Personalización de la Psicoterapia Basada en las Preferencias de los Pacientes vs. Monitoreo Rutinario de Resultados con PCOMs: Un Estudio Naturalístico

Autores/as

DOI:

https://doi.org/10.5944/rdp.v36i132.44869

Palabras clave:

Monitoreo Rutinario de Resultados, Preferencias terapéuticas, Personalización del Tratamiento, PCOMS, Retroalimentación

Resumen

Tener en cuenta las preferencias de los pacientes y realizar un monitoreo rutinario de resultados son componentes de una práctica basada en evidencia. Objetivos: comparar la efectividad, por un lado, de ajustar los procesos terapéuticos a las preferencias de rol o actividad de los pacientes, y por otro, del monitoreo rutinario de resultados utilizando el PCOMS. Método: diseño experimental con tres grupos de terapeutas por asignación aleatoria mediante tablas de números aleatorios. Muestra: Terapeutas N9, Pacientes N101. Las evaluaciones se realizaron en la admisión, en la tercera, octava y última sesión de tratamiento.  Se utilizaron modelos de ecuaciones de estimación generalizada (GEE) para analizar los efectos de la adherencia a diferentes enfoques terapéuticos sobre las dimensiones de la escala CORE-OM. Resultados: La psicoterapia monitoreada con el PCOMS obtuvo mejores resultados, diferencia significativa, que el tratamiento estándar y el tratamiento ajustado por las preferencias de los pacientes. En la segunda evaluación (tercera de tratamiento) los resultados de los dos tratamientos experimentales fueron similares. Conclusiones: El monitoreo rutinario de resultados es una estrategia que produce mejores resultados que el tratamiento habitual en el contexto marplatense. Ajustar los tratamientos a las preferencias de los pacientes es un área prometedora de buenos resultados.

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

Pablo Rafael Santangelo, Facultad de Psicología, Universidad Nacional de Mar del PLata

Profesor de grado y Postgrado UNMdP.

Director Programa de Formación y Entrenemiento en Psicoterapia, UNMdP.

Director Protyecto de investigación " Psicoterapia y Supervisión Clínica: Habilidades, Comptetencias Terapéuticas y Resultados de Tratamientos", UNMdP.

Coordinador docente Carrera Especialización en Psicoterapia Cognitiva - Fundación Aiglé - UNMdP.

Citas

Anker, M. G., Duncan, B. L., & Sparks, J. A. (2009). Using client feedback to improve couple therapy outcomes: a randomized clinical trial in a naturalistic setting. Journal of consulting and clinical psychology, 77(4), 693.

APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271–285. http://dx.doi.org/10.1037/0003-066X.61.4.271

Barber, J., & Resnick, S. G. (2022). Collect, share, act: A transtheoretical clinical model for doing measurement-based care 850 M. Barkham et al. in mental health treatment. Psychological Services, Advance online publication. doi: 10.1037/ser0000629

Barkham, M., De Jong, K., Delgadillo, J., & Lutz, W. (2023). Routine outcome monitoring and feedback in psychological in therapies. Open University Press. Mackgraw Hill.

Bovendeerd, B., De Jong, K., De Groot, E., Moerbeek, M., & De Keijser, J. (2022). Enhancing the effect of psychotherapy through systematic client feedback in outpatient mental healthcare: A cluster randomized trial. Psychotherapy Research, 32(6), 710-722.

Brattland, H., Koksvik, J. M., Burkeland, O., Gråwe, R. W., Klöckner, C., Linaker, O. M., ... & Iversen, V. C. (2018). The effects of routine outcome monitoring (ROM) on therapy outcomes in the course of an implementation process: A randomized clinical trial. Journal of Counseling Psychology, 65(5), 641.

