research article

“I know it’s bad for me and yet I do it”: exploring the factors that perpetuate smoking in Aboriginal Health Workers - a qualitative study

Research article

A prospective study of health care resource utilisation and selected costs of schizophrenia in France

Study protocol

A cohort study of the recovery of health and wellbeing following colorectal cancer (CREW study): protocol paper

Research article

Vasectomy as a proxy: extrapolating health system lessons to male circumcision as an HIV prevention strategy in Papua New Guinea

Research article

Exploring the relationship between population density and maternal health coverage