Full Answer
What is systematic treatment selection in psychology?
Systematic Treatment Selection (STS) is a form of technical eclectism that develops and plans treatments using empirically founded principles of psychotherapy. It is a model that provides systematic guidelines for the utilization of different psychotherapeutic strategies based on patient qualities and problem characteristics.
How do I select a treatment course?
There are different ways to identify and select a particular treatment course. Rational approaches rely on the particular formulations of each clinician and are largely based on theoretical posture and personal experience.
How do Clinicians choose the right treatment for each patient?
Planning and assigning a patient to a treatment that optimizes gains and fits the patient's needs is a shared objective among clinicians. However, selecting the most appropriate treatment for each patient can be a nebulous and unreliable task, varying by the clinician's biases and theoretical training and with uncertain or unmeasured results.
Does the intervention alone produce treatment effects?
Study #1 supported the contention of Beutler, Moleiro et al. (2003) that it is not the interventions alone that produce treatment effects. Patient, treatment, relationship, and patient-matching variables offer independent contributions to the prediction and development of positive treatment outcomes.
What is a binary treatment?
A 'treatment effect' is the average causal effect of a binary (0–1) variable on an outcome variable of scientific or policy interest.
Is selection bias and Endogeneity?
Endogenous selection bias results from conditioning on an endogenous variable that is caused by two other variables, one that is (or is associated with) the treatment and one that is (or is associated with) the outcome (Hernán et al. 2002, 2004).
What is a sample that has a selection bias?
Key Takeaways. Sample selection bias in a research study occurs when non-random data is selected for statistical analysis. Due to a flaw in the sample selection process, a subset of the data is excluded from the study, thereby impacting or negating the statistical significance of the test.
What is selection bias and how can you avoid it?
Selection bias affects the validity of program evaluations whenever selection of treatment and control groups is done non-randomly. The only foolproof way to avoid selection bias is to do a randomized control trial.
What is selection bias in psychology?
An error in choosing the individuals or groups to take part in a study. Ideally, the subjects in a study should be very similar to one another and to the larger population from which they are drawn (for example, all individuals with the same disease or condition).
What is an example of endogeneity?
For example, if they think a customer will buy even without a coupon, they did not send it or if they think a person might buy, they sent them more coupons.
What is selection bias healthcare?
Selection bias occurs when the association between exposure and health outcome is different for those who complete a study compared with those who are in the target population.
What is selection bias in clinical trials?
Selection bias occurs when recruiters selectively enrol patients into the trial based on what the next treatment allocation is likely to be. This can occur even if appropriate allocation concealment is used if recruiters can guess the next treatment assignment with some degree of accuracy.
What is selection sampling?
Selected sampling involves active selection of members of the population that are considered to be most representative of the objectives outlined in the inventory or monitoring program.
What is selection effect in research?
Selection Effect is the bias introduced when a methodology, respondent sample or analysis is biased toward a specific subset of a target population. Meaning it does not reflect the actual target population as a whole.
What is the difference between selection bias and sampling bias?
A distinction, albeit not universally accepted, of sampling bias is that it undermines the external validity of a test (the ability of its results to be generalized to the entire population), while selection bias mainly addresses internal validity for differences or similarities found in the sample at hand.
How do you identify selection bias?
Typically social work researchers use bivariate tests to detect selection bias (e.g., χ2 to compare the race of participants and non-participants). Occasionally multiple regression methods are used (e.g., logistic regression with participation/non-participation as the dependent variable).
What are the four core domains of variables used to guide the clinician in making treatment decisions?
Findings from the literature and the previous studies mentioned, led to extraction of four core domains of variables used to guide the clinician in making treatment decisions, including: (1) predisposing client variables; (2) treatment contexts; (3) relationship variables; and (4) specific strategies (Beutler & Consoli, 1990; Beutler & Harwood, 2000). The initial step in treatment selection is determining where the individual’s scores fall along several dimensions of predisposing client variables (coping style, resistance level, level of distress). These are commonly measured with several standard personality assessment tools (i.e., the Beck Depression Inventory II (BDI-II), the Minnesota Multiphasic Personality Inventory II (MMPI-II), the Therapeutic Reactance Scale (TRS), the STS Clinician Rating Form, etc.). Once identified, the context in which psychotherapy takes place is then specified which entails establishing the setting in which therapy will take place (inpatient vs. outpatient), the format (individual, family, or group), and the frequency/duration of treatment. Following, relationship variables between therapist and patient is examined which then leads to selection of specific interventions or techniques (symptom vs. conflict focus). Optimal treatment outcome is a function of the interaction of these identified core variables.
What is STS in therapy?
Systematic Treatment Selection (STS) is a form of technical eclectism that develops and plans treatments using empirically founded principles of psychotherapy. It is a model that provides systematic guidelines for the utilization of different psychotherapeutic strategies based on patient qualities and problem characteristics. Historically, it stems from accumulating evidence that no single theory is effective in treating all patients and common characteristics shared among different theoretical philosophies. A review of the literature and further research resulted in the extraction of four main decisional domains that are involved in determining effective treatment strategies. These domains include: (1) patient predisposing qualities, (2) treatment context, (3) relationship variables, and (4) intervention selection. These main principles provide the basis for which guidelines have been developed to systematically individualize treatment plans. The next step in the process is to effectively disseminate and implement this model, in which students and clinicians are taught to operate from a patient based rather than a theory based perspective.