Calsyn, R. J., Winter, J. P. & Morse, G. A. (2000). Do consumers who have a choice of treatment have better outcomes? Community Mental Health Journal, 36(2), 149-160. https://doi.org/10.1023/a:1001890210218

Castonguay, L. G., Barkham, M., Youn, S. J., & Page, A. C. (2021). Practice-based evidence: Findings from routine outcome monitoring. In M. Barkham, W. Lutz, & L. G. Castonguay (Eds.), Bergin and Garfield’s handbook of psychotherapy and behavior change (pp. 191–221). Wiley.

Clinton, D. & Sandell, R. (2014). Psychotherapy Preferences and Experiences Questionnaire (PEX) A short introduction.

Connors, E. H., Janse, P., de Jong, K., & Bickman, L. (2024). The Use of Feedback in Mental Health Services: Expanding Horizons on Reach and Implementation. Administration and Policy in Mental Health and Mental Health Services Research, 1-10.

Cooper, M., Duncan, B., Golden, S., & Toth, K. (2021). Systematic client feedback in therapy for children with psychological difficulties: Pilot cluster randomised controlled trial. Counselling Psychology Quarterly, 34(1), 21-36.

Cooper, M., Norcross, J. C., Raymond-Barker, B. & Hogan, T. P. (2019). Psychotherapy preferences of laypersons and mental health professionals: Whose therapy is it? Psychotherapy, 56(2), 205. https://doi.org/10.1037/pst0000226

Cooper, M., Stewart, D., Sparks, J., & Bunting, L. (2013). School-based counseling using systematic feedback: A cohort study evaluating outcomes and predictors of change. Psychotherapy Research, 23(4), 474-488.

Cooper, M., van Rijn, B., Chryssafidou, E., & Stiles, W. B. (2022). Activity preferences in psychotherapy: What do patients want and how does this relate to outcomes and alliance? Counselling Psychology Quarterly, 35(3), 503–526. https://doi.org/10.1080/09515070.2021.1877620

Delevry, D. & Le, Q. A. (2019). Effect of Treatment Preference in Randomized Controlled Trials: Systematic Review of the Literature and Meta-Analysis. The Patient-Patient-Centered Outcomes Research, 1-17. https://doi.org/10.1007/s40271-019-00379-6

Duncan, B. L., Miller, S. D., Sparks, J. A., Claud, D. A., Reynolds, L. R., Brown, J. y Johnson, L. D. (2003). The Session Rating Scale: Preliminary psychometric properties of a “working” alliance measure. Journal of brief Therapy, 3(1), 3-12.

Duncan, B. L., Reese, R. J., Lengerich, A. J., DeSantis, B., Comeau, C. V., & Johnson-Esparza, Y. (2021). Measurement-based care in integrated health care: A randomized clinical trial. Families, Systems & Health: the Journal of Collaborative Family Healthcare, 39(2), 259-268.

Duncan, B. & Sparks; J. (2019) The Partners for Change Outcome Management System. Sistema de Socios para la Gestión del Cambio. Manual de elearning integrado para PCOMS. Better Outcomes Now.

Eigenhuis, E., van Buuren, V. E., Boeschoten, R. E., Muntingh, A. D., Batelaan, N. M., & van Oppen, P. (2024). The Effects of Patient Preference on Clinical Outcome, Satisfaction and Adherence Within the Treatment of Anxiety and Depression: A Meta‐Analysis. Clinical Psychology & Psychotherapy, 31(3), e2985.

Faye Jacobsen, C., Karstoft, K. I., Falkenström, F., Nielsen, J., Lunn, S., & Poulsen, S. (2024). Client preferences, therapy activities and preference-activity match as predictors of therapy outcome. Psychotherapy Research, 1-16.

Fierro, C. (2020). Formación de grado en psicología en Argentina: período 2009-2015 [Tesis Doctoral, Universidad Nacional de San Luis, Argentina]. http://www.neu.unsl.edu.ar/?page_id=569

Hepner, K. A., Farmer, C. M., Brooks Holliday, S., Bharil, S., Kimerling, R. E., McGee-Vincent, P., McCaslin, S. E., & Rosen, C. (2019). Displaying behavioral health measurement based care data: Identifying key features from clinician and patient perspectives. RAND Corporation. https://www.rand.org/pubs/research_reports/RR3078.htm

Hess, T. (2017). Client Preference: Does Simply Asking Make a Difference? (Doctoral dissertation). Southern Illinois University at Edwardsville.

