human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND To date , the monitoring of patient progress using st and ardized assessment s has been neglected in hospital-based psychiatric care . Findings in outpatient psychotherapy have demonstrated clinical ly significant benefits for providing feedback to the sizeable minority of patients who were otherwise unlikely to experience positive outcome ( Lambert , 2007 ) . However , a similar system for presenting feedback on patient progress has not yet been assessed for group therapy within psychiatric inpatient setting s. The current study aim ed to develop and evaluate the effectiveness of a feedback system suitable for use in psychiatric services . METHODS In a nonr and omized trial , 1308 consecutive in patients and day patients , whose diagnoses were primarily depressive and anxiety disorders , completed the World Health Organization 's Wellbeing Index ( WHO-5 ) routinely during a ten-day cognitive behavioral therapy group . The first cohort ( n=461 ) received treatment as usual . The second cohort ( n=439 ) completed  monitoring measures without feedback , and for patients in the third cohort ( n=408 ) , feedback on progress was provided to both clinicians and patients midway through the treatment period . RESULTS Feedback was effective in reducing depressive symptoms ( F(1,649)=6.29 , p<.05 ) for those patients at risk of poor outcome , but not effective in improving wellbeing ( F(1,569)=1.14 , p>.05 ) . LIMITATIONS The current findings may be generalized to patient sample s that exhibit largely depressive disorders , however rigorous follow-up is warranted . CONCLUSIONS Similar to outpatient setting s , feedback appears to be beneficial for improving symptom outcomes but further time may be required for wellbeing to be affected Abstract The current study examined the effects of providing treatment progress information and problem-solving tools to both patients and therapists during the course of psychotherapy . Three hundred and seventy patients were r and omly assigned to one of two treatment groups : treatment-as-usual , or an experimental condition based on the use of patient/therapist feedback and clinical decision-support tools . Patients in the feedback condition were significantly more improved at termination than the patients in the treatment-as-usual condition . Treatment effects were not a consequence of different amounts of psychotherapy received by experimental and control clients . These findings are consistent with past research on these approaches although the effect size was smaller in this study . Not all therapists were aided by the feedback intervention Abstract Aim : The objective of the study was to evaluate the efficacy of the Outcome Question naire 45 ( OQ-45 ) with feedback in a Swedish psychiatric outpatient population using a r and omized controlled design . Method : In all 1720 patients made at least one regular visit to the clinics in the period 12 February 2007 to 10 February 2008 and received information about the study . Of these , 374 patients ( 22 % ) agreed to participate . After written consent , 188 patients were r and omized to the  feedback group and 186 patients to the control group . Those constituted the intention-to-treat ( ITT ) group . Two hundred and sixty-two patients ( 70 % ) completed the OQ-45 question naire at least twice , and they were included in the per- protocol analysis . Those who improved less than expected and were at risk for treatment failure were called alerted patients . Results : There was a tendency that patients who received feedback improved more than the controls in OQ-45 total score . In the ITT analysis , the P-value was 0.061 and the effect size g = 0.21 . In the per- protocol analysis the P-value was 0.076 and the effect size g = 0.24 . In the intervention group , 27 % of the patients were alerted because of risk of treatment failure vs. 28 % in the control group ( reaching level of alertness ) . The OQ-45 differences between the intervention and control groups did not significantly differ for patients who were alerted/reaching level of alertness and for non-alerted patients ( g = 0.17 and g = 0.28 , respectively ) . Conclusions : The feedback group had a tendency to improve more than the control group , possibly indicating that the method is effective , and the result ( basically ) supports previous findings Despite the overall efficacy of psychotherapy , dropouts are substantial , many clients do not benefit , therapists vary in effectiveness , and there may be a crisis of confidence among consumers . A research paradigm called patient-focused research --a method of enhancing outcome via continuous progress feedback -- holds promise to address these problems . Although feedback has been demonstrated to improve individual psychotherapy outcomes , no studies have examined couple therapy . The current study investigated the effects of providing treatment progress and alliance information to both clients and therapists during couple therapy .  