What is empirically supported treatment?
What are empirically supported treatments (EST)? It is assumed by most who would hear this term, that these treatments are based on rigorous empirical support. However, in reality the term has been defined to restrict evidence of efficacy to studies that have applied a RCT methodology. Accordingly, it is assumed that only this methodology will allow one to construct causal chains by which treatment can be seen to produce change. This is an overstatement of the value of RCTs as applied to psychotherapy research and an understatement of the role of other scientific methods to determine causal chains. However, while RCTs have provided clinical psychology with the assurance that psychotherapy works and is better than nothing, a reliance on this one methodology introduces limitations in clinical decision making ( Beutler & Forrester, 2014 ). In reality, the use of RCTs in psychotherapy have had to be modified to eliminate many of advantages of randomization. For example, in pharmacological research, neither the patient nor the clinician is aware of the treatment being offered. This kind of control is necessary to preserve the value of the randomization process. But, in psychotherapy, it is impossible for the principle participants to be blind to the treatment used. Likewise, in pharmacological research, each element of the treatment can be randomized, but in psychotherapy where the treatment is embodied within the persons giving and receiving it, the task of randomization is out of the question. Can one randomly assign therapists to different belief systems? Is culture a random event? Are preferences capable of being randomized across samples of patients and therapists? Yet all of these factors are embedded in the participants within psychotherapy and constitute aspects of the “treatment”. Clearly, not all—and maybe not even many--aspects of treatment can be randomly assigned to therapists and patients.
What are the four epochs of integrative psychotherapy?
These epochs began with the search for common healing factors (Epoch #1) and then progressed to the exploration of tailoring the use of patient specific procedures or “technical eclecticism” (Epoch #2). The third epoch saw the introduction of integration/eclecticism as a formal school ( Lazurus, 1967 ), and in turn, the differentiation of eclecticism and integrationism. With these changes, there was a return to “schools” (Epoch #4) with a focus on finding evidence based treatments that reliably produced change. It is during this epoch of change, that the field of integrative psychotherapy has achieved a degree of formality as a distinct approach, as interest in it has been shown to be durable and stable.
What is STS in therapy?
The STS is a prototype of Integrative Therapy that is based on the identification and application of multiple empirically derived principles of change that reflect the role of mediators as well as the moderating effects that comprise therapy fit. This model is founded upon the argument that no particular treatment model works well universally, across all patients, and most interventions work well on some patients ( Beutler & Harwood, 2002 ). Logically, therefor, if the therapy environment and procedures can be tailored to each patient, higher improvement rates should be observed. However, it is also acknowledged that by defining psychotherapy broadly to include external moderators and mediators in addition to interventions, the parameters of influence, cannot be established if one relies solely on a single research methodology. RCT, widely considered the “gold standard” for validating psychotherapeutic influences accounts for a relatively small percentage of the change occurring among treated patients and has failed to illucidate clear differences in efficacy when RCT based therapies are compared to treatments as usual or even with one another ( Norcross and Lambert, 2006, Wampold, 2001 ). These failures alone underline the conclusion that other factors besides interventions and diagnosis alone inform optimal psychotherapy outcomes. Thus, multiple methods designed to reveal unveil effects are required to adequately test psychotherapy. We have reviewed three studies with diverse methodologies, all of which converge on similar results and offer these convergences as examples of how such studies can reveal causal chains.
What is the second step in the STS system?
The second step in the process of developing the STS system was to identify common and specific characteristics of treatment whose effects are moderated by patient qualities. This step included the initial efforts to identify and measure distinguishing and resulted in the development of profiles that distinguished among treatments and sub-types of Cognitive Therapy. In addition to treatment factors that emerged in the literature reviews (e.g., Beutler et al., 2000, Castonguay and Beutler, 2006 ), efforts to define characteristics of treatment that distinguish different models of treastment, we also sought to develop treatment profiles.
What is the methodology of STS?
The methodology of STS was developed by the application of Aptitude Treatment Interaction (ATI) research designs which center on identifying client variables that mediate (i.e., facilitate) and moderate (i.e., differentially facilitate) the effects of interventions ( Beutler and Clarkin, 1990, Beutler et al., 2000 ). The STS principles which are encompassed in identifying the obptimal “FIT” of treatment for a particular patient, is highly dependent upon having a reliable and valid measure of: a) the patient's standing on the critical dimensions that mediate or moderate treatment, b) the active ingredients of the treatment as it is applied, and 3) outcome. Achieving the measurement tools required, proceeded in four steps, each one of which was linked closely to the derivation of factors that constitute Optimal Fit and Meaningful Change.
When did psychotherapy start?
Psychotherapy research has an extensive history that extends to the early 1900's. And through most of this history, eclectic and integrative approaches have been part of the scene. Even the early common factors approach to psychotherapy has been touted as an integrated approach to psychotherapy.
Is selecting the most appropriate treatment for each patient a nebulous and unreliable task?
However, selecting the most appropriate treatment for each patient can be a nebulous and unreliable task, varying by the clinician's biases and theoretical training and with uncertain or unmeasured results. There are different ways to identify and select a particular treatment course.