Jonášová, K., Čevelíček, M., Doležal, P., & Řiháček, T. (2024). Psychotherapists’ experience with in-session use of routine outcome monitoring: A qualitative meta-analysis. Administration and Policy in Mental Health and Mental Health Services Research, 1-17.

Kodet, J., Reese, R. J., Duncan, B. L., & Bohanske, R. T. (2019). Psychotherapy for depressed youth in poverty: Benchmarking outcomes in a public behavioral health setting. Psychotherapy, 56(2), 254.

Li, E., Kealy, D., Aafjes-van Doorn, K., McCollum, J., Curtis, J. T., Luo, X., & Silberschatz, G. (2024). “It Felt Like I Was Being Tailored to the Treatment Rather Than the Treatment Being Tailored to Me”: Patient Experiences of Helpful and Unhelpful Psychotherapy. Psychotherapy Research, 1-15.

Lindhiem, O., Bennett, C. B., Trentacosta, C. J. & McLear, C. (2014). Client preferences affect treatment satisfaction, completion, and clinical outcome: a meta-analysis. Clinical Psychology Review, 34(6), 506-517. https://doi.org/10.1016/j.cpr.2014.06.002

Lutz, W., Schwartz, B., & Delgadillo, J. (2022). Measurementbased and data-informed psychological therapy. Annual Review of Clinical Psychology, 18(1), 71–98. https://doi.org/10.1146/annurev-clinpsy-071720-014821

McLeod, J. (2015). Client preferences: building bridges between therapy and everyday life. Psychotherapy and Counselling Journal of Australia, 3(2).

Miller, S. D., Duncan, B. L., Brown, J., Sparks, J. A. y Claud, D. A. (2003). The outcome rating scale: A preliminary study of the reliability, validity, and feasibility of a brief visual analog measure. Journal of brief Therapy, 2(2), 91-100.

Østergård, O. K., Randa, H., & Hougaard, E. (2020). The effect of using the Partners for Change Outcome Management System as feedback tool in psychotherapy—A systematic review and meta-analysis. Psychotherapy Research, 30(2), 195-212.

Reese, R. J., Norsworthy, L. A., & Rowlands, S. R. (2009). Does a continuous feedback system improve psychotherapy outcome?. Psychotherapy: Theory, research, practice, training, 46(4), 418.

Reese, R. J., Toland, M. D., Slone, N. C., & Norsworthy, L. A. (2010). Effect of client feedback on couple psychotherapy outcomes. Psychotherapy: Theory, Research, Practice, Training, 47(4), 616.

Santangelo, P. R. (2020). Programa de formación y entrenamiento en psicoterapia: Fundamentos teóricos e implementación. Revista de psicoterapia, 31(117), 331-346.

Santangelo, P. R., & Conde, K. (2023). Preferencias psicoterapéuticas: versión argentina de las escalas PEX-1 y C-NIP-v1. 1. Revista de Psicología (PUCP), 41(1), 401-420.

Santangelo, P. R., Conde, K., Schupp, H. y Paoloni, N. (2021). Evaluación en psicoterapia: Propieda¬des psicométricas de la versión Argentina de la Escala de Calificación de Resultados y la Escala de Calificación de Sesiones. Revista de Psicoterapia, 32(119), 165-180. https://doi.org/10.33898/rdp. v32i119.503

Santangelo, P.R, Grave, L., Lao, G., Mattiello, M. y Millaman Rickert, G.E. (2022, 2 de diciembre). Escala de Calificación de Resultados. IX Congreso Internacional Marplatense de Psicología. Facultad de Psicología, Universidad Nacional de Mar del Plata, Argentina. https://www.mdp.edu.ar/index.php/noticias-de-la-universidad/780-ix-congreso-marplatense-internacional-de-psicologia

Schuman, D., Slone, N., Reese, R.J., & Duncan, B. (2014). Using client feedback to improve outcomes in group psychotherapy with soldiers referred for substance abuse treatment. Psychotherapy Research, 25(4), 396-407.

