A University of Massachusetts Amherst psychotherapy researcher conducted the first-of its kind research that found patients with mental health issues who were matched with therapists with a track record of treating their primary concerns had better outcomes than those who weren't.This "match effect" was also more beneficial for patients with severe conditions and those who identify as ethnic or racial minorities.These findings were published in JAMA Psychiatry and Journal of Consulting and Clinical Psychology.Professor of clinical psychology Michael Constantino is the lead author. He is also the director of the Psychotherapy Research Lab. Constantino seeks to discover the variation in outcomes for patients who receive mental health treatment. "We have become very interested in the so-called Therapist Effect." In the beginning, more emphasis was placed on what the treatment was than on who was providing it.Constantino and his colleagues discovered that psychotherapists have different strengths and weaknesses when it comes to treating different types mental health issues. These performance "report cards", which are based on therapist's past performance, can be used to tailor treatment towards what they do best.Researchers conducted a random clinical trial that involved 48 therapists as well as 218 outpatients in six Cleveland community clinics. The study was part of a larger, randomized clinical trial. The matching system was based on the history of therapists treating patients with similar concerns. Matching was based on the multidimensional Treatment Outcome Package (TOP), which evaluates 12 functional or symptomatic domains, including depression, quality-of-life, mania panic, somatic anxiety, psychosis and substance misuse. It also assesses sexual functioning, sleep, suicidality or violence, as well as work functioning. The matched patients were compared to those who were not case-assigned, such as due to therapist availability or convenient office location.The paper states that by collecting TOP data from sufficient patients, the outcomes tool can determine whether a therapist is stably efficient (historically on average their patients' conditions reliably improved), neutral, (historically on average their patients' condition neither reliably improved nor worsened) or ineffective (historically on average their patients' conditions reliably deteriorated).Matching requires that therapists have had at least 15 cases completed with patients who have successfully completed TOP before and afterwards. The therapists and patients did not know if they were matched or case-assigned for the trial. Constantino states that patients would have a stronger impact if they knew that they were empirically well-matched and not randomly assigned. This knowledge could foster more positive expectations which, in turn, can lead to better therapy outcomes.Patients' post-therapy reports showed that patients in the matched group had significantly lower levels of general impairment than those who were randomly assigned a therapy. Constantino states, "We demonstrated that this matching system can provide a significant boost in improvement rates."Constantino states that Constantino's findings showed that people who identify as ethnic or racial minorities saw an even greater improvement in the matched group. This could be a way to improve access and quality of mental health care for traditionally underserved communities.According to the JAMA Psychiatry paper, "Notably the good fit in the study was not due to changing the therapists' treatment methods, but rather the type of patients they treated." The current data show that the match system can increase the effectiveness of care by leveraging what a therapist has done in the past when treating certain mental health issues. However, neither the patient nor the therapist are aware of this information.###