Out patients ( N = 410 ) at a community family counseling clinic were r and omly assigned to 1 of 2 groups : treatment as usual ( TAU ) or feedback . Couples in the feedback condition demonstrated significantly greater improvement than those in the TAU condition at posttreatment , achieved nearly 4 times the rate of clinical ly significant change , and maintained a significant advantage on the primary measure at 6-month follow-up while attaining a significantly lower rate of separation or divorce . Mounting evidence of feedback effects with different measures and population s suggests that the time for routine tracking of client progress has arrived Objective : To investigate the effect of client feedback in group psychotherapy on attendance and treatment outcome for patients with eating disorders . Method : We conducted a r and omized clinical trial with central r and omization stratified for diagnosis and treatment type according to a computer-generated allocation sequence concealed to the investigators . One-hundred and 59 adult participants , diagnosed with bulimia nervosa , binge eating disorder , or eating disorder not otherwise specified according to DSM – IV , were included . Eighty participants were allocated to the experimental group , and 79 participants to the control group . Both groups received 20–25 weekly group psychotherapy sessions . In the experimental group , participants gave and received feedback about therapy progress and alliance , measured before and after each session using the Outcome Rating Scale and the Group Session Rating Scale . The primary outcome was rate of attendance to treatment sessions ; the secondary outcome was severity of eating disorder symptoms measured with the Eating Disorder Examination interview . Exploratory outcomes were psychological distress measured with the Symptom Checklist-90-R and the Outcome Rating Scale , social functioning measured with the Sheehan Disability Scale , and episodes of self-harm and suicide measured with a modified version of the Self-Harm Inventory . Results : Feedback compared with control did not affect the rate of attendance ( 0.59 vs. 0.58 ; p = .96 ) , the severity of symptoms ( 2.03 vs. 2.02 ; p = .46 ) , or any of the exploratory outcomes ( p values from 0.06 to 0.67 ) . Conclusions : Feedback neither increased attendance nor improved outcomes for out patients in group psychotherapy for eating disorders . The results are discussed from different perspectives Despite overall psychotherapy efficacy ( Lambert , 2013 ) , many clients do not benefit ( Reese , Duncan , Bohanske , Owen , & Minami , 2014 ) , dropouts are a problem ( Swift & Greenberg , 2012 ) , and therapists vary significantly in success rates ( Baldwin & Imel , 2013 ) , are poor judges of negative outcomes ( Chapman et al. , 2012 ) , and grossly overestimate their effectiveness ( Walfish , McAlister , O'Donnell , & Lambert , 2012 ) . Systematic client feedback offers 1 solution ( Duncan , 2014 ) . Several feedback systems have emerged ( Castonguay , Barkham , Lutz , & McAleavey , 2013 ) , but only 2 have r and omized clinical trial support and are included in the Substance Abuse and Mental Health Administration 's National Registry of Evidence -Based Programs and Practice s : The Outcome Question naire-45.2 System ( Lambert , 2010 ) and the Partners for Change Outcome Management System ( PCOMS ; Duncan , 2012 ) . This article presents the current status of PCOMS , the psychometrics of the PCOMS measures , its empirical support , and its clinical and training applications . Future directions and implication s of PCOMS research , training , and practice are detailed . Finally , we propose that systematic feedback offers a way , via large-scale data collection , to reprioritize what matters to psychotherapy outcome , recl aim our empirically vali date d core values and identity , and change the conversation from a medical model dominated discourse to a more scientific , relational perspective Abstract Providing outcome monitoring feedback to therapists seems to be a promising approach to improve outcomes in clinical practice . This study aims to examine the effect of feedback and investigate whether it is moderated by therapist characteristics . Patients ( n=413 ) were r and omly assigned to either a feedback or a no-feedback control condition . There was no significant effect of feedback  in the full sample , but feedback was effective for not-on-track cases for therapists who used the feedback . Internal feedback propensity , self-efficacy , and commitment to use the feedback moderated the effects of feedback . The results demonstrate that  feedback  is not effective under all circumstances and therapist factors are important when implementing feedback in clinical practice Using outcome data to monitor the progress of treatment and the therapeutic alliance , also known as " client feedback " or " patient-focused research , " has yielded impressive results in individual psychotherapy . Client