Journal
CLINICAL PSYCHOLOGY & PSYCHOTHERAPY
Volume 17, Issue 1, Pages 25-32Publisher
JOHN WILEY & SONS LTD
DOI: 10.1002/cpp.656
Keywords
Client Deterioration; Outcome Assessment; Clinical Judgment and Decision Making
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Routine clinical judgment is often relied upon to detect client deterioration. How reliable are therapists' judgments of deterioration? Two related studies were conducted to investigate therapist detection of client deterioration and therapist treatment decisions in situations of deterioration. The first study examined therapists' ability to detect client deterioration through the review of therapy progress notes. Therapist treatment decisions in cases of client deterioration were also explored. Therapists had considerable difficulty recognizing client deterioration, challenging the assumption that routine clinical judgment is sufficient when attempting to detect client deterioration. A second study was a survey of therapists asking how they detect client deterioration and what treatment decisions they make in response. Symptom worsening was the most commonly stated cue of deterioration. Copyright (C) 2009 John Wiley & Sons, Ltd.
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