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Efektivita psychoterapeutické péče v rámci preventivních programů zdravotních pojišťoven
Title in English | Effectiveness of psychotherapy in the context of health insurance companies’ preventive programs |
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Authors | |
Year of publication | 2024 |
Type | Article in Periodical |
Magazine / Source | Československá psychologie |
MU Faculty or unit | |
Citation | |
Web | article - open access |
Doi | http://dx.doi.org/10.51561/cspsych.68.3.308 |
Keywords | psychotherapy; effectiveness; naturalistic study |
Description | Objectives. This study aimed to (1) examine the magnitude of therapeutic change occurring among clients in mental health insurance prevention programs and (2) find predictors of this change. Sample and settings. N = 2059 clients (78% female) completed depression (PHQ-9), anxiety (GAD-7), and somatization (PHQ-15) questionnaires at the beginning and end of therapy, but no later than after the tenth session. The sample included therapies initiated in 2022 in the context of one of the preventive programs of Czech health insurance companies. Psychotherapy was conducted by 228 therapists. Hypotheses. Positive changes in depression, anxiety, and somatization were expected after psychotherapy. An interaction between baseline outcome severity and final outcome was expected. Statistical analyses. The magnitude of change and its predictors were estimated using a series of multilevel models in which the effect of the therapist (random effect) and other intervening variables were controlled. Percent change was expressed by categorizing clients into recovered, improved, no change, and deteriorated, using the concepts of statistically reliable and clinically significant change. Results. The effect size was d = -0.57 for depression, d = -0.62 for anxiety, and d = -0.40 for somatization. For the clinical part of the sample, the effect size was d = -1.05 for depression, d = -1.26 for anxiety, and d = -0.86 for somatization. Except for the baseline outcome severity, no substantive predictor of therapeutic change was found on either the client's or therapist's side. Limitations. The absence of a control group made it impossible to distinguish the effect of the therapeutic intervention from other sources of change. Only selected indicators of psychopathology were monitored. Results cannot be generalized outside the context of short-term individual psychotherapy provided in private practice. |
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