feedback has demonstrated reductions in premature terminations and improved psychotherapy outcomes . However , little research has been conducted using this paradigm with couples receiving therapy . The purpose of this study was to investigate whether the effectiveness of client feedback would extend to couple therapy . Results from a r and omized couple clinical trial conducted in a naturalistic setting indicated that couples in a client feedback condition demonstrated statistically significantly more improvement compared with couples receiving treatment as usual and that improvement occurred more rapidly . Also , 4 times as many couples in the feedback condition reported clinical ly significant change by the end of treatment Abstract This study investigated whether routine monitoring of client progress , often called “ client feedback , ” via an abbreviated version of the Partners for Change Outcome Management System ( PCOMS ) result ed in improved outcomes for soldiers receiving group treatment at an Army Substance Abuse Outpatient Treatment Program ( ASAP ) . Participants ( N = 263 ) were active-duty male and female soldiers r and omized into a group feedback condition ( n = 137 ) or a group treatment-as-usual ( TAU ) condition ( n = 126 ) . Results indicated that clients in the feedback condition achieved significantly more improvement on the outcome rating scale ( d = 0.28 ) , higher rates of clinical ly significant change , higher percentage of successful ratings by both clinicians and comm and ers , and attended significantly more sessions compared to the TAU condition . Despite a reduced PCOMS protocol and a limited duration of intervention , preliminary results suggest that the benefits of client feedback appear to extend to group psychotherapy with clients in the military struggling with substance abuse The purpose of this study was to examine the effects of feedback provided to counselors on the outcomes of patients treated at community-based substance abuse treatment programs . A version of the Outcome Question naire ( OQ-45 ) , adapted to include drug and alcohol use , was administered to patients ( N = 304 ) in 3 substance abuse treatment clinics . Phase I of the study consisted only of administration of the assessment instruments . Phase II consisted of providing feedback reports to counselors based on the adapted OQ-45 at every treatment session up to Session 12 . Patients who were found to not be progressing at an expectable rate ( i.e. , " offtrack " ) were administered a question naire that was used as a second feedback report for counselors . For offtrack patients , feedback compared with no feedback led to significant linear reductions in alcohol use throughout treatment and also in OQ-45 total scores and drug use from the point of the second feedback instrument to Session 12 . The effect for improving mental health functioning was evident at only 1 of the 3 clinics . These results suggest that a feedback system adapted to the treatment of substance use problems is a promising approach that should be tested in a larger r and omized trial OBJECTIVES In previous studies of patients on-track to recovery ( OT ) involving therapists receiving only patient progress feedback without clinical support tools ( CST ) inconsistent results were found . Possible effects of combining patient progress feedback with CST on OT patients remain unclear . METHODS At intake ( t1 ) , 252 patients of two in-patient psychosomatic clinics were r and omized either into the experimental group ( EG ) or the treatment-as-usual control group ( CG ) . Both groups were monitored weekly using the  self-report instruments " Outcome Question naire " ( OQ-45 ) and " Assessment of Signal Cases " ( ASC ) . Therapists received weekly patient progress feedback ( OQ-45 ) and CST feedback ( ASC ) only for EG patients starting at the week following intake ( t2 ) . Patients who did not deviate negatively from expected recovery curves by at least one st and ard deviation were considered OT patients ( N=209 ; NEG=111 ; NCG=98 ) . Since therapists received feedback at t2 for the first time , different patterns of change ( OQ-45 scales ) between the groups from t1 to t2 , t2 to t3 ( intake+two weeks ) , t2 to t4 ( intake+three weeks ) , and t2 to t5 ( last available OQ-45 score ) were evaluated by multilevel models . RESULTS Merely from t2 to t3 , the EG improved significantly more on the OQ-45 symptom distress scale than the CG ( p<0.05 ; g=0.12 ) . CONCLUSION Providing patient progress feedback and CST to therapists did not substantially surpass treatment-as-usual for OT patients in this explorative study except for a very small time-limited enhancement of symptom change Abstract Objective .  