She, Z., Duncan, B. L., Reese, R. J., Sun, Q., Shi, Y., Jiang, G., ... & Clements, A. L. (2018). Client feedback in China: A randomized clinical trial in a college counseling center. Journal of Counseling Psychology, 65(6), 727.

Slone, N. C., Reese, R. J., Mathews-Duvall, S., & Kodet, J. (2015). Evaluating the efficacy of client feedback in group psychotherapy. Group Dynamics: Theory, Research, and Practice, 19(2), 122.

Solstad, S. M., Castonguay, L. G., & Moltu, C. (2019). Patients’ experiences with routine outcome monitoring and clinical feedback systems: A systematic review and synthesis of qualitative empirical literature. Psychotherapy Research, 29(2), 157–170. https://doi.org/10.1080/10503307.2017.1326645

Swift, J. K. & Callahan, J. L. (2009). The impact of client treatment preferences on outcome: a meta-analysis. Journal of Clinical Psychology, 65(4), 368-381. https://doi.org/10.1002/jclp.20553

Swift, J. K., Callahan, J. L., Cooper, M. & Parkin, S. R. (2018). The impact of accommodating client preference in psychotherapy: A meta-analysis. Journal of Clinical Psychology, 74(11), 1924-1937. https://doi.org/10.1002/jclp.22680

Swift, J. K., Callahan, J. L., Cooper, M. & Parkin, S. R. (2019). Preferences. In J. C. Norcross y B. Wampold (Eds.), Psychotherapy relationships that work: Volume II: Evidence-based therapist contributions. Oxford University Press. https://doi.org/10.1093/med-psych/9780190843960.003.0006

Swift, J. K., Callahan, J. L. & Vollmer, B. M. (2011). Preferences. In J. C. Norcross (Ed.), Psychotherapy relationships that work (2nd ed., pp. 301-315). Oxford University. https://doi.org/10.1093/acpr of:oso/9780199737208.003.0015

Thew, G., Fountain, L., & Salkovskis, P. (2015). Service user and clinician perspectives on the use of outcome measures in psychological therapy. The Cognitive Behaviour Therapist, 8, E23. https://doi.org/10.1017/S1754470X15000598

Tompkins, K. A., Swift, J. K. & Callahan, J. L. (2013). Working with clients by incorporating their preferences. Psychotherapy, 50(3), 279-283. https://doi.org/10.1037/a0032031

Urbaniak, G. C., & Plous, S. (2013). Research randomizer (Version 4.0) [Computer software]. Retrieved on February 26, 2021, from http://www.randomizer.org/

Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The research evidence for what works in psychotherapy (2nd ed.). New York, NY: Routledge.

Windle, E., Tee, H., Sabitova, A., Jovanovic, N., Priebe, S. & Carr, C. (2020). Association of patient treatment preference with dropout and clinical outcomes in adult psychosocial mental health interventions: A systematic review and meta-analysis. JAMA Psychiatry, 77(3), 294-302. https://doi.org/10.1001/jamapsychiatry.2019.3750

Publicado

2025-11-01

Cómo citar

Santangelo, P. R., Conde, K., Millaman Rickert, G. E., Mattiello, M. E., Lao, G., & Pocorena, V. (2025). Personalización de la Psicoterapia Basada en las Preferencias de los Pacientes vs. Monitoreo Rutinario de Resultados con PCOMs: Un Estudio Naturalístico. Revista de Psicoterapia, 36(132), 86–97. https://doi.org/10.5944/rdp.v36i132.44869

Artículos similares

<< < 1 2 3 4 5 6 7 8 9 10 > >> 

También puede Iniciar una búsqueda de similitud avanzada para este artículo.