Reliability of Therapist Effects in Practice-Based Psychotherapy Research : A Guide for the Planning of Future Studies

This paper aims to provide researchers with practical information on sample sizes for accurate estimations of therapist effects (TEs). The investigations are based on an integrated sample of 48,648 patients treated by 1800 therapists. Multilevel modeling and resampling were used to realize varying sample size conditions to generate empirical estimates of TEs. Sample size tables, including varying sample size conditions, were constructed and study examples given. This study gives an insight into the potential size of the TE and provides researchers with a practical guide to aid the planning of future studies in this field

Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: rationale and design of a randomized controlled trial.

BACKGROUND: A few recent studies have found indications of the effectiveness of inpatient psychotherapy for depression, usually of an extended duration. However, there is a lack of controlled studies in this area and to date no study of adequate quality on brief psychodynamic psychotherapy for depression during short inpatient stay exists. The present article describes the protocol of a study that will examine the relative efficacy, the cost-effectiveness and the cost-utility of adding an Inpatient Brief Psychodynamic Psychotherapy to pharmacotherapy and treatment-as-usual for inpatients with unipolar depression. METHODS/DESIGN: The study is a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 130 consecutive adult inpatients with unipolar depression and Montgomery-Asberg Depression Rating Scale score over 18 will be recruited. The study is carried out in the university hospital section for mood disorders in Lausanne, Switzerland. Patients are assessed upon admission, and at 1-, 3- and 12- month follow-ups. Inpatient therapy is a manualized brief intervention, combining the virtues of inpatient setting and of time-limited dynamic therapies (focal orientation, fixed duration, resource-oriented interventions). Treatment-as-usual represents the best level of practice for a minimal treatment condition usually proposed to inpatients. Final analyses will follow an intention-to-treat strategy. Depressive symptomatology is the primary outcome and secondary outcome includes measures of psychiatric symptomatology, psychosocial role functioning, and psychodynamic-emotional functioning. The mediating role of the therapeutic alliance is also examined. Allocation to treatment groups uses a stratified block randomization method with permuted block. To guarantee allocation concealment, randomization is done by an independent researcher. DISCUSSION: Despite the large number of studies on treatment of depression, there is a clear lack of controlled research in inpatient psychotherapy during the acute phase of a major depressive episode. Research on brief therapy is important to take into account current short lengths of stay in psychiatry. The current study has the potential to scientifically inform appropriate inpatient treatment. This study is the first to address the issue of the economic evaluation of inpatient psychotherapy. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry (ACTRN12612000909820)

The Utility of an Efficient Outcomes Assessment System at University Counseling Centers

Due to increased demands placed on university counseling centers (UCCs) in recent years, there is a need for these centers to enhance the efficiency and effectiveness of their psychological services. Regularly monitoring client progress is one approach to increase the likelihood of positive clinical outcomes. This article describes the use of the Behavioral Health Measure–20 (BHM-20; Kopta & Lowry, 2002) in monitoring the progress of 13,803 clients at 23 UCCs across the United States from 2006–2011. Results show that the BHM-20, via the CelestHealth System–MH (CHS-MH), is an effective instrument for the electronic administration, scoring, and tracking of client progress. Overall, clients improved over the course of treatment and the benefit from treatment peaked between 7 to 10 sessions. Three case vignettes using the CHS-MH in patient care are presented. Implications for continuing the use of monitoring individual client change at UCCs are discussed

Crystallographic texture of submicron thin aluminum nitride films on molybdenum electrode for suspended micro and nanosystems

The structural properties of piezoelectric AlN/Mo/AlN stacks have been investigated for obtaining an improved c-axis oriented, piezoelectric AlN thin film on Mo electrodes to be employed in suspended nano- and micromechanical devices. With increasing thickness of the AlN interlayer up to 80 nm, the texture of the overgrown Mo layer improves significantly, marked by a significant reduction in full-width-at-half-maximum of the rocking curve obtained around 220 Bragg reflections. The improved orientation of Mo crystallites promotes the growth of preferentially c-axis oriented columns in the overgrown AlN film as evidenced by analyzes of crystal orientation determined by scanning nano-beam transmission electron diffraction. Atomic-Force Microscopy revealed only a slight deterioration of the surface roughness of AlN films upon introduction of the interlayer. The whole film stack has a total thickness of less than 1 ?m and is, thus, promising for suspended piezoelectric active RF devices