Outcome monitoring feedback has become popular , but its effect on treatment outcome has been mixed . Feedback seems most effective for patients who are not progressing well ( “ not on track ” ( NOT ) cases ) . There are some indications that patient feedback has an additional 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND To date , the monitoring of patient progress using st and ardized assessment s has been neglected in hospital-based psychiatric care . Findings in outpatient psychotherapy have demonstrated clinical ly significant benefits for providing feedback to the sizeable minority of patients who were otherwise unlikely to experience positive outcome ( Lambert , 2007 ) . However , a similar system for presenting feedback on patient progress has not yet been assessed for group therapy within psychiatric inpatient setting s. The current study aim ed to develop and evaluate the effectiveness of a feedback system suitable for use in psychiatric services . METHODS In a nonr and omized trial , 1308 consecutive in patients and day patients , whose diagnoses were primarily depressive and anxiety disorders , completed the World Health Organization 's Wellbeing Index ( WHO-5 ) routinely during a ten-day cognitive behavioral therapy group . The first cohort ( n=461 ) received treatment as usual . The second cohort ( n=439 ) completed  monitoring measures without feedback , and for patients in the third cohort ( n=408 ) , feedback on progress was provided to both clinicians and patients midway through the treatment period . RESULTS Feedback was effective in reducing depressive symptoms ( F(1,649)=6.29 , p<.05 ) for those patients at risk of poor outcome , but not effective in improving wellbeing ( F(1,569)=1.14 , p>.05 ) . LIMITATIONS The current findings may be generalized to patient sample s that exhibit largely depressive disorders , however rigorous follow-up is warranted . CONCLUSIONS Similar to outpatient setting s , feedback appears to be beneficial for improving symptom outcomes but further time may be required for wellbeing to be affected Abstract The current study examined the effects of providing treatment progress information and problem-solving tools to both patients and therapists during the course of psychotherapy . Three hundred and seventy patients were r and omly assigned to one of two treatment groups : treatment-as-usual , or an experimental condition based on the use of patient/therapist feedback and clinical decision-support tools . Patients in the feedback condition were significantly more improved at termination than the patients in the treatment-as-usual condition . Treatment effects were not a consequence of different amounts of psychotherapy received by experimental and control clients . These findings are consistent with past research on these approaches although the effect size was smaller in this study . Not all therapists were aided by the feedback intervention Abstract Aim : The objective of the study was to evaluate the efficacy of the Outcome Question naire 45 ( OQ-45 ) with feedback in a Swedish psychiatric outpatient population using a r and omized controlled design . Method : In all 1720 patients made at least one regular visit to the clinics in the period 12 February 2007 to 10 February 2008 and received information about the study . Of these , 374 patients ( 22 % ) agreed to participate . After written consent , 188 patients were r and omized to the  feedback group and 186 patients to the control group . Those constituted the intention-to-treat ( ITT ) group . Two hundred and sixty-two patients ( 70 % ) completed the OQ-45 question naire at least twice , and they were included in the per- protocol analysis . Those who improved less than expected and were at risk for treatment failure were called alerted patients . Results : There was a tendency that patients who received feedback improved more than the controls in OQ-45 total score . In the ITT analysis , the P-value was 0.061 and the effect size g = 0.21 . In the per- protocol analysis the P-value was 0.076 and the effect size g = 0.24 . In the intervention group , 27 % of the patients were alerted because of risk of treatment failure vs. 28 % in the control group ( reaching level of alertness ) . The OQ-45 differences between the intervention and control groups did not significantly differ for patients who were alerted/reaching level of alertness and for non-alerted patients ( g = 0.17 and g = 0.28 , respectively ) . Conclusions : The feedback group had a tendency to improve more than the control group , possibly indicating that the method is effective , and the result ( basically ) supports previous findings Despite the overall efficacy of psychotherapy , dropouts are substantial , many clients do not benefit , therapists vary in effectiveness , and there may be a crisis of confidence among consumers . A research paradigm called patient-focused research --a method of enhancing outcome via continuous progress feedback -- holds promise to address these problems . Although feedback has been demonstrated to improve individual psychotherapy outcomes , no studies have examined couple therapy . The current study investigated the effects of providing treatment progress and alliance information to both clients and therapists during couple therapy .  Out patients ( N = 410 ) at a community family counseling clinic were r and omly assigned to 1 of 2 groups : treatment as usual ( TAU ) or feedback . Couples in the feedback condition demonstrated significantly greater improvement than those in the TAU condition at posttreatment , achieved nearly 4 times the rate of clinical ly significant change , and maintained a significant advantage on the primary measure at 6-month follow-up while attaining a significantly lower rate of separation or divorce . Mounting evidence of feedback effects with different measures and population s suggests that the time for routine tracking of client progress has arrived Objective : To investigate the effect of client feedback in group psychotherapy on attendance and treatment outcome for patients with eating disorders . Method : We conducted a r and omized clinical trial with central r and omization stratified for diagnosis and treatment type according to a computer-generated allocation sequence concealed to the investigators . One-hundred and 59 adult participants , diagnosed with bulimia nervosa , binge eating disorder , or eating disorder not otherwise specified according to DSM – IV , were included . Eighty participants were allocated to the experimental group , and 79 participants to the control group . Both groups received 20–25 weekly group psychotherapy sessions . In the experimental group , participants gave and received feedback about therapy progress and alliance , measured before and after each session using the Outcome Rating Scale and the Group Session Rating Scale . The primary outcome was rate of attendance to treatment sessions ; the secondary outcome was severity of eating disorder symptoms measured with the Eating Disorder Examination interview . Exploratory outcomes were psychological distress measured with the Symptom Checklist-90-R and the Outcome Rating Scale , social functioning measured with the Sheehan Disability Scale , and episodes of self-harm and suicide measured with a modified version of the Self-Harm Inventory . Results : Feedback compared with control did not affect the rate of attendance ( 0.59 vs. 0.58 ; p = .96 ) , the severity of symptoms ( 2.03 vs. 2.02 ; p = .46 ) , or any of the exploratory outcomes ( p values from 0.06 to 0.67 ) . Conclusions : Feedback neither increased attendance nor improved outcomes for out patients in group psychotherapy for eating disorders . The results are discussed from different perspectives Despite overall psychotherapy efficacy ( Lambert , 2013 ) , many clients do not benefit ( Reese , Duncan , Bohanske , Owen , & Minami , 2014 ) , dropouts are a problem ( Swift & Greenberg , 2012 ) , and therapists vary significantly in success rates ( Baldwin & Imel , 2013 ) , are poor judges of negative outcomes ( Chapman et al. , 2012 ) , and grossly overestimate their effectiveness ( Walfish , McAlister , O'Donnell , & Lambert , 2012 ) . Systematic client feedback offers 1 solution ( Duncan , 2014 ) . Several feedback systems have emerged ( Castonguay , Barkham , Lutz , & McAleavey , 2013 ) , but only 2 have r and omized clinical trial support and are included in the Substance Abuse and Mental Health Administration 's National Registry of Evidence -Based Programs and Practice s : The Outcome Question naire-45.2 System ( Lambert , 2010 ) and the Partners for Change Outcome Management System ( PCOMS ; Duncan , 2012 ) . This article presents the current status of PCOMS , the psychometrics of the PCOMS measures , its empirical support , and its clinical and training applications . Future directions and implication s of PCOMS research , training , and practice are detailed . Finally , we propose that systematic feedback offers a way , via large-scale data collection , to reprioritize what matters to psychotherapy outcome , recl aim our empirically vali date d core values and identity , and change the conversation from a medical model dominated discourse to a more scientific , relational perspective Abstract Providing outcome monitoring feedback to therapists seems to be a promising approach to improve outcomes in clinical practice . This study aims to examine the effect of feedback and investigate whether it is moderated by therapist characteristics . Patients ( n=413 ) were r and omly assigned to either a feedback or a no-feedback control condition . There was no significant effect of feedback  in the full sample , but feedback was effective for not-on-track cases for therapists who used the feedback . Internal feedback propensity , self-efficacy , and commitment to use the feedback moderated the effects of feedback . The results demonstrate that  feedback  is not effective under all circumstances and therapist factors are important when implementing feedback in clinical practice Using outcome data to monitor the progress of treatment and the therapeutic alliance , also known as " client feedback " or " patient-focused research , " has yielded impressive results in individual psychotherapy . Client feedback has demonstrated reductions in premature terminations and improved psychotherapy outcomes . However , little research has been conducted using this paradigm with couples receiving therapy . The purpose of this study was to investigate whether the effectiveness of client feedback would extend to couple therapy . Results from a r and omized couple clinical trial conducted in a naturalistic setting indicated that couples in a client feedback condition demonstrated statistically significantly more improvement compared with couples receiving treatment as usual and that improvement occurred more rapidly . Also , 4 times as many couples in the feedback condition reported clinical ly significant change by the end of treatment Abstract This study investigated whether routine monitoring of client progress , often called “ client feedback , ” via an abbreviated version of the Partners for Change Outcome Management System ( PCOMS ) result ed in improved outcomes for soldiers receiving group treatment at an Army Substance Abuse Outpatient Treatment Program ( ASAP ) . Participants ( N = 263 ) were active-duty male and female soldiers r and omized into a group feedback condition ( n = 137 ) or a group treatment-as-usual ( TAU ) condition ( n = 126 ) . Results indicated that clients in the feedback condition achieved significantly more improvement on the outcome rating scale ( d = 0.28 ) , higher rates of clinical ly significant change , higher percentage of successful ratings by both clinicians and comm and ers , and attended significantly more sessions compared to the TAU condition . Despite a reduced PCOMS protocol and a limited duration of intervention , preliminary results suggest that the benefits of client feedback appear to extend to group psychotherapy with clients in the military struggling with substance abuse The purpose of this study was to examine the effects of feedback provided to counselors on the outcomes of patients treated at community-based substance abuse treatment programs . A version of the Outcome Question naire ( OQ-45 ) , adapted to include drug and alcohol use , was administered to patients ( N = 304 ) in 3 substance abuse treatment clinics . Phase I of the study consisted only of administration of the assessment instruments . Phase II consisted of providing feedback reports to counselors based on the adapted OQ-45 at every treatment session up to Session 12 . Patients who were found to not be progressing at an expectable rate ( i.e. , " offtrack " ) were administered a question naire that was used as a second feedback report for counselors . For offtrack patients , feedback compared with no feedback led to significant linear reductions in alcohol use throughout treatment and also in OQ-45 total scores and drug use from the point of the second feedback instrument to Session 12 . The effect for improving mental health functioning was evident at only 1 of the 3 clinics . These results suggest that a feedback system adapted to the treatment of substance use problems is a promising approach that should be tested in a larger r and omized trial OBJECTIVES In previous studies of patients on-track to recovery ( OT ) involving therapists receiving only patient progress feedback without clinical support tools ( CST ) inconsistent results were found . Possible effects of combining patient progress feedback with CST on OT patients remain unclear . METHODS At intake ( t1 ) , 252 patients of two in-patient psychosomatic clinics were r and omized either into the experimental group ( EG ) or the treatment-as-usual control group ( CG ) . Both groups were monitored weekly using the  self-report instruments " Outcome Question naire " ( OQ-45 ) and " Assessment of Signal Cases " ( ASC ) . Therapists received weekly patient progress feedback ( OQ-45 ) and CST feedback ( ASC ) only for EG patients starting at the week following intake ( t2 ) . Patients who did not deviate negatively from expected recovery curves by at least one st and ard deviation were considered OT patients ( N=209 ; NEG=111 ; NCG=98 ) . Since therapists received feedback at t2 for the first time , different patterns of change ( OQ-45 scales ) between the groups from t1 to t2 , t2 to t3 ( intake+two weeks ) , t2 to t4 ( intake+three weeks ) , and t2 to t5 ( last available OQ-45 score ) were evaluated by multilevel models . RESULTS Merely from t2 to t3 , the EG improved significantly more on the OQ-45 symptom distress scale than the CG ( p<0.05 ; g=0.12 ) . CONCLUSION Providing patient progress feedback and CST to therapists did not substantially surpass treatment-as-usual for OT patients in this explorative study except for a very small time-limited enhancement of symptom change Abstract Objective .  Outcome monitoring feedback has become popular , but its effect on treatment outcome has been mixed . Feedback seems most effective for patients who are not progressing well ( “ not on track ” ( NOT ) cases ) . There are some indications that patient feedback has an additional 
    Output:
    